Screening by chest photofluorography in Los Angeles. The minifilm circa 1970.

Abstract

Two decades ago, when extensive tuberculosis case-finding was underway, a minifilm of the chest was a high yield mass screening test. Today readings of “suspect tuberculosis” comprise a minority of significant minifilm findings, based upon the experience of the Breathmobile Project. Both a positive minifilm and a positive smoking history function as risk factors for questionnaire and spirometry evidence of early chronic respiratory disease. Two decades ago the variability of mini-film readings was the subject of several classical studies of screening techniques. Based upon an analysis of 26,000 Breathmobile minifilms, positive discordance continues to be a prominent phenomenon, the chest physicians and radiologists favoring different reading categories. A validity study of 837 minifilms showed dual readings had an average sensitivity of 72% and a specificity of 96%, compared with single readings whose values were 52% and 98%, respectively.