Reference values for digital X-ray radiogrammetry parameters in children and adolescents in comparison to estimates in patients with distal radius fractures.

The first objective of this study was to determine normative digital X-ray radiogrammetry (DXR) values, based on original digital images, in a pediatric population (aged 6-18 years). The second aim was to compare these reference data with patients suffering from distal radius fractures, whereas both cohorts originated from the same geographical region and were evaluated using the same technical parameters as well as inclusion and exclusion criteria. DXR-BMD and DXR-MCI of the metacarpal bones II-IV were assessed on standardized digital hand radiographs, without printing or scanning procedures. DXR parameters were estimated separately by gender and among six age groups; values in the fracture group were compared to age- and gender-matched normative data using Student's t tests and Z scores. In the reference cohort (150 boys, 138 girls), gender differences were found in bone mineral density (DXR-BMD), with higher values for girls from 11 to 14 years and for boys from 15 to 18 years (p < 0.05). Girls had higher normative metacarpal index (DXR-MCI) values than boys, with significant differences at 11-14 years (p < 0.05). In the case-control investigation, the fracture group (95 boys, 69 girls) presented lower DXR-BMD at 15-18 years in boys and 13-16 years in girls vs. the reference cohort (p < 0.05); DXR-MCI was lower at 11-18 years in boys and 11-16 years in girls (p < 0.05). Mean Z scores in the fracture group for DXR-BMD were -0.42 (boys) and -0.46 (girls), and for DXR-MCI were -0.51 (boys) and -0.53 (girls). These findings indicate that the fully digital DXR technique can be accurately applied in pediatric populations ≥ 6 years of age. The lower DXR-BMD and DXR-MCI values in the fracture group suggest promising early identification of individuals with increased fracture risk, without the need for additional radiation exposure, enabling the initiation of prevention strategies to possibly reduce the incidence of osteoporosis later in life.

The position effect in a Rasch-homogenous test: A fixed-links modeling approach.

The position effect describes the influence of just-completed items in a psychological scale on subsequent items. This effect has been repeatedly reported for psychometric reasoning scales and is assumed to reflect implicit learning during testing. One way to identify the position effect is fixed-links modeling. With this approach, two latent variables are derived from the test items. Factor loadings of one latent variable are fixed to 1 for all items to represent ability-related variance. Factor loadings on the second latent variable increase from the first to the last item describing the position effect. Previous studies using fixed-links modeling on the position effect investigated reasoning scales constructed in accordance with classical test theory (e.g., Raven’s Progressive Matrices) but, to the best of our knowledge, no Rasch-scaled tests. These tests, however, meet stronger requirements on item homogeneity. In the present study, therefore, we will analyze data from 239 participants who have completed the Rasch-scaled Viennese Matrices Test (VMT). Applying a fixed-links modeling approach, we will test whether a position effect can be depicted as a latent variable and separated from a latent variable representing basic reasoning ability. The results have implications for the assumption of homogeneity in Rasch-homogeneous tests.