Variability in interpretation of chest radiographs among Russian clinicians and implications for screening programmes: observational study

Abstract

Population screening for tuberculosis in Russia may be less than optimal owing to limited agreement on interpretation of chest radiographs, and may have implications for radiological screening programmes in other countries.

Tuberculosis screening in migrants in selected European countries shows wide disparities

“…Screening those who are symptomatic may increase yield. Indeed, recent research (in support of older influential research findings) [14] shows that substantial inter-and intraobserver variability occurs in the interpretation of radiographs and a as a test for tuberculosis, a chest radiograph has poor sensitivity and specificity [15]. Furthermore, in England and Wales, .50% of pulmonary tuberculosis occurring in those born abroad may develop within a year of a normal radiograph, supporting the notion that radiographic screening on entry may lack predictive value [12].…”

Inter-Observer Variability in the Detection and Interpretation of Chest X-Ray Anomalies in Adults in an Endemic Tuberculosis Area

“…In addition, the detection of these depends on their location, size, and content, and wall thickness. Balabanova et al [10] had found the similar inter-observer agreement between pneumologists and radiologists in Russia.…”

“…Abubakar et al [24] observed a moderate agreement for both radiologists and pneumologists. Balabanova et al [10] had reported a poor agreement between pneumologists and moderate between radiologists. However, in our study, the pneumologists because of their specific activities were of risk of "hindsight bias", especially since there were 23/47 cases of PTB.…”

“…Several studies have been conducted to assess the variability in the diagnosis of pulmonary tuberculosis (PTB) [8]- [10], of pneumoconiosis [2] [3], of lung cancers [4] [11], of pneumonia [8] [12] [13] and of lung nodules [7]. CXR is an important tool in the diagnosis of pulmonary tuberculosis [10] [14] [15]. In developing countries, where CXR is usually the only available or accessible chest imaging test and where PTB is endemic [16] [17], inter-observer variability in the interpretation of CXR has not been studied.…”

Screening for pulmonary tuberculosis in a Tanzanian prison and computer-aided interpretation of chest X-rays

“…10 Radiography would detect more active TB cases than the clinical questionnaires that are currently used to discover TB cases in African prisons. 3 Unfortunately, the diagnostic accuracy of CXRs for the detection of active pulmonary TB (PTB) is highly dependent on the reader, 11,12 and health personnel with TB-specific radiology training are scarce in sub-Saharan Africa, especially in the health facilities of penitentiary institutions.…”