Use of Automated Bone Age for Critical Growth Assessment

Clin Pediatr (Phila). 2015 Oct;54(11):1038-43. doi: 10.1177/0009922815572076. Epub 2015 Feb 10.

Abstract

Background: We compared the variability of bone age (BA) rating between clinicians and an automated system in children with congenital adrenal hyperplasia (CAH).

Method: A total of 126 radiographs assessed by 3 clinicians blinded to patient details using Greulich and Pyle (GP) (readers 1, 2, and 3) and BoneXpert (BX).

Results: Comparing BA rating with each other, the mean of the absolute differences varied from 0.42 ± 0.53 years (reader 1 and BX) to 0.57 ± 0.58 years (reader 2 and reader 3), P = .368. Comparing ratings that were consistent with all 4 methods (within 1 year of each other, 93/126, 74%) and the remaining, "outliers" (33/126, 26%), the outliers were younger (P = .003), smaller (height, P = .011, weight, P = .000), and prepubertal (P = .001).

Conclusion: The variability of BA rating in CAH children is similar whether performed by clinicians or an automated system. The greatest variability was in prepubertal children.

Keywords: Greulich and Pyle; congenital adrenal hyperplasia; growth; prepubertal; puberty.

MeSH terms

  • Adolescent
  • Adrenal Hyperplasia, Congenital / physiopathology*
  • Age Determination by Skeleton / methods*
  • Age Determination by Skeleton / statistics & numerical data
  • Child
  • Child Development / physiology*
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Observer Variation
  • Reproducibility of Results