Martín Pérez, S.E.; Martín Pérez, I.M.; Vega González, J.M.; Molina Suárez, R.; León Hernández, C.; Rodríguez Hernández, F.; Herrera Perez, M. Precision and Accuracy of Radiological Bone Age Assessment in Children among Different Ethnic Groups: A Systematic Review. Diagnostics2023, 13, 3124.
Martín Pérez, S.E.; Martín Pérez, I.M.; Vega González, J.M.; Molina Suárez, R.; León Hernández, C.; Rodríguez Hernández, F.; Herrera Perez, M. Precision and Accuracy of Radiological Bone Age Assessment in Children among Different Ethnic Groups: A Systematic Review. Diagnostics 2023, 13, 3124.
Martín Pérez, S.E.; Martín Pérez, I.M.; Vega González, J.M.; Molina Suárez, R.; León Hernández, C.; Rodríguez Hernández, F.; Herrera Perez, M. Precision and Accuracy of Radiological Bone Age Assessment in Children among Different Ethnic Groups: A Systematic Review. Diagnostics2023, 13, 3124.
Martín Pérez, S.E.; Martín Pérez, I.M.; Vega González, J.M.; Molina Suárez, R.; León Hernández, C.; Rodríguez Hernández, F.; Herrera Perez, M. Precision and Accuracy of Radiological Bone Age Assessment in Children among Different Ethnic Groups: A Systematic Review. Diagnostics 2023, 13, 3124.
Abstract
Introduction: Determination of radiological bone age (BA) is a diagnostic method that consists of estimating chronological age (CA) from the bone maturation of children. Although environmental and hormonal factors can interfere with bone ossification, the process is essentially dependent on ancestral inheritance. These ethnic backgrounds are not usually considered, which can lead to biased interpretations and inadequate decision-making by pediatricians or forensic experts. The objective of this study was to determine the precision and accuracy of these radiological procedures among different ethnic groups. Methods: A qualitative systematic review carried out following MOOSE statement and previously registered in the International Prospective Registry of Systematic Reviews PROSPERO (CRD42023449512). Search was performed in MEDLINE (PubMed) (n=561), Cochrane Library (n=261), CINAHL (n=103), Web of Science (WOS) (n=181) and public institutional repositories (n=37) from inception to 31st December 2022 using Mesh as “Diagnostic Techniques and Procedures”, “Diagnostic imaging”, “Radiography”, “Age Determination by Skeleton” and free terms combining with booleans “AND” and “OR”. PEDro scale, and Risk of Bias in non-randomized Studies of Exposure (ROBINS-E) were used to assess methodological quality and risk of bias of included studies respectively. Results: 51 articles (n=19,531) were included according to the inclusion criteria previously established. There was a good to moderate methodological quality and a high to very high risk of bias. Skeletal methods for determining BA were precised in terms of intra-observer and inter-observer reliability in all ethnic groups. Regarding to accuracy of Skeletal methods in Caucasians and Hispanic children, GPA was accurate at all ages, but in youths, TW3 RUS could be a consistent alternative. In Asian and Arab, GPA and TW3 overestimated BA in adolescents near adulthood. In African youths, GPA overestimated BA while TW3 was more accurate in estimating CA. Dental and Cervical radiographic methods are equally precise but lesser accurate than Skeletal BA determination. Conclusion: Skeletal radiographic methods GPA and TW3 are both precise for BA determination among all ethnical groups, but their accuracy in estimating CA can be altered by racial bias.
Keywords
diagnostic imaging; radiography; age determination by skeleton; racial group; children
Subject
Medicine and Pharmacology, Pediatrics, Perinatology and Child Health
Copyright:
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