title: Cross-cultural adaptation and validation of the Chinese version of Toronto Extremity Salvage Score for patients with extremity sarcoma.
abstract: OBJECTIVE
  As a widely used instrument for patients with extremity sarcoma, the Toronto Extremity Salvage Score (TESS) has never been cross-culturally adapted for Chinese population. The objective of our study was to investigate the comprehensibility, reliability and validity of the Chinese version of TESS for use in patients with extremity sarcoma.
  
  
  METHODS
  A consensus version of the Chinese TESS was developed under the review of a committee according to international guidelines. 64 patients were recruited to complete the Chinese TESS, the Musculoskeletal Tumor Society (MSTS) Rating Scale, and the Quality of Life Questionnaire Core 30 (QLQ-C30). Reliability was assessed using the intra-class correlation coefficient (ICC) and Cronbach's α. Validity was assessed with Pearson's correlation between the similar domains of the two questionnaires.
  
  
  RESULTS
  The ICCs for the test-retest reliability was 0.932 for the upper extremity questionnaire and 0.893 for lower extremity questionnaire, respectively. The Cronbach's α was 0.953 for the lower extremity questionnaire and 0.921 for the upper extremity questionnaire, respectively. Convergent validity of the TESS based on Pearson correlation coefficients indicated significantly moderate to high correlations between the TESS and the MSTS as well as the QLQ-C30, with r ranging from 0.535 to 0.782.
  
  
  CONCLUSIONS
  The Chinese TESS is a comprehensible, reliable, and valid instrument that can be utilized for future cross-cultural international studies of extremity sarcoma.
authors.affiliation: Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008 China.
authors.forename: Leilei
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008 China.
authors.forename: Minghui
authors.initials: M
authors.lastname: Sun
authors.affiliation: Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008 China.
authors.forename: Weixiang
authors.initials: W
authors.lastname: Sun
authors.affiliation: Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008 China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Qin
authors.affiliation: Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008 China.
authors.forename: Zezhang
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008 China.
authors.forename: Shoufeng
authors.initials: S
authors.lastname: Wang
keywords: Chinese; Extremity sarcoma; Function; TESS