Luo Jie, Wu Di, Tian Yu, Wang Yujie, Zhang Qin, He Zongwei, Wang Hong, Liu Qin
School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.
College of Medical Informatics, Chongqing Medical University, Chongqing, China.
Front Pediatr. 2024 Jul 16;12:1380934. doi: 10.3389/fped.2024.1380934. eCollection 2024.
To date, the reliability of pubertal development self-assessment tools is questioned, and very few studies have explored the comparison between these tools in longitudinal studies. Hence, this study aimed to examine the reliability of pubertal development self-assessment using realistic color images (RCIs) and the Pubertal Development Scale (PDS) in a longitudinal cohort study.
Our longitudinal study recruited 1,429 participants (695 boys and 734 girls), aged 5.8-12.2 years old, in Chongqing, China. We conducted two surveys, 6 months apart. Tanner stages were examined by trained medical students at each visit. RCIs and PDS scores were used to self-assess puberty at each visit. Agreement between physical examination and self-assessment was determined using weighted kappa (wk), accuracy, and Kendall rank correlation.
The concordance of puberty self-assessment using RCIs at baseline and the first follow-up was almost perfect in girls and boys, wk >0.800 (< 0.001). At baseline, the concordance of genital development self-assessment using RCIs was fair in boys, wk = 0.285 ( < 0.001), and that of boys' pubic hair development self-assessment using RCIs was poor, wk = 0.311 [95% confidence interval (CI) -0.157 to 0.818]. The wk of the PDS was less than 0.300, except for breast development. The reliability and validity of the PDS in this study population were low, and the consistency of the PDS was not good.
The concordance of RCIs is better than that of the PDS. Pubertal development self-assessment using RCIs is reliable, while the reliability and validity of the PDS are unacceptable. Therefore, RCIs are recommended as a reliable pubertal development self-assessment tool to measure pubertal development for large-scale epidemiological investigations and long-term longitudinal studies in China.
迄今为止，青春期发育自我评估工具的可靠性受到质疑，并且在纵向研究中很少有研究探讨这些工具之间的比较。因此，本研究旨在通过纵向队列研究，检验使用真实彩色图像（RCI）和青春期发育量表（PDS）进行青春期发育自我评估的可靠性。
我们的纵向研究在中国重庆招募了1429名参与者（695名男孩和734名女孩），年龄在5.8至12.2岁之间。我们进行了两次调查，间隔6个月。每次访视时由经过培训的医学生检查坦纳分期。每次访视时使用RCI和PDS评分进行青春期自我评估。使用加权kappa（wk）、准确性和肯德尔等级相关性来确定体格检查与自我评估之间的一致性。
在女孩和男孩中，使用RCI进行的青春期自我评估在基线和首次随访时的一致性几乎完美，wk>0.800（<0.001）。在基线时，使用RCI进行的男孩生殖器发育自我评估的一致性为中等，wk = 0.285（<0.001），使用RCI进行的男孩阴毛发育自我评估的一致性较差，wk = 0.311[95%置信区间（CI）-0.157至0.818]。除乳房发育外，PDS的wk小于0.300。PDS在本研究人群中的可靠性和有效性较低，且PDS的一致性不佳。
RCI的一致性优于PDS。使用RCI进行青春期发育自我评估是可靠的，而PDS的可靠性和有效性不可接受。因此，建议将RCI作为一种可靠的青春期发育自我评估工具，用于中国的大规模流行病学调查和长期纵向研究。
