Abstract
Background
Determination of bone age is routinely used for following up substitution therapy in congenital adrenal hyperplasia (CAH) but today is a procedure with significant subjectivity.
Objective
The aim was to test the performance of automatic bone age rating by the BoneXpert software package in all radiographs of children with CAH seen at our clinic from 1975 to 2006.
Materials and methods
Eight hundred and ninety-two left-hand radiographs from 100 children aged 0 to 17 years were presented to a human rater and BoneXpert for bone age rating. Images where ratings differed by more than 1.5 years were each rerated by four human raters.
Results
Rerating was necessary in 20 images and the rerating result was closer to the BoneXpert result than to the original manual rating in 18/20 (90 %). Bone age rating precision based on the smoothness of longitudinal curves comprising a total of 327 data triplets spanning less than 1.7 years showed BoneXpert to be more precise (P<0.001).
Conclusion
BoneXpert performs reliable bone age ratings in children with CAH.
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Notes
The triplets formed from a child are not statistically independent because each visit can participate in up to three triplets. The confidence interval (CI) of the estimated precision was therefore estimated by a Monte Carlo technique, which showed that the CIs are a factor of 1.3 times larger than one would derive by assuming that the triplets were independent
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Martin, D.D., Heil, K., Heckmann, C. et al. Validation of automatic bone age determination in children with congenital adrenal hyperplasia. Pediatr Radiol 43, 1615–1621 (2013). https://doi.org/10.1007/s00247-013-2744-8
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DOI: https://doi.org/10.1007/s00247-013-2744-8