Evidence mapPaperPMID 42250021Full record

SynthesisJournal of patient-reported outcomes2026

Critical appraisal of patient-reported and clinician-reported outcome measures assessing functional outcomes in lower extremity bone sarcoma patients-a COSMIN-based systematic review.

Kiki J Blom, Leonie G Tigelaar, Willem P Bekkering, Jos A M Bramer, Hendrik W B Schreuder, Sherron Furtado, Emanuela Palmerini, Nathalie Gaspar, Sandra J Strauss, Michiel A J Van de Sande and 4 more

Abstract readSystematic Review
In one paragraph

Synthesis in Journal of patient-reported outcomes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Kiki J Blom *Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID http://orcid.org/0000-0001-7115-6879
Leonie G Tigelaar *Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID http://orcid.org/0009-0002-1276-7009
Willem P BekkeringPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Jos A M BramerPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Hendrik W B SchreuderPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Sherron FurtadoRoyal National Orthopaedic Hospital (RNOH) NHS Trust, Stanmore, UK.ORCID http://orcid.org/0000-0002-9635-1571
Emanuela PalmeriniOsteoncology, Bone and Soft Tissue Tumors and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.ORCID http://orcid.org/0000-0003-3406-6705
Nathalie GasparDepartment of Oncology for Child and Adolescent, Gustave Roussy Cancer Campus, Villejuif, France.ORCID http://orcid.org/0000-0002-1827-8903
Sandra J StraussDepartment of Oncology, University College London Cancer Institute, London, UK.ORCID http://orcid.org/0000-0001-8328-0260
Michiel A J Van de SandePrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID http://orcid.org/0000-0002-9156-7656
Heleen Maurice-StamPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID http://orcid.org/0000-0002-2055-3230
Johannes H M MerksPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID http://orcid.org/0000-0001-7659-1028
Lianne M HavemanPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands. l.m.haveman-3@prinsesmaximacentrum.nl.ORCID http://orcid.org/0000-0001-8519-8906
FOSTER consortium and the EuroEwing Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLocal therapy for bone sarcoma often significantly impacts patients' physical abilities and participation in daily life, which underscores the need for accurate assessment of these outcomes to guide optimal care. This study aims to 1) evaluate the measurement properties of eight patient- and clinician-reported outcome measures identified in a recent systematic review (2024) as being used more than once in this population, and 2) recommend the most suitable instruments for evaluation in clinic and research.

methodsWe searched MEDLINE and Embase in July 2024 for studies assessing the development and/or measurement properties of the original version of the Baeck equestionnaire, Functional Mobility Assessment, Karnofsky Performance Status, Mankin score, MusculoSkeletal Tumor Society 1987 and 1993-Lower extremity (LE)scores, Reintegration to Normal Living (RNL) Index and Toronto Extremity Salvage Score (TESS) - LE. Full text availability was required. Measurement instruments were evaluated using COSMIN guidelines (July 2024 - January 2025).

resultsSeventy-three articles evaluating measurement properties of one of the eight instruments were included. The Baecke questionnaire, RNL Index and TESS-LE had clearly defined constructs of which only the RNL Index and TESS-LE demonstrated sufficient overall content validity (low- and moderate-quality evidence). The remaining instruments lacked clear construct definitions, resulting in indeterminate or insufficient content validity, and therefore cannot be recommended for use. Structural validity of the TESS-LE was inconsistent leading to indeterminate internal consistency, currently preventing its recommendation. Additionally, the evidence supporting sufficient measurement properties of the RNL Index was too limited to justify its use.

conclusionA clearly defined construct is the cornerstone of a measurement instrument and was lacking in most cases. The TESS-LE and RNL Index show promise due to their sufficient content validity, but require further refinement before they can be recommended as standard instruments to assess physical abilities and participation in daily life in bone sarcoma patients. Advancing measurement of these outcomes requires comprehensive validation and refinement of existing instruments to overcome their current limitations, or the development of new, reliable, and valid instruments tailored to this population. REGISTRATION: Study protocol registration in the PROSPERO database:CRD42022353668.

Indexed as

Bone NeoplasmsLower ExtremityPatient Reported Outcome MeasuresSarcomaActivities of Daily LivingHumansQuality of LifeSurveys and QuestionnairesBone tissueCOSMINDisability and healthFunctional statusHealth careInternational classification of functioningMeasurement propertiesNeoplasmsOutcome assessment

Identifiers

PMID42250021
PMCPMC13469031

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.