Validity of web-based self-assessment of pubertal development against pediatrician assessments

A web-based instrument for self-assessment of puberty could be convenient and feasible for large-scale multicenter population-based epidemiological studies for Tanner stages evaluation.

To validate web-based self-assessment of pubertal development against assessment by a pediatrician.

Outpatients aged 8-18 years were consecutively recruited in the endocrinology department of Beijing Children's Hospital from October 2016 to August 2017. A web-based self-assessment instrument for pubertal development was introduced to participants by an appointed pediatrician. Tanner stage of puberty was self-assessed by participants in a private environment. Participants were then examined by a senior pediatrician underwent blinded assessment. Weighted kappa and Spearman correlation analyses were conducted to evaluate agreement. The accuracy of the web-based instrument for self-assessment of pubertal onset was evaluated according to sensitivity, specificity, positive predictive value and negative predictive value.

A total of 174 participants (including 82 girls and 92 boys) were assessed consecutively. Correlation coefficients were 0.872 for pubic hair and 0.933 for testicular volume (P<0.001) among boys; a similar result was obtained for the weighted kappa value (0.825). For girls, the correlation coefficient and weighted kappa for pubic hair was 0.785 and 0.878, respectively. However, breast self-assessment had a medium level of agreement with pediatrician assessment (weighted kappa, 0.495; correlation coefficient, 0.643). Moreover, the accuracy of self-assessment in children aged 10 years or above was better than that in children aged less than 10 years.

Assessment of pubertal development using a web-based self-assessment instrument could be less accurate among children aged less than 10 years, especially for girls' breast assessment. Therefore, self-assessment of pubertal development, especially for breast development, should be interpreted cautiously.