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"The reading of x-rays is very subjective," says James Foster at Everest Re.
The outsourcing of record keeping and the reading of X-rays is already a multi-billion-dollar business.
Despite our national belief that the masses are a bit lunatic and that every business needs one strong leader, Surowiecki proves that even in areas that require specialized training, such as the reading of X-rays, groups of untrained people can often outfox an expert.
IRJ and SE participated in the reading of x-rays.
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It has been noted (personal communication with Dr. J. Sharp) that there is a tendency to give higher scores for individuals with low levels of disease involvement, perhaps related to "over-reading" of x-rays with early disease progression.
Before reading each batch of X-rays one re-read 5 X-rays, which had been previously read, to "calibrate" one's readings to a standard.
The central reading of the X-rays (central assessment) in a subset of patients (n=282 (87%)) resulted in a reclassification of some patients.
Moreover, our study does have several strengths, including a large sample size relative to comparable studies [ 7, 8, 12, 13, 33], and centralized reading of the X-rays with uniform criteria that was likely to limit variability in the dataset.
The percentage of patients with radiographic sacroiliitis in INFAST (59%), based on the local reading of the x-rays, was relatively high compared to the other IFX trial described above that had a similar symptom duration (12% 6), but the percentage was not so different from other analyses of patients with axial SpA in the first 3 5 years of their disease (50% 7 18).
Some of the variability across studies may be due to the challenge of reading x-rays of patients with early sacroiliitis; rather low sensitivity and specificity have been reported in some studies.
The vast majority of doctors reading breast X-rays are general radiologists who at most took a medical school rotation in mammography.
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