title: Comparison of bone age readings by pediatric endocrinologists and pediatric radiologists using two bone age atlases.
abstract: BACKGROUND
  Pediatric endocrinologists at a children's hospital were concerned that bone age readings by radiologists frequently differed from their readings by >1 year.
  
  
  OBJECTIVE
  To compare consistency of bone age readings by endocrinologists vs. radiologists, and the Greulich and Pyle (GP) atlas vs. the recently published Gilsanz and Ratib (GR) digital atlas.
  
  
  METHODS
  Sixteen radiographs were read by seven radiologists and five endocrinologists, using both the GP and GR atlases. Time to complete all 16 readings was recorded. An intraclass correlation coefficient (ICC) was used to assess the level of agreement between the two disciplines and the use of different atlases.
  
  
  RESULTS
  The ICCs for the seven radiologists and five endocrinologists were both 0.95; the ICC for readings done by GP vs. GR for all raters was 0.96. The number of outlier readings was similar for radiologists and endocrinologists but was higher for GR than for GP. Radiologists spent less time (1.15 min) reading each bone age than endocrinologists (2.4 min).
  
  
  CONCLUSIONS
  Under controlled conditions, pediatric endocrinologists and radiologists displayed nearly identical consistencies in reading bone ages. The GR atlas performed similarly to the GP atlas, except for an increased number of outliers, and might be suitable as a replacement for GP.
authors.affiliation: Department of Endocrinology, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, 111 Michigan Ave., NW, Washington, DC 20010, USA. pkaplowi@cnmc.org
authors.forename: Paul
authors.initials: P
authors.lastname: Kaplowitz
authors.forename: Shylaja
authors.initials: S
authors.lastname: Srinivasan
authors.forename: Jianping
authors.initials: J
authors.lastname: He
authors.forename: Robert
authors.initials: R
authors.lastname: McCarter
authors.forename: Mohammed Reza
authors.initials: MR
authors.lastname: Hayeri
authors.forename: Raymond
authors.initials: R
authors.lastname: Sze
mesh_terms: D000365:Age Determination by Skeleton / Q000379:methods*; D001271:Atlases as Topic; D002648:Child; D004219:District of Columbia; D004704:Endocrinology; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D015588:Observer Variation; D010372:Pediatrics; D011361:Professional Competence; D011873:Radiology Information Systems; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014962:X-Ray Film