Development, Validation, and Reliability of Functional
Outcome Questionnaire on Toronto Extremity Salvage
Score [TESS] to Thai Version for Patients with Bone
and Soft-Tissue Sarcoma
Phutsapong Srisawat MD, MSc1, Wittawat Ketsararat MD1, Sutipat Pairojboriboon MD1,
Puwadol Veeraphun MD1, Thipachart Punyaratabandhu MD1, Supichai Chareonvareekul MD1,
Thawee Songpatanasilp MD, PhD1, Sahachart Pipithkul MD1
Affiliation :
1 Musculoskeletal Oncology Unit, Department of Orthopedic Surgery, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
Objective : To develop and test the validity and reliability of the Thai version of the Toronto Extremity Salvage Score [TESS]
questionnaire for patients with bone and soft-tissue Sarcoma.
Materials and Methods : The Thai version of the TESS was developed by translation, back translation, and review for consensus.
Then the questionnaire’s validity and reliability was tested in 140 patients (70 upper extremities and 70 lower extremities). The
validity was tested in two aspects, by content validity and criterion validity. The content validity was done through a physician-rated
scoring for content validity index [CVI]. The criterion validity was measured by comparing with the clinical-rated Musculoskeletal
Tumor Society Score [MSTS] by Pearson’s correlation coef(cid:976)icient (r). The reliability was tested in two aspects namely internal
consistency by Cronbach’s alpha coef(cid:976)icient and external consistency by intraclass coef(cid:976)icient [ICC].
Results : TESS was translated into a Thai version and tested in Thai patients. For upper extremity TESS, the mean score was
82.15±21.9. The validity was acceptable (CVI = 0.90, r = 0.612). The reliability was high (Cronbach’s alpha = 0.975, ICC = 0.910).
Regarding lower extremity TESS, the mean score was 87.99±14.39. The validity was acceptable (CVI = 0.95, r = 0.636). The reliability
was high (Cronbach’s alpha = 0.981, ICC = 0.810).
Conclusion : The Thai version of TESS was valid and reliable to evaluate functional outcome in Thai bone and soft tissue sarcoma
patients.
Keywords : Toronto extremity salvage score [TESS], Functional outcome, Thai version, Sarcoma, Validity, Reliability
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