Assessment of Physicians’ Proficiency in Reading Pneumoconiosis X-rays with a Set of Examination Films: 8-Index Study and 4-factor Study

Kusaka, Yukinori

Tuesday, March 20, 2012

Ground Floor (Cancun Center)

Yukinori Kusaka, Department of Environmental Health, University Of Fukui School Of Medicine, Eiheiji, Japan

Huashi Zhou, Department of Environmental Health, School of Medicine, University of Fukui, Fukui, Japan

Narufumi Suganuma, Department of Environmental Medicine, Kochi University School of Medicine, Kochi, Japan

Ponglada Subhannachart, Academic Affairs Cluster, Central Chest Institute of Thailand, NONTHABURI, Thailand

Somkiat Siriruttanapruk, Bureau of Occupational and Environmental Diseases, Ministry of Public Health, Bangkok, Thailand

Narongpon Dumavibhat, Department of Prevention and Social Medicine, Faculty of Medicine, Mahidol University Siriraj Hospital, Bangkok, Thailand

Xing Zhang, Institute of Hygiene, Zhejiang Academy of Medical Sciences, Hang Zhou, China

P.k. Sishodiya, occupational Hygiene, National Institute of Miners’ Health, Dehli, India

Khuong Van Duy, Department of Occupational Health, Ha Noi Medical University School of Public Health, Hannoi, Vietnam

K.g. Hering, Department of Diagnostic Radiology, Radiological Clinic, Miner’s Hospital, Dortmund, Germany

John E. Parker, Pulmonary and Critical Care Medicine, Robert C, Byrd Health Sciences Center, School of Medicine, West Virginia University, Morgantown, United States

Eduardo Algranti, Divisao de Medicina, Fundacentro, San Paulo, Brazil

Igor Fedotov, Occupational Health Safety, International Labor Office, Geneva, Switzerland

Hisao Shida, Committee of Compensation of Asbestos Related Diseases, Ministry of Environment Protection, Kawasaki, Japan

Masanori Akira, Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan

Introduction
The 60-film set was developed by experts (expert group) for examining 8 indices (sensitivity and specificity for pneumoconiosis, sensitivity and specificity for large opacities, sensitivity and specificity for pleural plaque, profusion increment consistency for small opacities, and shape differentiation for small opacities) of physicians’ reading skills on pneumoconiosis X-ray according to ILO 2000 Classification. The aims were firstly to examine differences in 8-index data between groups, secondly to investigate the factor structure of 8-index data, and thirdly to examine differences in factor scores between groups.

Methods
53 physicians (A-Group) attended the “Asian Intensive Reader of Pneumoconioses” training course, and 22 physicians (B-Group) attended Brazilian course. After training, they took examination of reading 60-film exam set. The 8-index data were compared between the two examinee groups and the expert group by t-test. The 8-index data of the pooled group from two groups were subjected to exploratory factor analysis. Then scores of factors were examined in groups for comparison.

Results
There were significant differences in sensitivity for pneumoconiosis and sensitivity for large opacities at p<0.05 between A-Group and B-Group. There was a significant difference in sensitivity for large opacities at p<0.05 between pooled group and B-Group. The examinee groups were inferior to the expert group in all of indices. A 4-factor was analyzed to structure 8-index: The specificity for pneumoconiosis, specificity for large opacities, specificity for pleural plaque and shape differentiation for small opacities loaded on Factor 1; The sensitivity for pneumoconiosis and sensitivity for large opacities loaded on Factor 2; The sensitivity for pleural plaque loaded on Factor 3; The profusion increment consistency loaded on Factor 4. Factor 2 score in A-Group were significantly higher than in B-Group.

Discussion
Accordingly, the 60-film set providing 8-index and 4 factor scores structuring 8-index was suggested appropriately to assess physicians’ reading proficiency at different training settings.

A1609 Assessment of Physicians’ Proficiency in Reading Pneumoconiosis X-rays with a Set of Examination Films: 8-Index Study and 4-factor Study