title: Comparison between objective assessment and  self-assessment of sexual maturation in children and  adolescents.
abstract: OBJECTIVE
  To assess the correlations between objective assessment and self-assessment of sexual maturation in the outpatient and school settings.
  
  
  METHODS
  Three hundred and nineteen individuals, 178 (96 boys and 82 girls) from an outpatient clinic and 141 (73 boys and 68 girls) from public schools (8.3-18.7 years), of whom 73 individuals (39 girls an d 34 boys) had a body mass index above the 85th percentile, according to 2000 CDC Growth Chart, were analyzed. All of them were examined sequentially and individually by two trained physicians after a written consent form was signed by parents or surrogates, and then submitted to self-assessment using pictures (Tanner stages). Kappa coefficients between examiners and the self-assessment were calculated based on the collected data. A p value <5%was established as statistically significant.
  
  
  RESULTS
  No significant difference was observed between correlations obtained from the outpatient clinic and schools, and both groups were combined for analysis. The correlations obtained by examiners were significantly higher than those from self-assessment, with a kappa coefficient (and confidence interval) of 0.75 (0.8-0.69) for breasts/genitals across examiners against 0.27 (0.34-0.20) and 0.29 (0.36-0.22) between the two examiners and the self-assessment (p < 0.0001).
  
  
  CONCLUSIONS
  In the studied sample, self-assessment of the pubertal stage should not replace the objective assessment made by trained professionals. Improvement of the self-assessment method may validate its use in population-based studies.
authors.affiliation: Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
authors.forename: Jenner C V
authors.initials: JC
authors.lastname: Azevedo
authors.forename: Lana M P
authors.initials: LM
authors.lastname: Brasil
authors.forename: Taísa B M A
authors.initials: TB
authors.lastname: Macedo
authors.forename: Lucia F C
authors.initials: LF
authors.lastname: Pedrosa
authors.forename: Ricardo F
authors.initials: RF
authors.lastname: Arrais
mesh_terms: D000293:Adolescent; D001828:Body Image; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010808:Physical Examination / Q000379:methods*; D011627:Puberty / Q000502:physiology*; D012647:Self-Assessment; D016353:Self-Examination; D012741:Sexual Maturation / Q000502:physiology*; D011795:Surveys and Questionnaires