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NFBlSI-18 NCCN/FACT Bladder Symptom Index For patients with Bladder cancer; A FACT/NCCN-Bladder Symptom Index LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The NCCN-FACT Bladder Symptom Index-18 (NFBlSI-18) assesses the symptoms perceived as most important by bladder cancer patients and oncology clinical experts. A total of 31 individuals with advanced bladder cancer rated the importance of 28 symptoms. In addition, 10 oncology clinical experts rated symptoms as treatment- or disease-related. Patient-rated symptoms were reconciled with published clinicians’ symptom priorities, producing the NFBlSI-18. Participants completed measure and performance status to examine initial validity. Reliability revealed good internal consistency for the NFBlSI-18 (α = 0.83) and the measure The was significantly associated with QOL criteria and performance status in the expected direction. It is a valid, brief measure of the most important symptoms of advanced bladder cancer. MEASURE NAME: NCCN/FACT Bladder Symptom Index (NCCN/FACT FBlSI-18) VERSION: 2 NUMBER OF ITEMS: 18 PATIENT POPULATION: Bladder cancer patients 18 years and older RECALL PERIOD: Past 7 days RESPONSE SCALE: 5 point Likert-type scale DATA COLLECTION: Paper and electronic ADMINISTRATION: Self-administration and interview when applicable SUBSCALE DOMAINS: Disease-Related Symptoms – Physical, Disease-Related Symptoms – Emotional, Treatment Side-Effects, Function/Well-Being TIME FOR COMPLETION: 5-10 minutes SCORING: Manual scoring template, some items are reverse scored. Subscale scores and total scores possible. RELATED MEASURES: FBlSI , FACT-Bl , FACT-Bl-Cys DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the NFBlSI-18 can be obtained by registering for permission. Users are not permitted to translate the NFBlSI-18 without permission from FACIT.org. Permission from FACIT.org to translate the NFBlSI-18 may also be contingent upon timeline expectations and availability of FACIT staff. Translations must undergo a rigorous methodology under the guidance of FACIT.org which includes multiple translators, QA steps and cognitive interviews with patients. For commercial use, FACITtrans is the approved translation vendor to translate the FACIT measurement system. Please contact us for more information. VIEW AVAILABLE LANGUAGES Language Availability Licensing Licensing Licensing fees are assessed on a per trial/per measure basis for commercial use. There is no fee for use of the English version, but a license should be obtained. Non-commercial use is assessed on a case-by-case basis. Licensing fees are typically not applied to investigator-initiated research, students, or clinical use. To license an available version of this measure for commercial or non-commercial use, please complete our registration form . All of the information provided in the form will be kept strictly confidential. For questions, please contact us . LICENSE THIS MEASURE Selected References Selected References Cella, D., Paul, D., Yount, S., Winn, R., Chang, C-H, Banik, D., & Weeks, J. What are the most important symptom targets when treating advanced cancer? A survey of providers in the National Comprehensive Cancer Network (NCCN). Cancer Investigation 2003; 21(4): 526-535. doi: 10.108/CNV-120022366. Cella, D., Rosenbloom, S., Beaumont, J., Yount, J., Paul, D., Hampton, D., Abernethy, A., Jacobsen, P., Syrjala, K., & Von Roenn, J. Development and validation of 11 symptom indexes to evaluate response to chemotherapy for advanced cancer. Journal of the National Comprehensive Cancer Network ; 2011; 9(3): 268-278. doi: 10.6004/jnccn.2011.0026. Jensen S.E., Beaumont J.L., Jacobsen P.B., Abernathy A., Syrjala K., Cella D. Measuring priority symptoms in advanced bladder cancer: development and initial validation of a brief symptom index. Journal of Supportive Oncology 2013; 11(2): 86-93. Bonomi, A.E., Cella, D.D., Hahn, E.A., Bjordal, K., Sperner, B., Gangeri, L., Bergman, B., Willems, J., Hanquet, P., & Zittoun, R. Multilingual translation of the Functional Assessment of Cancer Therapy (FACT) quality of life measurement system. Quality of Life Research 1996; 5: 309-320. Degboe A., Ivanescu C., Rohay J.M., Turner R.R., Cella D. Validity and performance of the Functional Assessment of Cancer Therapy-Bladder (FACT-Bl) among advanced urothelial cancer patients. Supportive Care in Cancer 2019. Eremenco, S., Arnold, B., Cella, D. A comprehensive method for the translation and cross-cultural validation of health status questionnaires. Evaluation & the Health Professions 2005; 28(2): 212-232. Webster K., Cella D., Yost K. The Functional Assessment of Chronic Illness Therapy (FACIT) measurement system: Properties applications, and interpretation. Health and Quality of Life Outcomes 2003; 1(1): 79-85. Yost K.J., Eton D.T. Combining distribution- and anchor-based approaches to determine minimally important differences: The FACIT experience. Evaluation & the Health Professions 2005; 28(2): 172-191. LICENSE THIS MEASURE Related Measures Related Measures FBlSI Functional Assessment of Cancer Therapy Bladder Cancer Symptom Index - 7 Item Version LEARN MORE FACT-Bl Functional Assessment of Cancer Therapy – Bladder LEARN MORE FACT-Bl-Cys Functional Assessment of Cancer Therapy – Bladder – Cystectomy LEARN MORE

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FACT-O Functional Assessment of Cancer Therapy – Ovarian For patients with Ovarian cancer LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The Functional Assessment of Cancer Therapy – Ovarian (FACT-O) provides a reliable and valid assessment of the quality of life of women with ovarian cancer, and is appropriate as a brief quality of life assessment in clinical trials and descriptive studies. It was initially validated with 232 ovarian cancer patients attending an outpatient gynecologic oncology clinic, who completed the measure at baseline. The patients’ FACT-O scores were then compared with their performance status, disease stage, treatment status, and other factors hypothesized to be related to quality of life. Patients received a second measure either one week after baseline to assess the instrument’s test-retest reliability and/or two months after baseline to evaluate its sensitivity to change in performance status. Overall, the subscales correlated with other measures as expected; all correlations were in the hypothesized direction. Patients with advanced disease, poor performance status, and who were receiving active treatment had lower scores on physical, functional, and ovarian cancer-specific scales. The total FACT-O and emotional well-being scores were lower for patients with poor performance status and patients in active treatment. The FACT-O total and all subscale scores except emotional well-being were sensitive to decreases in performance status. MEASURE NAME: Functional Assessment of Cancer Therapy – Ovarian (FACT-O) VERSION: 4 NUMBER OF ITEMS: 39 PATIENT POPULATION: Ovarian cancer patients 18 years and older RECALL PERIOD: Past 7 days RESPONSE SCALE: 5 point Likert-type scale DATA COLLECTION: Paper and electronic ADMINISTRATION: Self-administration and interview when applicable SUBSCALE DOMAINS: Physical Well-Being, Social/Family Well-Being, Emotional Well-Being, Functional Well-Being, Ovarian Cancer Subscale TIME FOR COMPLETION: 10-15 minutes SCORING: Manual scoring template, some items are reverse scored. Subscale scores, total scores and TOI scores possible. SAS/SPSS algorithms available. RELATED MEASURES: FOSI , NFOSI-18 , FACT-Cx DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACT-O can be obtained by registering for permission. Users are not permitted to translate the FACT-O without permission from FACIT.org. Permission from FACIT.org to translate the FACT-O may also be contingent upon timeline expectations and availability of FACIT staff. Translations must undergo a rigorous methodology under the guidance of FACIT.org which includes multiple translators, QA steps and cognitive interviews with patients. For commercial use, FACITtrans is the approved translation vendor to translate the FACIT measurement system. Please contact us for more information. VIEW AVAILABLE LANGUAGES Language Availability Licensing Licensing Licensing fees are assessed on a per trial/per measure basis for commercial use. There is no fee for use of the English version, but a license should be obtained. Non-commercial use is assessed on a case-by-case basis. Licensing fees are typically not applied to investigator-initiated research, students, or clinical use. To license an available version of this measure for commercial or non-commercial use, please complete our registration form . All of the information provided in the form will be kept strictly confidential. For questions, please contact us . LICENSE THIS MEASURE Selected References Selected References Basen-Engquist, K., Bodurka-Bevers D., Fitzgerald M., Webster K., Cella D., Hu S., & Gershenson D. Reliability and Validity of the Functional Assessment of Cancer Therapy-Ovarian. The Journal of Clinical Oncology 2001; 19(6): 1809-1817. doi: 10.1200/jco.2001.19.6.1809. Bonomi, A.E., Cella, D.D., Hahn, E.A., Bjordal, K., Sperner, B., Gangeri, L., Bergman, B., Willems, J., Hanquet, P., & Zittoun, R. Multilingual translation of the Functional Assessment of Cancer Therapy (FACT) quality of life measurement system. Quality of Life Research 1996; 5: 309-320. Eremenco, S., Arnold, B., Cella, D. A comprehensive method for the translation and cross-cultural validation of health status questionnaires. Evaluation & the Health Professions 2005; 28(2): 212-232. Webster K., Cella D., Yost K. The Functional Assessment of Chronic Illness Therapy (FACIT) measurement system: Properties applications, and interpretation. Health and Quality of Life Outcomes 2003; 1(1): 79-85. Yost K.J., Eton D.T. Combining distribution- and anchor-based approaches to determine minimally important differences: The FACIT experience. Evaluation & the Health Professions 2005; 28(2): 172-191. LICENSE THIS MEASURE Related Measures Related Measures FOSI Functional Assessment of Cancer Therapy Ovarian Cancer Symptom Index - 8 Item Version LEARN MORE NFOSI-18 National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Ovarian Cancer Symptom Index - 18 Item Version LEARN MORE FACT-Cx Functional Assessment of Cancer Therapy – Cervix LEARN MORE

View all available languages for this measure. BACK FACT-Br Languages Afrikaans Chinese - Simplified Chinese - Traditional Czech Danish Dutch French German Hebrew Hindi Italian Japanese Kannada Malayalam Norwegian Polish Portuguese Russian Spanish Swedish Thai

OMWQ Oral Mucositis Weekly Questionniare A weekly measure for patients with oral mucositis LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Originally developed by Amgen in conjunction with clinical studies in support of palifermin, the OMWQ is a reliable, valid, and responsive patient-reported measure of oral mucositis severity. While multiple variants of the OMDQ/OMWQ have been published, the version licensed by FACIT.org is the official, final version developed by Amgen. MEASURE NAME: Oral Mucositis Weekly Questionniare (OMWQ) VERSION: 2 NUMBER OF ITEMS: 8 PATIENT POPULATION: Oral mucositis patients 18 years and older RECALL PERIOD: Past week RESPONSE SCALE: Various DATA COLLECTION: Paper and electronic ADMINISTRATION: Self-administration and interview when applicable SUBSCALE DOMAINS: Not available TIME FOR COMPLETION: Not available SCORING: Manual scoring template RELATED MEASURES: OMDQ , FACT-HN , NFHNSI-22 DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the OMWQ can be obtained when licensing the measure. Users are not permitted to translate the OMWQ without prior permission from FACIT.org. Permission may also be contingent upon timeline expectations and availability of FACIT staff. Translations must undergo a rigorous methodology under the guidance of FACIT.org which includes multiple translators and cognitive interviews with patients. For commercial use, FACITtrans is the approved translation vendor of the OMWQ. Please contact us for more information. VIEW AVAILABLE LANGUAGES Language Availability Licensing Licensing Licensing fees are assessed on a per trial/per measure basis for commercial use. There is no fee for use of the English version, but a license should be obtained. Non-commercial use is assessed on a case-by-case basis. Licensing fees are typically not applied to investigator-initiated research, students, or clinical use. To license an available version of this measure for commercial or non-commercial use, please complete our registration form . All of the information provided in the form will be kept strictly confidential. For questions, please contact us . LICENSE THIS MEASURE Selected References Selected References Stiff PJ, Erder H, Bensinger WI, Emmanouilides C, Gentile T, Isitt J, Lu ZJ, Spielberger R. Reliability and validity of a patient self-administered daily questionnaire to assess impact of oral mucositis (OM) on pain and daily functioning in patients undergoing autologous hematopoietic stem cell transplantation (HSCT). Bone Marrow Transplant. 2006 Feb;37(4):393-401. doi: 10.1038/sj.bmt.1705250. PMID: 16415901. LICENSE THIS MEASURE Related Measures Related Measures OMDQ Oral Mucositis Daily Questionnaire LEARN MORE FACT-HN Functional Assessment of Cancer Therapy – Head and Neck LEARN MORE NFHNSI-22 National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Head & Neck Cancer Symptom Index - 22 Item Version LEARN MORE

View all available languages for this measure. BACK NFBlSI-18 Languages Afrikaans Arabic Bengali Bulgarian Chinese - Simplified Chinese - Traditional Croatian Czech Danish Dutch English Estonian Finnish French German Greek Gujarati Hebrew Hindi Hungarian Italian Japanese Kannada Korean Latvian Lithuanian Malayalam Marathi Norwegian Polish Portuguese Punjabi Romanian Russian Serbian Sesotho Slovak Slovene Spanish Swedish Tamil Telugu Thai Turkish Xhosa Zulu

peds FAACT Pediatric Functional Assessment of Anorexia/Cachexia Treatment LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the peds FAACT measure: MEASURE NAME: Pediatric Functional Assessment of Anorexia/Cachexia Treatment (peds FAACT) VERSION: 1 NUMBER OF ITEMS: Child - 37 items Parent of child - 37 items Adolescent - 40 items Parent of adolescent - 40 items PATIENT POPULATION: Pediatric cancer patients 7-18 years old experiencing anorexia/cachexia RECALL PERIOD: Past 7 days RESPONSE SCALE: 5 point Likert-type scale DATA COLLECTION: Paper and electronic ADMINISTRATION: Self-administration and interview when applicable SUBSCALE DOMAINS: Physical Well-Being, Emotional Well-Being & Illness Experience, Social and Family Well-Being, Anorexia/cachexia subscale TIME FOR COMPLETION: 10-15 minutes SCORING: None RELATED MEASURES: FAACT , peds FACIT-F , peds FACT-Br DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the peds FAACT can be obtained by registering for permission. Users are not permitted to translate the peds FAACT without permission from FACIT.org. Permission from FACIT.org to translate the peds FAACT may also be contingent upon timeline expectations and availability of FACIT staff. Translations must undergo a rigorous methodology under the guidance of FACIT.org which includes multiple translators, QA steps and cognitive interviews with patients. For commercial use, FACITtrans is the approved translation vendor to translate the FACIT measurement system. Please contact us for more information. VIEW AVAILABLE LANGUAGES Language Availability Licensing Licensing Licensing fees are assessed on a per trial/per measure basis for commercial use. There is no fee for use of the English version, but a license should be obtained. Non-commercial use is assessed on a case-by-case basis. Licensing fees are typically not applied to investigator-initiated research, students, or clinical use. To license an available version of this measure for commercial or non-commercial use, please complete our registration form . All of the information provided in the form will be kept strictly confidential. For questions, please contact us . LICENSE THIS MEASURE Selected References Selected References Bonomi, A.E., Cella, D.D., Hahn, E.A., Bjordal, K., Sperner, B., Gangeri, L., Bergman, B., Willems, J., Hanquet, P., & Zittoun, R. Multilingual translation of the Functional Assessment of Cancer Therapy (FACT) quality of life measurement system. Quality of Life Research 1996; 5: 309-320. Eremenco, S., Arnold, B., Cella, D. A comprehensive method for the translation and cross-cultural validation of health status questionnaires. Evaluation & the Health Professions 2005; 28(2): 212-232. Webster K., Cella D., Yost K. The Functional Assessment of Chronic Illness Therapy (FACIT) measurement system: Properties applications, and interpretation. Health and Quality of Life Outcomes 2003; 1(1): 79-85. Yost K.J., Eton D.T. Combining distribution- and anchor-based approaches to determine minimally important differences: The FACIT experience. Evaluation & the Health Professions 2005; 28(2): 172-191. LICENSE THIS MEASURE Related Measures Related Measures FAACT Functional Assessment of Anorexia/Cachexia Treatment LEARN MORE peds FACIT-F Pediatric Functional Assessment of Chronic Illness Therapy – Fatigue LEARN MORE peds FACT-Br Pediatric Functional Assessment of Cancer Therapy – Brain LEARN MORE

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