Methods for determining pubertal status in research studies: literature review and opinions of experts and adolescents

Abstract

In lifecourse studies that encompass the adolescent period, the assessment of pubertal status is important, but can be challenging. We aimed to identify current methods for pubertal assessment and assess their appropriateness for population-based research by combining a review of the literature with the views of experts in the field. We searched bibliographic databases, extracted data and assessed study quality to inform a workshop with 21 experts. Acceptability of different approaches was explored with a panel of ten adolescents. We screened 11,935 abstracts, assessed 157 articles and summarised results from 38 articles. Combining these with the opinions of experts, self-assessment was found to be a practical method for use in studies where agreement with the gold standard of clinical assessment by physical examination to within one Tanner stage was acceptable. Serial measures of height and foot size accurately indicated timing of the pubertal growth spurt and age at peak height velocity, and were seen as feasible within longitudinal studies. Hormonal and radiological methods did not offer a practical means of assessing pubertal status. Assessment of voice maturation was promising, but needed validation. Young people thought that self-assessment, foot size and voice assessments were acceptable, and preferred an assessor of the same sex for clinical assessment. This review thus informs researchers working in lifecourse and adolescent health, and identifies future directions in order to improve validity of the methods.

Greater Reduction in Abdominal Than in Upper Arms Subcutaneous Fat in 10- to 12-Year-Old Tennis Players: A Volumetric MRI Study

“…Nevertheless, we cannot rule out differences due to the potential influence of genetic, nutritional, or environmental factors on SATv stores (28). Another limitation is that pubertal staging may have been biased by parents assessment (52). Due to the small amount of SATv in the TPs, it was not possible to distinguish deep from superficial SATv.…”

Effects of a School-Based Physical Activity Intervention for Obesity and Health-Related Physical Fitness in Adolescents With Intellectual Disability: Protocol for a Randomized Controlled Trial

“…Research suggests that Tanner staging from a clinical assessment is the gold standard measurement of puberty status [61]. The Tanner staging system consists of 5 stages, separately designed for boys and girls, which are determined by pubic hair growth in both sexes, breast development in girls, and testicular development in boys [62]. However, this kind of assessment is challenging in school settings.…”

Relationships of sex hormones with muscle mass and muscle strength in male adolescents at different stages of puberty

“…Nonetheless, the hand grip strength is a reliable and simple surrogate of upper extremity strength, and some studies found that it correlates well with other muscle strength tests such as the knee extension strength [ 41 , 42 ]. Fourth, the clinical assessment with Tanner staging is widely recognized as the gold standard method for assessing pubertal development [ 43 ]. However, the privacy concerns make it difficult to obtain consent from the adolescents and their parents.…”