Simplified Chinese Version of the Spinal Instability Neoplastic Score in Evaluating Patients with Spinal Metastatic Tumor: A Cross-Cultural Adaptation and Validation
Abstract Background: The Spinal Instability Neoplastic Score (SINS) in simplified Chinese has not been developed so far. This study aimed to translate the SINS into simplified Chinese, adapt it cross-culturally and to validate its psychometric properties in measuring spinal instability in patients with spinal metastatic tumors in the Chinese mainland. Methods: The original version of SINS (in English) was translated and cross-culturally adapted into simplified Chinese according to the internationally recognized guidelines. Internal consistency was evaluated with Cronbach’s alpha. Test-retest reliability was examined among the patients with a 4-week interval. The validity of the Chinese version of SINS (SC-SINS) was assessed by examining its relationship with Kostuik classification. In addition, floor and ceiling effects were considered present if more than 15% of respondents achieved the lowest or highest possible total score. Principal component analysis was conducted to confirm the factor structure of each subscale.Results: No major problems occurred in the forward and back translations of SINS. The internal consistency of SC-SINS was excellent (Cronbach’s a =0.857, ranging from 0.68 to 0.85). Test-retest reliability was also excellent with a value of 0.89, ranging from 0.86 to 0.95. Validity analyses indicated that the SC-SINS was positively and significantly correlated with Kostuik classification. All items showed principal component coefficients of over 0.4. No floor or ceiling effects was found in the SC-SINS.Conclusion: The results indicate that the SC-SINS is reliable and valid in measuring the spinal stability in patients with spinal metastatic tumor.