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Yin M, Sun Z, Ding X, Wang T, Sun Y, Li L, Gao X, Ma J, Huang Q, Xiao J, Mo W. Cross-cultural adaptation and validation of simplified Chinese version of the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ) 2.0 with its assessment in clinical setting. Spine J 2022; 22:2024-2032. [PMID: 36031097 DOI: 10.1016/j.spinee.2022.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/17/2022] [Accepted: 08/18/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The treatment of spinal metastases (SM) has been significantly improved in recent years, which gives health-related quality of life (HRQOL) further significance in management of SM. The Spine Oncology Study Group Outcomes Questionnaire version 2.0 (SOSGOQ 2.0) was a specific targeted SM HRQOL criterion that was previously reported to pose good reliability and validity. However, there is no culturally adapted, reliable, and validated version of SOSGOQ 2.0 in mainland China. PURPOSE The current study aimed to translate the SOSGOQ 2.0 in a cross-cultural fashion, before evaluating the reliability and validity of the adapted simplified Chinese version of (SC-SOSGOQ 2.0) for patients with spinal metastases (SM). STUDY DESIGN/SETTING Translation, cross-cultural adaptation, and validation were performed on the Chinese version of the SOSGOQ 2.0. PATIENT SAMPLE Patients who were diagnosed with metastatic spinal disease, posing at least 6-years experience of education and the ability to read and speak Chinese. OUTCOME MEASURES Reliability and Validity of the SC-SOSGOQ 2.0 were measured to assess HRQOL in patients with SM. METHODS The cross-cultural adaptation of the SOSGOQ 2.0 was conducted following international guidelines. The reliability and validity of the SC-SOSGOQ 2.0 was assessed in a multi-center, prospective observational study. The test-retest reliability was assessed by comparing the results of the first and final SC-SOSGOQ 2.0 scales, with 2 weeks apart. The discriminative, concurrent, and construct validity of the cross-culturally adapted questionnaire was individually evaluated. The relationship among the SC-SOSGOQ 2.0, SC-EQ-5D-5L and SC-SF-36 was assessed using the correlation coefficients. RESULTS One hundred and twenty patients were included in this study. No floor or ceiling effects were observed for the SC-SOSGOQ 2.0. The Cronbach's α for domains of neurological function, pain, mental health, social function, and post-therapy were 0.825, 0.876, 0.896, 0.897, 0.943, and 0.835, respectively. The value of inter-class correlation coefficient ranged from 0.55 to 0.83, which reflected a satisfactory test-retest reliability. Concurrent assessment of criterion validity demonstrated a moderate-to-strong correlation in all domains of SC-SOSGOQ 2.0 with the SC-EQ-5D-5L (0.34-0.74) and SC-SF-36 (0.33-0.76). The best-correlated domain was physical function (0.741 in the EQ-5D-5L and 0.722 in the SF-36). CONCLUSIONS The SC-SOSGOQ 2.0 demonstrated an excellent acceptability, score distribution, internal consistency, test-retest reliability and validity. It was therefore considered as a tool effective for evaluating HRQOL of Chinese patients with SM.
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Affiliation(s)
- Mengchen Yin
- Department of Orthopedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Orthopedics Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
| | - Zhengwang Sun
- Department of Musculoskeletal Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Xing Ding
- Department of Orthopedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tao Wang
- Department of Orthopedics, The Second Hospital of Anhui Medical University, Anhui, China
| | - Yueli Sun
- Department of Orthopedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lin Li
- Department of Orthopedics Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xin Gao
- Department of Orthopedics Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Junming Ma
- Department of Orthopedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Quan Huang
- Department of Orthopedics Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Jianru Xiao
- Department of Orthopedics Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Wen Mo
- Department of Orthopedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Chen J, Wu C, Hong H, Wang X, Zhang J, Xue P, Jiang J, Wang D, Cui Z. Simplified Chinese Version of the Spinal Instability Neoplastic Score in Evaluating Patients with Metastatic Spinal Tumor: A Cross-Cultural Adaptation and Validation. Orthop Surg 2022; 14:1630-1637. [PMID: 35715948 PMCID: PMC9363738 DOI: 10.1111/os.13363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 05/12/2022] [Accepted: 05/20/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To translate the original English version of the Spinal Instability Neoplastic Score (SINS) into simplified Chinese, adapt it cross‐culturally, validate its psychometric properties in measuring spinal instability in patients with metastatic spinal tumors in the Chinese mainland, examine the reliability and validity to demonstrate its accuracy and applicability in clinical practice. Methods Patients diagnosed with metastatic spinal disease between January 2016 and January 2020 were recruited. The number of participants was advised to be at least 50 for appropriate analysis of reliability, construct validity, as well as ceiling or floor effects, and recruitment of 100 patients was advised for internal consistency analysis. The study was conducted in two phases: first, the SINS was translated into simplified Chinese; second, the factor structure, internal consistency, test–retest reliability, validity, and floor and ceiling effects of the SC‐SINS were assessed. The internationally recognized cross‐cultural adaptation guidelines were followed. Internal consistency was evaluated with Cronbach's alpha. Test–retest reliability was examined among the patients with a 4‐week interval. The validity of the Chinese version of SINS (SC‐SINS) was assessed by examining its relationship with Kostuik classification. Principal component analysis was conducted to confirm the factor structure of each subscale. Results A total of 160 participants (88 males and 72 females) were enrolled. No major difficulties occurred in the forward and backward translations of SINS. The internal consistency of SC‐SINS was excellent (Cronbach's α =0.857, ranging from 0.68 to 0.85). Test–retest reliability was also excellent with a value of 0.89, ranging from 0.86 to 0.95. Validity analyses indicated that the SC‐SINS was positively and significantly correlated with Kostuik classification. The correlation between “Posterolateral Involvement of Spinal Elements” and “1‐2 Partial Damage” was the highest with a correlation value of 0.792. The correlation between “Pain” and “1–2 Partial Damage” was the lowest with a value of 0.341. All items showed principal component coefficients greater than 0.4. The values of Factor 1 ranged from 0.523 to 0.681; Factor 2 ranged from 0.591 to 0.731; Factor 3 ranged from 0.613 to 0.754; Factor 4 ranged from 0.461 to 0.711; Factor 5 ranged from 0.513 to 0.701; and Factor 6 ranged from 0.501 to 0.668. In addition, neither floor nor ceiling effects were seen in the SC‐SINS. Conclusion The SC‐SINS demonstrated high internal consistency and test–retest reliability, which has been proven valid and reliable to measure spinal stability in patients from the Chinese mainland with metastatic spinal tumor.
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Affiliation(s)
- Jiajia Chen
- Department of Spine Surgery, Affiliated Hospital 2 of Nantong University, Nantong University, Nantong, Jiangsu, China
| | - Chunshuai Wu
- Department of Spine Surgery, Affiliated Hospital 2 of Nantong University, Nantong University, Nantong, Jiangsu, China
| | - Hongxiang Hong
- Department of Spine Surgery, Affiliated Hospital 2 of Nantong University, Nantong University, Nantong, Jiangsu, China
| | - Xiangyu Wang
- Department of Spine Surgery, Affiliated Hospital 2 of Nantong University, Nantong University, Nantong, Jiangsu, China
| | - Jinlong Zhang
- Department of Spine Surgery, Affiliated Hospital 2 of Nantong University, Nantong University, Nantong, Jiangsu, China
| | - Pengfei Xue
- Department of Spine Surgery, Affiliated Hospital 2 of Nantong University, Nantong University, Nantong, Jiangsu, China
| | - Jiawei Jiang
- Department of Spine Surgery, Affiliated Hospital 2 of Nantong University, Nantong University, Nantong, Jiangsu, China
| | - Dan Wang
- Department of Orthopedic, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhiming Cui
- Department of Spine Surgery, Affiliated Hospital 2 of Nantong University, Nantong University, Nantong, Jiangsu, China
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Yao XC, Shi XJ, Xu ZY, Tan J, Wei YZ, Qi L, Zhou ZH, Du XR. Preliminary establishment of a spinal stability scoring system for multiple myeloma. World J Clin Cases 2021; 9:9023-9037. [PMID: 34786385 PMCID: PMC8567514 DOI: 10.12998/wjcc.v9.i30.9023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/26/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Multiple myeloma is an incurable malignant plasma cell disorder that represents the most common primary malignant bone tumor. It commonly involves bone metastasis in multiple vertebral bodies, and the Spinal Instability Neoplastic Score scoring system may not be fully applicable to multiple myeloma (MM) patients.
AIM To evaluate the spinal stability of patients with MM spinal involvement to guide their clinical treatment.
METHODS By using the Delphi method, we collected and extracted information through a series of questionnaires and improved it via feedback. We also preliminarily established a spinal stability scoring system for multiple myeloma.
RESULTS Fifteen clinicians completed a second round of questionnaires and compared their answers with those of the first round of questionnaires to identify significant comments or changes that required group discussions. As a result, no further feedback was used to improve the scoring system. After integrating the information from the expert consultation questionnaire, we established the initial scoring system for MM spine stability and used the scoring system to assess a series of representative clinical cases. The MM spinal stability scoring system was created by calculating the scores of the six separate components: location, pain, number of segments, physiological curvature, comorbidities, and neurological function. The minimum value was “0”, and the maximum value was “24”. A score of “0–10” indicated “spine stability”, a score of “11–17” indicated “potential instability”, and a score of “18–24” indicated “spine instability”. Patients with a score of “11–24” need an intervention such as surgery.
CONCLUSION The initial establishment of the MM spine stability scoring system provides a vital theoretical basis for the evaluation of spine stability in individuals with MM.
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Affiliation(s)
- Xing-Chen Yao
- Department of Orthopedic, Beijing Chaoyang Hospital, Beijing 100020, China
| | - Xiang-Jun Shi
- Department of Hematology, Beijing Chaoyang Hospital, Beijing 100020, China
| | - Zi-Yu Xu
- Department of Orthopedic, Beijing Chaoyang Hospital, Beijing 100020, China
| | - Jie Tan
- Department of Hematology, Beijing Chaoyang Hospital, Beijing 100020, China
| | - Yan-Zhe Wei
- Department of Orthopedic, Beijing Chaoyang Hospital, Beijing 100020, China
| | - Lei Qi
- Department of Orthopedic, Beijing Chaoyang Hospital, Beijing 100020, China
| | - Zi-Hao Zhou
- Department of Orthopedic, Beijing Chaoyang Hospital, Beijing 100020, China
| | - Xin-Ru Du
- Department of Orthopedic, Beijing Chaoyang Hospital, Beijing 100020, China
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Chen G, Zhang B, Tao L, Chen Z, Sun C. The diagnostic accuracy of CT-based "Banner cloud sign" for dural ossification in patients with thoracic ossification of the ligamentum flavum: a prospective, blinded, diagnostic accuracy study protocol. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1606. [PMID: 33437805 PMCID: PMC7791266 DOI: 10.21037/atm-20-5439] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Ossification of the ligamentum flavum (OLF) is the most common cause of thoracic spinal stenosis, which responds poorly to conservative treatment. Thus, surgery is the only effective treatment for OLF. The existence of dural ossification (DO) makes surgery challenging and increases the risk of intra-/post-operative complications. To date, several methods have been proposed to identify DO, but either the diagnostic accuracy is low or the feasibility is poor. Therefore, the aim of this study was to propose a new imaging sign (Banner cloud sign, BCs), evaluate the accuracy of BCs in the diagnosis of DO, and provide reliable evidence-based data for its application in clinical practice. Methods A prospective, blinded, diagnostic accuracy study will be conducted to assess and compare the accuracy of BCs in the diagnosis of DO with other radiological signs [Tram track sign (TTs) and Comma sign (Cs)]. A total of 120 patients diagnosed with OLF who underwent decompression at the Peking University Third Hospital between January 2018 and June 2019 will be enrolled. Patients' medical records and imaging data will be retrieved from the hospital database server. An observational group consisting of six spine surgeons (with different seniority levels) and two epidemiological researchers will read the patients' images to identify typical imaging signs and determine the presence of DO. Surgical records will be reviewed to confirm the presence of DO, and the results will serve as the reference standard for estimating accuracy. The primary outcome of the study is to determine the accuracy of BCs for DO diagnosis, and the secondary outcome is to compare the sensitivity, specificity, area under the receiver operating characteristic (ROC) curve and inter-observer reliability of each imaging sign. The time taken and level of confidence in DO diagnosis of each observer will also be compared. Discussion This study represents the first large-scale investigation of the diagnostic value of BCs, TTs and Cs in the diagnosis of DO, and will provide convincing evidence about their clinical application. Trial registration Registered on 29 February 2020. Trial number is ChiCTR2000030380.
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Affiliation(s)
- Guanghui Chen
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
| | - Baoliang Zhang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Zhongqiang Chen
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
| | - Chuiguo Sun
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
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