Title |
Reproducibility and inter-observer agreement of Greulich-Pyle protocol to estimate skeletal age among female adolescent soccer players
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Published in |
BMC Pediatrics, October 2020
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DOI | 10.1186/s12887-020-02383-4 |
Pubmed ID | |
Authors |
Yuri V. Faustino-da-Silva, Diogo V. Martinho, Manuel J. Coelho-e-Silva, João Valente-dos-Santos, Jorge Conde, Tomás G. Oliveira, Enio R. V. Ronque, Ricardo R. Agostinete, Rômulo A. Fernandes, Lauren B. Sherar |
Abstract |
Background: Skeletal age (SA) is considered the best method of assessing biological maturation. The aim of this study was to determine intra-observer (reproducibility) and inter-observer agreement of SA values obtained via the Greulich-Pyle (GP) method. In addition, the variation in calculated SAs by alternative GP protocols was examined. Methods: The sample was composed of 100 Portuguese female soccer players aged 12.0–16.7 years. SAs were determined using the GP method by two observers (OB1: experience 2000 exams using several methods). The radiographs were examined using alternative GP protocols: (wholeGP) the plate was matched to the atlas as an overall approach; (30-boneGP) bone-by-bone inspections of 30-bones; (GPpmb) bone-by-bone inspections of the pre-mature bones only. For the 30-boneGP and GPpmb approaches, SA was calculated via the mean (M) and the median (Md). Results: Reproducibility ranged 82–100% and 88–100% for OB1 and OB2, respectively. Inter-observer agreement (100 participants multiplied by 30 bones) was 92.1%. For specific bones, agreement rates less than 90% were found for scaphoid (81%), medial phalange V (83%), trapezium (84%) and metacarpal V (87%). Differences in wholeGP SAs obtained by the two observers were moderate (d-cohen was 0.79). Mean differences between observers when using bone-by bone SAs were trivial (30-boneGP: d-cohen less than 0.05; GPpmb: d-cohen less than 0.10). The impact of using the mean or the median was negligible, particularly when analyses did not include bones scored as mature. Conclusion: The GP appeared to be a reasonably reproducible method to assess SA and inter-observer agreement was acceptable. There is evidence to support a recommendation of only scoring pre-mature bones during later adolescence. Further research is required to examine whether these findings are consistent in younger girls and in boys. |
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Geographical breakdown
Country | Count | As % |
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Unknown | 30 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Bachelor | 3 | 10% |
Researcher | 3 | 10% |
Student > Ph. D. Student | 3 | 10% |
Professor | 2 | 7% |
Other | 5 | 17% |
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Social Sciences | 1 | 3% |
Other | 0 | 0% |
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