![msts r msts r](https://i.ytimg.com/vi/kPdgocVoewo/hqdefault.jpg)
Patients were enrolled between June 2014 and September 2015 from two orthopaedic oncology clinics. Only English-speaking patients aged 18 years or above who were able to provide informed consent were approached for these studies. These studies compared physical function questionnaires in patients with lower ( ) and upper ( ) extremity bone metastases, myeloma, or lymphoma. We included data from the first 128 patients who completed a set of physical function questionnaires for two prior studies. Our institutional review board approved secondary use of prospectively collected data for the purpose of this study, and a waiver of informed consent was obtained. Secondarily, we compared MSTS domain scores and assessed agreement between the clinician and patient perceived scores. We therefore sought to evaluate if there is a difference between patient and clinician reported physical function using the MSTS score in a cohort of patients with bone metastases of the extremities. It is unclear whether the clinician derived MSTS score is representative of the patients’ perceived function. Studies in other fields have demonstrated discrepancies between patient and physician assessment of physical and mental health. The scoring system has been criticized because it was developed to be completed by a clinician, instead of measuring function as perceived by the patient however, the MSTS score is still used because of its simplicity and brevity (it consists of six items). The validity and reliability of this tool were found to be acceptable when applied to a sample of patients with malignant musculoskeletal tumors. The Musculoskeletal Tumor Society (MSTS) recognized this and developed a system-the MSTS score-to evaluate function in patients with musculoskeletal tumors. Traditionally, studies focused on oncological and surgical outcomes (e.g., survival and local recurrence), but more emphasis has been placed on measuring impairment and disability over the past decades. Treatment for bone metastatic disease is often palliative and aims to maintain function and quality of life for the remaining life span.
![msts r msts r](https://www.researchgate.net/publication/26789814/figure/fig1/AS:310088033161219@1450942156636/MSTs-and-ranks-illustrated-in-a-sequence-alignment-and-associated-distance-tree-T-A.png)
This is important for acknowledging when informing patients about the expected outcome of treatment and for understanding patients’ perceptions.
![msts r msts r](https://forum.msts.cz/data/attachments/17/17069-f5d1ef44f2912246c131fe1701c37a49.jpg)
Clinician reports overestimate function as compared to the patient perceived score. 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 ( ). The median age was 63 years (interquartile range : 55–71) and the study included 74 (58%) women. The MSTS score was also derived from clinicians’ reports in the medical record. 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.
![msts r msts r](https://i.ytimg.com/vi/P-c2OvnrD38/maxresdefault.jpg)
128 patients with bone metastasis of the lower ( ) and upper ( ) extremity completed the MSTS score. We therefore evaluated if there is a difference between patient and clinician reported function using the MSTS score. 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.