Assessment methods for quality of life in cancer patients: the FACIT measurement system
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INTERNATIONAL JOURNAL OF PHARMACEUTICAL MEDICINE 2000, 14:78-81
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ORIGINAL ARTICLE
Assessment methods for quality of life in cancer patients: the FACIT measurement system David Cella Center on Outcomes Research and Education, Evanston Northwestern Healthcare, 1000 Central Street, Suite 101, Evanston, IL 60201, USA
Received 4 February 2000; accepted 9 February 2000
Summary The Functional Assessment of Chronic Illness Therapy (FACIT) measurement system is a collection of 27 quality of life (QOL) scales, with several more in development, targeted at the management of chronic illnesses including cancer (FACT), human immunodeficiency virus (HIV) infection (FAHI), and multiple sclerosis (FAMS). The core FACIT scale (FACT-G) consists of a general questionnaire with 27 items related to four dimensions of health: physical, functional, social, and emotional well-being. There are also symptom- and treatment-specific scales as well as assessments for other areas of concern (e.g. spirituality and palliative care). Many of the questionnaires are available in over 30 languages. The validity, reliability, and the sensitivity to change in health status over time of the FACIT questionnaires have been well documented. Currently, the FACIT scales have been implemented in Phase II and III clinical trials and other cancer-related treatment evaluations. Future efforts in improving the FACIT measurement system include identification of items that are sensitive to specific patient populations, collection of data to establish national normative and bench mark scores, construction of a QOL item bank, and development of computerized adaptive testing programmes (CAT) to measure precisely a given concept based on ongoing responses.
Keywords: cancer, quality of life, FACIT, assessment, questionnaire development.
Introduction When evaluating outcomes of chronic disease therapy in clinical trials or in clinical practice, clinicians are concerned with three key issues: quantity of life (i.e. duration of survival), quality of life (i.e. patient well-being), and the cost of therapy. All three parameters are measurable; however, quality of life (QOL) may be measured using one of several non-equivalent metrics. The quality of life (QOL) questionnaire developed by the European Organization for Research and Treatment of Cancer (EORTC) and the Functional Assessment of Chronic Illness Therapy (FACIT) measurement system are currently the two most widely used QOL measuring tools in cancer clinical trials. The previous article in this issue by Theresa Young discusses the development process and guidelines for the EORTC questionnaires. This article focuses on the development of the Functional Assessment of Chronic Illness Therapy (FACIT) measurement system. The INTERNATIONAL JOURNAL OF PHARMACEUTICAL MEDICINE
FACIT is a collection of 27 QOL questionnaires, with others in development, targeted at the management of chronic illnesses including cancer, human immunodeficiency virus (HIV) infection, and multiple sclerosis. The term FACIT was recently introduc
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