Evidence map›Paper›PMID 25158602›Full record

Observational studyArthritis research & therapy2014

Automated determination of bone age and bone mineral density in patients with juvenile idiopathic arthritis: a feasibility study.

Janneke Anink, Charlotte M Nusman, Lisette W A van Suijlekom-Smit, Rick R van Rijn, Mario Maas, Marion A J van Rossum

Open access · goldAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Arthritis research & therapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 23 citations in OpenAlex.

  1. Trial
  2. Automated bone age calculation is an independent predictor of vertebral fracture burden in Duchenne muscular dystrophy.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
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  6. Traditional and New Methods of Bone Age Assessment-An OverviewJournal of clinical research in pediatric endocrinology · 2021
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  7. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Janneke Anink
Charlotte M Nusman
Lisette W A van Suijlekom-Smit
Rick R van Rijn
Mario Maas
Marion A J van Rossum
Academic Medical Center · NLEmma Kinderziekenhuis · NLErasmus MC - Sophia Children’s Hospital · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionChronic inflammation combined with glucocorticoid treatment and immobilization puts juvenile idiopathic arthritis (JIA) patients at risk of impaired growth and reduced bone mineral density (BMD). Conventional methods for evaluating bone age and BMD are time-consuming or come with additional costs and radiation exposure. In addition, an automated measurement of bone age and BMD is likely to be more consistent than visual evaluation. In this study, we aimed to evaluate the feasibility of an automated method for determination of bone age and (cortical) bone mineral density (cBMD) in severely affected JIA patients. A secondary objective was to describe bone age and cBMD in this specific JIA population eligible for biologic treatment.

methodsIn total, 69 patients with standard hand radiographs at the start of etanercept treatment and of calendar age within the reliability ranges (2.5 to 17 years for boys and 2 to 15 years for girls) were extracted from the Dutch Arthritis and Biologicals in Children register. Radiographs were analyzed using the BoneXpert method, thus automatically determining bone age and cBMD expressed as bone health index (BHI). Agreement between measurements of the left- and right-hand radiographs and a repeated measurement of the left hand were assessed with the intraclass correlation coefficient (ICC). Regression analysis was used to identify variables associated with Z-scores of bone age and BHI.

resultsThe BoneXpert method was reliable in the evaluation of radiographs of 67 patients (radiographs of 2 patients were rejected because of poor image quality). Agreement between left- and right-hand radiographs (ICC = 0.838 to 0.996) and repeated measurements (ICC = 0.999 to 1.000) was good. Mean Z-scores of bone age (-0.36, P = 0.051) and BHI (-0.85, P < 0.001) were lower compared to the healthy population. Glucocorticoid use was associated with delayed bone age (0.79 standard deviation (SD), P = 0.028), and male gender was associated with a lower Z-score of BHI (0.65 SD, P = 0.021).

conclusionsBoneXpert is an easy-to-use method for assessing bone age and cBMD in patients with JIA, provided that radiographs are of reasonable quality and patients' bone age lies within the age ranges of the program. The population investigated had delayed bone maturation and lower cBMD than healthy children.

Indexed as

AdolescentAge Determination by SkeletonArthritis, JuvenileAutomationBone DensityChildChild, PreschoolEtanerceptFeasibility StudiesFemaleHumansImmunoglobulin GImmunosuppressive AgentsMaleRadiographic Image Interpretation, Computer-AssistedReceptors, Tumor Necrosis FactorEtanerceptImmunoglobulin GImmunosuppressive AgentsReceptors, Tumor Necrosis Factor

Identifiers

PMID25158602
PMCPMC4293113
OpenAlexW2153474115

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.