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View all available languages for this measure. BACK FPSI Languages Arabic Bulgarian Chinese - Simplified Chinese - Traditional Czech Danish Dutch English Finnish French German Hebrew Hungarian Italian Japanese Korean Norwegian Polish Portuguese Russian Spanish Swedish

FANLTC Functional Assessment of Non-Life Threatening Conditions LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The Functional Assessment of Non-Life Threatening Conditions (FANLTC) is a 26-item version of the FACT-G designed to be administered to patients with non-life threatening conditions. The item from the FACT-G making reference to anxiety about death has been removed, and the instrument measures four domains of HRQOL: Physical, social/family, emotional and functional well-being. MEASURE NAME: Functional Assessment of Non-Life Threatening Conditions (FANLTC) VERSION: 4 NUMBER OF ITEMS: 26 PATIENT POPULATION: 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 TIME FOR COMPLETION: 5-10 minutes SCORING: Manual scoring template, some items are reverse scored. Subscale scores and total scores available. SAS/SPSS algorithms available. RELATED MEASURES: FACT-G , FACT-G7 , FACT-GP DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FANLTC can be obtained by registering for permission. Users are not permitted to translate the FANLTC without permission from FACIT.org. Permission from FACIT.org to translate the FANLTC 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.F., Tulsky D.S., Gray G., Sarafian B., Lloyd S., Linn E., Bonomi A., Silberman M., Yellen S.B., Winicour P., Brannon J., Eckberg K., Purl S., Blendowski C., Goodman M., BarnicleM., Stewart I., McHale M., Bonomi P., Kaplan E., Taylor S., Thomas C., Harris J. The Functional Assessment of Cancer Therapy (FACT) Scale: Development and validation of the general measure. Journal of Clinical Oncology 1993; 11(3): 570-579. Brucker P.S., Yost K.J., Cashy J., Webster K., Cella D. General population and cancer patient norms for the Functional Assessment of Cancer Therapy – General (FACT-G). Evaluation & the Health Professions 2005; 28(2): 192-211. 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. Cella D., Zagari M.J., Vandoros C., Gagnon D.D., Hurtz H.J., Nortier J.W.R. Epoetin alfa treatment results in clinically significant improvements in quality of life in anemic cancer patients when referenced to the general population. Journal of Clinical Oncology 2003; 21(2): 366-373. 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-G7 Functional Assessment of Cancer Therapy – General – 7 Item Version LEARN MORE FACT-GP Functional Assessment of Cancer Therapy – General Population LEARN MORE

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NFHSI-18 National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Hepatobiliary Cancer Symptom Index - 18 Item Version For patients with Hepatobiliary cancer (liver, bile duct and pancreas); a FACT/NCCN-Hepatobiliary Symptom Index LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The NCCN/FACT Hepatobiliary Cancer Symptom Index-18 assesses symptoms of importance to patients with hepatobiliary and pancreatic cancers and demonstrates promising measurement properties. The scale is a good candidate for brief symptom assessment in clinical trials. As part of a larger study in collaboration with the NCCN, 50 people (60% male, 80% Caucasian, average age 60.4 yrs) with Stage 3 or 4 hepatobiliary or pancreatic cancer were recruited. Participants generated and ranked up to 10 important symptoms and concerns that physicians should monitor when assessing the value of chemotherapy. Patients were also able to provide open-ended, qualitative information that was evaluated systematically. Ten expert physicians also provided input on priority symptoms. The resulting 18-item NFHSI (NFHSI-18) demonstrated high internal consistency (α = 0.89) and moderate to strong correlations with measures of physical well-being (ρ = 0.76), emotional well-being (ρ = 0.52), and functional well-being (ρ = 0.57). Scores were also highly correlated with the original hepatobiliary scale of the FACT-Hep (ρ =0.82; all p<0.001). Compared to patients with better performance status, patients with poor performance status had worse NFHSI-18 symptom scores, F (3, 47) = 9.74; p=0.0003. MEASURE NAME: National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Hepatobiliary Cancer Symptom Index - 18 Item Version (NFHSI-18) VERSION: 2 NUMBER OF ITEMS: 18 PATIENT POPULATION: Hepatobiliary 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: FACT-Hep , FHSI , FACT-G DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the NFHSI-18 can be obtained by registering for permission. Users are not permitted to translate the NFHSI-18 without permission from FACIT.org. Permission from FACIT.org to translate the NFHSI-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 Butt, Z., Parikh, N.D., Beaumont, J. L., Rosenbloom, S. K., Syrjala, K. L., Abernethy, A. P., Benson, A. B., & Cella, D. Development and validation of a symptom index for advanced hepatobiliary and pancreatic cancers: The NCCN-FACT Hepatobiliary-Pancreatic Symptom Index (NFHSI). Cancer 2012; 118(23): 5997-6004. 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. Rosenbloom, S., Yount, S., Yost, K., Hampton, D., Paul, D., Abernethy, A., Jacobsen, P., Syrjala, K., Von Roenn, J., Cella, D. Development and validation of eleven symptom indices to evaluate response to chemotherapy for advanced cancer: Measurement compliance with regulatory demands. Farquhar, I., Summers, K., Sorkin, A. (Eds.). The Value of Innovation: Impacts on Health, Life Quality and Regulatory Research. Emerald Group Publishing Inc. 2007; 16: 53-66. doi: 10.1016/S0194-3960(08)16003-6. Yount, S., Cella, D., Webster, K., Heffernan, N., Chang, C.-H., Odom, L., & van Gool, R. Assessment of patient-reported clinical outcome in Pancreatic and other Hepatobiliary Cancers: The FACT Hepatobiliary Symptom Index. Journal of Pain & Symptom Management 2002; 24(1), 32-44. doi: 10.1016/S0885-3924(02)00422-0. 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-Hep Functional Assessment of Cancer Therapy – Hepatobiliary LEARN MORE FHSI Functional Assessment of Cancer Therapy Hepatobiliary Cancer Symptom Index - 8 Item Version LEARN MORE FACT-G Functional Assessment of Cancer Therapy – General LEARN MORE

PROMIS SF v1.0-Dyspnea-Severity 10a Patient Reported Outcomes Measurement Information System - Short Form - Dyspnea-Severity 10a For patients with dyspnea LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The PROMIS SF v1.0 – Dyspnea-Severity 10a is part I of the FACIT-Dyspnea adopted by the PROMIS Health Organization. MEASURE NAME: Patient Reported Outcomes Measurement Information System - Short Form - Dyspnea-Severity 10a VERSION: 1 NUMBER OF ITEMS: 10 PATIENT POPULATION: Dyspnea patients 18 years and older RECALL PERIOD: Past 7 days RESPONSE SCALE: 4 point Likert-type scale 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: Severity 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 SF v1.0 – Dyspnea-Severity 5a , PROMIS SF v1.0 – Dyspnea-Severity 5b DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the PROMIS-SF-v1.0-Dyspnea-Severity 10a can be obtained by registering for permission. Users are not permitted to translate the PROMIS-SF-v1.0-Dyspnea-Severity 10a without permission from FACIT.org. Permission from FACIT.org to translate the PROMIS-SF-v1.0-Dyspnea-Severity 10a 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 SF v1.0 – Dyspnea Severity 5a Patient-Reported Outcomes Measurement Information System Short Form - Dyspnea Severity 5a LEARN MORE PROMIS SF v1.0 – Dyspnea Severity 5b Patient-Reported Outcomes Measurement Information System Short Form - Dyspnea Severity 5b LEARN MORE

FACT-B Functional Assessment of Cancer Therapy – Breast For patients with Breast cancer LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The Functional Assessment of Cancer Therapy - Breast (FACT-B) is a 37-item instrument designed to measure five domains of HRQOL in breast cancer patients: Physical, social, emotional, functional well-being as well as a breast-cancer subscale (BCS). Utilized with the 27 core FACT-G items, the FACT-B was developed with an emphasis on patients’ values and brevity. Initial validation involved two patient samples. The first was tested twice over a 2-month period to assess sensitivity to change. Significant sensitivity to change in performance status rating (PSR) was demonstrated for the FACT-B total score, the Physical Well-Being (PWB) subscale, the Functional Well-Being (FWB) subscale, and the BCS. Sensitivity to change in QL as measured by the Functional Living Index-Cancer (FLIC) was documented in the FACT-B total score, PWB, FWB, and Emotional Well-Being (EWB). Additional validity and reliability data were obtained from a larger sample. The alpha coefficient (internal consistency) for the FACT-B total score was high (a = .90), with subscale alpha coefficients ranging from .63 to .86. Evidence supported test-retest reliability, as well as convergent, divergent, and known groups validity. MEASURE NAME: Functional Assessment of Cancer Therapy – Breast (FACT-B) VERSION: 4 NUMBER OF ITEMS: 37 PATIENT POPULATION: Breast 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, Breast Cancer Subscale TIME FOR COMPLETION: 10-15 minutes SCORING: Manual scoring template, some items are reverse scored. Subscale scores, total scores and TOI possible. SAS/SPSS algorithms available. RELATED MEASURES: NFBSI-16 , FBSI , FACT-B+4 DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACT-B can be obtained by registering for permission. Users are not permitted to translate the FACT-B without permission from FACIT.org. Permission from FACIT.org to translate the FACT-B 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 Brady M.J., Cella D.F., Mo F., Bonomi A.E., Tulsky D.S., Lloyd S.R., Deasy S., Cobleigh M., Shiomoto G. Reliability and validity of the Functional Assessment of Cancer Therapy – Breast quality-of-life instrument. Journal of Clinical Oncology 1997; 15(3): 974-986. 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. Cella D., Land S.R., Chang C.H., Day R., Costantino J.P., Wolmark N., Ganz P.A. Symptom measurement in the Breast Cancer Prevention Trial (BCPT) (P-1): Psychometric properties of a new measure of symptoms for midlife women. Breast Cancer Research and Treatment 2008; 109: 515-526. 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. Eton D.T., Cella D., Yost K.J., Yount S.E., Peterman A.H., Neuberg D.S., Sledge G.W., Wood W.C. A combination of distribution- and anchor-based approaches determined minimally important differences (MIDs) for four endpoints in a breast cancer scale. Journal of Clinical Epidemiology 2004; 57: 898-910. Hahn, E.A., Holzner, B., Kemmler, G., Sperner-Unterweger, B., Hudgens, S., Cella, D. Cross-cultural evaluation of health status using item response theory: FACT-B comparisons between Austrian and U.S. breast cancer patients. Evaluation & the Health Professions 2005; 28(2): 233-259. Henderson V.P., Massion A.O., Druker S. The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: A randomized trial. Breast Cancer Research and Treatment 2012; 131: 99-109. Kugbey, N., Meyer-Weitz, A., & Oppong Asante, K. Access to health information, health literacy and health-related quality of life among women living with breast cancer: Depression and anxiety as mediators. Patient Education and Counseling 2019; 102(7): 1357-1363. doi: 10.1016/j.pec.2019.02.014. Kugbey, N., Meyer-Weitz, A., & Oppong Asante, K. Mental adjustment to cancer and quality of life among women living with breast cancer in Ghana. The International Journal of Psychiatry in Medicine 2019; 54(3): 217-230. doi: : 10.1177/0091217418805087. Kugbey, N., Oppong Asante, K., & Meyer-Weitz, A. Doctor–patient relationship mediates the effects of shared decision making on health-related quality of life among women living with breast cancer. South African Journal of Psychology 2019; 49(3); 364–375. doi: 10.1177/0081246318801. Kugbey, N., Oppong Asante, K., & Meyer-Weitz, A. Depression, anxiety and quality of life among women living with breast cancer in Ghana: mediating roles of social support and religiosity. Supportive Care in Cancer 2019; 1-8. doi: 10.1007/s00520-019-05027-1. Lemieux J., Goodwin P.J., Bordeleau L.J., Lauzier S., Théberge V. Quality-of-life measurement in randomized clinical trials in breast cancer: An updated systematic review (2001-2009). Journal of the National Cancer Institute 2011; 103(3): 178-231. Pandey M., Thomas B.C., Ramdas K., Eremenco S., Nair M.K. Quality of life in breast cancer patients: Validation of a FACT-B Malayalam version. Quality of Life Research 2002; 11: 87-90. Thomas R., Godward S., Makris A., Bloomfield D., Moody A.M., Williams M. Giving patients a choice improves quality of life: A multi-centre, investigator-blind, randomized, crossover study comparing Letrozole and Anastrozole. Clinical Oncology 2004; 16: 485-491. Ursini LA, Nuzzo M, Rosa C, DI Guglielmo FC, DI Tommaso M, Trignani M, Borgia M, Allajbej A, Patani F, DI Carlo C, Porreca A, DI Nicola M, Genovesi D, Caravatta L. Quality of Life in Early Breast Cancer Patients: A Prospective Observational Study Using the FACT-B Questionnaire. In Vivo. 2021 May-Jun;35(3):1821-1828. doi: 10.21873/invivo.12443. PMID: 33910868. 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 NFBSI-16 National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Breast Cancer Symptom Index - 16 Item Version LEARN MORE FBSI Functional Assessment of Cancer Therapy - Breast Symptom Index LEARN MORE FACT-B+4 Functional Assessment of Cancer Therapy – Lymphedema LEARN MORE

PROMIS, C-Path, OMWQ, OMDQ, HAMSIQ, MICRA and more. Our great customer service and licensing experience is why more and more developers trust FACIT with their licensing needs. Additional Measures LICENSED BY FACIT.ORG SMDDS : Symptoms of Major Depressive Disorder Scale MFSAF v4.0 : Myelofibrosis Symptom Assessment Form v4.0 Diary MFSAF v4.0 : Myelofibrosis Symptom Assessment Form v4.0 7-day Recall NSCLC-SAQ: Non-Sm all Cell Lung Cancer Symptom Assessment Questionnaire ADSD/ANSD: Asthma Daytime Symptom Diary and Asthma Nighttime Symptom Diary DIBSS-C: Diary for Irritable Bowel Syndrome Symptoms - Constipation All C-Path Clinical Outcome Assessment (COA) Measures C-Path COA measures and their licensing procedures can be found on the C-Path COA website. Clicking the link below will leave the FACIT site and redirect you to the C-Path COA website. Go to the C-Path COA website OMWQ : Oral Mucositis Weekly Questionnaire OMDQ : Oral Mucositis Daily Questionnaire HAMSIQ : Hand-Foot and Mucositic Symptom and Impact Questionnaire MICRA : Multidimensional Impact of Cancer Risk Assessment PRAI : Patient-Reported Arthralgia Inventor y PRRS: Patient Roles and Responsibilities Scale CRRS: Caregiver Roles and Responsibilities Scale PROMIS SF v1.0 - Fatigue 10a : Patient-Reported Outcomes Measurement Information System - Fatigue Short Form 10a PROMIS SF v1.0 – Fatigue 13a : Patient-Reported Outcomes Measurement Information System - Fatigue Short Form 13a PROMIS SF v1.0 – Dyspnea-Severity 10a : Patient-Reported Outcomes Measurement Information System - Dyspnea Severity Short Form 10a PROMIS SF v1.0 – Dyspnea Functional Limitations 10a : Patient-Reported Outcomes Measurement Information System - Dyspnea Functional Limitations Short Form 10a PROMIS SF v1.0 – Dyspnea-Severity 5a : Patient-Reported Outcomes Measurement Information System - Dyspnea Severity Short Form 5a PROMIS SF v1.0 – Dyspnea-Severity 5b : Patient-Reported Outcomes Measurement Information System - Dyspnea Severity Short Form 5b PROMIS SF v1.0 – Dyspnea-Functional Limitations 5a : Patient-Reported Outcomes Measurement Information System - Dyspnea Functional Limitations Short Form 5a PROMIS SF v1.0 – Dyspnea-Functional Limitations 5b : Patient-Reported Outcomes Measurement Information System - Dyspnea Functional Limitations Short Form 5b PROMIS Item Bank v1.0 – Dyspnea Severity : Patient-Reported Outcomes Measurement Information System Item Bank - Dyspnea Severity PROMIS Item Bank v1.0 – Dyspnea Functional Limitations : Patient-Reported Outcomes Measurement Information System Item Bank - Dyspnea Functional Limitations BESS : BCPT Eight Symptom Scale NVMBQ: Nausea and Vomiting Management Barriers Questionnaire DMD: Diarrhea Management Diary Deep Vein Thrombosis Leg Symptom Index (DVT-LSI) LICENSE A MEASURE COA information updated frequently.

View all available languages for this measure. BACK FACT-GOG-NTX-12 Languages Chinese - Simplified Chinese - Traditional Czech Danish Dutch English Finnish French German Greek Gujarati Hindi Hungarian Italian Japanese Korean Marathi Portuguese Russian Sesotho Setswana Spanish Swedish Turkish

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

FACT-En Functional Assessment of Cancer Therapy – Endometrial For patients with Endometrial cancer LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FACT-En measure: MEASURE NAME: Functional Assessment of Cancer Therapy – Endometrial (FACT-En) VERSION: 4 NUMBER OF ITEMS: 43 PATIENT POPULATION: Endometrial 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, Endometrial 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: FACT-Cx , FACT-V , FACT-O DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACT-En can be obtained by registering for permission. Users are not permitted to translate the FACT-En without permission from FACIT.org. Permission from FACIT.org to translate the FACT-En 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-Cx Functional Assessment of Cancer Therapy – Cervix LEARN MORE FACT-V Functional Assessment of Cancer Therapy – Vulva LEARN MORE FACT-O Functional Assessment of Cancer Therapy – Ovarian LEARN MORE

View all available languages for this measure. BACK PROMIS Pool v1.0 - Dyspnea Assistive Devices and Resources Languages English

PROMIS Item Bank v1.0 - Dyspnea Functional Limitations Patient Reported Outcomes Measurement Information System Item Bank - Dyspnea Functional Limitations For patients with dyspnea LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview A bank of dyspnea items. MEASURE NAME: PROMIS Item Bank v1.0 - Dyspnea Functional Limitations VERSION: 1 NUMBER OF ITEMS: 33 PATIENT POPULATION: Dyspnea patients 18 years and older RECALL PERIOD: Past 7 days RESPONSE SCALE: 4 point Likert-type scale 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: Functional Limitations TIME FOR COMPLETION: 10-15 minutes SCORING: PROMIS Scoring Service: http://www.healthmeasures.net/score-and-interpret/calculate-scores/scoring-instructions RELATED MEASURES: FACIT-Dyspnea , PROMIS SF v1.0-Dyspnea-Functional Limitations 10a , PROMIS SF v1.0-Dyspnea-Functional Limitations 5a DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the PROMIS Item Bank v1.0 - Dyspnea Functional Limitations can be obtained by registering for permission. Users are not permitted to translate the PROMIS Item Bank v1.0 - Dyspnea Functional Limitations without permission from FACIT.org. Permission from FACIT.org to translate the PROMIS Item Bank v1.0 - Dyspnea Functional Limitations 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 SF v1.0 – Dyspnea Functional Limitations 10a Patient-Reported Outcomes Measurement Information System Short Form - Dyspnea Functional Limitations 10a LEARN MORE PROMIS SF v1.0 – Dyspnea Functional Limitations 5a Patient-Reported Outcomes Measurement Information System Short Form - Dyspnea Functional Limitations 5a LEARN MORE