ArticleAsian Pacific journal of cancer prevention : APJCP2026
Translation and Validation of the Neurologic Assessment in Neuro-Oncology Scale into Indonesian (NANO-Ina).
Article in Asian Pacific journal of cancer prevention : APJCP, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveAssessment of treatment efficacy in neuro-oncology is measured by radiographic criteria. This can be misleading, as imaging findings may not translate into clinical benefit. The NANO scale, constructed by multidisciplinary experts, is an objective and measurable metric of neurological function that can be evaluated during routine examinations in brain tumor patients, so that patients receive an overall assessment of progression, along with radiological findings. This study aims to determine the validity and reliability of the Indonesian version of the NANO scale (NANO-Ina).
methodsThe study was performed at Cipto Mangunkusumo National Referral Hospital, Jakarta. The validity and reliability process incorporated forward and backward translation to ensure cross-cultural equivalence, and an initial trial was conducted with 10 physicians to identify potential issues and refine item clarity. Subsequently, the 9 domains of the NANO-INA version were tested on 30 pathologically confirmed brain tumor patients by 2 distinct physicians separately. Inter-rater reliability was analyzed using the Kappa statistics.
resultA total of 30 subjects were enrolled from January to August 2023, which included subjects mostly diagnosed with brain metastasis (30%), and the rest were equally distributed among meningioma, glioblastoma, and other primary brain tumors (23.3%). Among these, the majority had not received any treatment (77%), and the remaining were on chemoradiation (10%), chemotherapy (10%), and radiation (3.3%). Our inter-observer variability study demonstrated that the NANO-INA scale exhibits substantial to almost perfect agreement (kappa statistic ranging from 0.629-0.935) for all domains (p<0.05), with the highest agreement observed in strength, facial strength, and language.
conclusionThe NANO-INA scale shows a high level of inter-observer agreement and serves as a reliable tool for assessing neurological function in patients with brain tumors in clinical settings in Indonesia.
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