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PubMed1991

[Transcultural validation of a measurement scale].

This monography presents the validation study results of a new scale to measure family needs: The Family Needs Inventory (IBF) (Chartier and Coutu-Wakulczyk, 1988). The scale is available in both French and English from the Departement des sciences infirmières of the Université de Sherbrooke. Based on a perceptual framework, the IBF is a self-report scale composed of 33 items. It offers three different subscores of the importance of needs: the global score of needs, the intensity need index and the total number of needs. The IBF was validated on a sample of 400 subjects. These subjects were drawn from the adult population of immediate family members visiting a patient in surgical or medical intensive care units in three different geographical regions, in Québec, northeast Ontario and France. The reliability yielded a 0.90 Cronback Alpha coefficient and the homogeneity coefficient for Spearman-Brown and Guttman procedures were 0.88 respectively. The principal component factor analysis and factorial matrices lead to examine the conceptual structure of five independent factors.

Cross-Cultural Comparison↗

PubMed1995

"Healthy Dubec" -design of a joint Czech-American community project for the reduction of cardiovascular and cerebrovascular disease (adapted from American experience).

The project is a combination of individual and community-based intervention which adapted and modified methods and techniques originally used in The Three-City Community Study and The Stanford Five-City Project in a small community outside Prague. The goal is to reduce cardiovascular and cerebrovascular risk factors by primary and secondary prevention, using a community-based approach. 61.5% of examined population with the low risk score during the baseline survey was exposed to intervention by community-based methods. 38.5% of adult population was included in intervention activities within the framework of secondary prevention in high risk groups. There are described: the method of community oriented intervention and the intervention oriented on high risk groups - nutrition intervention, quit smoking activities, stress control, physical activity promotion.

Adolescent↗

PubMed2026

Prostate Cancer, Genetic Susceptibility, and Risk of Chronic Non-Urological Complications.

BACKGROUND: Chronic nonurological complications are common among prostate cancer (PCa) survivors; however, their spectrum, magnitude, and genetic contribution remain poorly characterized. METHODS: We evaluated 15 commonly reported nonurological complications and tested their associations with exposure to PCa and disease-specific polygenic risk scores (PRS) in the UK Biobank (UKB; N = 219,133). Analyses were conducted using cause-specific Cox proportional-hazards models within a full-cohort framework with time-updated PCa status, delayed entry at study recruitment, and age as the underlying time scale. RESULTS: After recruitment, incident PCa was diagnosed in 13,780 men, of which 1,656 (12.02%) had metastatic PCa (mPCa). Risks for seven complications were higher among men with PCa, adjusting for genetic background (all p < 0.05), including osteoporosis, venous thromboembolism, depression, and four primary cancers (bladder, kidney, colorectal, and pancreatic). Risks were consistently stronger among men exposed to mPCa than non-mPCa; for example, the hazard ratio (HR) (95% confidence interval) for osteoporosis was 1.88 (1.63-2.18) for any PCa, 4.67 (3.11-7.01) for mPCa, and 1.75 (1.50-2.04) for non-mPCa. Elevated risks for three additional complications (coronary artery disease, type 2 diabetes and chronic obstructive pulmonary disease) were observed only among men with mPCa. The risks for these ten complications were further increased among men with higher disease-specific PRS; for example, the HR for osteoperosis in mPCa patients in the top PRS quartile was 13.57 (8.24-22.34) compared with men without PCa (p < 0.001). CONCLUSION: PCa diagnosis and inherited genetic susceptibility jointly contribute to increased risks of multiple chronic non-urological complications among survivors.

Humans↗

PubMed1999

A theoretical framework for environmental noise annoyance.

Noise annoyance is a phenomenon of 'mind and mood'. It is only partly determined by acoustic factors: typical noise metrics (LAeq and the like) allow only the prediction of aggregated annoyance scores (community levels) with moderate degree of precision. Many non-acoustic factors have been identified with varying degrees of association with annoyance. However, the proper identification and understanding of the role of non-acoustical factors can only be achieved on the basis of sound theories about rise and reduction of noise annoyance. This article discusses first the few systematic theories to understand the relative role of acoustic and non-acoustic factors. Then, it presents a theoretical perspective that places a major non-acoustic factor in the center: perceived control. It views noise annoyance as a form of psychological stress: disturbances may tax persons resources, and different people may use different ways of coping to deal with annoyance. The focus on perceived control also highlights that for residents exposed to environmental noise 'noise management at the source' often will be an equally important external stimulus to respond to as 'noise at the source'.

Journal Article↗

PubMed2026

Beyond exons: Linking noncoding heritability and polygenicity across complex human traits and disorders.

The genetic architecture of complex traits spans a continuum of polygenicity, yet it remains unclear how differences in polygenicity relate to the functional localization of SNP heritability across the genome. We use a MiXeR-based framework to partition heritability across 74 functional annotations covering exonic, intronic, and intergenic regions for 34 complex traits and introduce a likelihood-based annotation contribution score that quantifies annotation-specific impact on heritability. Exons account for a minority of heritability, and their contribution decreases with increasing polygenicity, from an average of 22% in less-polygenic somatic diseases and biomarkers to 13% in highly polygenic psychiatric and cognitive phenotypes. Intergenic fractions show the opposite trend, whereas intronic fractions remain relatively stable. Analysis of the broader set of functional annotations also reveals systematic differences along the polygenicity axis: highly polygenic traits show stronger contributions from comparative genomics and variant-effect scores, whereas less-polygenic traits show stronger contributions from promoter, transcription, and chromatin annotations. Together, these results indicate that the functional partitioning of heritability systematically varies with polygenicity, shifting from gene-proximal regulatory architectures to architectures shaped by numerous dispersed regulatory effects.

MiXeR↗

PubMed1999

Private self-consciousness and the five-factor model of personality: distinguishing rumination from reflection.

A distinction between ruminative and reflective types of private self-attentiveness is introduced and evaluated with respect to L. R. Goldberg's (1982) list of 1,710 English trait adjectives (Study 1), the five-factor model of personality (FFM) and A. Fenigstein, M. F. Scheier, and A. Buss's (1975) Self-Consciousness Scales (Study 2), and previously reported correlates and effects of private self-consciousness (PrSC; Studies 3 and 4). Results suggest that the PrSC scale confounds two unrelated, motivationally distinct dispositions--rumination and reflection--and that this confounding may account for the "self-absorption paradox" implicit in PrSC research findings: Higher PrSC scores are associated with more accurate and extensive self-knowledge yet higher levels of psychological distress. The potential of the FFM to provide a comprehensive framework for conceptualizing self-attentive dispositions, and to order and integrate research findings within this domain, is discussed.

Attention↗

PubMed2026

Graph-KIR: graph-based KIR copy number estimation and allele calling using short-read sequencing data.

MOTIVATION: The Killer-cell Immunoglobulin-like Receptor (KIR) is a highly polymorphic region in the human genome, associated with autoimmune diseases and organ transplantation. The sequences of KIR genes are highly similar among star alleles as well as in between individual genes, with the copy number of each KIR gene typically ranging from 0 to 4. In this study, we introduce Graph-KIR, a tool designed to estimate gene copy numbers and predict full-resolution (7-digit, encompassing both coding and non-coding sequence variations) from a whole genome sequencing (WGS) sample. RESULTS: Graph-KIR is capable of independently typing KIR alleles per sample with no reliance on the distribution of any framework gene in a cohort. In a set of 100 simulated samples, Graph-KIR demonstrated 99.2% accuracy in copy number estimation and high F1-score of allele typing: 91.79% at 7-digit resolution, 97.37% at 5-digit resolution, and 97.11% at 3-digit resolution. Graph-KIR outperforms existing tools such as Geny (96.39% F1-score), PING's WGS version (92.77% F1-score), and T1K (90.44% F1-score) at 5-digit resolution. By analyzing the results on 44 HPRC samples, Graph-KIR achieves better F1-score than Geny and PING at 7-digit resolution. The release of Graph-KIR adds another valuable tool to assist users in accurately estimating copy numbers and calling alleles of KIR genes from WGS samples. AVAILABILITY AND IMPLEMENTATION: The Graph-KIR and paper-related pipeline codes are available at https://github.com/linnil1/KIR_graph.

Receptors, KIR↗

PubMed2003

Olfactory short-term memory and related amygdala recordings in patients with temporal lobe epilepsy.

Olfactory short-term recognition memory was assessed with a delayed odour-matching task in 38 patients with unilateral temporal lobe epilepsy (TLE) and stereotactic electroencephalography (SEEG) recordings taken prior to surgical treatment. The amygdala SEEG activity associated with odorant stimulation was examined in 18 patients. Because the invasive SEEG procedure is only performed in a clinical framework, electrophysiological data obtained from these patients could not be analysed in comparison with data obtained from control subjects. Behavioural results (hits, false alarms, discrimination, bias scores) showed global impairment of odour recognition memory in patients when compared with controls. We also found lower discrimination and higher false alarm scores in left than in right TLE patients, and higher false alarm scores in male than in female patients. The hemisphere effect is discussed in terms of psychosocial trait differences between patients. Electrophysiological recordings collected from the amygdala demonstrated that odorant stimulation was associated with chemosensory evoked potentials (CSEPs). Analysis revealed that CSEPs obtained for target odorants had lower peak amplitudes and latencies than those obtained in response to sample odorants. The reduced peak amplitudes suggest a mechanism of repetition suppression--a process assumed to reflect neural activity related to high-level cognitive processes such as attention, memory and decision making. Latency modulations appear rather to be linked to early stages of information processing and may therefore reflect a facilitation process due to selective attention.

Adult↗

PubMed2026

Genetic risk stratification of common diseases in breast cancer survivors: a population-based cohort study.

IMPORTANCE: Patients diagnosed with breast cancer (BCa) are at increased risk of multiple common diseases; however, the spectrum of these diseases and the contribution of inherited genetic susceptibility remain incompletely characterized. METHODS: We evaluated 15 common diseases and tested their associations with BCa exposure and disease-specific polygenic risk scores (PRS) in the UK Biobank (UKB; N = 254,736). Analyses were performed using cause-specific Cox proportional hazards models within a full-cohort framework, with time-updated BCa status, delayed entry at study recruitment, and age as the underlying time scale. RESULTS: After recruitment, incident BCa was diagnosed in 11,386 women (4.47%), including 2,742 (24.08%) with metastatic BCa. Patients with BCa had an increased risk of nine diseases spanning cardiovascular, metabolic, and neuropsychiatric domains (P<0.003, Bonferroni-corrected). Elevated risks were generally observed among patients with both early staged and advanced BCa. Inherited susceptibility further stratified disease risk, with the highest risks observed among patients with BCa with elevated disease-specific PRS. For example, compared with women without BCa, the hazard ratio (HR; 95% CI) for osteoporosis was 2.33 (2.15-2.52) among women with any BCa, 2.38 (2.18-2.59) among those with non-metastatic BCa, and 2.12 (1.78-2.54) among those with metastatic BCa; the HR was 4.48 (3.99-5.02) among patients with BCa in the highest quartile of osteoporosis-specific PRS (all P<0.001). In contrast, BCa was not significantly associated with risk of coronary artery disease. CONCLUSION: BCa and inherited genetic susceptibility jointly contribute to increased risk of multiple common diseases, supporting the integration of genetic risk stratification into survivorship care.

Complications↗

PubMed1975

Communicative behavior in schizophrenia. The relation of adaptive styles to kinetic and linguistic aspects of interview behavior.

Recent studies of formal kinetic and linguistic aspects of communication suggest that these may be important signposts of internal processes responsible for the regulation and organization of verbal thought. If so, the formal analysis of communication patterns of patients known to have difficulty in cognitive organization (chronic schizophrenics) should reveal kinetic and linguistic characteristics consistent with their level of adaptive cognitive functioning. In the present study, 16 chronic nonparanoid schizophrenic patients were video recorded during a clinical interview, and their kinetic and linguistic behavior was analyzed according to systems developed in our laboratory. Eight of these patients were chronic, isolated patients, classified by means of a scale for measuring proneness to future hospitalization, as extremely "prone" to rehospitalization, and eight were chronic, overtly oppositional patients, classified as "nonprone" to hospitalization. Prone patients are known to exhibit a relatively impoverished form of cognitive functioning, while nonprone patients exhibit more highly differentiated cognitive functioning. The major findings of this study revealed that the isolated prone patients could be distinguished from the nonprone patients, in their communicative behavior, by an increased utilization of the most repetitive and unpatterned stimulation of body parts, as well as the most simple form of linguistic narration of experience. The oppositional nonprone patients more often utilized circumscribed, patterned, and brief kinetic stimulation of body parts, as well as a form of language construction characterized by a complex conditional (i.e., causal, deductive, or purposive) framework for the expression of thought. In addition, social and affective components of the scale measuring hospital proneness were related to our formal kinetic and linguistic scoring categories. An explanation of these findings was offered based upon the well documented relationship observed in the literature between isolation and hyperarousal in chronic schizophrenia. That is, an attempt was made to integrate these findings with the notion that the schizophrenic disorder reflects an integrative deficit which is regulated by increasing the magnitude of proprioceptive feedback (and hence, arousal) through stereotyped repetitive motor activity.

Adaptation, Psychological↗

PubMed2002

Psychological impact of fire disaster on children and their parents.

Six weeks following a major wildfire, children's psychosocial functioning was examined. Employing a multimethod assessment approach, the short-term mental health consequences of the fire were evaluated. Individual adjustment was compared between families who reported high levels of loss as a result of the fire (high-loss group) and families who reported relatively low levels of loss resulting from the fire (low-loss group). Standardized assessment procedures were employed for children and adolescents as well as their parents. In general, high-loss participants reported slightly higher levels of post-traumatic stress disorder (PTSD) symptoms and significantly higher scores on the Impact of Events Scale. PTSD symptoms reported by parents were generally significantly correlated with (but not concordant with) PTSD symptoms reported by their children. The high-loss group scored significantly higher on the Resource Loss Index than did the low-loss group. Preexisting and comorbid disorders and previous stressors are described. A methodological framework for future studies in this area is discussed.

California↗

PubMed2025

ProgModule: A novel computational framework to identify mutation driver modules for predicting cancer prognosis and immunotherapy response.

BACKGROUND: Cancer originates from dysregulated cell proliferation driven by driver gene mutations. Despite numerous algorithms developed to identify genomic mutational signatures, they often suffer from high computational complexity and limited clinical applicability. METHODS: Here, we presented ProgModule, an advanced computational framework designed to identify mutation driver modules for cancer prognosis and immunotherapy response prediction. In ProgModule, we introduced the Prognosis-Related Mutually Exclusive Mutation (PRMEM) score, which optimizes the balance between exclusive mutation coverage and the incorporation of mutation combination mechanisms critical for cancer prognosis. RESULTS: Applying to BLCA and HNSC cohorts, ProgModule successfully identified driver modules that stratify patients into distinct prognostic subgroups, and the combination of these modules could serve as an effective prognostic biomarker. Extending our method to diverse cancers, ProgModule presented robust prognostic performance and stability across model parameters, including stopping criteria and network topology. Moreover, our analysis suggested that driver modules can predict immunotherapeutic benefit more effectively than existing signatures. Further analyses based on published CRISPR data indicated that genes within these modules may serve as potential therapeutic targets. CONCLUSIONS: Altogether, ProgModule emerges as a powerful tool for identifying mutation driver modules as prognostic and immunotherapy response biomarkers, and genes within these modules may be used as potential therapeutic targets for cancer, offering new insights into precision oncology.

Humans↗

PubMed2026

Effects of different training modalities on lower-limb explosive power, acceleration, 20-m sprint performance, and change-of-direction ability in youth soccer players: a systematic review and network meta-analysis.

BACKGROUND: Youth soccer players repeatedly perform explosive actions, short accelerations, linear sprints, decelerations, and multidirectional movements. However, the comparative effects of different structured physical-conditioning programmes remain uncertain. METHODS: Seven databases were searched from inception to 3 July 2026 using a final expanded search strategy encompassing plyometric, strength or resistance, sprint, acceleration, speed, change-of-direction, neuromuscular, multicomponent, and combined training. Randomised controlled trials involving healthy youth soccer players were eligible. Intervention arms were classified using operational, content-based node definitions. Construct-restricted primary networks and expanded sensitivity networks were analysed using frequentist random-effects network meta-analysis. Hedges' adjusted g was preferentially calculated from post-intervention or final-follow-up means, standard deviations, and sample sizes. Estimates were presented so that positive values indicated better performance. P-scores were treated as descriptive ranking summaries. Risk of bias was assessed using an adapted study-level application of the five-domain RoB 2 framework, and confidence in the evidence was assessed using CINeMA. A post hoc strict-age sensitivity analysis excluded two age-boundary studies. RESULTS: Eighty-nine studies were included in the expanded quantitative analysis, of which 74 contributed to at least one construct-restricted primary network. The primary lower-limb explosive-power, acceleration, 20-m sprint, and planned change-of-direction networks included 55, 20, 25, and 38 studies, respectively. Compared with usual soccer training, plyometric training combined with sprint and/or change-of-direction training showed favourable estimates for lower-limb explosive power (SMD 0.79, 95% CI 0.55 to 1.03), acceleration (1.19, 0.90 to 1.49), 20-m sprint performance (0.80, 0.33 to 1.28), and planned change-of-direction ability (1.46, 1.13 to 1.80). Corresponding I² values were 34.6%, 21.8%, 65.0%, and 41.0%. Between-design inconsistency was detected in the 20-m sprint (P = 0.0036) and change-of-direction (P = 0.0007) networks. CINeMA confidence for these four comparisons was low, low, very low, and low, respectively. Expanded sensitivity networks showed substantially greater heterogeneity. The highest-ranked intervention differed across outcome domains but remained consistent within each outcome across the three analysis sets. Excluding the two age-boundary studies did not materially alter the principal estimates. CONCLUSIONS: Plyometric training combined with sprint and/or planned change-of-direction training produced favourable comparative estimates across the four performance outcomes. However, evidence for several nodes and active-versus-active comparisons was sparse, heterogeneity in programmes and outcomes was present, inconsistency was detected in some networks, and confidence in the evidence was low or very low. These limitations do not support a conclusion that any training category is universally superior. The findings should be interpreted as provisional category-level signals rather than definitive training prescriptions. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD420261347297, registered on 21 March 2026, https://www.crd.york.ac.uk/PROSPERO/view/CRD420261347297 .

Change-of-direction ability↗

PubMed1996

Effects of induced mood states on objective and projective dependency scores.

In two experiments involving a total of 144 participants (72 women and 72 men), we examined the effects of induced mood states on college students' scores on widely used objective and projective measures of dependency. In both experiments, induced mood states significantly influenced participants' scores on the projective dependency test but did not affect their scores on the objective dependency test. Findings are discussed in the context of previous studies comparing objective and projective dependency measures and with respect to theoretical frameworks that distinguish implicit from self-attributed dependency needs.

Adult↗

PubMed2002

Analysis of early complications after radical cystectomy: results of a collaborative care pathway.

PURPOSE: We examined our recent series of patients who underwent radical cystectomy to determine and analyze the early perioperative morbidity of the procedure in a contemporary series treated with the guidance of a clinical pathway. MATERIALS AND METHODS: We reviewed the records of 304 consecutive patients who underwent radical cystectomy from December 1995 to July 2000. We specifically evaluated complications that developed within 30 days of the procedure. Potential variables predictive of early morbidity were analyzed, including patient age, gender, race, American Society of Anesthesiologists score, type of urinary diversion, smoking history, estimated blood loss, transfusion requirement, pathological stage and operative time. RESULTS: The overall minor complication rate was 30.9% (94 of 304 patients). Postoperative ileus was the most common minor complication, affecting 54 patients (18%). Increased blood loss and major complications predicted a significantly higher likelihood of ileus on multivariate analysis (p = 0.02 and 0.001, respectively). Major complications in 15 patients (4.9%) correlated with higher American Society of Anesthesiologists score, surgical intensive care unit admission and transfusion requirement (p = 0.01, <0.001 and 0.001, respectively). The early mortality rate was 0.3% (1 patient). CONCLUSIONS: Within the framework of a clinical pathway, radical cystectomy can be performed safely with an acceptable rate of early minor and major complications. Delay in the return of bowel function is the most common minor complication. Increased estimated blood loss, transfusion requirement and a major complication predicted a higher likelihood of postoperative ileus. The acceptable rate of early morbidity in this series in a 5-year period validates its use in patients undergoing radical cystectomy.

Adult↗

PubMedDate not supplied

Designing self-report instruments for family assessment.

As family medicine research expands, more and better self-report measures for quantifying family systems variables will be required. These measures should be developed from an accepted paradigm for instrument design that includes the following. They should be: 1) grounded in a contemporary conceptual framework; 2) constructed following a rational theoretical design that includes the sequential stages of construct identification, construct definition, item generation, item editing, item formatting, and item scoring; 3) analyzed empirically at the item level for item distribution characteristics, item-scale correlation, and item-response style correlations; 4) analyzed at the scale level for scale distribution characteristics, scale-scale correlations, and scale-response style correlation; 5) revised based on editing and empirical analysis; and 6) psychometrically evaluated for reliability (eg, internal consistency, test-retest) and validity (construct related, criterion related, and content related). Normative data from various reference populations must also be obtained to provide a basis for interpreting scores. Finally, test manuals must be written to summarize test development data and provide information on administration procedures, scoring, and interpretation.

Behavior↗

PubMed2026

Multi-Omics Integration Identifies a Five-Gene Metabolic Signature With Experimental Validation in Clear Cell Renal Cell Carcinoma.

BACKGROUND: Clear cell renal cell carcinoma (ccRCC) is hallmarked by profound metabolic reprogramming; however, its intricate crosstalk with the tumor immune microenvironment (TIME) and its clinical ramifications remain inadequately elucidated. This study aims to systematically decipher the metabolic-immune interplay in ccRCC through multi-omics integration, with the goal of identifying robust prognostic biomarkers and actionable therapeutic vulnerabilities. AIMS: This study aims to systematically decipher the metabolic-immune interplay in clear cell renal cell carcinoma (ccRCC) through multi‑omics integration, and to identify robust prognostic biomarkers and actionable therapeutic vulnerabilities that can inform precision risk stratification and individualized treatment strategies. METHODS: We integrated bulk transcriptomic, genomic, and clinical data from multiple ccRCC cohorts. Differential expression and functional enrichment analyses were performed to characterize metabolic pathway alterations. Mendelian randomization (MR) was employed to infer causal relationships between metabolic disorders and ccRCC risk. A machine learning-based prognostic framework, incorporating SHAP (SHapley Additive exPlanations) for feature interpretability, was constructed and rigorously validated. TIME heterogeneity was dissected using deconvolution algorithms, while drug sensitivity, tumor mutation burden (TMB), and TIDE scores were utilized to assess therapeutic responses and immune evasion. Candidate gene function was evaluated through in vitro gain- and loss-of-function assays, with expression validated via TCGA, HPA, western blot, and qRT-PCR. RESULTS: Enrichment analysis identified coordinated dysregulation in lipid metabolism, energy homeostasis, and hypoxia response pathways. MR analysis confirmed lipid metabolism disorders as a causal risk factor for ccRCC. Our machine-learning model, centered on five core SHAP-identified features (SUCLA2, ACAT1, PC, SUCLG1, and HMGCS2), demonstrated superior predictive accuracy over conventional clinical staging. Immune profiling unveiled dichotomous TIME states: the low-risk group retained active immune surveillance, whereas the high-risk group was enriched with immunosuppressive subsets. Drug sensitivity screening pinpointed LY2109761 and carmustine as high-risk-specific candidate agents. Furthermore, TMB and TIDE analyses stratified high-risk patients displaying genomic instability and immune evasion phenotypes. Functionally, SUCLA2 knockdown significantly enhanced ccRCC cell proliferation and invasion, while its overexpression suppressed these malignant phenotypes, corroborating its tumor-suppressive role. Expression patterns of the hub genes were consistently validated across multi-level datasets and experimental assays. CONCLUSION: This study establishes a precision oncology framework for ccRCC by functionally linking metabolic biomarkers, immunophenotypes, and stratified therapeutic strategies. Importantly, we identify SUCLA2 as a potential functional tumor suppressor and a promising target for further mechanistic and translational investigation.

Humans↗

PubMed1999

Evaluating functional outcome in patients with lower extremity sarcoma.

The Short Form 36, The Toronto Extremity Salvage Score, and the 1987 and 1993 Musculoskeletal Tumor Society Rating Scales were compared as measures of functional status for patients with lower extremity sarcoma. The study included 97 patients with lower extremity sarcoma and evaluated each measure on the following measurement properties: conceptual framework; statement of the purpose; feasibility; breadth of content; depth of measurement; cross sectional and longitudinal reliability; and validity and responsiveness. The Short Form 36 represents patients' perceptions of their physical and mental health and is practical to use. However, the validity of the measure is questionable for the patients with sarcoma because the subscale structure could not be reproduced in the current data. The Toronto Extremity Salvage Score meets all standards of measurement with the exception of breadth of content as it measures only physical function. The 1987 and 1993 Musculoskeletal Tumor Society scales do not meet the standards of measurement. In choosing an outcome measure for the extremity sarcoma population, the Toronto Extremity Salvage Score has superior measurement properties when compared with the Short Form 36 or the 1987 and 1993 Musculoskeletal Tumor Society scales. The Toronto Extremity Salvage Score is a reliable and efficient measure for monitoring patients and for use in clinical trials.

Adolescent↗