A Comparison of Automatic Bone Age Assessments between the Left and Right Hands: A Tool for Filtering Measurement Errors

Abstract

This study aimed to investigate whether the left and right hands yield the same bone age using the automated bone age assessment (BAA) system and proposed the right-hand BAA as a tool for filtering out measurement errors. The Bland–Altman, Passing–Bablok, and Spearman correlation coefficients were analyzed to compare the automated BAA results for each hand. The absolute difference between each hand obtained by the model (ADBH model) was calculated. The mean absolute difference (MAD) was estimated between the automatic BAA results for each hand and the reference standard. The mean of the ADBH model was 0.23 ± 0.19 years; 92.2% of the participants showed an ADBH model result of <0.5 years. The Passing–Bablok regression analysis revealed an excellent overall correlation between the BAAs of both hands. Of the total cases, 59 participants showed an ADBH model result >0.5 years, with a MAD between the model and the reference standard of 0.409 years for the left hand and 0.424 years for the right hand; both MADs were higher than those of previous studies using the same model. Given the excellent overall correlation of the BAA between both hands using the model, the high ADBH model value may indicate BAA measurement errors and serve as a cue for manual supervision.