Studies of Physical Disability. Reliability of Measurement of Skeletal Age From Hand Films12

This study developed out of the observation that children with osteochondritis are often retarded in skeletal age (7). It was necessary to determine the reliability of our readings of skeletal age in order to study the relation of skeletal maturity to the course of this disease. The analysis deals with within-judge and between-judge reliability. The literature on reliability has been increasing in recent years. Procedures have varied, sometimes a judge being retested (4, 5, 6) or two judges comparing their readings (3), and there are divergent opinions as to the reliability of such readings (2). In our own medical setting, clinicians frequently asked others to read hand films for skeletal age. This presented an opportunity to examine the stability of agreement rather than to accept the readings unquestioningly. Our study was intended to be comparable to a clinical situation wherein a number of judges with different backgrounds employed somewhat different methods of reading hand films.