January 2012: Three new publications

The validation of BoneXpert is extended by three new publications

  1. Annals of Human Biology describes the standarisation of Tanner Whitehouse bone age in BoneXpert
  2. Journal of Pediatric Endocrinology and Metabolism brings a validation of BoneXpert in children with precocious puberty
  3. Handbook of Growth features a review of adult height prediction models, reporting also a new validation study

Most of the studies of BoneXpert have used the Greulich Pyle (GP) bone age, which is more precise than the Tanner-Whitehouse (TW) bone age and gives more accurate adult height prediction. However, TW bone age remains an important method in clinical research and practice, and with the paper “Standardization of the Tanner-Whitehouse bone age method…”, BoneXpert’s TW bone age has been given a solid foundation. It is based on the manual ratings of 3374 images from the First Zurich Longitudinal study, and it agrees well with Tanner’s Gold Series. BoneXpert’s TW3 and GP bone ages are, on average, at level.

BoneXpert is intended to determine bone age for all children seen in pediatric endocrinology, except those with obviously different bone shapes like seen in dysplasias. Previously BoneXpert was validated in various conditions of short stature, e.g. Turner and GHD. Another common condition is precocious puberty, and the new paper in JPEM presents a timely validation study in these children. Today, clinics see an increasing number of patients to be investigated for precocious puberty, and a bone age test is often performed.

Adult height prediction (AHP) based on bone age is frequently used, but it has been difficult to make progress in the AHP models due the rater variability of the underlying bone age. The few newer models, the TW3 and RWT models, have not gained much use. As a result, most clinicians still use the old Bayley-Pinneau and TW-mark II methods. With the advent of automated bone age rating, this is about to change. The review of AHP models published as Chapter 3 in Springer’s new handbook aims to “bring order” in this domain. The qualities and features of the old models are reviewed, and it is explained how the BoneXpert AHP model, based on automated bone age determination takes the best of these models and brings it all into a consistent and operational model. The review also presents a hitherto unpublished validation of the BoneXpert AHP model in a large study of Danish children.

The three new publications are listed under Publications.

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