title: Reliability of pubertal self-assessment in Hong Kong Chinese children.
abstract: OBJECTIVE
  To validate a Tanner stages self-assessment questionnaire using gender-specific line drawings and brief explanatory text in Chinese.
  
  
  METHODS
  
  
  
  METHODS
  A cross sectional study design.
  
  
  METHODS
  One primary and two secondary schools.
  
  
  METHODS
  172 boys and 182 girls aged between 8 and 18 years.
  
  
  METHODS
  Students' self-assessments of pubertal maturation were compared with assessments made by a same gender rater using visual depiction physical examination. Raters' physical examinations were performed after the children had answered the self-assessment questionnaire individually and in private. Raters were blinded to the self-assessment results. Accuracy rates and weighted kappa statistic were used to evaluate the degree of agreement between children and raters.
  
  
  RESULTS
  Substantial to almost perfect agreement was found between self- and rater's assessments of breast development and pubic hair growth in girls [weighted kappa 0.72 (P < 0.0001, 95% CI 0.66, 0.79) and 0.83 (P < 0.0001, 95% CI 0.78, 0.87) respectively]. Moderate to substantial agreement was found between self- and rater's assessments of male genital development and pubic hair growth [weighted kappa 0.58 (P < 0.0001, 95% CI 0.48, 0.68) and 0.80 (P < 0.0001, 95% CI 0.74, 0.86) respectively]. Most agreements between self- and rater's assessments differed by only one Tanner stage. Agreement was higher for girls than boys. Girls tended to overestimate their breast stages and boys tended to underestimate their genitalia development.
  
  
  CONCLUSIONS
  This study confirms that a Tanner pubertal self-assessment questionnaire with line drawings and explanatory Chinese text can reliably estimate sexual maturation status in Hong Kong Chinese children.
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. noelptchan@yahoo.com.hk
authors.forename: Noel P T
authors.initials: NP
authors.lastname: Chan
authors.forename: Rita Y T
authors.initials: RY
authors.lastname: Sung
authors.forename: Alice Ps
authors.initials: AP
authors.lastname: Kong
authors.forename: William B
authors.initials: WB
authors.lastname: Goggins
authors.forename: Hung K
authors.initials: HK
authors.lastname: So
authors.forename: E Anthony S
authors.initials: EA
authors.lastname: Nelson
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology*; D044466:Asian People; D001828:Body Image; D015992:Body Mass Index; D001940:Breast / Q000254:growth & development; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005836:Genitalia, Female / Q000254:growth & development; D005837:Genitalia, Male / Q000254:growth & development; D006723:Hong Kong; D006801:Humans; D008297:Male; D010808:Physical Examination; D011627:Puberty / Q000502:physiology / Q000523:psychology*; D015203:Reproducibility of Results; D012647:Self-Assessment; D012741:Sexual Maturation / Q000502:physiology; D011795:Surveys and Questionnaires