title: The Discrepancy between Patient and Clinician Reported Function in Extremity Bone Metastases.
abstract: Background. The Musculoskeletal Tumor Society (MSTS) scoring system measures function and is commonly used but criticized because it was developed to be completed by the clinician and not by the patient. We therefore evaluated if there is a difference between patient and clinician reported function using the MSTS score.Methods. 128 patients with bone metastasis of the lower (n= 100) and upper (n= 28) extremity completed the MSTS score. The MSTS score consists of six domains, scored on a 0 to 5 scale and transformed into an overall score ranging from 0 to 100% with a higher score indicating better function. The MSTS score was also derived from clinicians' reports in the medical record.Results. The median age was 63 years (interquartile range [IQR]: 55-71) and the study included 74 (58%) women. We found that the clinicians' MSTS score (median: 65, IQR: 49-83) overestimated the function as compared to the patient perceived score (median: 57, IQR: 40-70) by 8 points (p< 0.001).Conclusion. Clinician reports overestimate function as compared to the patient perceived score. This is important for acknowledging when informing patients about the expected outcome of treatment and for understanding patients' perceptions.
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Stein J
authors.identifier: 0000-0003-3939-7765
authors.initials: SJ
authors.lastname: Janssen
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Eva A J
authors.initials: EA
authors.lastname: van Rein
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Nuno Rui
authors.initials: NR
authors.lastname: Paulino Pereira
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Raskin
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Marco L
authors.initials: ML
authors.lastname: Ferrone
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Hornicek
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Santiago A
authors.initials: SA
authors.lastname: Lozano-Calderon
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Schwab