Abstract
We evaluated the inter-rater agreement between self-assessed Tanner staging and clinical examination and the intra-individual agreement of self-assessed information on various puberty markers in late adolescents from the longitudinal nationwide Puberty Cohort, a sub-cohort of the Danish National Birth Cohort (DNBC). We invited 715 children from the ongoing Puberty Cohort between June 2016 and January 2017. In total, 366 children (51%) returned an add-on questionnaire identical to the questionnaire used to collect information on puberty markers, including Tanner staging, in the Puberty Cohort. Of these, 197 (54%) also participated in a clinical examination with Tanner staging. We used percentage agreement and weighted kappa statistics to evaluate the inter-rater and intra-individual agreement. Due to late entry, more than 75% of children were Tanner stage 4 or above at clinical examination. In girls, the inter-rater agreement for pubic hair and breast staging was 54% and 52%, respectively, yielding weighted kappas of fair strength. In boys, pubic hair and genital staging agreed in 55% and 33%, respectively, corresponding to weighted kappas of fair to moderate strength. Boys tended to underestimate genitalia staging consistently. The intra-individual agreement on Tanner staging was 75-77% in girls and 69% in boys, whereas the intra-individual agreement on axillary hair and acne was above 92%. Self-assessment of late stages of pubertal development may be misclassified, leading to random errors in studies of puberty timing. However, self-assessment continues to serve as an important time-and cost-saving tool in large prospective puberty cohorts.
Original language | English |
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Journal | Journal of Pediatric Endocrinology and Metabolism |
Volume | 31 |
Issue | 7 |
Pages (from-to) | 763-772 |
Number of pages | 10 |
ISSN | 0334-018X |
DOIs | |
Publication status | Published - 26 Jul 2018 |
Keywords
- Adolescent
- Body Image
- Breast/growth & development
- Child
- Female
- Follow-Up Studies
- Genitalia, Female/growth & development
- Genitalia, Male/growth & development
- Humans
- Longitudinal Studies
- Male
- Puberty
- Self-Assessment
- Sexual Maturation
- Surveys and Questionnaires