title: Development and evaluation of a new chest radiograph reading and recording system for epidemiological surveys of tuberculosis and lung disease.
abstract: OBJECTIVE
  The development and evaluation of a new chest radiograph reading and recording system (CRRS) for community surveys of tuberculosis (TB) and lung disease.
  
  
  METHODS
  An experienced pulmonologist read 2608 chest X-rays (CXRs) performed as part of a TB prevalence survey using the newly developed CRRS. The kappa (kappa) for inter-reader agreement was calculated after a second reader reported on a stratified random sample of 810 (31%) of the 2608 CXRs. The kappa for intra-reader agreement was calculated from the repeated reporting of a stratified random sample of 104 CXRs.
  
  
  RESULTS
  The kappa agreement between the two readers was 0.69 (95%CI 0.64-0.74) for abnormalities consistent with TB and 0.47 (95%CI 0.42-0.53) for any abnormalities. The kappa for intra-reader agreement was 0.90 (95%CI 0.81-0.99) for abnormalities consistent with TB and 0.85 (95%CI 0.74-0.95) for any abnormalities.
  
  
  CONCLUSIONS
  This standardised method for CXR reading and recording provides satisfactory inter- and intra-reader agreement, making it suitable for surveys of TB and other forms of lung disease in the community. Its use will permit comparisons of results obtained in different surveys.
authors.affiliation: Department of Paediatrics and Child Health, Faculty of Health Sciences, Desmond Tutu TB Centre, Stellenbosch University, Cape Town, South Africa. 14321823@sun.ac.za
authors.forename: S
authors.initials: S
authors.lastname: Den Boon
authors.forename: E D
authors.initials: ED
authors.lastname: Bateman
authors.forename: D A
authors.initials: DA
authors.lastname: Enarson
authors.forename: M W
authors.initials: MW
authors.lastname: Borgdorff
authors.forename: S
authors.initials: S
authors.lastname: Verver
authors.forename: C J
authors.initials: CJ
authors.lastname: Lombard
authors.forename: E
authors.initials: E
authors.lastname: Irusen
authors.forename: N
authors.initials: N
authors.lastname: Beyers
authors.forename: N W
authors.initials: NW
authors.lastname: White
mesh_terms: D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening; D011159:Population Surveillance; D015995:Prevalence; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D013019:South Africa / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology*