title: Reliability of the cervical vertebrae maturation (CVM) method.
abstract: OBJECTIVE
  To assess the reliability of the cervical vertebrae maturation method (CVM).
  
  
  BACKGROUND
  Skeletal maturity estimation can influence the manner and time of orthodontic treatment. The CVM method evaluates skeletal growth on the basis of the changes in the morphology of cervical vertebrae C2, C3, C4 during growth. These vertebrae are visible on a lateral cephalogram, so the method does not require an additional radiograph.
  
  
  METHODS
  In this website based study, 10 orthodontists with a long clinical practice (3 routinely using the method - "Routine user - RU" and 7 with less experience in the CVM method - "Non-Routine user - nonRU") rated twice cervical vertebrae maturation with the CVM method on 50 cropped scans of lateral cephalograms of children in circumpubertal age (for boys: 11.5 to 15.5 years; for girls: 10 to 14 years). Kappa statistics (with lower limits of 95% confidence intervals (CI)) and proportion of complete agreement on staging was used to evaluate intra- and inter-assessor agreement.
  
  
  RESULTS
  The mean weighted kappa for intra-assessor agreement was 0.44 (range: 0.30-0.64; range of lower limits of 95% CI: 0.12-0.48) and for inter-assessor agreement was 0.28 (range: -0.01-0.58; range of lower limits of 95% CI: -0.14-0.42). The mean proportion of identical scores assigned by the same assessor was 55.2 %(range: 44-74 %) and for different pairs of assessors was 42 % (range: 16-68 %).
  
  
  CONCLUSIONS
  The reliability of the CVM method is questionable and if orthodontic treatment should be initiated relative to the maximum growth, the use of additional biologic indicators should be considered (Tab. 4, Fig. 1, Ref. 24).
authors.forename: A
authors.initials: A
authors.lastname: Predko-Engel
authors.forename: M
authors.initials: M
authors.lastname: Kaminek
authors.forename: K
authors.initials: K
authors.lastname: Langova
authors.forename: P
authors.initials: P
authors.lastname: Kowalski
authors.forename: P S
authors.initials: PS
authors.lastname: Fudalej
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods*; D002508:Cephalometry / Q000379:methods*; D002574:Cervical Vertebrae / Q000033:anatomy & histology* / Q000254:growth & development*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012372:ROC Curve; D015203:Reproducibility of Results
keywords: reliability of the method.; skeletal age; cervical vertebrae maturation (CVM)