Greene R, Boggis C, Jantsch H
Radiology. 1984 Sep;152(3):569-73. doi: 10.1148/radiology.152.3.6463238.
Radiographic evidence of pleural thickening was evaluated in 1,216 shipyard workers (high-risk group) and 214 executives (low-risk group) and classified according to two threshold levels: low (any detectable thickening) and high (thickening less than or equal to 2 mm excluded). Results were markedly different, affecting the low-risk group more than the high-risk group. Changing from the high to the low threshold markedly increased pleural findings and scores as well as inter-reader correlation while reducing both differences between risk groups and detection of additional findings on supplementary oblique views. When data on prevalence and extent of pleural thickening were combined, differences between risk groups were maximized; however, when only prevalence was considered, such differences were minimized, particularly with a low threshold. These findings indicate that different or ambiguous threshold criteria produce divergent results in screening surveys for asbestos-related disease. The authors recommend that explicit minimal pleural threshold criteria be adopted.
对1216名造船厂工人（高危组）和214名管理人员（低危组）的胸膜增厚的影像学证据进行了评估，并根据两个阈值水平进行分类：低阈值（任何可检测到的增厚）和高阈值（排除小于或等于2毫米的增厚）。结果明显不同，对低危组的影响大于高危组。从高阈值改为低阈值显著增加了胸膜检查结果和评分以及阅片者之间的相关性，同时减少了风险组之间的差异以及补充斜位片上额外检查结果的检出率。当将胸膜增厚的患病率和范围的数据合并时，风险组之间的差异最大；然而，当仅考虑患病率时，这种差异最小，尤其是在低阈值时。这些发现表明，不同或不明确的阈值标准在石棉相关疾病的筛查调查中会产生不同的结果。作者建议采用明确的最小胸膜阈值标准。
