Validation of Indian Version of Musculoskeletal Tumor Society Score Questionnaire for Lower Extremity: A Hospital-based Cohort Study

Aims and background: Scoring systems are regarded as quantitative methods to assess the severity of a disease and its treatment modalities.The Musculoskeletal Tumor Society (MSTS) score questionnaire, which was developed in 1985 and revised in 1993 to measure the functional outcome in patients with neoplasms, still holds good.All scoring systems need validation in the native language of the people being used.Methods: Here, we have created an Indian version of the MSTS scoring system and validated the psychometric properties of the created version.All the patients who were operated on for aggressive benign and malignant bone tumors of the lower limbs were included in the study.Two independent observers who were well-versed in the Hindi language made a consensual draft.The questionnaire was administered to the patients at two different points in time, and the results were analyzed. Results:The lower extremity version demonstrated an excellent internal consistency (Cronbach's = 0.999: CI = 0.9-1.0) at day 0 and excellent reliability (Cronbach's = 0.999: CI = 0.9-1.0)except for good reliability (Cronbach's = 0.87: CI = 0.80-0.92) of gait score at day 10. Conclusion:From the above validation, we conclude that the Hindi version of the MSTS score can be easily used in place of the English in our Indian population.Clinical significance: Validation of standard studies in native languages is required in order to produce "patient-reported outcomes." The very purpose of reported outcomes fails if the interpretation of the standard score is not well understood by the reporter (patient).