Validity of web‐based self‐assessment of pubertal development against pediatrician assessments

IMPORTANCE: A web‐based instrument for self‐assessment of puberty could be convenient and feasible for large‐scale multicenter population‐based 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 web‐based 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.