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Meta-Analysis
. 2022 Sep 16;12(1):15607.
doi: 10.1038/s41598-022-19944-5.

Validity of age estimation methods and reproducibility of bone/dental maturity indices for chronological age estimation: a systematic review and meta-analysis of validation studies

V Marconi #  1 , M Iommi #  2   3 , C Monachesi  4 , A Faragalli  2   3 , E Skrami  5   6 , R Gesuita  2   3 , L Ferrante  2   3 , F Carle  2   3   7
Affiliations
Meta-Analysis

Validity of age estimation methods and reproducibility of bone/dental maturity indices for chronological age estimation: a systematic review and meta-analysis of validation studies

V Marconi et al. Sci Rep. .

Abstract

Several approaches have been developed to estimate age, an important aspect of forensics and orthodontics, using different measures and radiological examinations. Here, through meta-analysis, we determined the validity of age estimation methods and reproducibility of bone/dental maturity indices used for age estimation. The PubMed and Google Scholar databases were searched to December 31, 2021 for human cross-sectional studies meeting pre-defined PICOS criteria that simultaneously assessed the reproducibility and validity. Meta-estimates of validity (mean error: estimated age-chronological age) and intra- and inter-observer reproducibility (Cohen's kappa, intraclass correlation coefficient) and their predictive intervals (PI) were calculated using mixed-effect models when heterogeneity was high (I2 > 50%). The literature search identified 433 studies, and 23 met the inclusion criteria. The mean error meta-estimate (mixed effects model) was 0.08 years (95% CI - 0.12; 0.29) in males and 0.09 (95% CI - 0.12; 0.30) in females. The PI of each method spanned zero; of nine reported estimation methods, Cameriere's had the smallest (- 0.82; 0.47) and Haavikko's the largest (- 7.24; 4.57) PI. The reproducibility meta-estimate (fixed effects model) was 0.98 (95% CI 0.97; 1.00) for intra- and 0.99 (95% CI 0.98; 1.00) for inter-observer agreement. All methods were valid but with different levels of precision. The intra- and inter-observer reproducibility was high and homogeneous across studies.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the search results from the databases.
Figure 2
Figure 2
Quality assessment obtained using the QUADAS-2 instrument for the 23 selected studies.
Figure 3
Figure 3
Forest plots showing the pooled mean errors of the age predictions for males (A) and females (B) by method of age estimation.
Figure 3
Figure 3
Forest plots showing the pooled mean errors of the age predictions for males (A) and females (B) by method of age estimation.
Figure 3
Figure 3
Forest plots showing the pooled mean errors of the age predictions for males (A) and females (B) by method of age estimation.
Figure 3
Figure 3
Forest plots showing the pooled mean errors of the age predictions for males (A) and females (B) by method of age estimation.
Figure 4
Figure 4
Forest plots showing the pooled inter-examiner (A) and intra-examiner (B) agreement.
See this image and copyright information in PMC

Comment in

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