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Clinical Orthopaedics and Related Research®

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01-09-2016 | Basic Research

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

Authors: Shintaro Iwata, MD, Kosuke Uehara, MD, Koichi Ogura, MD, Toru Akiyama, MD, Yusuke Shinoda, MD, Tsukasa Yonemoto, MD, Akira Kawai, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 9/2016

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 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. Factor analysis revealed that all items had high loading values and communalities; we identified a central role for the items “walking” and “gait” according to the Akaike information criterion network. The total MSTS score was correlated with that of the TESS (r = 0.81; 95% CI, 0.73–0.87; p < 0.001) and the physical component summary and physical functioning of the SF-36.

Conclusions

The Japanese-language translation of the MSTS scoring system for the lower extremity has sufficient reliability and reasonable validity. Nevertheless, the observation of a ceiling effect suggests poor ability of this system to discriminate from among patients who have a high level of function.

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Title: Reliability and Validity of a Japanese-language and Culturally Adapted Version of the Musculoskeletal Tumor Society Scoring System for the Lower Extremity
Authors: Shintaro Iwata, MD
Kosuke Uehara, MD
Koichi Ogura, MD
Toru Akiyama, MD
Yusuke Shinoda, MD
Tsukasa Yonemoto, MD
Akira Kawai, MD
Publication date: 01-09-2016
Publisher: Springer US
Published in: Clinical Orthopaedics and Related Research® / Issue 9/2016
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-016-4880-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Questions/purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purpose

Methods

Results

Conclusions

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