ESPE Abstracts

Introduction: Recent publications report an earlier age of onset of pubertal changes in the US and Europe. Referrals to pediatric-endocrinologist for early puberty are increasing. Precocious puberty diagnosis is often delayed, especially in boys. Improvement in pubertal assessment (age at onset of puberty) by pediatricians and general practitioners is needed to participate in the PROSPEL study and to improve management of pubertal abnormalities.

Materials and Methods: Private physicians were recruited in Bordeaux and Toulouse to participate in a training session on practical modalities for assessing pubertal stages according to Tanner's classification. Slides showed breast development and pubic hair. An orchidometer was distributed to each participant for testicular volume estimation. The post-intervention assessment included a test administered on their mobile phone via the Kahoot application and "blind" palpation of orchidometer beads. Intra-individual reproducibility was analyzed by repeatedly presenting the same orchidometer element. Inter-individual reproductibility was assessed by a double examination of a number of children.

Results: Sixty-three physicians participated in the study (35 pediatricians and 28 general practitioners), where 87.5% distinguished a prepubescent child from a pubescent with the slide test, and 80% with the blind palpation test. Intra-individual reproducibility showed a weak agreement. Inter-individual reproductibility was excellent. In the PROSPEL preliminary feasibility study, all the physicians were certified at the end of the training session. During a 4 weeks period, 2646 children (1318 girls - 1328 boys) were included, in a homogeneous age distribution. The study was carried out in 83.5% of cases.

Discussion and conclusion: Our results validate our training methodology and certification process for participating physicians in the PROSPEL study.