Performance of a new pubertal self-assessment questionnaire: a preliminary study

We describe the performance of a new, self‐assessment questionnaire that aims to measure pubertal status by using gender‐specific line drawings of the Tanner puberty stages. The study was carried out on 103 children aged 12–16 years attending a paediatric endocrinology outpatient clinic and used physical examination by clinic doctors as the ‘gold standard’. Of 133 consecutive, eligible children, 108 (81%) agreed to participate in the study. Data were collected from 62 (60%) males and 41 (40%) females. Mean age was 14.78 years (SD = 1.26 years, range 12.08–16.98 years). For the pubic hair distribution Tanner stage, there was agreement to within one Tanner stage for 90 children (88%), weighted kappa statistic for inter‐rater agreement = 0.68 [95% CI 0.49,0.87]. For the female breast/male genitalia Tanner stage, there was agreement to within one Tanner stage for 75 children (76%), kappa = 0.48 [95% CI 0.31,0.64]. The children tended to underestimate their stage of pubertal development. Overall, the kappa statistics implied good agreement for the pubic hair question and moderate agreement for the breast/genitalia stage question in both girls and boys. The questionnaire may prove useful in situations such as large‐scale epidemiological studies, in which direct examination of children to determine pubertal status is not possible, and further validation in normal adolescents is warranted.