TY - JOUR
T1 - Self-assessed puberty is reliable in a low-income setting in rural Pakistan
AU - Campisi, Susan C.
AU - Humayun, Khadija N.
AU - Wasan, Yaqub
AU - Soofi, Sajid
AU - Islam, Muhammad
AU - Lou, Wendy
AU - Vandermorris, Ashley
AU - Söder, Olle
AU - Bhutta, Zulfiqar A.
N1 - Publisher Copyright:
© 2020 Susan C. Campisi et al., published by De Gruyter. This work is licensed under the Creative Commons Attribution 4.0 International License.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Objectives: Staging sexual maturation is an integral component of adolescent research. The Pubertal Development Scale (PDS) is commonly used as a puberty self-assessment tool because it avoids the use of images. Among the youth living in rural Pakistan, we determined the accuracy of self-reported pubertal assessments using a modified PDS compared to the 'gold standard' of physically assessed Tanner stages by a physician. Methods: The strength of agreement between self-assessed puberty using a modified PDS and the 'gold' standard of physician-assessed Tanner stages was reported using weighted kappa (κw) for girls (n = 723) of 9.0-14.9 years of age or boys (n = 662) of 10.0-15.9 years of age living in the rural District of Matiari. Results: Agreement between the gold standard and self-assessment for puberty was substantial, with a κw of 0.73 (95% confidence interval [CI]: 0.67; 0.79) for girls and a κw of 0.61 (95% CI: 0.55; 0.66) for boys. Substantial agreement was observed for both boys and girls classified as thinness but only for girls with a normal body mass index. Those who were classified as severely thin had moderate agreement. The prevalence of overestimation was 18.5% (95% CI: 15.9-21.5) for girls and 2.7% (95% CI: 1.7-4.3) for boys, while the prevalence of underestimation estimation was 8.0% (95% CI: 6.2-10.2) for girls and 29.0% (95% CI: 25.8-32.6) for boys. Conclusions: Most girls and boys assessed their pubertal development with substantial agreement with physician assessment. Girls were better able to assess their puberty, but they were more likely to overestimate. Agreement for boys was also substantial, but they were more likely to underestimate their pubertal development. In this rural Pakistan population, the PDS seems to be a promising tool for self-assessed puberty.
AB - Objectives: Staging sexual maturation is an integral component of adolescent research. The Pubertal Development Scale (PDS) is commonly used as a puberty self-assessment tool because it avoids the use of images. Among the youth living in rural Pakistan, we determined the accuracy of self-reported pubertal assessments using a modified PDS compared to the 'gold standard' of physically assessed Tanner stages by a physician. Methods: The strength of agreement between self-assessed puberty using a modified PDS and the 'gold' standard of physician-assessed Tanner stages was reported using weighted kappa (κw) for girls (n = 723) of 9.0-14.9 years of age or boys (n = 662) of 10.0-15.9 years of age living in the rural District of Matiari. Results: Agreement between the gold standard and self-assessment for puberty was substantial, with a κw of 0.73 (95% confidence interval [CI]: 0.67; 0.79) for girls and a κw of 0.61 (95% CI: 0.55; 0.66) for boys. Substantial agreement was observed for both boys and girls classified as thinness but only for girls with a normal body mass index. Those who were classified as severely thin had moderate agreement. The prevalence of overestimation was 18.5% (95% CI: 15.9-21.5) for girls and 2.7% (95% CI: 1.7-4.3) for boys, while the prevalence of underestimation estimation was 8.0% (95% CI: 6.2-10.2) for girls and 29.0% (95% CI: 25.8-32.6) for boys. Conclusions: Most girls and boys assessed their pubertal development with substantial agreement with physician assessment. Girls were better able to assess their puberty, but they were more likely to overestimate. Agreement for boys was also substantial, but they were more likely to underestimate their pubertal development. In this rural Pakistan population, the PDS seems to be a promising tool for self-assessed puberty.
KW - Puberty development scale
KW - Self-assessment
KW - Sexual maturity rating
UR - http://www.scopus.com/inward/record.url?scp=85090859551&partnerID=8YFLogxK
U2 - 10.1515/jpem-2020-0246
DO - 10.1515/jpem-2020-0246
M3 - Article
C2 - 32817583
AN - SCOPUS:85090859551
SN - 0334-018X
VL - 33
SP - 1191
EP - 1196
JO - Journal of Pediatric Endocrinology and Metabolism
JF - Journal of Pediatric Endocrinology and Metabolism
IS - 9
ER -