Forensic age estimation in living children: how accurate is the Greulich-Pyle method in Sabah, East Malaysia?
BackgroundThe Greulich and Pyle's Radiographic Atlas of Skeletal Development of the Hand and Wrist (GP Atlas) is the most widely used method of determining the bone age (BA) of a child. It is also a widely accepted method for forensic age determination. As there is limited local bone age data f...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1137960/full |
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| author | Khin Mya Nang Abdul Jabbar Ismail Anithaa Tangaperumal Aye Aye Wynn Tin Tin Thein Firdaus Hayati Yong Guang Teh |
| author_facet | Khin Mya Nang Abdul Jabbar Ismail Anithaa Tangaperumal Aye Aye Wynn Tin Tin Thein Firdaus Hayati Yong Guang Teh |
| author_sort | Khin Mya Nang |
| collection | DOAJ |
| description | BackgroundThe Greulich and Pyle's Radiographic Atlas of Skeletal Development of the Hand and Wrist (GP Atlas) is the most widely used method of determining the bone age (BA) of a child. It is also a widely accepted method for forensic age determination. As there is limited local bone age data for forensic age estimation, the purpose of this study was to assess the accuracy of the GP Atlas for forensic age determination in living Sabahan children.MethodThis study recruited 182 children between the ages of 9 years to 18 years. BA estimation of the left-hand anteroposterior radiographs were performed by two experienced radiologists using the Greulich-Pyle method.ResultsThe BA estimates from two radiologists had very high interobserver reliability (ICC 0.937) and a strong positive interobserver correlation (r > 0.90). The GP method, significantly and consistently underestimated chronological age (CA) by 0.7, 0.6 and 0.7 years in overall children, boys and girls respectively with minimal errors. Mean absolute error and root of mean squared error for overall children was 1.5 and 2.2 years respectively, while mean absolute percentage error was 11.6%. This underestimation was consistent across all age groups but was statistically significant only at 13–13.9 and 17–18.9 years old age groups.ConclusionDespite high interobserver reliability of BA estimation using the GP Atlas, this method consistently underestimates the age of the child in all children to a significant degree, for both boys and girls across all age groups, with an acceptably low level of error metrics. Our findings suggest that locally validated GP Atlas or other type of assessments (artificial intelligence or machine learning) are needed for assessment of BA to accurately predict CA, since current GP Atlas standards significantly underestimated chronological age with minimal error for children in Sabah. A larger population-based study would be necessary for establishing a validated atlas of a bone age in Malaysia. |
| first_indexed | 2024-03-13T05:27:32Z |
| format | Article |
| id | doaj.art-8d170f670d804ce7bfcdff56f4dbef07 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-13T05:27:32Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-8d170f670d804ce7bfcdff56f4dbef072023-06-15T05:14:37ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-06-011110.3389/fped.2023.11379601137960Forensic age estimation in living children: how accurate is the Greulich-Pyle method in Sabah, East Malaysia?Khin Mya Nang0Abdul Jabbar Ismail1Anithaa Tangaperumal2Aye Aye Wynn3Tin Tin Thein4Firdaus Hayati5Yong Guang Teh6Department of Pathology & Microbiology, Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MalaysiaDepartment of Anaesthesiology, Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MalaysiaDepartment of Radiology, Serdang Hospital, Kajang, MalaysiaDepartment of Pathology & Microbiology, Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MalaysiaDepartment of Pathology & Microbiology, Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MalaysiaDepartment of Surgery, Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MalaysiaDepartment of Radiology, Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MalaysiaBackgroundThe Greulich and Pyle's Radiographic Atlas of Skeletal Development of the Hand and Wrist (GP Atlas) is the most widely used method of determining the bone age (BA) of a child. It is also a widely accepted method for forensic age determination. As there is limited local bone age data for forensic age estimation, the purpose of this study was to assess the accuracy of the GP Atlas for forensic age determination in living Sabahan children.MethodThis study recruited 182 children between the ages of 9 years to 18 years. BA estimation of the left-hand anteroposterior radiographs were performed by two experienced radiologists using the Greulich-Pyle method.ResultsThe BA estimates from two radiologists had very high interobserver reliability (ICC 0.937) and a strong positive interobserver correlation (r > 0.90). The GP method, significantly and consistently underestimated chronological age (CA) by 0.7, 0.6 and 0.7 years in overall children, boys and girls respectively with minimal errors. Mean absolute error and root of mean squared error for overall children was 1.5 and 2.2 years respectively, while mean absolute percentage error was 11.6%. This underestimation was consistent across all age groups but was statistically significant only at 13–13.9 and 17–18.9 years old age groups.ConclusionDespite high interobserver reliability of BA estimation using the GP Atlas, this method consistently underestimates the age of the child in all children to a significant degree, for both boys and girls across all age groups, with an acceptably low level of error metrics. Our findings suggest that locally validated GP Atlas or other type of assessments (artificial intelligence or machine learning) are needed for assessment of BA to accurately predict CA, since current GP Atlas standards significantly underestimated chronological age with minimal error for children in Sabah. A larger population-based study would be necessary for establishing a validated atlas of a bone age in Malaysia.https://www.frontiersin.org/articles/10.3389/fped.2023.1137960/fullbone ageforensic ageGreulich-Pyle atlasSabahradiograph |
| spellingShingle | Khin Mya Nang Abdul Jabbar Ismail Anithaa Tangaperumal Aye Aye Wynn Tin Tin Thein Firdaus Hayati Yong Guang Teh Forensic age estimation in living children: how accurate is the Greulich-Pyle method in Sabah, East Malaysia? Frontiers in Pediatrics bone age forensic age Greulich-Pyle atlas Sabah radiograph |
| title | Forensic age estimation in living children: how accurate is the Greulich-Pyle method in Sabah, East Malaysia? |
| title_full | Forensic age estimation in living children: how accurate is the Greulich-Pyle method in Sabah, East Malaysia? |
| title_fullStr | Forensic age estimation in living children: how accurate is the Greulich-Pyle method in Sabah, East Malaysia? |
| title_full_unstemmed | Forensic age estimation in living children: how accurate is the Greulich-Pyle method in Sabah, East Malaysia? |
| title_short | Forensic age estimation in living children: how accurate is the Greulich-Pyle method in Sabah, East Malaysia? |
| title_sort | forensic age estimation in living children how accurate is the greulich pyle method in sabah east malaysia |
| topic | bone age forensic age Greulich-Pyle atlas Sabah radiograph |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1137960/full |
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