Noel PT Chan, RN, RM, MSc in Epidemiology and Biostatistics, PhD candidate in Social Medicine of the School of Public Health, The Chinese University of Hong Kong.
Reliability of pubertal self-assessment in Hong Kong Chinese children
Article first published online: 28 JUN 2008
© 2008 The Authors. Journal compilation © 2008 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 44, Issue 6, pages 353–358, June 2008
How to Cite
Chan, N. P., Sung, R. Y., Kong, A. P., Goggins, W. B., So, H. K. and Nelson, E. A. S. (2008), Reliability of pubertal self-assessment in Hong Kong Chinese children. Journal of Paediatrics and Child Health, 44: 353–358. doi: 10.1111/j.1440-1754.2008.01311.x
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Accepted for publication 27 November 2007.
- Hong Kong Chinese children;
- sexual maturation;
- Tanner pubertal line-drawing self-assessment questionnaire
Aim: To validate a Tanner stages self-assessment questionnaire using gender-specific line drawings and brief explanatory text in Chinese.
Methods: Design: A cross sectional study design. Setting: One primary and two secondary schools. Participants: 172 boys and 182 girls aged between 8 and 18 years. Main outcome measures: Students' self-assessments of pubertal maturation were compared with assessments made by a same gender rater using visual depiction physical examination. Raters' physical examinations were performed after the children had answered the self-assessment questionnaire individually and in private. Raters were blinded to the self-assessment results. Accuracy rates and weighted kappa statistic were used to evaluate the degree of agreement between children and raters.
Results: Substantial to almost perfect agreement was found between self- and rater's assessments of breast development and pubic hair growth in girls [weighted kappa 0.72 (P < 0.0001, 95% CI 0.66, 0.79) and 0.83 (P < 0.0001, 95% CI 0.78, 0.87) respectively]. Moderate to substantial agreement was found between self- and rater's assessments of male genital development and pubic hair growth [weighted kappa 0.58 (P < 0.0001, 95% CI 0.48, 0.68) and 0.80 (P < 0.0001, 95% CI 0.74, 0.86) respectively]. Most agreements between self- and rater's assessments differed by only one Tanner stage. Agreement was higher for girls than boys. Girls tended to overestimate their breast stages and boys tended to underestimate their genitalia development.
Conclusion: This study confirms that a Tanner pubertal self-assessment questionnaire with line drawings and explanatory Chinese text can reliably estimate sexual maturation status in Hong Kong Chinese children.