Chest X‐rays in hypersensitivity pneumonitis: A metaanalysis of secular trend

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Abstract
A metaanalysis of published reports of outbreaks of hypersensitivity pneumonitis was undertaken. A statistically significant substantial decline was seen in the sensitivity of chest X‐rays (percent of positive in cases of disease) for the diagnosis of hypersensitivity pneumonitis over the years 1950–1980. Chest X‐rays were also less likely to be abnormal where a population‐based approach to the diagnosis of disease had been undertaken. Such declines in the diagnostic “sensitivity” of a test may be related to secular trends in knowledge and recognition of disease or to changes in the disease itself. Standardization of chest X‐ray interpretation alone, even if successful, may not resolve the issue of accurate diagnosis of interstitial lung disease.