Purpose

To evaluate the agreement between observers using Greulich-Pyle (GP) and Gilsanz-Ratib (GR) methods, between four specialities (radiology, pediatrics, pediatric endocrinology and pediatric radiology) and between observers and automated tool in the bone age estimation.

Materials and methods

A total of 99 observers participated in this questionnaire-based study. BoneXpert was used for the automated tool. Experienced, senior, and junior observers were defined by their experience, and the bone age determined by experienced observers was regarded as the ground truth. Agreement between observers was evaluated using the coefficient of variance (CV) and intraclass correlation coefficient (ICC), and they were reevaluated after adding BoneXpert to the observers. Agreement of BoneXpert, the senior, and the junior observers was also evaluated using the root-mean-square-error (RMSE) values and Blant Altman method by comparing with the ground truth.

Results

The CV ranged from 4.98% to 22.08%. The ICC were 0.980 for GP, 0.980 for GP and BoneXpert, 0.973 for GR, and 0.976 for GR and BoneXpert, and the ICC between four specialities ranged form 0.963 to 0.990. BoneXpert tool had the lowest RMSE values (0.504 years for GP atlas).

Conclusion

Automated bone age estimation showed comparable results with GP and GR methods and its utilization may decrease inter-observer variability.

中文翻译：

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Greulich-Pyle和Gilsanz-Ratib Atlas方法与自动估计年龄的工具对比：多观察者一致性研究

目的

为了评估观察者之间使用Greulich-Pyle（GP）和Gilsanz-Ratib（GR）方法的协议，四个专业（放射学，儿科，儿科内分泌学和儿科放射学）之间以及观察者和自动工具在骨龄估计中的一致性。

材料和方法

共有99位观察者参加了这项基于问卷的研究。BoneXpert用于自动化工具。经验丰富的，资深的和初级的观察者是根据他们的经验确定的，而经验丰富的观察者所确定的骨骼年龄被视为基本事实。使用方差系数（CV）和组内相关系数（ICC）评估观察者之间的一致性，并在向观察者添加BoneXpert之后重新评估它们。还通过使用均方根误差（RMSE）值和Blant Altman方法与基本事实进行比较，评估了BoneXpert，高级和初级观察者的一致性。

结果

简历的范围从4.98％到22.08％。GP的ICC为0.980，GP和BoneXpert为0.980，GR为0.973，GR和BoneXpert为0.976，四个专业之间的ICC为0.963至0.990。BoneXpert工具的RMSE值最低（GP地图集为0.504年）。

结论

自动化的骨龄估算显示了与GP和GR方法可比的结果，其利用可能会降低观察者之间的差异。