PIO COMPONENTS
POPULATION (P)	Adolescents and young adults in the transition to adulthood (≥16 years) undergoing forensic age assessment for legal, immigration, asylum, or criminal justice purposes.
INDEX TEST (I)	Wrist-hand skeletal maturation assessment using radiographic methods, including the Greulich-Pyle (GP) atlas method, Tanner-Whitehouse methods (TW2, TW3), automated/artificial intelligence methods (BoneXpert, deep learning, machine learning algorithms), epiphyseal fusion assessment methods, and combined or modified approaches.
OUTCOMES (O)	–primary outcomes include diagnostic accuracy metrics at specific legal age thresholds (16, 18, 21 years) considering sensitivity, specificity, positive and negative predictive values (PPV, NPV), accuracy, area under the receiver operating characteristic curve (AUC), receiver operating characteristic (ROC) curve, likelihood ratios (LR+, LR−), diagnostic odds ratio (DOR); –secondary outcomes include method accuracy measures, considering mean absolute error (MAE), mean squared error (MSE), root mean squared error (RMSE), correlation coefficients (Pearson r, Spearman ρ), concordance correlation coefficient, and limits of agreement. –tertiary outcomes include reliability measures: inter-rater reliability (intraclass correlation coefficients-ICC, and Cohen’s kappa), agreement statistics.