Reliability and Validity of a Japanese-language and Culturally Adapted Version of the Musculoskeletal Tumor Society Scoring System for the Lower Extremity

Abstract

Background The Musculoskeletal Tumor Society (MSTS) scoring system is a widely used functional evaluation tool for patients treated for musculoskeletal tumors. Although the MSTS scoring system has been validated in English and Brazilian Portuguese, a Japanese version of the MSTS scoring system has not yet been validated. Questions/purpose We sought to determine whether a Japanese-language translation of the MSTS scoring system for the lower extremity had (1) sufficient reliability and internal consistency, (2) adequate construct validity, and (3) reasonable criterion validity compared with the Toronto Extremity Salvage Score (TESS) and SF-36 using psychometric analysis. Methods The Japanese version of the MSTS scoring system was developed using accepted guidelines, which included translation of the English version of the MSTS into Japanese by five native Japanese bilingual musculoskeletal oncology surgeons and integrated into one document. One hundred patients with a diagnosis of intermediate or malignant bone or soft tissue tumors located in the lower extremity and who had undergone tumor resection with or without reconstruction or amputation participated in this study. Reliability was evaluated by test-retest analysis, and internal consistency was established by Cronbach's alpha coefficient. Construct validity was evaluated using the principal factor analysis and Akaike information criterion network. Criterion validity was evaluated by comparing the MSTS scoring system with the TESS and SF-36. Results Test-retest analysis showed a high intraclass correlation coefficient (0.92; 95% CI, 0.88-0.95), indicating high reliability of the Japanese version of the MSTS The institution of one or more of the authors (SI, KO, TY, AK) has received, during the study period, funding from the National Cancer Center Research and Development Fund (Grant 26-A-4). Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that may pose a conflict of interest with respect to the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, and all investigations were conducted in conformity with the ethical principles of research. This work was performed at the Chiba Cancer Center, The University of Tokyo Hospital, National Cancer Center Hospital, and Saitama Medical Center, Jichi Medical University. 123Clin Orthop Relat Res (2016) 474:2044-2052 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® scoring system, although a considerable ceiling effect was observed, with 23 patients (23%) given the maximum score. Cronbach's alpha coefficient was 0.87 (95% CI, 0.82-0.90), suggesting a high level of internal consistency. F...

Functional evaluation for patients with lower extremity sarcoma: application of the Chinese version of Musculoskeletal Tumor Society scoring system

“…Comparably, in our study the ICCs for test-retest analysis and inter-observer analysis were 0.93 and 0.90, which demonstrated a higher level of reliability for Chinese MSTS. Moreover, we found a high internal consistency of Chinese MSTS as indicated by Cronbach’s α value of 0.86, which was similar to with a value of 0.87 for the Japanese version and a value of 0.84 for the Brazilian version [8, 9]. For the validity analysis, we investigated the correlation between Chinese MSTS and TESS that has been previously validated in Chinese population.…”

Reliability and Validity of the Musculoskeletal Tumor Society Scoring System for the Upper Extremity in Japanese Patients

“…A scree plot was analyzed to determine the best number of constructs. The degrees of correlation among the items in the MSTS-UE were evaluated using the Akaike Information Criterion (AIC) network to examine the latent structure of the MSTS-UE construct validity; this is a graphic modeling method that assesses relationships among items [1,2,5,12,18,19]. The Categorical Data Analysis Program (The Japanese Institute of Statistical Mathematics, Tachikawa, Japan) was used to conduct crosstable analyses involving all combinations of questionnaire items and searched for the best subset and categorization of explanatory items simultaneously and then matching combinations were automatically indicated using the AIC [20].…”

“…Since then, this system has been used in many studies, and it has become a commonly used functional assessment tool [13]. Although the MSTS scoring system for the lower extremity has been translated, culturally adapted, and validated for use in Japanese patients [12], to our knowledge, the MSTS scoring system for the upper extremity (MSTS-UE) has not been validated for Japanese patients. The rationale for our study was to validate the MSTS-UE for use by others in research.…”

Assessment of physical function in children with cancer: A systematic review

“…This limitation of the KIGGS-AQ is in line with literature reporting that children tend to overestimate their moderate-to-vigorous physical activity, 50,51 a limitation worth considering given the prevalence of inactivity in paediatric cancer populations 52,53. Although further investigation of the Lan-There was, however, no robust data to support either.The MSTS, although translated and validated for Japanese and Brazilian languages,54,55 is yet to be validated in any population in its orig-inal English language version. Other commonly used measures, such as Bruininks-Oseretsky Test of Motor Proficiency, Movement Battery Assessment for Children, Timed Up and Down Stairs, Timed Up and Go, Six Minute Walk Test and ActiGraph activity monitors have been validated in other paediatric populations 27,[56][57][58][59][60].…”