Assessing inter-rater reliability (IRR) of Tanner staging and orchidometer use with boys: a study from PROS.

BACKGROUND

Few studies have systematically assessed the reliability of pubertal markers; most are flawed by limited numbers of markers and ages studied.

AIM: To conduct a comprehensive examination of inter-rater reliability in the assessment of boys' sexual maturity.

SUBJECTS: 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.