All but one study included both boys and girls. The studies included from 68 to 2614 persons with known chronological age. We found 17 studies that compared chronological age with skeletal age based on hand x-ray and the GP atlas. Two people independently assessed risk of bias in the included studies by the QUADAS-2 checklist to assess the quality of diagnostic accuracy studies. Both approaches require a known chronological age and an observed skeletal age:Ī) is based on the chronological age and presents the average difference between chronological age and GP skeletal age based on the maturation stages of the Greulich and Pyle atlas for separate age groups (ages not combined in more than annual increments).ī) is based on the GP skeletal age and presents the average chronological age from GP skeletal age in the Greulich and Pyle atlas. We included two different approaches to present the data (in this report referred to as approach A and B). We included 17 studies with results that present age estimation based on the Greulich & Pyle atlas. Two people independently considered these studies in full text. Of these, we found 658 potentially relevant publications for age estimation using x-ray of the hand. Two people independently read title and summary for 10640 references. The search for studies that used the Greulich and Pyle atlas was updated in January 2017. The literature search covered studies that use x-ray of the teeth or hand, and CT or MRI of the clavicle, knee and ankle for age estimation of children and adolescents between 10 and 25 years. We searched for studies in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and Google Scholar. In parallel, we have also conducted a systematic review of age estimation using Demirjians development stages on wisdom teeth. Since the Greulich and Pyle atlas is the most widely used method for age estimating based on x-ray of the hand, we chose to focus on this system. The objective of this systematic review is to assess the scientific evidence on the agreement between chronological age and bone age based on the maturation stages of the Greulich and Pyle atlas (GP skeletal age), and, if possible, to describe any variations between different populations. Department of Forensic Sciences has, in cooperation with the Knowledge Centre for the Health Services, conducted a systematic examination of the scientific evidence on several of the medical age estimation methods. 2017 transferred with the Department of Forensic Sciences to Oslo University Hospital). In 2016, the Norwegian Institute of Public Health was assigned a national professional responsibility to evaluate and improve the methods used for medical age estimation (from 1.1. These methods have been criticized for their lack of precision, but currently no better methods have been suggested. Evaluation of skeletal maturation of the hand and tooth development has been used for age assessment of asylum seekers in Norway in cases of doubt. To ensure that children receive their rights and that adults are not treated as children, it is necessary to assign a chronological age for these individuals. SummaryĮvery year, young unaccompanied asylum seekers arrive in Norway, many without knowing how old they are or unable to document their age. We considered that only one study was conducted in such a way that it can adequately describe the method's ability to estimate age. ![]() Here we did no meta-analysis, since results from three of the four studies were so affected by the phenomenon «age mimicry» that we do not have confidence in the results. The studies that presented the distribution of chronological age from GP skeletal age are the most relevant if the Greulich and Pyle atlas is used for age estimation. The difference between GP skeletal age and chronological age was on average rarely more than one year for each age group. These two approaches are not comparable and we have therefore conducted two separate analyses. ![]() 13 studies presented results for GP skeletal age from chronological age, 2 presented results for chronological age from GP skeletal age and 2 were data-sets which we used to present both types of results. This systematic review summarizes the scientific evidence on the agreement between skeletal age from the Greulich and Pyle atlas (hereafter called GP skeletal age) and chronological age.Ī total of 17 studies met our criteria. The Greulich and Pyle atlas is used to estimate the age of children and adolescents. The changes have not affected the conclusion. Updated analyses based on corrected and reviewed data.
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