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Self-assessment of pubertal development in a puberty cohort

  • Andreas Ernst EMAIL logo , Lea Lykke B. Lauridsen , Nis Brix , Camilla Kjersgaard , Jørn Olsen , Erik T. Parner , Niels Clausen , Lars Henning Olsen and Cecilia H. Ramlau-Hansen
Published/Copyright: June 28, 2018
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 31 Issue 7

Abstract

Background

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).

Methods

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.

Results

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%.

Conclusions

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.

Keywords: data quality; epidemiology; puberty; Tanner stages
Corresponding author: Andreas Ernst, MD, Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark, Phone: +45 2398 6181
aAndreas Ernst and Lea Lykke B. Lauridsen share first authorship.

Acknowledgments

We kindly thank the staff at Department of Occupational Medicine, Aarhus University Hospital, for making rooms for clinical examinations available.

  1. Author contributions: A.E. drafted the article. A.E., L.L.B.L, C.H.R.H. and J.O. conceptualized and designed the study. A.E., L.L.B.L., N.B., C.K. and N.C. performed the clinical examinations. A.E. and E.T.P. analyzed the data. All authors contributed substantially to the interpretation of data, reviewed the article critically for important intellectual content, approved the final version to be published and agrees to be accountable for all aspects of the work. The present study was approved by the relevant authorities and all participants gave a written informed consent prior to enrollment.

  2. Research funding: This work was supported by the Danish Council for Independent Research (DFF 4183-00152) and the Faculty of Health at Aarhus University. The Danish National Birth Cohort was established with a significant grant from the Danish National Research Foundation. Additional support was obtained from the Danish Regional Committees; the Pharmacy Foundation; the Egmont Foundation; the March of Dimes Birth Defects Foundation; the Health Foundation; and other minor grants. The DNBC Biobank has been supported by the Novo Nordisk Foundation and the Lundbeck Foundation. Follow-up of mothers and children has been supported by the Danish Medical Research Council (SSVF 0646, 271-08-0839/06-066023, O602-01042B, 0602-02738B); the Lundbeck Foundation (195/04, R100-A9193); The Innovation Fund Denmark (0603-00294B [09-067124]); the Nordea Foundation (02-2013-2014); Aarhus Ideas (AU R9-A959-13-S804); University of Copenhagen Strategic Grant (IFSV 2012); and the Danish Council for Independent Research (DFF – 4183-00594 and DFF – 4183-00152).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organizations played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpem-2018-0178).

Received: 2018-04-17
Accepted: 2018-05-28
Published Online: 2018-06-28
Published in Print: 2018-07-26

©2018 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/jpem-2018-0178
Keywords for this article
data quality; epidemiology; puberty; Tanner stages

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Prevalence of cranial MRI findings in girls with central precocious puberty: a systematic review and meta-analysis
  4. Original Articles
  5. Can having a sibling with type 1 diabetes cause disordered eating behaviors?
  6. Wrist circumference as a novel predictor of obesity in children and adolescents: the CASPIAN-IV study
  7. Evaluation of Mn-superoxide dismutase and catalase gene expression in childhood obesity: its association with insulin resistance
  8. Impact of a group-based treatment program on adipocytokines, oxidative status, inflammatory cytokines and arterial stiffness in obese children and adolescents
  9. Clinical management of childhood hyperthyroidism with and without Down syndrome: a longitudinal study at a single center
  10. Detection of distant metastasis at the time of ablation in children with differentiated thyroid cancer: the value of pre-ablation stimulated thyroglobulin
  11. Random serum free cortisol and total cortisol measurements in pediatric septic shock
  12. Self-assessment of pubertal development in a puberty cohort
  13. Growth, the Mediterranean diet and the buying power of adolescents in Greece
  14. Clinical and molecular genetic characterization of two patients with mutations in the phosphoglucomutase 1 (PGM1) gene
  15. Genetic analysis of three families with X-linked dominant hypophosphatemic rickets
  16. Clinical heterogeneity and molecular profile of triple A syndrome: a study of seven cases
  17. No central adrenal insufficiency found in patients with Prader-Willi syndrome with an overnight metyrapone test
  18. Case Reports
  19. A novel mutation in the proopiomelanocortin (POMC) gene of a Hispanic child: metformin treatment shows a beneficial impact on the body mass index
  20. Hypertriglyceridemia thalassemia syndrome
  21. Severe consumptive hypothyroidism caused by multiple infantile hepatic haemangiomas
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