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FLSI-12 Functional Assessment of Cancer Therapy Lung Cancer Symptom Index - 12 Item Version For patients with Lung cancer; a FACT-Lung Symptom Index (a subset of FACT-L containing 12 items) LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FLSI-12 measure: MEASURE NAME: Functional Assessment of Cancer Therapy Lung Cancer Symptom Index - 12 Item Version (FLSI-12) VERSION: 4 NUMBER OF ITEMS: 12 PATIENT POPULATION: Lung 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: Lung cancer symptom index TIME FOR COMPLETION: Less than 5 minutes SCORING: Manual scoring template, some items are reverse scored. Total scores possible. RELATED MEASURES: FACT-L , FLSI , NFLSI-17 , FACT-PSI , FACT-LCS DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FLSI-12 can be obtained by registering for permission. Users are not permitted to translate the FLSI-12 without permission from FACIT.org. Permission from FACIT.org to translate the FLSI-12 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., Eton, D., Hensing, T., Masters, G., & Parasuraman, B. Relationship between symptom change, objective tumor measurements, and performance status during chemotherapy for advanced lung cancer. Clinical Lung Cancer 2008; 9(1): 51-58. doi: 10.3816/CLC.2008.n.009. Yount, S., Rothrock, N., Bass, M., Beaumont, J., Pach, D., Lad, R., Patel, J., Corona, M., Weiland, R., Del, K., & Cella, D. A randomized trial of weekly symptom telemonitoring in advanced lung cancer. Journal of Pain and Symptom Management 2014; 47(6): 973-989. doi: 10.1016/j.jpainsymman.2013.07.01. 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-L Functional Assessment of Cancer Therapy – Lung LEARN MORE FLSI Functional Assessment of Cancer Therapy Lung Cancer Symptom Index - 6 Item Version LEARN MORE NFLSI-17 National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Lung Cancer Symptom Index - 17 Item Version LEARN MORE

PROMIS SF v1.0-Dyspnea-Severity 5b Patient Reported Outcomes Measurement Information System - Short Form - Dyspnea-Severity 5b For patients with dyspnea LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The PROMIS SF v1.0 – Dyspnea-Severity 5b includes 5 items from part I of the FACIT-Dyspnea adopted by the PROMIS Health Organization. MEASURE NAME: Patient Reported Outcomes Measurement Information System - Short Form - Dyspnea-Severity 5b VERSION: 1 NUMBER OF ITEMS: 5 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 10a , PROMIS SF v1.0 – Dyspnea-Severity 5a DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the PROMIS-SF-v1.0-Dyspnea-Severity 5b can be obtained by registering for permission. Users are not permitted to translate the PROMIS-SF-v1.0-Dyspnea-Severity 5b without permission from FACIT.org. Permission from FACIT.org to translate the PROMIS-SF-v1.0-Dyspnea-Severity 5b 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 10a Patient-Reported Outcomes Measurement Information System Short Form - Dyspnea Severity 10a LEARN MORE PROMIS SF v1.0 – Dyspnea Severity 5a Patient-Reported Outcomes Measurement Information System Short Form - Dyspnea Severity 5a LEARN MORE

FACT-N Functional Assessment of Cancer Therapy – Neutropenia For patients with Neutropenia LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FACT-N measure: MEASURE NAME: Functional Assessment of Cancer Therapy – Neutropenia (FACT-N) VERSION: 4 NUMBER OF ITEMS: 46 PATIENT POPULATION: Cancer patients 18 and older with neutropenia 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, Neutropenia 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-MM , FACT-BMT , FACT-G DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACT-N can be obtained by registering for permission. Users are not permitted to translate the FACT-N without permission from FACIT.org. Permission from FACIT.org to translate the FACT-N 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 Wagner, L., Beaumont, J., Ding, B., Malin, J., Peterman, A., Calhoun, E., & Cella, D. Measuring health-related quality of life and neutropenia specific concerns among older adults undergoing chemotherapy: Validation of the Functional Assessment of Cancer Therapy – Neutropenia (FACT-N). Supportive Care in Cancer 2008; 16: 47-56. doi: 10.1007/s00520-007-0270-7. 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-MM Functional Assessment of Cancer Therapy – Multiple Myeloma LEARN MORE FACT-BMT Functional Assessment of Cancer Therapy - Bone Marrow Transplantation LEARN MORE FACT-G Functional Assessment of Cancer Therapy – General LEARN MORE

FAIT-F Functional Assessment of Incontinence Therapy – Fecal LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FAIT-F measure: MEASURE NAME: Functional Assessment of Incontinence Therapy – Fecal (FAIT-F) VERSION: 4 NUMBER OF ITEMS: 39 PATIENT POPULATION: Patients 18 and older with fecal incontinence 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, Fecal Incontinence Subscale TIME FOR COMPLETION: 10-15 minutes SCORING: Manual scoring template, some items are reverse scored. Subscale scores and total scores available. SAS/SPSS algorithms available. RELATED MEASURES: FAIT-U , FACIT-D , FACIT-AD DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FAIT-F can be obtained by registering for permission. Users are not permitted to translate the FAIT-F without permission from FACIT.org. Permission from FACIT.org to translate the FAIT-F 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 FAIT-U Functional Assessment of Incontinence Therapy – Urinary LEARN MORE FACIT-D Functional Assessment of Chronic Illness Therapy – Diarrhea LEARN MORE FACIT-AD Functional Assessment of Chronic Illness Therapy - Abdominal Discomfort LEARN MORE

FACIT-COST COST: A FACIT Measure of Financial Toxicity For financial toxicity LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Developed in conjunction with the University of Chicago, the COST is a patient-reported outcome measure that describes the financial distress experienced by cancer patients. Since its initial publication, an additional item from the FACIT System has been included to screen for financial toxicity and to provide a good global summary item for financial toxicity. MEASURE NAME: COST: A FACIT Measure of Financial Toxicity (FACIT-COST) VERSION: 2 NUMBER OF ITEMS: 12 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: Financial Toxicity TIME FOR COMPLETION: Less than 5 minutes SCORING: Manual scoring template, some items are reverse scored. Total scores possible. RELATED MEASURES: FACT-G , FACT-G7 , FACT-GP DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the COST can be obtained by registering for permission. Users are not permitted to translate the COST without permission from FACIT.org. Permission from FACIT.org to translate the COST 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 de Souza J.A., Yap B.J., Wroblewski K., Blinder V., Araújo F.S., Hlubocky F.J., Nicholas L.H., O'Connor J.M., Brockstein B., Ratain M.J., Daugherty C.K., Cella D. Measuring financial toxicity as a clinically relevant patient-reported outcome: The validation of the COmprehensive Score for financial Toxicity (COST). Cancer 2017 Feb 1;123(3):476-484. doi: 10.1002/cncr.30369. Epub 2016 Oct 7. PMID: 27716900; PMCID: PMC5298039. Ezeife D.A., Morganstein B.J., Lau S., Law J.H., Le L.W., Bredle J., Cella D., Doherty M.K., Bradbury P., Liu G., Sacher A., Shepherd F.A., Leighl N.B. Financial Burden Among Patients with Lung Cancer in a Publically Funded Health Care System. Clin Lung Cancer 2019 Jul;20(4):231-236. doi: 10.1016/j.cllc.2018.12.010. Epub 2018 Dec 22. PMID: 30797721. Hlubocky F.J. et al. Financial Toxicity Has Never Been More Important in Cancer Care: How Do We Measure It?. JCO Oncol Pract 21, 52-56(2025). DOI:10.1200/OP.24.00162 Huntington S.F., Weiss B.M., Vogl D.T., Cohen A.D., Garfall A.L., Mangan P.A., Doshi J.A., Stadtmauer E.A. Financial toxicity in insured patients with multiple myeloma: a cross-sectional pilot study. Lancet Haematol 2015 Oct;2(10):e408-16. doi: 10.1016/S2352-3026(15)00151-9. Epub 2015 Sep 17. PMID: 26686042. Pangestu, S., Purba, F.D., Setyowibowo, H. et al. Validity, test-retest reliability, and responsiveness of the Indonesian version of FACIT-COST measure for subjective financial toxicity. Health Qual Life Outcomes 22, 89 (2024). https://doi.org/10.1186/s12955-024-02303-5. Pangestu, S. et al. Comprehensive Score for Financial Toxicity and Health-Related Quality of Life in Patients With Cancer and Survivors: A Systematic Review and Meta-Analysis. Value in Health , Volume 26, Issue 2, 300–316, February 2023. https://doi.org/10.1016/j.jval.2022.07.017. Patel, M.R., Troost, J.P., Heisler, M. et al. Clinically meaningful classes of financial toxicity for patients with diabetes. J Patient Rep Outcomes 9, 2 (2025). https://doi.org/10.1186/s41687-024-00834-5. Patel MR, Zhang G, Heisler M, Song PXK, Piette JD, Shi X, Choe HM, Smith A, Resnicow K. Measurement and validation of the Comprehensive Score for financial toxicity (COST) in a population with diabetes. Diabetes Care, 2022. Sadigh, G., Switchenko, J., Weaver, K.E. et al. Correlates of financial toxicity in adult cancer patients and their informal caregivers. Support Care Cancer (2021). https://doi.org/10.1007/s00520-021-06424-1. 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-G7 Functional Assessment of Cancer Therapy - General - 7 Item Version LEARN MORE FACT-GP Functional Assessment of Cancer Therapy - General Population LEARN MORE

FAPSI Functional Assessment of Cancer Therapy Prostate Cancer Symptom Index - 8 Item Version For patients with Prostate cancer; A FACT-Prostate Symptom Index (a subset of FACT-P containing 8 items) LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FAPSI measure: MEASURE NAME: Functional Assessment of Cancer Therapy Prostate Cancer Symptom Index - 8 Item Version (FAPSI) VERSION: 4 NUMBER OF ITEMS: 8 PATIENT POPULATION: Prostate 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: Prostate cancer subscale TIME FOR COMPLETION: Less than 5 minutes SCORING: Manual scoring template, some items are reverse scored. Total scores available. SAS/SPSS algorithms available. RELATED MEASURES: FACT-P , NFPSI-17 , FACT-RNT DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FAPSI can be obtained by registering for permission. Users are not permitted to translate the FAPSI without permission from FACIT.org. Permission from FACIT.org to translate the FAPSI 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. Yount, S., Cella, D., Banik, D., Ashraf, T., & Shevrin, D. (2003). Brief assessment of priority symptoms in hormone refractory prostate cancer: the FACT Advanced Prostate Symptom Index (FAPSI). Health and quality of life outcomes 1 69. doi:10.1186/1477-7525-1-69. 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-P Functional Assessment of Cancer Therapy – Prostate LEARN MORE NFPSI-17 National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Prostate Cancer Symptom Index - 17 Item Version LEARN MORE FACT-RNT Functional Assessment of Cancer Therapy – Radionuclide Therapy LEARN MORE

FACIT-Dyspnea Item Bank Functional Assessment of Chronic Illness Therapy - Dyspnea - Item Bank For patients with Dyspnea LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FACIT-Dyspnea Item Bank: MEASURE NAME: Functional Assessment of Chronic Illness Therapy - Dyspnea - Item Bank VERSION: Not available NUMBER OF ITEMS: Not available PATIENT POPULATION: Dyspnea patients 18 years and older RECALL PERIOD: Past 7 days RESPONSE SCALE: 4 point Likert-type scales DATA COLLECTION: Paper and electronic ADMINISTRATION: Self-administration and interview when applicable SUBSCALE DOMAINS: Not available TIME FOR COMPLETION: Not available SCORING: Not available RELATED MEASURES: PROMIS SF v1.0 – Dyspnea-Severity 10a , PROMIS SF v1.0 – Dyspnea Functional Limitations 10a , FACIT-Dyspnea DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACIT-Dyspnea Item Bank can be obtained by registering for permission. Users are not permitted to translate the FACIT-Dyspnea Item Bank without permission from FACIT.org. Permission from FACIT.org to translate the FACIT-Dyspnea Item Bank 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 PROMIS SF v1.0 – Dyspnea-Severity 10a Patient-Reported Outcomes Measurement Information System Short Form - Dyspnea Severity 10a LEARN MORE PROMIS SF v1.0 – Dyspnea Functional Limitations 10a Patient-Reported Outcomes Measurement Information System Short Form - Dyspnea Functional Limitations 10a LEARN MORE FACIT-Dyspnea Functional Assessment of Chronic Illness Therapy - Dyspnea LEARN MORE

PROMIS Pool v1.0 - Dyspnea Activity Motivation Patient Reported Outcomes Measurement Information System Pool - Dyspnea Activity Motivation 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 Activity Motivation MEASURE NAME: PROMIS Pool v1.0 - Dyspnea Activity Motivation VERSION: 1 NUMBER OF ITEMS: 7 PATIENT POPULATION: Dyspnea patients 18 years and older RECALL PERIOD: Past 7 days RESPONSE SCALE: 5 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: Activity Motivation 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 Activity Requirements , PROMIS Pool v1.0 - Dyspnea Airborne Exposure DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the PROMIS Pool v1.0 - Dyspnea Activity Motivation can be obtained by registering for permission. Users are not permitted to translate the PROMIS Pool v1.0 - Dyspnea Activity Motivation without permission from FACIT.org. Permission from FACIT.org to translate the PROMIS Pool v1.0 - Dyspnea Activity Motivation 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 Activity Requirements Patient-Reported Outcomes Measurement Information System Pool - Dyspnea Activity Requirements LEARN MORE PROMIS Pool v1.0 - Dyspnea Airborne Exposure Patient-Reported Outcomes Measurement Information System Pool - Dyspnea Airborne Exposure LEARN MORE

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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.

FACIT-TS-PS Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - Patient Satisfaction LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FACIT-TS-PS measure: MEASURE NAME: Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - Patient Satisfaction (FACIT-TS-PS) VERSION: 4 NUMBER OF ITEMS: 30 PATIENT POPULATION: Chronic illness patients 18 years and older undergoing treatment RECALL PERIOD: Past 7 days RESPONSE SCALE: Multiple Likert-type response scales DATA COLLECTION: Paper and electronic ADMINISTRATION: Self-administration and interview when applicable SUBSCALE DOMAINS: Physician Communication, Treatment Staff Communication, Technical Competence, Nurse Communication, Confidence & Trust TIME FOR COMPLETION: 5-10 minutes SCORING: Manual scoring template. Subscale scores and total scores possible. RELATED MEASURES: FACIT-TS-G , FACIT-SWiP , CCSQ DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACIT-TS-PS can be obtained by registering for permission. Users are not permitted to translate the FACIT-TS-PS without permission from FACIT.org. Permission from FACIT.org to translate the FACIT-TS-PS 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 Peipert, J., Beaumont, J., Bode, R., Cella, D., Garcia, S., Hahn, E. Development and validation of the functional assessment of chronic illness therapy treatment satisfaction (FACIT TS) measures. Quality of Life Research 2014; 23: 815-824 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-TS-G Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction – General LEARN MORE FACIT-SWiP Functional Assessment of Chronic Illness Therapy - Satisfaction with Pharmacist LEARN MORE CCSQ Chemotherapy Convenience and Satisfaction Questionnaire LEARN MORE