Evidence map›Paper›PMID 40369744›Full record

Trial reportJournal of the Chinese Medical Association : JCMA2025

Artificial intelligence algorithm improves radiologists' bone age assessment accuracy.

Tien-Yu Chang, Ting Ywan Chou, I-An Jen, Yeong-Seng Yuh

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of the Chinese Medical Association : JCMA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

4 authors.

Tien-Yu ChangDepartment of Radiology, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC.
Ting Ywan ChouDepartment of Radiology, Cardinal Tien General Hospital, Taipei, Taiwan, ROC.
I-An JenInstitute of Public Health, National Yang Ming Chiao Tung University, Hsinchu, Taiwan, ROC.
Yeong-Seng YuhDepartment of Pediatrics, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundArtificial intelligence (AI) algorithms can provide rapid and precise radiographic bone age (BA) assessment. This study assessed the effects of an AI algorithm on the BA assessment performance of radiologists, and evaluated how automation bias could affect radiologists.

methodsIn this prospective randomized crossover study, six radiologists with varying levels of experience (senior, mid-level, and junior) assessed cases from a test set of 200 standard BA radiographs. The test set was equally divided into two subsets: datasets A and B. Each radiologist assessed BA independently without AI assistance (A- B-) and with AI assistance (A+ B+). We used the mean of assessments made by two experts as the ground truth for accuracy assessment; subsequently, we calculated the mean absolute difference (MAD) between the radiologists' BA predictions and ground-truth BA and evaluated the proportion of estimates for which the MAD exceeded one year. Additionally, we compared the radiologists' performance under conditions of early AI assistance with their performance under conditions of delayed AI assistance; the radiologists were allowed to reject AI interpretations.

resultsThe overall accuracy of senior, mid-level, and junior radiologists improved significantly with AI assistance than without AI assistance (MAD: 0.74 vs 0.46 years, p < 0.001; proportion of assessments for which MAD exceeded 1 year: 24.0% vs 8.4%, p < 0.001). The proportion of improved BA predictions with AI assistance (16.8%) was significantly higher than that of less accurate predictions with AI assistance (2.3%; p < 0.001). No consistent timing effect was observed between conditions of early and delayed AI assistance. Most disagreements between radiologists and AI occurred over images for patients aged ≤8 years. Senior radiologists had more disagreements than other radiologists.

conclusionThe AI algorithm improved the BA assessment accuracy of radiologists with varying experience levels. Automation bias was prone to affect less experienced radiologists.

Indexed as

Age Determination by SkeletonAlgorithmsArtificial IntelligenceRadiologistsAdultCross-Over StudiesFemaleHumansMaleProspective StudiesAge determined by skeletonArtificial intelligenceRadiologists

Identifiers

PMID40369744
PMCPMC12637141

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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.