Skeletal development of the hand and wrist: digital bone age companion-a suitable alternative to the Greulich and Pyle atlas for bone age assessment?

Purpose: To assess reader performance and subjective workflow experience when reporting bone age studies with a digital bone age reference as compared to the Greulich and Pyle atlas (G&P). We hypothesized that pediatric radiologists would achieve equivalent results with each method while digital wor...

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Published in:Skeletal Radiology Vol. 46; no. 6; pp. 785 - 794
Main Authors: Bunch, Paul, Altes, Talissa, McIlhenny, Joan, Patrie, James, Gaskin, Cree, Bunch, Paul M, Altes, Talissa A, Gaskin, Cree M
Format: diagnostic images pictorial research tables/charts Journal Article
Published: Springer Nature Jun2017
Online Access:View this record in EBSCOhost
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      dt: Jun2017
      vid: 46
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00256-017-2616-7
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        atl: Skeletal development of the hand and wrist: digital bone age companion-a suitable alternative to the Greulich and Pyle atlas for bone age assessment?
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        au:
          Bunch, Paul
          Altes, Talissa
          McIlhenny, Joan
          Patrie, James
          Gaskin, Cree
          Bunch, Paul M
          Altes, Talissa A
          Gaskin, Cree M
        affil: Department of Radiology , Massachusetts General Hospital , 55 Francis Street Boston 02114 USA
      sug:
        subj:
          Radiography Methods
          Hand Anatomy and Histology
          Age Determination by Skeleton Methods
          Infant
          Reproducibility of Results
          Male
          Child
          Adolescence
          Wrist
          Child, Preschool
          Female
          Wrist Anatomy and Histology
          Hand
          Human
          Infant: 1-23 months
          Child: 6-12 years
          Adolescent: 13-18 years
          Child, Preschool: 2-5 years
          Male
          Female
      ab: Purpose: To assess reader performance and subjective workflow experience when reporting bone age studies with a digital bone age reference as compared to the Greulich and Pyle atlas (G&P). We hypothesized that pediatric radiologists would achieve equivalent results with each method while digital workflow would improve speed, experience, and reporting quality.Materials and Methods: IRB approval was obtained for this HIPAA-compliant study. Two pediatric radiologists performed research interpretations of bone age studies randomized to either the digital (Digital Bone Age Companion, Oxford University Press) or G&P method, generating reports to mimic clinical workflow. Bone age standard selection, interpretation-reporting time, and user preferences were recorded. Reports were reviewed for typographical or speech recognition errors. Comparisons of agreement were conducted by way of Fisher's exact tests. Interpretation-reporting times were analyzed on the natural logarithmic scale via a linear mixed model and transformed to the geometric mean. Subjective workflow experience was compared with an exact binomial test. Report errors were compared via a paired random permutation test.Results: There was no difference in bone age determination between atlases (p = 0.495). The interpretation-reporting time (p < 0.001) was significantly faster with the digital method. The faculty indicated preference for the digital atlas (p < 0.001). Signed reports had fewer errors with the digital atlas (p < 0.001).Conclusions: Bone age study interpretations performed with the digital method were similar to those performed with the Greulich and Pyle atlas. The digital atlas saved time, improved workflow experience, and reduced reporting errors relative to the Greulich and Pyle atlas when integrated into electronic workflow.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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