Establishing a radiographic diagnosis of pneumoconiosis involves the input of at least 2 trained radiologists. In the event of disagreement additional reviewers may become involved, until a final diagnosis is reached.


Radiograph readers may be classified as "A" or "B":

(1) "A" readers have completed a training course or have demonstrated competence in the classification of pneumoconiosis on chest radiographs.

(2) "B" readers have undergone a certification examination and must be recertified every 4 years.



(1) A radiograph is examined first by an "A" or "B" reader.

(2) The radiograph is then submitted to a new "B" reader.

(3) If the diagnosis of the initial and second readers disagree, then the radiograph is submitted to another "B" reader.

(4) If the second and third readers disagree, then the radiograph is submitted to a panel of 3 "B" readers who deliver a consensus opinion.


A diagnosis may be returned if there is agreement between:

(1) the initial and second reviewers

(2) the second and third reviewers

(3) a consensus panel of 3 reviewers


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