Reliability of pubertal maturation self-assessment in a school-based survey

Jaruratanasirikul, Somchit; Kreetapirom, Piyawut; Tassanakijpanich, Nattaporn; Sriplung, Hutcha

doi:10.1515/jpem-2014-0053

Cited by 18 publications

(18 citation statements)

References 23 publications

(31 reference statements)

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“…Among girls, correlations between self- and physician-assessed breast and pubic hair development were also similar to those previously reported in the US (31, 34), Hong Kong (54), and Brazil (55) whereas correlations for genital and pubic hair development among boys were somewhat lower in the current study (34, 54, 55). Boys tended to overestimate their genital development stage, while girls’ assessments were generally more highly correlated with physician reports (Table V), a pattern that has been observed in several previous studies (32, 53, 56). However, using physician assessment as the gold standard has the implicit assumption that it is without error when there is evidence that this assumption is weak (57–60).…”

Section: Discussionsupporting

confidence: 78%

Validity of Self-Assessed Sexual Maturation Against Physician Assessments and Hormone Levels

Chavarro

Watkins

Afeiche

et al. 2017

The Journal of Pediatrics

117

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Objective To compare self-report and physician assessments of sexual maturation against serum hormone markers to evaluate the hypothesis that the validity of self-assessed sexual maturation is underestimated in traditional validation studies. Study design We adapted a self-assessment instrument that 248 Mexican children and adolescents, age 8–13 years, completed. Participants were examined by a trained pediatrician and provided fasting blood samples for measurement of reproductive (testosterone, estradiol, sex hormone-binding globulin (SHBG), Inhibin B) and other hormones (C-peptide, insulin-like growth factor 1 (IGF-1), leptin, dehydroepiandrosterone sulfate (DHEA-S)) known to change during adolescence. Spearman correlations (r) were calculated among the average rank of all hormones, self-, and physician-assessed Tanner stage. The method of triads was used to assess validity of self-reports by estimating correlations between self-assessments and true, but unobservable, sexual maturation based on all available data. 95% confidence intervals (CI) were constructed using bootstrap sampling. Results Validity of self-reported genitalia staging for boys was modest (r[95%CI]=0.50[0.31–0.65]) and inferior to physician assessment (0.75[0.56–0.93]). Breast stage was well reported (0.89[0.79–0.97]) and superior to physician assessment (0.80[0.70–0.89]). Pubic hair stage reported by boys (0.91[0.79–0.99]) and girls (0.99[0.96–1.00]) were superior to physician assessment (0.79[0.57–0.97] and 0.91[0.83–0.97], respectively). Conclusion Self-assessment can be validly used in epidemiologic studies for evaluation of sexual maturation in children. Physician assessment may be necessary for accurate assessment of genitalia development in boys.

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Section: Discussionsupporting

confidence: 78%

Validity of Self-Assessed Sexual Maturation Against Physician Assessments and Hormone Levels

Chavarro

Watkins

Afeiche

et al. 2017

The Journal of Pediatrics

117

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“…First, despite the fact that data on growth and testosterone levels varied in the expected direction with Tanner scores at 12 years of age, a shortcoming is the use of a self-administered Tanner assessment tool. Though considered reliable 45,46 and necessary in the current situation because of the vulnerable nature of our sample, self-assessment never quite attains the accuracy of direct examination by trained observers. 47,48 Additional factors in this cohort such as IQ differences between groups at 12 years of age could further bias self-report measures.…”

Section: Discussionmentioning

confidence: 86%

Caregiving Disruptions Affect Growth and Pubertal Development in Early Adolescence in Institutionalized and Fostered Romanian Children: A Randomized Clinical Trial

Johnson

Tang

Almas

et al. 2018

The Journal of Pediatrics

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Objectives To determine the effects of foster care vs institutional care, as well as disruptions in the caregiving environment on physical development through early adolescence. Study design This was a randomized controlled trial of 114 institutionalized, though otherwise healthy, children from 6 orphanages and 51 never institutionalized control children living in birth families (family care group) in Bucharest, Romania. Children were followed from baseline (21 months, range 5–31) through age 12 years for caregiving disruptions and growth trajectories and through age 14 years for pubertal development. Results Children randomized to the foster care group showed greater rates of growth in height, weight, and body mass index (BMI) through age 12 years than institutionalized group. Tanner development was delayed in institutionalized group boys compared with foster care group and family care group boys at 12 but not 14 years. There were no differences in Tanner development and age of menarche among foster care group, institutionalized group, and family care group girls at ages 12 and 14 years. More disruptions in caregiving between 30 months and 12 years moderated decreases in growth rates of height in foster care group and weight in foster care group and institutionalized group across age. institutionalized group boys with ≥2 disruptions showed lower Tanner scores at age 12 vs institutionalized group and foster care group boys with <2 disruptions. foster care group girls with ≥2 disruptions had higher Tanner scores at age 14 vs foster care group girls with <2 disruptions. Age of menarche was not affected by caregiving disruptions. Conclusions For children who experienced early institutionalization, stable placement within family care is essential to ensuring the best outcomes for physical developmental. Trial registration clinicaltrials.gov: NCT00747396.

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“…44 The literature on bias in self-assessment has been inconsistent, 32,33,43 but there is some evidence that suggests that age and stage of development influence the direction of bias, with younger, less developed girls more likely to overestimate breast development and older, more developed girls more likely to underestimate breast development. 43,45,46 We observed that girls aged ≥11 years were more accurate compared with the clinical gold standard than their mothers.…”

Section: Accuracy Of Breast Development Versus Clinical Assessment Asmentioning

confidence: 80%

“…Previous studies comparing clinical and self-assessment reported agreement ranging from 0.37 to 0.91. 40,43,[45][46][47] Previous studies have shown a wide range of accuracy for self-assessed pubic hair staging, 40,45,47,48 although 2 studies that also examined mother report suggest that self-staging may be more reliable than maternal staging for pubic hair development. 33,41 We found that girls were more likely to report a higher stage of pubic hair development than their mothers.…”

Section: Maternal Versus Self-staging Of Pubic Hair Developmentmentioning

confidence: 99%

Comparison of Clinical, Maternal, and Self Pubertal Assessments: Implications for Health Studies

et al. 2016

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Reliability of pubertal maturation self-assessment in a school-based survey

Abstract: Pubertal self-assessment using line drawings with a short description can be used as a reliable method to assess pubic hair maturation in boys and girls, but can be used with less reliability to assess the breast maturation in young girls.

Cited by 18 publications

References 23 publications

Validity of Self-Assessed Sexual Maturation Against Physician Assessments and Hormone Levels

Validity of Self-Assessed Sexual Maturation Against Physician Assessments and Hormone Levels

Caregiving Disruptions Affect Growth and Pubertal Development in Early Adolescence in Institutionalized and Fostered Romanian Children: A Randomized Clinical Trial

Comparison of Clinical, Maternal, and Self Pubertal Assessments: Implications for Health Studies

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