Download this measure in English. BACK FACT-Cog English Downloads Download PDF Download DOC

The Functional Assessment of Chronic Illness Therapy System of Quality of Life questionnaires and all related subscales, translations, and adaptations (“FACIT System”) are owned and copyrighted by David Cella, Ph.D. The ownership and copyright of the FACIT System resides strictly with Dr. Cella. Copyright / Terms of Use Copyright The Functional Assessment of Chronic Illness Therapy System of Quality of Life questionnaires and all related subscales, translations, and adaptations (“FACIT System”) are owned and copyrighted by David Cella, Ph.D. The ownership and copyright of the FACIT System resides strictly with Dr. Cella. Dr. Cella has granted FACIT.org (We/Us) the right to license usage of the FACIT System to other parties. Terms of Use For purposes of reviewing and learning about the FACIT measurement system, users may access and download English versions of FACIT measures and items from this website. You may also request access to translated versions by registering on the site and requesting them. However, in order to use any of our measures, permission must first be obtained by registering and obtaining a license. You can research our measures here : Once you have determined which questionnaire is best for your research question or population, you will need to register in order to either request translated versions and/or request a license-for-use. Answers to other questions can be found in our FAQ section. Use of any FACIT measure without licensed permission constitutes a violation of copyright law. The following terms are applicable to all our licenses. Other terms also apply: If you receive a translation at no cost (e.g., if you represent a non-profit organization or hospital), you may not earn or enable any financial gain through the distribution, re-use, marketing, or transfer of the licensed material. You agree that the use or implementation of the FACIT system (including any resulting data) under your license will not be used in any commercial activity and will not benefit any party via any financial transaction. You may not modify any part of the FACIT System without expressed permission from FACIT.org. You may not translate any part of the FACIT System without expressed permission from FACIT.org. In any publication that references the FACIT System and on every element of the FACIT System used in data collection, any copyright information will be listed as it appears on the questionnaire itself. If the FACIT System is made available on the Internet, one of the following security measures must be implemented to ensure controlled access: (1) password-protected access: all users must be required to enter a valid, individualized password; (2) restricted link or access code: alternatively, access to the FACIT System may be granted through a special link or access code, which must be securely distributed and controlled by Licensee. We ask that you provide us with copies of any publications resulting from your study or produced as a result of collecting data with any FACIT questionnaire. Due to the ongoing and evolving nature of questionnaire development, treatment modalities, and cross-cultural linguistic research, FACIT.org reserves the right to make adaptations or revisions to wording in the FACIT System. If such changes occur while your license is in force, you will have the option to use the changed or unchanged version. FACIT.org reserves the right to withdraw any license if the licensee engages in scientific or copyright misuse of the FACIT system of questionnaires.

View all available languages for this measure. BACK FACT-GOG-NTX-4 Languages Afrikaans Arabic Bengali Bosnian Bulgarian Cebuano Chinese - Simplified Chinese - Traditional Croatian Czech Danish Dutch English Finnish French German Greek Gujarati Hebrew Hindi Hungarian Italian Japanese Kannada Korean Latvian Lithuanian Malay Malayalam Marathi Norwegian Polish Portuguese Punjabi Romanian Russian Serbian Sesotho Setswana Slovak Spanish Swedish Tagalog Tamil Telugu Thai Turkish Ukrainian Urdu Vietnamese Xhosa Zulu

PROMIS Pool v1.0 - Dyspnea Airborne Exposure Patient Reported Outcomes Measurement Information System Pool - Dyspnea Airborne Exposure For patients with dyspnea LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details on the PROMIS Pool v1.0 - Dyspnea Airborne Exposure MEASURE NAME: PROMIS Pool v1.0 - Dyspnea Airborne Exposure VERSION: 1 NUMBER OF ITEMS: 6 PATIENT POPULATION: Dyspnea patients 18 years and older RECALL PERIOD: Past 7 days RESPONSE SCALE: Yes/No DATA COLLECTION: Paper and electronic For permission to implement and administer the measure electronically, please visit: https://www.healthmeasures.net/implement-healthmeasures/administration-platforms ADMINISTRATION: Self-administration and interview when applicable SUBSCALE DOMAINS: Airborne Exposure TIME FOR COMPLETION: Less than 5 minutes SCORING: PROMIS Scoring Service: http://www.healthmeasures.net/score-and-interpret/calculate-scores/scoring-instructions RELATED MEASURES: FACIT-Dyspnea , PROMIS Pool v1.0 - Dyspnea Assistive Devices and Resources , PROMIS Pool v1.0 - Dyspnea Characteristics DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the PROMIS Pool v1.0 - Dyspnea Airborne Exposure can be obtained by registering for permission. Users are not permitted to translate the PROMIS Pool v1.0 - Dyspnea Airborne Exposure without permission from FACIT.org. Permission from FACIT.org to translate the PROMIS Pool v1.0 - Dyspnea Airborne Exposure 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 Choi, S., Victorson, D., Yount, S., Anton, S., & Cella, D. Development of a conceptual framework and calibrated item banks to measure patient reported dyspnea severity and related functional limitations. Value in Health 2011; 14: 291-306. Ruo, B., Choi, S., Baker, D., Grady, K., & Cella,D. Development and validation of a computer adaptive test measuring dyspnea in heart failure. Journal of Cardiac Failure 2010; 16(8): 659-668. doi: 10.1016/j.cardfail.2010.03.002. Victorson, D., Anton, S., Hamilton, A., Yount, S., & Cella, D. A conceptual model of the experience of dyspnea and functional limitations in COPD. Value in Health 2009; 12(6): 1018-1025. Yount, S., Choi, S., Victorson, D., Ruo, B., Ray, D., Cella, D., Anton, S., & Hamilton, A. (2011) Brief, valid measures of dyspnea and related functional limitations in chronic obstructive pulmonary disease (COPD). Value in Health 2011; 14: 307-315. 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 FACIT-Dyspnea Functional Assessment of Chronic Illness Therapy - Dyspnea-10 item LEARN MORE PROMIS Pool v1.0 - Dyspnea Assistive Devices and Resources Patient-Reported Outcomes Measurement Information System Pool - Dyspnea Assistive Devices and Resources LEARN MORE PROMIS Pool v1.0 - Dyspnea Characteristics Patient-Reported Outcomes Measurement Information System Pool - Dyspnea Characteristics LEARN MORE

View all available languages for this measure. BACK NFBSI-16 Languages Afrikaans Arabic Bengali Bulgarian Chinese - Simplified Chinese - Traditional Czech Danish Dutch English Finnish French German Greek Hebrew Hindi Hungarian Italian Japanese Kannada Korean Malay Malayalam Marathi Polish Portuguese Punjabi Romanian Russian Spanish Swedish Tamil Telugu Turkish Vietnamese

Download scoring documents for this measure. BACK PROMIS SF v1.0-Dyspnea-Functional Limitations Scoring Downloads http://www.healthmeasures.net/score-and-interpret/calculate-scores/scoring-instructions

Download scoring documents for this measure. BACK FACT-CSI Scoring Downloads Download DOC - FACT-CSI Download DOC - FACT-GINET Download DOC - FACT-LNET Download DOC - FACT-PNET

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FACT-EF Functional Assessment of Cancer Therapy - Enteral Feeding For patients receiving Enteral Feeding LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FACT-EF measure: MEASURE NAME: Functional Assessment of Cancer Therapy - Enteral Feeding (FACT-EF) VERSION: 1 NUMBER OF ITEMS: 20 PATIENT POPULATION: Patient population: Cancer patients 18 years and older undergoing enteral feeding 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: None TIME FOR COMPLETION: 5-10 minutes SCORING: Manual scoring template, some items are reverse scored. Total scores possible. RELATED MEASURES: FACT-G , FACT-EGFRI-18 , FACT-Bl-Cys DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACT-EF can be obtained by registering for permission. Users are not permitted to translate the FACT-EF without permission from FACIT.org. Permission from FACIT.org to translate the FACT-EF 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 FACT-G Functional Assessment of Cancer Therapy – General LEARN MORE FACT-EGFRI-18 Functional Assessment of Cancer Therapy - Epidermal Growth Factor Inhibitors 18 Item Version LEARN MORE FACT-Bl-Cys Functional Assessment of Cancer Therapy – Bladder – Cystectomy LEARN MORE

View all available languages for this measure. BACK FAHI Languages Afrikaans Chinese - Traditional Danish Dutch English French German Greek Gujarati Italian Japanese Korean Malay Norwegian Polish Portuguese Romanian Russian Sesotho Spanish Swedish Turkish Thai Ukrainian Urdu Xhosa Zulu

View all available languages for this measure. BACK FACT-Taxane Languages Afrikaans Arabic Bengali Bosnian Chinese - Simplified Chinese - Traditional Czech Danish Dutch English Finnish French German Greek Gujarati Hebrew Hungarian Italian Japanese Kannada Korean Latvian Macedonian Malay Malayalam Marathi Norwegian Polish Portuguese Romanian Russian Serbian Spanish Swedish Tagalog Tamil Thai Turkish

Download scoring documents for this measure. BACK NFBSI-16 Scoring Downloads Download DOC