Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada.
Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.
J Clin Endocrinol Metab. 2020 Aug 1;105(8). doi: 10.1210/clinem/dgaa135.
Clinicians, researchers, and global health advocates often include pubertal development in outcomes. However, assessments of pubertal stage can be challenging because of the sensitive nature and feasibility of clinical examinations, especially in larger settings.
To determine the accuracy of self-assessed Tanner staging when compared with physically assessed Tanner stages by a clinician.
MEDLINE, PubMed, Embase, Web of Science, Scopus, the Cochrane Library, CINAHL.
Studies were included if they reported 5 × 5 tables of self-assessment compared to clinician-assessment for the 5-stage Tanner scale.
We extracted data to generate complete 5 × 5 tables for each study, including any subgroup eligible for the analysis, such as overweight/obese youth.
After screening, 22 studies representing 21,801 participants met our inclusion criteria for the meta-analysis. Overall agreement was moderate or substantial between the 2 assessments, with breast stage 1, female pubic hair 1, male pubic hair 1, and male pubic hair 5 having the highest agreement. When stages were collapsed into pre- (Tanner stage 1), in (stages 2,3), and completing (stages 4,5) puberty, levels of agreement improved, especially for pre- and completing pubertal development. Most included studies comprised Caucasian youth. More studies are needed which include a broader range of geographic and socioeconomic settings, as well as a greater diversity of racial/ethnic groups.
Self-assessment of puberty is most accurate when identifying Tanner stage 1, Tanner stage 5 and when development is categorized into prepuberty, in, and completing puberty phases. Use of self-assessment data should be structured accordingly.
PROSPERO # CRD42018100205.
临床医生、研究人员和全球卫生倡导者经常将青春期发育纳入结果评估中。然而，由于临床检查的敏感性和可行性，青春期发育评估可能具有挑战性，尤其是在较大的环境中。
确定自我评估的 Tanner 分期与临床医生进行的体格评估的 Tanner 分期相比的准确性。
MEDLINE、PubMed、Embase、Web of Science、Scopus、Cochrane 图书馆、CINAHL。
如果研究报告了自我评估与临床医生评估的 5 级 Tanner 量表的 5×5 表格，则将其纳入研究。
我们提取数据为每个研究生成完整的 5×5 表格，包括任何符合分析条件的亚组，如超重/肥胖的青少年。
筛选后，有 22 项研究代表 21801 名参与者符合我们的荟萃分析纳入标准。两种评估之间的总体一致性为中度或高度一致，乳房 1 期、女性阴毛 1 期、男性阴毛 1 期和男性阴毛 5 期的一致性最高。当阶段合并为青春期前（Tanner 1 期）、青春期（2、3 期）和青春期完成（4、5 期）时，一致性水平提高，特别是青春期前和青春期完成发育。大多数纳入的研究都包括白种人青少年。需要更多的研究，包括更广泛的地理和社会经济环境，以及更多的种族/族裔群体。
自我评估青春期发育在识别 Tanner 1 期、Tanner 5 期以及将发育分为青春期前、青春期和青春期完成阶段时最准确。应相应地使用自我评估数据。
PROSPERO # CRD42018100205。
