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Confidence, consent and chaperones for pubertal staging examinations: a national survey
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    Is self assessment the way forward in general paediatric clinics?
    • Justin G Daniels, Consultant Paediatrician and Deputy CMO Barking, Havering and Redbridge University Hospitals NHS Trust

    Pubertal staging is rarely needed in a general paediatric clinic and I wonder if there is a way to avoid the difficult issues in examining older children and young people.
    I think the issues around chaperones are complex, as a male doctor, male patients often do not want a female nurse as a chaperone and on the whole peri-pubertal girls do not want to be examined at all by a male doctor.
    My strategy, when needed, is therefore to ask older children and young people to let me know what they think their pubertal stage is - testicular size can be self-assessed using a standard orchidometer, all other changes can be described with reference to standard drawings from a growth chart.
    I realise this is not evidence based practice but wonder if there is the possibility of a trial to compare paediatrician-assessed as opposed to self-assessed staging in non-specialist clinics?

    Conflict of Interest:
    None declared.