The Standards of Skeletal Maturity of Hand and Wrist for Chinese-China 05 Ⅱ.Reliability of Assessing Skeletal Age by RUS-CHN and TW_3-C Carpal Methods / 中国运动医学杂志

ABSTRACT

Objective The reliability of the RUS-CHN of The Standards of Skeletal Maturity of Hand and Wrist for Chinese-China 05 and the TW_3-C Carpal methods was studied and the effects of readers' experience on the measured skeletal age were determined.Methods Under the conditions that readers were blinded to the age and sex of the children,the hand and wrist radiographs of 75 children(skeletal age from 3 to 18 years) were independently read by 11 readers using RUS-CHN method and the radiographs of 46 children(skeletal age from 3 to 13.5 years) were analyzed by 6 readers using TW_3-C Carpal method.The radiographs were re-read by the same readers 20 days later.The percentage agreement in the ratings and the differences of skeletal age in the rereading were used to evaluate the reliability.Results It was found that(a) intraobserver percentage agreement of ratings were 63.4% to 82.2% for RUS-CHN and 65.6% to 83.2% for TW_3-C Carpal respectively,the intraobserver 95% confidence limits for a single reading were ?0.40 year to ?0.76 year for RUS-CHN and ?0.38 year to(?0.71) year for TW_3-C Carpal respectively;(b) interobserver percentage agreement of ratings were 61.3% to 77.3% for RUS-CHN and 77.4% to 88.0% for TW_3-C Carpal respectively;interobserver 95% confidence limits for a single reading were ?0.42 year to ?0.96 year for RUS-CHN and ?0.42 year to ?0.78 year for TW_3-C Carpal respectively.Conclusion The present findings suggest that the reliability of skeletal age assessment between readers is significantly different and that the reliability levels of the experienced and relative experienced readers is higher,which can be obtained for few nonexperienced readers through training of assessment of skeletal age.The assessments of skeletal age are unreliability for the majority of non-experienced readers,so that the further training for them is needed.