title: Assessing inter-rater reliability (IRR) of Tanner staging and orchidometer use with boys: a study from PROS.
abstract: BACKGROUND
  Few studies have systematically assessed the reliability of pubertal markers; most are flawed by limited numbers of markers and ages studied.
  
  
  OBJECTIVE
  To conduct a comprehensive examination of inter-rater reliability in the assessment of boys' sexual maturity.
  
  
  METHODS
  Eight pairs of practitioners independently rated 79 consecutive boys aged 8-14 years.
  
  
  METHODS
  Two raters in each of eight practices independently rated boys aged 8-14 years, presenting for physical examinations, on key pubertal markers: pubic hair and genitalia (both on 5-point Tanner scales), testicular size (via palpation and comparison with a four-bead Prader orchidometer), and axillary hair (via a three-point scale).
  
  
  RESULTS
  Intraclass correlations assessing degree of inter-rater reliability for pubertal markers ranged from 0.61 to 0.94 (all significant at p < 0.001). Rater Kappas for signs of pubertal initiation ranged from 0.49 to 0.79.
  
  
  CONCLUSIONS
  Practitioners are able to reliably stage key markers of male puberty and identify signs of pubertal initiation.
authors: American Academy of Pediatrics, Elk Grove Village, IL 60007, USA.
authors: Eric J
authors: EJ
authors: Slora
authors: Alison B
authors: AB
authors: Bocian
authors: Marcia E
authors: ME
authors: Herman-Giddens
authors: Donna L
authors: DL
authors: Harris
authors: Steven E
authors: SE
authors: Pedlow
authors: Steven A
authors: SA
authors: Dowshen
authors: Richard C
authors: RC
authors: Wasserman
mesh_terms: D000293:Adolescent; D002648:Child; D005837:Genitalia, Male / Q000254:growth & development; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011627:Puberty; D015203:Reproducibility of Results; D012741:Sexual Maturation; D013737:Testis / Q000033:anatomy & histology