The discrepancies between assessments of physicians in microfilm examination for tuberculosis screening

• Main Authors: Abdurrahman Abakay, Mehmet Toksöz, Abdullah Çetin Tanrıkulu, Özlem Abakay, Şenay Ekinci
• Format: Article
• Language: English
• Published: Dicle University Medical School 2010-06-01
• Series: Dicle Medical Journal
• Subjects: Tuberculosis; microfilm; screening; physicians; assessment differences
• Online Access: http://www.dicle.edu.tr/fakulte/tip/dergi/yayin/372/07.pdf

Objectives: Microfilm (MF) are used in community based screening for tuberculosis (TB) in Turkey. This study aimed differences in evaluation between various physicians.Materials and Methods: In the Mardin Prison, 253 microfilms(MFs) were obtained during periodic TB screening in January 2006. A chest disease specialist doctor, a radiologyspecialist doctor and a general practitioner doctor assessed the MFs separately. The results were classified as i) Normal, ii) Active TB disease findings, iii) and Sequel TB disease findings.Results: A total of 13 MFs were not taken into considerationbecause of technically unsatisfactory radiographs. The end results were as follows; three physicians had agreed about diagnosis in 159 MFs (66.2%). In 81 MFs (33.8%) at least one physician had a different opinion about microfilm. The general practitioner reported 19 MFs (8%) as active TB disease findings and the radiology specialistdoctor reported 22 MFs (9%) as active TB disease. However, the chest diseases specialist doctor reported 26 MFs (11%) as having active TB disease findings. No significant difference was found in active TB diagnosis between three physicians (p>0.05). The frequency of sequelTB diagnosis was higher in Chest disease specialist compared with other physicians (p<0.05).Conclusion: Although MF is a fast screening method, considerable disagreement was found in evaluating abnormalfindings among reporting physicians. As TB is a disease with various radiologic appearances, usage of microbiological diagnostic modalities should be added to subjective radiographic methods.