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Validation of the Brazilian Version of the Musculoskeletal Tumor Society Rating Scale for Lower Extremity Bone Sarcoma

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The Musculoskeletal Tumor Society (MSTS) rating scale is an English-language instrument used worldwide to assess functional evaluation of patients with musculoskeletal cancer. Despite its use in several studies in English-speaking countries, its validity for assessing patients in other languages is unknown. The translation and validation of widely used scales can facilitate the comparison across international patient samples.

Objectives/purposes

The objectives of this study were (1) to translate and culturally adapt the MSTS rating scale for functional evaluation in patients with lower extremity bone sarcomas to Brazilian Portuguese; (2) analyze its factor structure; and (3) test the reliability and (4) validity of this instrument.

Method

The MSTS rating scale for lower limbs was translated from English into Brazilian Portuguese. Translations were synthesized, translated back into English, and reviewed by a multidisciplinary committee for further implementation. The questionnaire was administered to 67 patients treated for malignant lower extremity bone tumors who were submitted to limb salvage surgery or amputation. They also completed a Brazilian version of the Toronto Extremity Salvage Score (TESS). Psychometric properties were analyzed including factor structure analysis, internal consistency, interobserver reliability, test-retest reliability, and construct validity (by comparing the adapted MSTS with TESS and discriminant validity).

Results

The MSTS rating scale for lower limbs was translated and culturally adapted to Brazilian Portuguese. The MSTS-BR proved to be adequate with only one latent dimension. The scale was also found to be reliable in a population that speaks Brazilian Portuguese showing good internal consistency (Cronbach’s alpha = 0.84) and reliability (test-retest reliability and interobserver agreement of 0.92 and 0.98, respectively). Validity of the Brazilian MSTS rating scale was proved by moderate with TESS and good discriminant validity.

Conclusions

The Brazilian version of the MSTS rating scale was translated and validated. It is a reliable tool to assess functional outcome in patients with lower extremity bone sarcomas. It can be used for functional evaluation of Brazilian patients and crosscultural comparisons.

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Acknowledgments

We thank Regina Mathias Baptista, Paul Woolcock, and Alexander Bizzocchi for their help in translation; Dr Ricardo Toma and Dr André Ferrari França de Camargo for their help in the interviews; and the team “Research on Research” for their help in preparing the manuscript.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil

    Daniel Cesar Seguel Rebolledo MD, Olavo Pires de Camargo MD, PhD & Andre Mathias Baptista MD, PhD

  2. Research on Research Group, Duke University Health System, Durham, NC, USA

    João Ricardo Nickenig Vissoci MD

  3. Medicine Department, Faculdade Inga, Maringá, Paraná, Brazil

    João Ricardo Nickenig Vissoci MD

  4. Department of Surgery, Research on Research Group, Duke University Medical Center, Durham, NC, USA

    Ricardo Pietrobon MD, PhD

Authors
  1. Daniel Cesar Seguel Rebolledo MD
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  2. João Ricardo Nickenig Vissoci MD
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  3. Ricardo Pietrobon MD, PhD
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  4. Olavo Pires de Camargo MD, PhD
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  5. Andre Mathias Baptista MD, PhD
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Corresponding author

Correspondence to Daniel Cesar Seguel Rebolledo MD.

Additional information

Each author certifies that he, or a member of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 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, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at Orthopaedics and Traumatology Department, University of São Paulo General Hospital, São Paulo, Brazil; and Duke University Medical Center, Durham, NC, USA.

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Rebolledo, D.C.S., Vissoci, J.R.N., Pietrobon, R. et al. Validation of the Brazilian Version of the Musculoskeletal Tumor Society Rating Scale for Lower Extremity Bone Sarcoma. Clin Orthop Relat Res 471, 4020–4026 (2013). https://doi.org/10.1007/s11999-013-3211-4

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  • DOI: https://doi.org/10.1007/s11999-013-3211-4

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