目的:Greulich-Pyle(GP)是各种骨科中最常用的骨龄测定方法(BAD)之一,儿科,放射学,和法医情况。我们旨在调查最相关学科之间GP方法的观察者间和观察者内可靠性及其对土耳其人口的适用性。
方法:一百八十(90个男孩,包括90名年龄小于18岁(平均9.33)的女孩)患者。两名骨科医生评估了失明的研究者混合的X射线,两位放射科医生,和两名儿科内分泌学家根据GP图谱确定骨骼年龄。一个月后重复该过程。作为一种统计方法,使用配对t检验进行比较,采用组内相关系数检验进行可靠性检验,并确定95%置信区间.结果根据Landis-Koch分类。
结果:所有结果与实际年龄一致(p<0.001),根据调查人员的评估,与实际年龄相比。在初步评估时,该方法的观察者间可靠性为0.999(优秀);在第二次评估中,观察者间可靠性为0.997(优秀)。该方法的观察者内部可靠性在所有观察者中都是“极好的”。当结果按性别单独评估时,在所有研究人员中发现了极好的观察者内相关性和与实际年龄的极好相关性(>0.9).当X射线根据年龄范围分为三组并进行评估时,在青春期期间获得了与实际年龄的“中度”和“良好”相关性。
结论:用于骨龄测定的GP方法具有出色的观察者间和观察者内可靠性。在青春期期间,应牢记骨龄评估中的潜在差异.相关专家可以安全,可重复地使用此方法。
OBJECTIVE: Greulich-Pyle (GP) is one of the most used method for bone age determination (BAD) in various orthopedic, pediatric, radiological, and forensic situations. We aimed to investigate the inter- and intra-observer reliability of the GP method between the most relevant disciplines and its applicability to the Turkish population.
METHODS: One-hundred and eighty (90 boys, 90 girls) patients with a chronological age younger than 18 (mean 9.33) were included. X-rays mixed by the blinded investigator were evaluated by two orthopedists, two radiologists, and two pediatric endocrinologists to determine skeletal age according to the GP atlas. A month later the process was repeated. As a statistical method, Paired t-test was used for comparison, an Intraclass Correlation Coefficients test was used for reliability and a 95 % confidence interval was determined. Results were classified according to Landis-Koch.
RESULTS: All results were consistent with chronological age (p<0.001), according to the investigators\' evaluations compared with chronological age. At the initial evaluation, the interobserver reliability of the method was 0.999 (excellent); at the second evaluation, the interobserver reliability was 0.997 (excellent). The intra-observer reliability of the method was \'excellent\' in all observers. When results were separately evaluated by gender, excellent intraobserver correlation and excellent correlation with chronological age were found among all researchers (>0.9). When X-rays were divided into three groups based on age ranges and evaluated, \'moderate\' and \'good\' correlations with chronological age were obtained during the peripubertal period.
CONCLUSIONS: The GP method used in skeletal age determination has excellent inter- and intra-observer reliability. During the peripubertal period, potential discrepancies in bone age assessments should be kept in mind. This method can be used safely and reproducibly by the relevant specialists.