Heyworth Benton E, Osei Daniel A, Fabricant Peter D, Schneider Robert, Doyle Shevaun M, Green Daniel W, Widmann Roger F, Lyman Stephen, Burke Stephen W, Scher David M
Boston Children's Hospital, Boston, MA, USA.
J Pediatr Orthop. 2013 Jul-Aug;33(5):569-74. doi: 10.1097/BPO.0b013e318293e5f2.
Radiographic assessment of skeletal age in pediatric patients is a common practice among orthopaedic surgeons. Current methods of assessment remain labor intensive and require special resources. This study sought to investigate a novel, abridged method of bone age assessment that may serve as a simpler and more efficient alternative to the current standard.
A shorthand bone age (SBA) method developed at our institution was compared against the Greulich and Pyle method from which it was derived. Standard left hand bone age radiographs of 140 male and 120 female patients, previously assigned skeletal ages ranging from 12.5 to 16 years in males and 10 to 16 years in females by musculoskeletal radiologists using the Greulich and Pyle radiographic atlas, were read using the shorthand method by 3 attending pediatric orthopaedic surgeons and an orthopaedic surgery resident. The shorthand method utilizes a single, univariable criterion for each age, rather than a multivariable subjective comparison to a radiographic atlas. All reviewers were blinded to the original bone age determination. Interobserver reliability, intraobserver reliability, and agreement with the previous records utilizing the atlas were calculated using weighted κ.
The SBA method readings demonstrated substantial agreement with readings by the Greulich and Pyle atlas, demonstrating weighted κ values ranging from 0.71 to 0.75. The SBA method also demonstrated substantial to almost perfect interobserver and intraobserver reliability, with values ranging from 0.77 to 0.87 and from 0.87 to 0.95, respectively.
These results are comparable or superior to previous reports which investigate the validity and reliability of other skeletal age assessment tools. The SBA assessment tool offers a simple and efficient alternative to current methods.
Diagnostic study, level III.
在儿科患者中进行骨骼年龄的影像学评估是骨科医生的常见做法。目前的评估方法仍然需要大量人力且需要特殊资源。本研究旨在探究一种新的、简化的骨龄评估方法，该方法可能是当前标准方法更简单、更有效的替代方法。
将我们机构开发的一种简化骨龄（SBA）方法与它所源自的格氏和派氏方法进行比较。140例男性和120例女性患者的标准左手骨龄X线片，此前由肌肉骨骼放射科医生使用格氏和派氏X线图谱确定男性骨骼年龄范围为12.5至16岁，女性为10至16岁，由3名儿科骨科主治医生和1名骨科住院医生使用简化方法进行阅片。简化方法针对每个年龄采用单一的单变量标准，而不是与X线图谱进行多变量主观比较。所有阅片者均不知晓原始的骨龄测定结果。使用加权κ统计观察者间可靠性、观察者内可靠性以及与先前图谱记录的一致性。
SBA方法的阅片结果与格氏和派氏图谱的阅片结果显示出高度一致性，加权κ值范围为0.71至0.75。SBA方法还显示出高度至几乎完美的观察者间和观察者内可靠性，值分别为0.77至0.87和0.87至0.95。
这些结果与之前研究其他骨骼年龄评估工具有效性和可靠性的报告相当或更优。SBA评估工具为当前方法提供了一种简单有效的替代方法。
诊断性研究，III级。
