Reliability and validity of computer-assisted estimates of Tanner-Whitehouse skeletal maturity (CASAS): comparison with the manual method.
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.
Tanner
J M
JM
Institute of Education, University of London, UK.
Oshman
D
D
Lindgren
G
G
Grunbaum
J A
JA
Elsouki
R
R
Labarthe
D
D
D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D002648:Child; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods* / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results