Tanner J M, Oshman D, Lindgren G, Grunbaum J A, Elsouki R, Labarthe D
Institute of Education, University of London, UK.
Horm Res. 1994;42(6):288-94. doi: 10.1159/000184211.
Three observers rated 57 X-rays from normal healthy children in Project HeartBeat! twice each by CASAS, the computer-assisted version of the TW2 RUS bone age method. Differences between duplicates of individual bone ratings which reached or exceeded 1.0 unit (or 1 stage) were 5% within observer and 8% between observers for CASAS, and 17 and 33%, respectively, for the unassisted MANUAL method. In children followed longitudinally, CASAS scores increased much more steadily than MANUAL scores, largely because the bones were rated, in the former system, on a continuous rather than a discrete-integer scale. We conclude that CASAS is a more reliable and probably a more valid estimator of skeletal maturity than the MANUAL version of the TW2 RUS method.
在“心跳计划”中，三名观察者使用计算机辅助版的TW2 RUS骨龄评估方法（CASAS）对57名正常健康儿童的X光片进行了两次评分。对于CASAS，同一观察者两次单独骨骼评分之间达到或超过1.0单位（或1个阶段）的差异在观察者内部为5%，观察者之间为8%；而对于无辅助的手动方法，相应差异分别为17%和33%。在纵向随访的儿童中，CASAS评分的增长比手动评分更为稳定，这主要是因为在前者系统中，骨骼评分采用的是连续而非离散整数尺度。我们得出结论，与TW2 RUS方法的手动版相比，CASAS是一种更可靠且可能更有效的骨骼成熟度评估方法。
