Journal of Clinical Oncology, Vol 11, 570-579, Copyright © 1993 by American Society of Clinical Oncology

ARTICLES

The Functional Assessment of Cancer Therapy scale: development and validation of the general measure

DF Cella, DS Tulsky, G Gray, B Sarafian, E Linn, A Bonomi, M Silberman, SB Yellen, P Winicour and J Brannon
Rush-Presbyterian-St Luke's Medical Center, Chicago, IL.

PURPOSE: We developed and validated a brief, yet sensitive, 33-item general cancer quality-of-life (QL) measure for evaluating patients receiving cancer treatment, called the Functional Assessment of Cancer Therapy (FACT) scale. METHODS AND RESULTS: The five-phase validation process involved 854 patients with cancer and 15 oncology specialists. The initial pool of 370 overlapping items for breast, lung, and colorectal cancer was generated by open-ended interview with patients experienced with the symptoms of cancer and oncology professionals. Using preselected criteria, items were reduced to a 38-item general version. Factor and scaling analyses of these 38 items on 545 patients with mixed cancer diagnoses resulted in the 28-item FACT-general (FACT- G, version 2). In addition to a total score, this version produces subscale scores for physical, functional, social, and emotional well- being, as well as satisfaction with the treatment relationship. Coefficients of reliability and validity were uniformly high. The scale's ability to discriminate patients on the basis of stage of disease, performance status rating (PSR), and hospitalization status supports its sensitivity. It has also demonstrated sensitivity to change over time. Finally, the validity of measuring separate areas, or dimensions, of QL was supported by the differential responsiveness of subscales when applied to groups known to differ along the dimensions of physical, functional, social, and emotional well-being. CONCLUSION: The FACT-G meets or exceeds all requirements for use in oncology clinical trials, including ease of administration, brevity, reliability, validity, and responsiveness to clinical change. Selecting it for a clinical trial adds the capability to assess the relative weight of various aspects of QL from the patient's perspective.
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				D. Khuntia, P. Brown, J. Li, and M. P. Mehta Whole-Brain Radiotherapy in the Management of Brain Metastasis J. Clin. Oncol., March 10, 2006; 24(8): 1295 - 1304. [Abstract] [Full Text] [PDF]

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				H. Ishikawa, T. Saeki, T. Otani, T. Suzuki, K. Shimozuma, H. Nishino, S. Fukuda, and K. Morimoto Aged Garlic Extract Prevents a Decline of NK Cell Number and Activity in Patients with Advanced Cancer J. Nutr., March 1, 2006; 136(3): 816S - 820S. [Abstract] [Full Text] [PDF]

				S. Burdette-Radoux and H. B. Muss Adjuvant chemotherapy in the elderly: whom to treat, what regimen? Oncologist, March 1, 2006; 11(3): 234 - 242. [Abstract] [Full Text] [PDF]

				D. Dubois, R. Dhawan, H. van de Velde, D. Esseltine, S. Gupta, M. Viala, and C. de la Loge Descriptive and Prognostic Value of Patient-Reported Outcomes: The Bortezomib Experience in Relapsed and Refractory Multiple Myeloma J. Clin. Oncol., February 20, 2006; 24(6): 976 - 982. [Abstract] [Full Text] [PDF]

				J. L. Steel, D. T. Eton, D. Cella, M. C. Olek, and B. I. Carr Clinically meaningful changes in health-related quality of life in patients diagnosed with hepatobiliary carcinoma Ann. Onc., February 1, 2006; 17(2): 304 - 312. [Abstract] [Full Text] [PDF]

				K. E. Steinhauser, C. I. Voils, E. C. Clipp, H. B. Bosworth, N. A. Christakis, and J. A. Tulsky "Are You at Peace?": One Item to Probe Spiritual Concerns at the End of Life Arch Intern Med, January 9, 2006; 166(1): 101 - 105. [Abstract] [Full Text] [PDF]

				M. A. Socinski, A. Ivanova, K. Bakri, J. Wall, M. Q. Baggstrom, T. A. Hensing, A. Mears, M. Tynan, J. Beaumont, A. H. Peterman, et al. A randomized phase II trial comparing every 3-weeks carboplatin/paclitaxel with every 3-weeks carboplatin and weekly paclitaxel in advanced non-small cell lung cancer Ann. Onc., January 1, 2006; 17(1): 104 - 109. [Abstract] [Full Text] [PDF]

				M. A. Lieberman and B. A. Goldstein Self-help On-line: An Outcome Evaluation of Breast Cancer Bulletin Boards J Health Psychol, December 1, 2005; 10(6): 855 - 862. [Abstract] [PDF]

				E. E.W. Cohen, M. A. Kane, M. A. List, B. E. Brockstein, B. Mehrotra, D. Huo, A. M. Mauer, C. Pierce, A. Dekker, and E. E. Vokes Phase II Trial of Gefitinib 250 mg Daily in Patients with Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck Clin. Cancer Res., December 1, 2005; 11(23): 8418 - 8424. [Abstract] [Full Text] [PDF]

				H. G. M. Fan, N. Houede-Tchen, Q.-L. Yi, I. Chemerynsky, F. P. Downie, K. Sabate, and I. F. Tannock Fatigue, Menopausal Symptoms, and Cognitive Function in Women After Adjuvant Chemotherapy for Breast Cancer: 1- and 2-Year Follow-Up of a Prospective Controlled Study J. Clin. Oncol., November 1, 2005; 23(31): 8025 - 8032. [Abstract] [Full Text] [PDF]

				E. S. Costanzo, S. K. Lutgendorf, S. L. Bradley, S. L. Rose, and B. Anderson Cancer Attributions, Distress, and Health Practices Among Gynecologic Cancer Survivors Psychosom Med, November 1, 2005; 67(6): 972 - 980. [Abstract] [Full Text] [PDF]

				A. Shafqat, L. H. Einhorn, N. Hanna, G. W. Sledge, A. Hanna, B. E. Juliar, P. Monahan, and S. Bhatia Screening studies for fatigue and laboratory correlates in cancer patients undergoing treatment{dagger} Ann. Onc., September 1, 2005; 16(9): 1545 - 1550. [Abstract] [Full Text] [PDF]

				L. Wenzel, H. Q. Huang, B. J. Monk, P. G. Rose, and D. Cella Quality-of-Life Comparisons in a Randomized Trial of Interval Secondary Cytoreduction in Advanced Ovarian Carcinoma: A Gynecologic Oncology Group Study J. Clin. Oncol., August 20, 2005; 23(24): 5605 - 5612. [Abstract] [Full Text] [PDF]

				R. S. Herbst, M. Arquette, D. M. Shin, K. Dicke, E. E. Vokes, N. Azarnia, W. K. Hong, and M. S. Kies Phase II Multicenter Study of the Epidermal Growth Factor Receptor Antibody Cetuximab and Cisplatin for Recurrent and Refractory Squamous Cell Carcinoma of the Head and Neck J. Clin. Oncol., August 20, 2005; 23(24): 5578 - 5587. [Abstract] [Full Text] [PDF]

				Y.-B. Cheung, C. Goh, J. Thumboo, K.-S. Khoo, and J. Wee Variability and Sample Size Requirements of Quality-of-Life Measures: A Randomized Study of Three Major Questionnaires J. Clin. Oncol., August 1, 2005; 23(22): 4936 - 4944. [Abstract] [Full Text] [PDF]

				B. J. Monk, H. Q. Huang, D. Cella, and H. J. Long III Quality of Life Outcomes From a Randomized Phase III Trial of Cisplatin With or Without Topotecan in Advanced Carcinoma of the Cervix: A Gynecologic Oncology Group Study J. Clin. Oncol., July 20, 2005; 23(21): 4617 - 4625. [Abstract] [Full Text] [PDF]