Construction of a Simplified Bone Age Assessment Model in Chinese Children Aged 3 to 18 Years

Category	Detail
Condition	Bone age assessment (BAA) for evaluating physiological maturity and growth status in children
Key Mechanisms	Simplified bone age evaluation using linear regression models based on grades of radius, ulna, and metacarpal bones from left-hand X-rays
Target Population	Chinese children aged 3 to 18 years
Care Setting	Pediatric endocrinology and general pediatric clinical settings

Traditional BAA methods are complex, time-consuming, and require professional expertise.
A simplified 3-bone model (radius, ulna, metacarpal I) achieves high accuracy (R² > 0.94, RMSE < 0.5 years).
Incorporating pubertal stage improves bone age assessment accuracy.

Use the Tanner-Whitehouse 3-China radius-ulna-short bone (TW3-C-RUS) method as the gold standard for bone age assessment.
Perform bone age assessment using left-hand wrist radiographs.
Group children by pubertal stage to refine assessment accuracy.

Apply simplified 3-bone regression models for rapid bone age evaluation in clinical practice.
Consider bone grade consistency to use single or few bones as proxies when applicable.
Use regression models when bone grades are inconsistent.

Conduct reassessments by trained pediatricians to minimize subjective bias, ensuring discrepancies ≤ 0.5 years.
Calibrate X-ray devices daily to maintain consistency in imaging results.

Potential inaccuracies due to individual variations in developmental patterns.
Early fusion of carpal bones limits their use in older children.
Overfitting and information loss may occur when converting bone grades to scores and mapping to bone age.

Normal Chinese children aged 3 to 18 years undergoing bone age assessment.

Simplified models enable quicker and accurate bone age evaluation, facilitating timely clinical decisions for growth-related conditions.

Train nonmedical personnel thoroughly for preliminary bone age assessments to improve efficiency.
Use multiple rounds of assessment and blinded review to reduce subjective bias.
Incorporate pubertal staging in bone age evaluation models for enhanced precision.
Prefer the TW3-C-RUS method over carpal bone assessment in older children due to early carpal fusion.
Utilize regression models directly converting bone grades to bone age to reduce information loss.

Clinical Scorecard: Development of an Enhanced Model for Bone Age Evaluation in Chinese Children Aged 3 to 18 Years