May 13, 2020

ACR Comments on Proposed Changes to NIOSH B Reader Program

The American College of Radiology® (ACR®) has submitted comments in response to a proposed rule to amend National Institute for Occupational Safety and Health (NIOSH), Coal Workers' Health Surveillance Program regulations.

The proposed rule would allow NIOSH to suspend or revoke B Reader certification for any B Reader found by NIOSH to have engaged in a pattern of providing unreasonably inaccurate chest radiograph classifications.

B Readers are a special group of physicians who have passed a special NIOSH proficiency exam to be recognized by NIOSH as qualified to classify chest radiographs that identify pneumoconiosis.

The B Reader Program aims to ensure competency in radiographic reading by evaluating the ability of readers to classify a test set of radiographs, thereby creating and maintaining a pool of qualified readers having the ability to provide accurate and precise International Labor Organization classifications.

The ACR’s comments acknowledged examples from formal litigation and compensation proceedings that represented unreasonably inaccurate radiograph classifications that may be suggestive of B Reader bias or skill deficits. However, the comments noted NIOSH’s proposal could invite abuse and result in inappropriate decertification of competent B Readers if implemented without appropriate safeguards. They also identified other important quality assurance needs that were not addressed in the proposed rule.