Updating Skeletal Maturity Methods for U.S. Children

描述（由申请人提供）：目前评估美国儿童骨骼成熟度的方法在种族/民族代表性和过时的样本方面都是不足的。美国是一个多种族的国家，但骨骼发育的标准是基于许多代以前的白人儿童。提出的研究的主要目标是纠正这种差异，并提供最新的种族特异性模块在FELS方法骨骼成熟度评估。不同种族/族裔群体的儿童将通过全国多个现有的放射照片集被包括在内。更新的骨骼成熟度评估方法将通过三个具体目标来完成。目标1将确定不同种族之间骨骼成熟的时间和速度及其个体组成部分的差异。目标2将使用来自当代儿童的数据重新校准FELS方法。这一目标也将提供一个新的程序，评估骨骼成熟度与性别和种族特定的模块。该程序将是用户友好的和开源的，具有独立和基于网络的能力。目标3将把两个新的解释性参数整合到FELS评估程序的输出中：五种成熟类别对骨骼年龄的相对贡献，以及对特定儿童骨骼成熟的未来赶上或减缓的预测。这三个目标的结合将有利于全国儿童的治疗和临床管理。

DESCRIPTION (provided by applicant): Current methods for assessing skeletal maturity in US children are inadequate both in terms of racial/ethnic representation and outdated samples. The United States is a multi-racial nation, yet skeletal maturity standards are based on white children from many generations ago. The primary goal of the proposed study is to rectify this disparity, and provide up-to-date race-specific modules in the FELS method for skeletal maturity assessment. Children of diverse racial/ethnic groups will be included via multiple existing radiographic collections nationwide. The updated method for skeletal maturity assessment will be accomplished through three specific aims. Aim 1 will determine differences between races in both the timing and tempo of skeletal maturity and its individual components. Aim 2 will re-calibrate the FELS method using data from contemporary children. This aim will also provide a new program for assessment of skeletal maturity with sex- and race- specific modules. The program will be user-friendly and open source, with both stand-alone and web-based capability. Aim 3 will integrate two new interpretive parameters into the FELS assessment program output: relative contribution of five maturation categories to skeletal age, and prediction of future catch up or slow- down in skeletal maturation for a given child. The combination of these three aims will serve to benefit the treatment and clinical management of children nationwide.