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FACT-HN Functional Assessment of Cancer Therapy – Head & Neck For patients with Head & Neck cancer LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The Functional Assessment of Cancer Therapy – Head & Neck (FACT-H&N) is a reliable and valid measure for head and neck cancer patients, assessing unique disease specific concerns in addition to general health status. FACT-H&N subscale and total scores are sensitive to patient groups on the basis of treatment status (on vs. off treatment) and global performance status. The head & neck subscale includes 12 items on symptoms and issues specific to head and neck cancers, including ability to eat, dry mouth, difficulty breathing, difficulty swallowing, voice quality, ability to communicate, body image, pain in the mouth, throat, or neck, and alcohol and tobacco use. MEASURE NAME: Functional Assessment of Cancer Therapy – Head & Neck (FACT-HN) VERSION: 4 NUMBER OF ITEMS: 39 PATIENT POPULATION: Head & neck 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, Head & Neck 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: FHNSI , NFHNSI-22 , FACT-MBIS DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACT-HN can be obtained by registering for permission. Users are not permitted to translate the FACT-HN without permission from FACIT.org. Permission from FACIT.org to translate the FACT-HN 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 D'Antonio, L., Zimmerman G., Cella, D., & Long, S. Quality of life and functional status measures in patients with head and neck cancer. Archives of Otolaryngology-Head & Neck Surgery 1996; 122: 482-487. List, M.A., D'Antonio, L.L., Cella, D.F., Siston, A., Mumby, P., Haraf, D., & Vokes, E. The Performance Status Scale for Head and Neck Cancer (PSS-HN) and the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) Scale: A study of utility and validity. Cancer 1996; 77(11): 2294-2301. doi: 10.1002/(SICI)1097-0142(19960601)77:11<2294::AID-CNCR17>3.0.CO;2-S. Nayak SG, George A, Sharan K, Nayak BS, Ravishankar N. Effectiveness of Comprehensive Intervention Programme on Quality of life, fatigue, self-efficacy, and psychosocial distress among head and neck cancer patients receiving radiotherapy. Support Care Cancer . 2024 Mar 7;32(4):216. doi: 10.1007/s00520-024-08381-x. PMID: 38448712; PMCID: PMC10917822. Reeve, B., Cai, J., Zhang, H., Choi, J., Weissler, M., Cella, D., & Olshan, A. Health-related quality of life differences between African-Americans and Non-Hispanic whites with head and neck cancer. Head and Neck 2013; 35(9): 1255-64. doi: 10.1002/hed.23115. Ringash J, Lockwood G, O'Sullivan B, Warde P, Bayley A, Cummings B, Kim J, Sellmann S, & Waldron J. Hyperfractionated, accelerated radiotherapy for locally advanced head and neck cancer: quality of life in a prospective phase I/II trial. Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology, 2008; 87(2):181-187. doi: 10.1016/j.radonc.2007.12.028. Ringash, J., Bernstein, L, Cella, D., Logemann, J., Movsas, B., Murphy, B., Trotti, A., Wells, N., Yueh, B., & Ridge, J. Outcomes toolbox for head and neck cancer research. Head & Neck 2015; 37(3): 425-39. doi: 10.1002/hed.23561. 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 FHNSI Functional Assessment of Cancer Therapy Head & Neck Cancer Symptom Index - 10 Item Version LEARN MORE NFHNSI-22 National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Head & Neck Cancer Symptom Index - 22 Item Version LEARN MORE FACT-MBIS FACT/McGill Body Image Scale - Head & Neck LEARN MORE

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FACIT-CNI-NTX Functional Assessment of Chronic Illness Therapy – Calcineurin Inhibitor Neurotoxicity For patients receiving calcium inhibitor treatment LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FACIT-CNI-NTX measure: MEASURE NAME: Functional Assessment of Chronic Illness Therapy – Calcineurin Inhibitor Neurotoxicity (FACIT-CNI-NTX) VERSION: 1 NUMBER OF ITEMS: 8 PATIENT POPULATION: Patients 18 and older receiving calcium inhibitor treatment 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: CNI-NTX scale TIME FOR COMPLETION: Less than 5 minutes SCORING: Manual scoring template, some items are reverse scored. RELATED MEASURES: FACT/GOG-NTX-4 , FACT/GOG-NTX , FACT/GOG-NTX-12 DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACIT-CNI-NTX can be obtained by registering for permission. Users are not permitted to translate the FACIT-CNI-NTX without permission from FACIT.org. Permission from FACIT.org to translate the FACIT-CNI-NTX 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 Hurt CN, Greene GJ, Friedewald J, Waterman AD, Ladner D, Tang X, Fowler K, Kaiser K, Cella D, Peipert JD. Development of a Patient Reported Outcome Measure of Side Effects for Patients Taking Calcineurin Inhibitors: The FACIT-CNI-Ntx. Am J Kidney Dis. 2025 Jan 23:S0272-6386(25)00041-1. doi: 10.1053/j.ajkd.2024.11.012. 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/GOG-NTX-4 Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity 4 Item Version LEARN MORE FACT/GOG-NTX Functional Assessment of Cancer Therapy/Gynecologic Oncology Group – Neurotoxicity LEARN MORE FACT/GOG-NTX-12 Functional Assessment of Cancer Therapy/Gynecologic Oncology Group – Neurotoxicity 12 Item Version LEARN MORE

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MICRA Multidimensional Impact of Cancer Risk Assessment For patients who have undergone genetic testing for risk of cancer LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The Multidimensional Impact of Cancer Risk Assessment (MICRA) is a tool to measure the specific impact of result disclosure after genetic testing. The authors compared its performance with that of questionnaires measuring general and cancer-specific distress. Participants (158 females) responded 1 month after they received genetic test results. They were divided into 4 standard clinical test result groups: BRCA1/2 positive, BRCA1/2 negative, panel negative, and true negative. Factor analysis supported the formation of 3 subscales: Distress, Uncertainty, and Positive Experiences. All 3 MICRA subscales differentiated participants who were BRCA1/2 positive from the other 3 groups. MICRA thus helps identify subgroups of vulnerable genetic testing participants. MEASURE NAME: Multidimensional Impact of Cancer Risk Assessment (MICRA) VERSION: 1 NUMBER OF ITEMS: 25 PATIENT POPULATION: Patients 18 years and older who have received cancer-related genetic testing RECALL PERIOD: Past 7 days RESPONSE SCALE: 4 point Likert-type scale DATA COLLECTION: Paper and electronic ADMINISTRATION: Self-administration and interview when applicable SUBSCALE DOMAINS: Distress, Uncertainty, Positive Experiences TIME FOR COMPLETION: Not available SCORING: Manual scoring template, some items are reverse scored. Subscale scores and total scores possible. RELATED MEASURES: FACT-G , FACT-G7 , FANLTC DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the MICRA can be obtained when licensing the measure. Users are not permitted to translate the MICRA without prior permission from FACIT.org. Permission may also be contingent upon timeline expectations and availability of FACIT staff. Translations must undergo a rigorous methodology under the guidance of FACIT.org which includes multiple translators and cognitive interviews with patients. For commercial use, FACITtrans is the approved translation vendor of the MICRA. 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, Hughes C, Peterman A, Chang CH, Peshkin BN, Schwartz MD, Wenzel L, Lemke A, Marcus AC, Lerman C. A brief assessment of concerns associated with genetic testing for cancer: the Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire. Health Psychol . 2002 Nov;21(6):564-72. 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 FANLTC Functional Assessment of Non-Life Threatening Conditions LEARN MORE

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FACIT-SWiP Functional Assessment of Chronic Illness Therapy - Satisfaction with Pharmacist Satisfaction with Pharmacist Scale LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FACIT-SWiP measure: MEASURE NAME: Functional Assessment of Chronic Illness Therapy - Satisfaction with Pharmacist (FACIT-SWiP) VERSION: 4 NUMBER OF ITEMS: 7 PATIENT POPULATION: Patients 18 and older receiving pharmacy care 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: Satisfaction with Pharmacist Subscale TIME FOR COMPLETION: Less than 5 minutes SCORING: Manual scoring template, some items are reverse scored. Total scores possible. SAS/SPSS algorithms available. RELATED MEASURES: FACIT-TS-G , FACIT-TS-PS , CCSQ DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACIT-SWiP can be obtained by registering for permission. Users are not permitted to translate the FACIT-SWiP without permission from FACIT.org. Permission from FACIT.org to translate the FACIT-SWiP 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 Hernandez, L., Chang, C.H., Cella, D., Corona, M., Shiomoto, G., & McGuire, D.B. Development and validation of the Satisfaction with Pharmacist Scale. Pharmacotherapy 2000; 20(7): 837-843. 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-TS-PS Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - Patient Satisfaction LEARN MORE CCSQ Chemotherapy Convenience and Satisfaction Questionnaire LEARN MORE

View all available languages for this measure. BACK NFOSI-18 Languages Arabic Bengali Bulgarian Cebuano Chinese - Simplified Chinese - Traditional Croatian Czech Danish Dutch English Estonian Finnish French German Greek Gujarati Hebrew Hiligaynon Hindi Hungarian Italian Japanese Korean Latvian Malay Malayalam Marathi Norwegian Polish Portuguese Romanian Russian Slovak Spanish Swedish Tagalog Tamil Thai Turkish Ukrainian

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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

FACT-ICM-17 Functional Assessment of Cancer Therapy – Immune Checkpoint Modulator 17 Item Symptom Index For patients receiving immunotherapy treatment LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The FACT-ICM-17 is a brief, validated measure developed to assess the most common, distressing, and clinically useful symptomatic ICM-related immune-related adverse events. It is appropriate for use in research as well as routine symptom monitoring and management. MEASURE NAME: Functional Assessment of Cancer Therapy – Immune Checkpoint Modulator 17 Item Symptom Index VERSION: 1 NUMBER OF ITEMS: 17 PATIENT POPULATION: Cancer patients 18 years and older receiving immunotherapy treatment 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: ICM TIME FOR COMPLETION: 5-10 minutes SCORING: Manual scoring template, total score possible RELATED MEASURES: FACT-ICM , FACT- G, FACT-RNT DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACT-ICM-17 can be obtained by registering for permission. Users are not permitted to translate the FACT-ICM-17 without permission from FACIT.org. Permission from FACIT.org to translate the FACT-ICM-17 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 Gudenkauf LM, Tometich DB, Hoogland AI, Li XY, Kirtane K, Small BJ, Barata A, Gonzalez BD, Chung CH, Shafique MR, Gray J, Khushalani NI, Postow MA, Cella D, Webster KA, Dicker AP, Jim HSL. Validation of the Functional Assessment of Cancer Therapy – Immune Checkpoint Modulator 17-Item Symptom Index (FACT-ICM-17) to Facilitate Implementation in Research and Clinical Care. Available at SSRN: https://ssrn.com/abstract=5034323 or http://dx.doi.org/10.2139/ssrn.5034323 Hansen AR, Ala-Leppilampi K, McKillop C, Siu LL, Bedard PL, Abdul Razak AR, Spreafico A, Sridhar SS, Leighl N, Butler MO, Hogg D, Sacher A, Oza AM, Al-Agha R, Maurice C, Chan CT, Shapera S, Feld JJ, Nisenbaum R, Webster K, Cella D, Parsons J. Development of the Functional Assessment of Cancer Therapy-Immune Checkpoint Modulator (FACT-ICM): A toxicity subscale to measure quality of life in patients with cancer who are treated with ICMs. Cancer. 2020 Apr 1;126(7):1550-1558. doi: 10.1002/cncr.32692. Epub 2020 Jan 8. PMID: 31914209. Webster KA, O’Connor ML, Hansen AR, Kircher S, Jim HSL, Dicker AP, Janda M, Ala-leppilampi K, Bingham CO III, Feliciano J, Henry NL, Steffen McLouth LE, Cella D. Development of a Functional Assessment of Chronic Illness Therapy item library and primary symptom list for the assessment of patient-reported adverse events associated with immune checkpoint modulators. J Cancer Metastasis Treat 2020;6:8. http://dx.doi.org/10.20517/2394-4722.2019.38. 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-ICM Functional Assessment of Cancer Therapy – Immune Checkpoint Modulator LEARN MORE FACT-G Functional Assessment of Cancer Therapy – General LEARN MORE FACT-RNT Functional Assessment of Cancer Therapy – Radionuclide Therapy LEARN MORE

FACT-Br-CI Functional Assessment of Cancer Therapy – Brain Cognitive Index For patients with Brain cancer LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The FACT-Br-CI measures self-reported cognition in patients with brain cancer. Studies that included the FACT-Br could be retrospectively analyzed to assess subjective cognitive outcomes, enriching the information from prior research. Integration of the FACT-Br-CI in routine clinical care may be an efficient method of monitoring cognition. MEASURE NAME: Functional Assessment of Cancer Therapy – Brain Cognitive Index (FACT-Br-CI) VERSION: 4 NUMBER OF ITEMS: 9 PATIENT POPULATION: Brain 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: Cognitive Index TIME FOR COMPLETION: 5 minutes SCORING: Manual scoring template, some items are reverse scored. RELATED MEASURES: FBrSI , NFBrSI-24 , FACT-Br DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACT-Br-CI can be obtained by registering for permission. Users are not permitted to translate the FACT-Br-CI without permission from FACIT.org. Permission from FACIT.org to translate the FACT-Br-CI 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 Zarrella GV, Perez A, Dietrich J, Parsons MW. Reliability and validity of a novel cognitive self-assessment tool for patients with cancer. Neurooncol Pract . 2021 Jul 21;8(6):691-698. doi: 10.1093/nop/npab045. PMID: 34777838; PMCID: PMC8579089. Weitzner, M.A., Meyers, C.A., Gelke, C., Byrne, K., Cella, D.F., & Levin, V.A. The Functional Assessment of Cancer Therapy (FACT) Scale: Development of a brain subscale and revalidation of the general version (FACT-G) in patients with primary brain tumors. Cancer 1995; 75(5): 1151-1161. Thavarajah, N., Bedard, G., Zhang, L., Cella, D., Beaumont, J., Tsao, M., Barnes, E., Danjoux, C., Sahgal, A., Soliman, H., & Chow, E. The Functional Assessment of Cancer Therapy – Brain (FACT-Br) for assessing quality of life in patients with brain metastases: A comparison of recall periods. Journal of Pain Management 2013; 6(3): 223-234. Thavarajah, N., G., Zhang, L., Cella, D., Beaumont, J. Tsao, M., Barnes, E., Danjoux, C., Sahgal, A., Soliman, H., & Chow, E. Psychometric validation of the functional assessment of cancer therapy—brain (FACT-Br) for assessing quality of life in patients with brain metastases Supportive Care in Cancer 2014; 22 (4): 1017-1028. doi: 10.1007/s00520-013-2060-8. Verhaak, E., Schimmel, W. C., Sitskoorn, M. M., Bakker, M., Hanssens, P. E., & Gehring, K. (2019). Multidimensional assessment of fatigue in patients with brain metastases before and after Gamma Knife radiosurgery. Journal of neuro-oncology , 144 (2), 377-384. Verhaak, E., Gehring, K., Hanssens, P. E., & Sitskoorn, M. M. (2019). Health-related quality of life of patients with brain metastases selected for stereotactic radiosurgery. Journal of neuro-oncology , 143 (3), 537-546. Verhaak, E., Schimmel, W. C., Gehring, K., Emons, W. H., Hanssens, P. E., & Sitskoorn, M. M. (2020). Health-related quality of life after Gamma Knife radiosurgery in patients with 1–10 brain metastases. Journal of Cancer Research and Clinical Oncology , 1-11. 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 FBrSI Functional Assessment of Cancer Therapy Brain Cancer Symptom Index - 15 Item Version LEARN MORE NRBrSI-24 National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Brain Cancer Symptom Index - 24 Item Version LEARN MORE FACT-Br Functional Assessment of Cancer Therapy – Brain LEARN MORE