Discriminatory ability of cervical vertebral maturation stages in predicting attainment of the legal age threshold of 14 years: A pilot study using lateral cephalograms

Abstract

Purpose: In India, the age of 14 years is the legal age threshold for child labour. Therefore, in suspected instances of child labour, age assessment plays a crucial role in determining whether a violation of the law on the employment of children has occurred. The aim of this retrospective cross-sectional study was to assess the discriminatory ability of stages of cervical vertebral maturation (CVM) in predicting the legal age threshold of 14 years. Materials and Methods: Routinely taken lateral cephalograms from 408 subjects aged 10 to 18 years were evaluated retrospectively using the CVM stages described by Baccetti et al. Descriptive statistics, accuracy, sensitivity, specificity, positive and negative predictive values, and likelihood ratios were calculated for stages 2, 3, and 4 of CVM. Results: Real age increased as the CVM stage gradually increased. The results of 2 × 2 contingency tables showed that CVM stage 4 produced an accuracy of 71% and 73%, a false positive rate of 7% and 18%, and a post-test probability of 59% and 68% for boys and girls, respectively. Conclusion: Based on these findings, it can be concluded that the stages of CVM are of limited use for predicting the attainment of the legal age threshold of 14 years. Future studies should investigate whether combinations of skeletal and dental methods could achieve better accuracy and post-test probability.

Assessment of Frontal Sinus Morphology and Cervical Vertebral Maturation for Evaluation of Skeletal Maturity

“…Individuals who are illegal or have lost their legal status can be examined to estimate their chronological age using CVM. At around 15-16 years of age, the somatic pattern of cervical vertebral growth reaches its final maturation, with the greatest cervical vertebral growth rate occurring between 10 and 12 years (30,31). However, a few studies have shown that the use of a single variable, such as CVM, is unreliable in estimating age.…”

Evaluating Skeletal Maturity at Time of Surgical Correction of Pectus Excavatum Based on Medial Clavicle Epiphyseal Ossification

“…Therefore, younger patients within the stage 1 period will require further delineation by adjunctive skeletal maturation assessment methods such as the commonly employed radiographic analysis of hand-wrist ossification, 17 or less frequently commissioned radiographic evaluations of proximal humerus ossification or cone-beam CT of the cervical vertebrae. 17,[40][41][42] Furthermore, objective evaluation of success of surgery was not completed. Such objective measures, including extent of surgical correction achieved, patient satisfaction, and deformity recurrence rates, are essential to consider in the debate regarding optimal timing for SCOPE.…”