Murphy R L, Gaensler E A, Holford S K, Del Bono E A, Epler G
Am Rev Respir Dis. 1984 Mar;129(3):375-9. doi: 10.1164/arrd.1984.129.3.375.
We studied 386 workers exposed to asbestos to assess the value of chest auscultation by a trained technician in detecting asbestosis as defined by previously reported clinical, physiologic, and roentgenologic criteria. The presence and degree of crackles were assessed at preselected basilar lung sites by a technician whose performance was validated by comparison with computer-generated time-expanded waveforms of tape recordings of lung sounds. Asbestosis was present in only 2.8% of the total population, but it was present in 8.6% of those with over 25 yr or more of employment. The technician correctly identified all the workers in whom the diagnosis was most certain, that is, those with all criteria positive. The overall true positive rate was 55%. The majority (94.8%) of those with no abnormal criteria were correctly classified. Auscultation by an objectively validated technician can be a useful noninvasive method for screening industrial populations exposed to asbestos.
我们研究了386名接触石棉的工人，以评估由训练有素的技术人员进行胸部听诊在检测根据先前报告的临床、生理和放射学标准定义的石棉沉着病方面的价值。一名技术人员在预先选定的肺底部部位评估啰音的存在和程度，该技术人员的表现通过与计算机生成的肺音录音时间扩展波形进行比较而得到验证。石棉沉着病仅在总人口的2.8%中存在，但在工作25年或更长时间的人群中占8.6%。该技术人员正确识别了所有诊断最为确定的工人，即所有标准均为阳性的工人。总体真阳性率为55%。大多数（94.8%）无异常标准的人被正确分类。由经过客观验证的技术人员进行听诊可以作为一种有用的非侵入性方法，用于筛查接触石棉的工业人群。
