摘要
Importance:A web-based instrument for self-assessment of puberty could be convenient and feasible for large-scale multicenter populationbased epidemiological studies for Tanner stages evaluation.Objective:To validate web-based self-assessment of pubertal development against assessment by a pediatrician.Methods: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.Results: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.Interpretation:Assessment of pubertal development using a webbased 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.
