Aim: A new method (BX AHP) for adult height prediction (AHP), based on automated bone age (BoneXpert®, here called autBA) assessment, has been developed and validated. The aim of this study was to evaluate the performance of autBA and BX AHP in comparison with manual Greulich-Pyle bone age (manBA) and Bayley-Pinneau AHP (BP AHP) in children with untreated idiopathic short stature (ISS; including familial short stature and constitutional delay of growth and puberty). Materials and Methods: We acquired the adult height of 190 patients (123 boys and 67 girls) with ISS and 448 (303 male and 135 female) X-rays of their left hand. Results: Mean adult height was 168 ± 6 cm for boys and 155 ± 7 cm for girls. The root mean square error of AHP using BP AHP was 6.35 cm for boys and 4.55 cm for girls. BX AHP using autBA achieved 4.71 cm for boys (p = 0.0013) and 3.72 cm for girls (0.04); including parent’s height improved its root mean square error to 4.46 cm (0.0001) for boys and 3.35 cm (0.02) for girls. Conclusion: The new AHP model performed significantly better than the BP AHP model. Including parental height further improved the performance of AHP.

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