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Comparison of digital and film chest radiography for detection and medical surveillance of silicosis in a setting with a high burden of tuberculosis |
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| Authors: | Alfred Franzblau Jim teWaterNaude Ananda Sen Hannah d'Arcy Jacqueline S. Smilg Khanyakude S. Mashao Cristopher A. Meyer James E. Lockey Rodney I. Ehrlich |
| Affiliation: | 1. Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan;2. Diagnostic Medicine, Claremont, Cape Town, South Africa;3. Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa;4. Department of Radiology, Charlotte Maxeke Johannesburg Academic Hospital, Parktown, Johannesburg, South Africa;5. Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;6. Medical Bureau of Occupational Diseases, Braamfontein, Johannesburg, South Africa;7. Dr SK Matseke Memorial Private Hospital, Diepkloof, Soweto, South Africa;8. Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;9. Department of Environmental Health, Pulmonary Medicine, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio |
| Abstract: | BackgroundContinuing use of analog film and digital chest radiography for screening and surveillance for pneumoconiosis and tuberculosis in lower and middle income countries raises questions of equivalence of disease detection. This study compared analog to digital images for intra‐rater agreement across formats and prevalence of changes related to silicosis and tuberculosis among South African gold miners using the International Labour Organization classification system.MethodsMiners with diverse radiological presentations of silicosis and tuberculosis were recruited. Digital and film chest images on each subject were classified by four expert readers.ResultsReadings of film and soft copy digital images showed no significant differences in prevalence of tuberculosis or silicosis, and intra‐rater agreement across formats was fair to good. Hard copy images yielded higher prevalences.ConclusionFilm and digital soft copy images show consistent prevalence of findings, and generally fair to good intra‐rater agreement for findings related to silicosis and tuberculosis. |
| Keywords: | digital radiographs pneumoconiosis silicosis surveillance tuberculosis |