Validation of software for a bone age patient through the cervical vertebrae
DOI:
https://doi.org/10.7308/aodontol/2017.53.e07Keywords:
Software validation, Cervical vertebrae, Age determination by skeletonAbstract
Aim: The present study aimed to validate a software (Easy Age) to assess skeletal maturation by cervical vertebrae, demonstrating its applicability and reproducibility.
Methods: For this, the sample consisted of 500 lateral radiographs of patients of both genders, from 7 to 15 years of age, who were examined by three evaluators, twice for the visual method and twice with the software. To evaluate the inter- and intra-examiner agreement, the Kappa test was applied, which showed a substantial level of agreement for the visual assessment of the cervical vertebrae, while the evaluation of the cervical vertebrae through the software showed a level that presented almost perfect agreement for all evaluators. Friedman’s test was applied to compare the ratings between the 1st and 2nd visual examinations and between the 1st and 2nd examinations using the software, which presented no significant differences. To validate the software, a comparison was performed between the results obtained by the visual method and those obtained by the software, using the Spearman correlation test.
Results: The results showed a strong, statistically significant correlation between the measurements from the visual examination and those from the software evaluation.
Conclusion: It can therefore be concluded that the software is valid and improved the applicability and reproducibility of the method of estimating skeletal age.
Downloads
References
Lamparski DG. Skeletal age assessment utilizing cervical vertebrae. Pittsburg. Dissertação [Mestrado] - University of Pittsburg; 1972.
Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop. 1995;107:58-66.
Baccetti T, Franchi L, McNamara Júnior J. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod. 2002;72:316-23.
Baccetti T, Franchi L, Toffol L, Ghiozzi B, Cozza P. The diagnostic performance of chronologic age in the assessment of skeletal maturity. Prog Orthod. 2006;7:176-88.
Kumar S, Singla A, Sarma R, Virdi MS, Anupam A, Mittal B. Skeletal maturation evaluation mandibular second molar calcification stages. Angle Orthod. 2012;82:501-6.
Chen J, Hu H, Guo J, Liu Z, Liu R, Li F, et al. Correlation between dental maturity and cervical vertebral maturity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:777-83.
Flores-Mir C, Burgess CA, Chanpney M, Jensen RJ, Pitcher MR, Major PW. Correlation of skeletal maturation stages determined by cervical vertebrae hand-wrist evaluations. Angle Orthod. 2006;76:1-5.
Lai EH, Liu JP, Chang JZ, Tsai SJ, Yao CC, Chen MH, et al. Radiographic assessment of skeletal maturation stages for orthodontic patients: hand-wrist bones or cervical vertebrae? J Formos Med Assoc. 2008;107:316-25.
Al Khal HA, Wong RW, Rabie AB. Elimination of hand-wrist radiographs for maturity assessment in children needing orthodontic therapy. Skeletal Radiol. 2008;37:195-200.
Stiehl J, Müller B, Dibbets J. The development of the cervical vertebrae as an indicator of skeletal maturity: comparison with the classic method of hand-wrist radiograph. J Orofac Orthop. 2009;70:327-35.
San Róman P, Palma JC, Oteo MD, Nevado E. Skeletal maturation determined by cervical vertebrae development. Eur J Orthod. 2002;24:303-11.
Zhao XG, Lin J, Jiang JH, Wang Q, Ng SH. Validity and reliability of a method for assessment of cervical vertebral maturation. Angle Orthod. 2012;82:229-34.
Prasad M, Ganji VSK, George SA, Talapaneni AK, Shetty SK. A comparison between cervical vertebrae and modified MP3 stages for the assessment of skeletal maturity. J Nat Sci Biol Med. 2013;4:74-80.
Gupta G, Mogra S, Shetti VS, Goyal S, Garg S. Hand-wrist radioghaphs - are you really required as maturation indicators? Ind J Dent Sci. 2013;5:30-3.
Pasciuti E, Franchi L, Baccetti T, Milani S, Farronato G. Comparison of three methods to assess individual skeletal maturity. J Orofac Orthop. 2013;74:397-408.
Caldas MP, Ambrosano GM, Haiter Neto F. Computer-assisted analysis of cervical vertebral bone age using cephalometric radiographs in Brazilian subjects. Braz Oral Res. 2010;24:120-6.
Santiago RC, Cunha AR, Júnior GC, Fernandes N, Campos MJS, Costa LFM, et al. New software for cervical vertebral geometry assessment and its relationship to skeletal maturation – a pilot study. Dentomaxillofac Radiol. 2014;43:20130238.
Gabriel DB, Southard KA, Qian F, Marshall SD, Franciscus RG, Southard TE. Cervical vertebrae maturation method: poor reproducibility. Am J Orthod Dentofacial Orthop. 2009;136:478.e1-7.
Nestman TS, Marshall SD, Qian F, Holton N, Franciscus RG, Southard TE. Cervical vertebrae maturation method morphologic criteria: poor reproducibility. Am J Orthod Dentofacial Orthop. 2011;140:182-8.
Santiago RC, Costa LFM, Vitral RW, Fraga MR, Bolognese AM, Maia LC. Cervical vertebral maturation as a biologic indicator of skeletal maturity. Angle Orthod. 2012;82:1123-31.
Baptista RS, Quaglio CL, Mourad LMEH, Hummel AD, Caetano CAC, Ortolani CLF, et al. A semi-automated method for bone age assessment using cervical vertebral maturation. Angle Orthod. 2012;82:658-62.
Sokic E, Tiro A, Sokic-Begovic A, Nakas E. Semi-automatic assesment of Cervical Vertebral Maturation stages using cephalograph images and centroid-based clustering. Acta Stomatol Croat. 2012;46:280-90.
Padalino S, Sfondrini MF, Chenuil L, Scudeller L, Gandini P. Reliability of skeletal maturity analysis using the cervical vertebrae maturation method on dedicated software. Int Orthod. 2014;12:483-93.
Dzemidzic V, Sokic E, Tiro A, Nakas E. Computer based assessment of cervical vertebral maturation stages using digital lateral cephalograms. Acta Inform Med. 2015;23:364-8.
Ferreira PF. Easy age, versão 2. São Paulo: Freeware; 2014. [acesso em 15 de Março de 2017]. Disponível em: www.easyage.sourceforge.net.
Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-91.
Lehmann EL. Nonparametrics: statistical methods based on ranks. Pearson Education; 1998.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-74.
Pressman RS. Engenharia de software. 7ª ed. Rio de Janeiro: Mc Graw Hill; 2007. 780p.
Sommerville, I. Engenharia de software. 9ª ed. São Paulo: Pearson Prentice Hall; 2011. 529 p.
