2023/10/04 by Sebastián Eustaquio Martín Pérez, Isidro Miguel Martín Pérez, Jesús María Vega González +4 · 1 voice
Medicine · #Bone health and osteoporosis research #Hip disorders and treatments #Bone fractures and treatments
paper · pdf · doi:10.3390/diagnostics13193124
openalex publication_date 2023/10/04 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/31
Aim: The aim was to identify, evaluate, and summarize the findings of relevant individual studies on the precision and accuracy of radiological BA assessment procedures among children from different ethnic groups. Materials and Methods: A qualitative systematic review was carried out following the MOOSE statement and previously registered in PROSPERO (CRD42023449512). A search was performed in MEDLINE (PubMed) (n = 561), the Cochrane Library (n = 261), CINAHL (n = 103), Web of Science (WOS) (n = 181), and institutional repositories (n = 37) using MeSH and free terms combined with the Booleans “AND” and “OR”. NOS and ROBINS-E were used to assess the methodological quality and the risk of bias of the included studies, respectively. Results: A total of 51 articles (n = 20,100) on radiological BA assessment procedures were precise in terms of intra-observer and inter-observer reliability for all ethnic groups. In Caucasian and Hispanic children, the Greulich–Pyle Atlas (GPA) was accurate at all ages, but in youths, Tanner–Whitehouse radius–ulna–short bones 3 (TW3-RUS) could be an alternative. In Asian and Arab subjects, GPA and Tanner–Whitehouse 3 (TW3) overestimated the BA in adolescents near adulthood. In African youths, GPA overestimated the BA while TW3 was more accurate. Conclusion: GPA and TW3 radiological BA assessment procedures are both precise but their accuracy in estimating CA among children of different ethnic groups can be altered by racial bias.