title: Validation of bone age methods by their ability to predict adult height.
abstract: OBJECTIVE
  Several bone age (BA) methods are in use today. The aim of this study was to introduce a framework for assessing the validity of a BA method by its ability to predict adult height (H) and to apply it to manual ratings based on Greulich-Pyle (GP) and Tanner-Whitehouse 3 (TW) and to the fully automated BoneXpert method.
  
  
  METHODS
  The study used X-rays of 232 children from the First Zurich Longitudinal Study recorded close to each anniversary.
  
  
  METHODS
  For each height measurement (h), we calculated the growth potential (gp), defined as gp = (H-h)/H. The standard deviation of the gp prediction error for children of the same age was taken as a measure of the validity of the BA method and averaged over the age range 10-18 years for boys and 8-16 years for girls to obtain the overall gp prediction error (GPPE).
  
  
  RESULTS
  Manual TW yielded GPPE = 1.32% [95% CI 1.28-1.36], and was significantly outperformed by manual GP with GPPE = 1.26% [1.22-1.30]. The automated rating obtained GPPE = 1.23%, and omitting radius and ulna yielded GPPE = 1.22%.
  
  
  CONCLUSIONS
  Manual GP rating is better than manual TW rating in predicting adult height, and the fully automated method works as well as manual GP rating.
authors.affiliation: Visiana, Holte, Denmark.
authors.forename: Hans Henrik
authors.initials: HH
authors.lastname: Thodberg
authors.forename: Julia
authors.initials: J
authors.lastname: Neuhof
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ranke
authors.forename: Oskar G
authors.initials: OG
authors.lastname: Jenni
authors.forename: David D
authors.initials: DD
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods*; D001827:Body Height / Q000502:physiology*; D001846:Bone Development / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D050276:Hand Bones / Q000000981:diagnostic imaging / Q000254:growth & development*; D006801:Humans; D008297:Male; D055815:Young Adult