Comparison of physician- and self-assessed pubertal onset in Japanese children

Mayako Saito-Abe; Minaho Nishizato; Kiwako Yamamoto-Hanada; Liming Yang; Maki Fukami; Yoshiya Ito; Kenji Ihara; Atsushi Iwabuchi; Shingo Okamoto; Yasuhiro Naiki; Yukihiro Ohya; Reiko Horikawa

doi:10.3389/fped.2023.950541

Comparison of physician- and self-assessed pubertal onset in Japanese children

Front Pediatr. 2023 Mar 21:11:950541. doi: 10.3389/fped.2023.950541. eCollection 2023.

Authors

Affiliations

¹ Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, Tokyo, Japan.
² The Red Cross Hokkaido College of Nursing, Division of Clinical Medicine, Hokkaido, Japan.
³ Department of Pediatrics, Faculty of Medicine, Oita University, Oita, Japan.
⁴ Department of Pediatrics, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
⁵ Okamoto Internal Medicine and Pediatrics Clinic, Nara, Japan.
⁶ Endocrinology and Metabolism Division, National Center for Child Health and Development, Tokyo, Japan.

Abstract

Introduction: Physical examinations to assess pubertal development are challenging in large epidemiological surveys. This study aimed to assess the reliability of judgment of pubertal onset in Japanese children by the original pubertal self-assessment sheet.

Methods: A total of 144 children aged 10 or 12 years were recruited between March 2019 and September 2020 from the pediatric endocrine outpatient clinics of participating institutions. Agreement between the physician- and participantassessed pubertal onsets was determined using unweighted kappa (UK) and Gwet's agreement coefficient (AC1).

Results: The physician's assessment of pubertal onset was in slight agreement with that of the self-assessment sheet in 10-year-old boys (UK: 0.23 and AC1: 0.14), whereas the agreement between the physician's assessment and self-assessment sheet results was good and the physician's assessment was fair (UK: 0.64 and AC1: 0.94) in 12-year-old boys. The physician's assessment of pubertal onset were in good and moderate agreement with the self-assessment sheet in 10-year-old girls (UK/AC1: 0.74/0.78, respectively). In 12-year-old girls, although it showed poor agreement with UK (0.46), there was a very good agreement with AC1 (0.88).

Conclusions: Although self-assessment of breast development was in good agreement with that of the physician's assessment for determining pubertal onset in girls, large-scale epidemiological studies are difficult to conduct for adolescent boys, especially for those in the early pubertal stage.

Keywords: epidemiology; pubertal development scale; puberty onset; self-assessment; tanner stage.

Grants and funding

This study was funded and supported by the Ministry of the Environment Japan and approved by the Research Ethics Committees of the National Center for Child Development. The findings and conclusions of this article are solely the authors' responsibility and do not represent the official views of the government agency.