Experts in Asbestos Cases May Overstate Findings

Expert-witness physicians who interpret chest X-rays for plaintiffs claiming damage from occupational asbestos exposure may be biased in the findings they report, new research suggests.

Expert-witness physicians who interpret chest X-rays for plaintiffs claiming damage from occupational asbestos exposure may be biased in the findings they report, new research suggests. Investigators have found that such physicians were much more likely than an independent group of consultants to describe case-related X-rays as being abnormal. As reported in the journal Academic Radiology, Dr. Joseph N. Gitlin, from Johns Hopkins Medical Institutions in Silver Spring, Maryland, and colleagues compared the interpretations of expert-witness physicians and six consultant radiologists of 492 chest X-rays used in asbestos lawsuits. The consultants were did not know the origin of the films they evaluated. The expert-witness physicians identified abnormalities in 96 percent of the cases, the authors note. In contrast, when the consultant radiologists looked at the X-rays, the abnormality rate was just 5 percent. A review of the medical literature also failed to support the high positivity rate recorded by the expert-witness physicians. “There is no support in the literature on X-ray studies of workers exposed to asbestos and other mineral dusts for the high level of positive findings recorded by the initial readers in this report,” the investigators conclude. Gitlin’s team has “sounded an alarm with regard to the accuracy of…readers in asbestos-related litigation,” Dr. Murray L. Janower and Dr. Leonard Berlin note in a related editorial. “The alarm will undoubtedly reverberate, as it should, throughout the courtrooms of the nation, the offices of the Public Health Services National Institute for Occupational Safety and Health, the headquarters of the American College of Radiology, and radiologic facilities in every state,” they add. Janower of Wellesley, Massachusetts is a past chairman of the American College of Radiology Committee on Ethics. Berlin of Skokie, Illinois has written a book on radiology and the law. (Source: Reuters, Academic Radiology, August 2004.)