Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.
J Adolesc Health. 2011 Apr;48(4):325-30. doi: 10.1016/j.jadohealth.2010.09.020. Epub 2010 Dec 30.
Sexual maturation assessment using physical examination may no longer be feasible in some large epidemiologic surveys, such as National Health and Nutrition Examination Survey, because of the sensitivity of the examination and privacy concerns. This study tested the feasibility of a new automated audio computer-assisted self-interview (ACASI) module for children and adolescents for self-assessment of sexual maturation.
A cross-sectional feasibility study was conducted at a large urban children/adolescent clinic in Washington D.C. Self-assessed sexual maturation (Tanner stages) was reported by 234 youths (119 boys and 115 girls) aged 8-18 years by using the ACASI module. Girls assessed their breast and pubic hair development, and boys assessed their genital and pubic hair development. Self-assessments were compared with Tanner stages recorded by clinical examiners during routine well-child physical examinations conducted on the same day.
There was good/excellent agreement between boy's self-assessment and the examiner's assessment of their genital stage (weighted κ: .65, 95% confidence interval [CI]: .55-.75) and pubic hair stage (weighted κ: .78, CI: .70-.86). There was excellent agreement between girl's self-assessment and the examiner's assessment of their breast stage (weighted κ: .81, CI: .74-.87) and pubic hair stage (weighted κ: .78, CI: .71-.86).
The ACASI method is a feasible method of pubertal self-assessment for participants as young as 8 years in large epidemiologic surveys. However, additional testing is needed to determine the validity of this ACASI module.
在某些大型流行病学调查中，如国家健康和营养检查调查，由于检查的敏感性和隐私问题，使用体格检查评估性成熟可能不再可行。本研究测试了一种新的自动音频计算机辅助自我访谈（ACASI）模块用于儿童和青少年自我评估性成熟的可行性。
在华盛顿特区的一家大型城市儿童/青少年诊所进行了一项横断面可行性研究。通过使用 ACASI 模块，234 名 8-18 岁的青少年（119 名男孩和 115 名女孩）报告了自我评估的性成熟度（Tanner 分期）。女孩评估了她们的乳房和阴毛发育情况，男孩评估了他们的生殖器和阴毛发育情况。自我评估结果与当天进行的常规儿童健康体检中临床医生记录的 Tanner 分期进行了比较。
男孩的自我评估与医生评估的生殖器分期（加权κ：.65，95%置信区间 [CI]：.55-.75）和阴毛分期（加权κ：.78，CI：.70-.86）之间具有良好/极好的一致性。女孩的自我评估与医生评估的乳房分期（加权κ：.81，CI：.74-.87）和阴毛分期（加权κ：.78，CI：.71-.86）之间具有极好的一致性。
ACASI 方法是在大型流行病学调查中对年龄最小为 8 岁的参与者进行青春期自我评估的一种可行方法。然而，需要进一步的测试来确定这个 ACASI 模块的有效性。
