Reliability of Pubertal Self Assessment Method: An Iranian Study

Objective This investigation aims to evaluate the validity of a Persian Tanner Stages Self-Assessment Questionnaire. Methods In this cross sectional study, 190 male students aged 8-16 years selected from three layers of different regions of Tehran (North, Central and South) were enrolled. A Persian questionnaire illustrated with Tanner stages of puberty (genital development and pubic hair distribution) was prepared. Children were asked to select the illustration that best described their pubertal development. Tanner status of the children was also estimated by an independent physician using physical examination. The degree of agreement between subjects’ judgments with assessments made by the rater was compared through the calculation of the weighted kappa statistic coefficient. Findings We found a substantial agreement between self-assessment of pubertal development made by the children and doctor's assessment of genital development (kappa=0.63, P<0.0001) and also the pubic hair distribution (kappa= 0.74, P<0.0001). Although a large proportion of subjects in G4 (89.2%) and G5 (85.7%) were capable of accurately or almost accurately identifying their own Tanner sexual stages, some degree of disagreement was observed in G3 Tanner stage (%46.9). Conclusion Self-assessment of puberty should be used very cautiously and may not be a substitute method for routine evaluation of pubertal state especially for early and mid pubertal groups.