Updating Skeletal Maturity Methods for U.S. Children

描述(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充分的。美国是一个多种族的国家，但骨骼成熟标准是基于许多世代以前的白人儿童。拟议研究的主要目标是纠正这种差异，并在骨骼成熟度评估的FELS方法中提供最新的种族特定模块。不同种族/民族的儿童将通过全国范围内现有的多个放射照片集进行纳入。最新的骨骼成熟度评估方法将通过三个具体目标来实现。目标1将确定不同种族在骨骼成熟及其个体组成部分的时间和节奏方面的差异。Aim 2将使用当代儿童的数据重新校准FELS方法。这一目标还将为评估骨骼成熟度提供一个新的计划，包括性别和种族特定模块。该程序将是用户友好的和开放源码的，具有独立和基于网络的能力。目标3将在FELS评估程序的输出中加入两个新的解释参数：五个成熟类别对骨骼年龄的相对贡献，以及对未来渔获量的预测 特定儿童骨骼成熟的加速或减慢。这三个目标的结合将有助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methods for assessing skeletal maturity in US children are inadequate both in terms of racial/ethnic representation and outdated samples.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.