Overview
The Functional Assessment of Cancer Therapy – Anemia (FACT-An) contains 20 items related to symptoms and concerns of patients with anemia along with the 27-item Functional Assessment of Cancer Therapy-General (FACT-G). Thirteen of the 20 items deal with fatigue, while the remaining 7 cover other concerns related to anemia. Using semi-structured interviews with 14 anemic oncology patients and 5 oncology experts, two instruments were produced: The FACIT-Fatigue and the FACT-Anemia. These measures were then tested with a second sample of 50 cancer patients with hemoglobin levels ranging from 7 to 15.9 g/dL. The 47-item FAC7-An scores were found to be stable (test-retest r = 0.87) and internally consistent (coefficient alpha range= 0. 95-0. 96). The symptom-specific subscales also showed good stability (test-retest r range = 0.84-0.90), and the Fatigue subscale showed strong internal consistency (coefficient alpha range = 0. 93-0. 95). Internal consistency of the miscellaneous non-fatigue items was lower but acceptable (alpha range = 0.5 9-0. 70), particularly in light of their strong relationship to patient-rated performance status and hemoglobin level. Convergent and discriminant validity testing revealed a significant positive relationship with other known measures of fatigue, a significant negative relationship with vigor, and a predicted lack of relationship with social desirability. The FACT-An is useful measure of quality of life in cancer treatment, adding more focus to the problems of fatigue and anemia.
MEASURE NAME:
Functional Assessment of Cancer Therapy – Anemia (FACT-An)
VERSION:
4
NUMBER OF ITEMS:
47
PATIENT POPULATION:
Cancer patients 18 years and older with anemia
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, Anemia 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:
FACIT-Fatigue, FACIT-F, PROMIS SF v1.0 – Fatigue 13a
Language Availability
Available translations of the FACT-An can be obtained by registering for permission. Users are not permitted to translate the FACT-An without permission from FACIT.org. Permission from FACIT.org to translate the FACT-An 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.
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.
Selected References
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Greenberg, P., Sun, Z., Miller, K., Bennett, J., Tallman, M., Dewald, G., van der Jagt, R., Houston, J., Thomas, M., Cella, D., & Rowe, J. Treatment of myelodysplastic syndromes patients with erythropoietin with or without granulocyte colony-stimulating factor: results of a prospective randomized phase III trial by the Eastern Cooperative Oncology Group (E1996). Blood 2009; 114(12): 2393–2400. doi: 10.1182/blood-2009-03-211797.
Mesa, R., Niblack, J., Wadleigh, M., Verstovsek, S., Camoriano, J., Barnes, S., Tan, A., Atherton, P., Sloan, J., Tefferi, A. The Burden of Fatigue and Quality of Life in Myeloproliferative Disorders (MPDs). An International Internet-Based Survey of 1179 MPD Patients. Cancer 2007; 109(1): 68-76. doi: 10.1002/cncr.22365.
Pinchon, D., Stanworth, S., Dore ´e, C., Brunskill, S., & Norfolk, D. Quality of life and use of red cell transfusion in patients with myelodysplastic syndromes. A systematic review. American Journal of Hematology 2009; 84(10):671-677. doi: 10.1002/ajh.21503.
Spiriti. M., Latagliata, R., Niscola, P., Cortelezzi. A., Francesconi. M., Ferrari, D., Volpe, E., Clavio, M., Grossi. A., Reyes, M., Musto, P., Mitra, M., Azzarà, A., Pagnini, D., D’Arena, G., Spadano, A., Balleari, E., Pecorari, P., Capochiani, E., De Biasi, E., Perego, D., Monarca, B., Pisani, F., Scaramella, G., & Petti, M. Impact of a new dosing regimen of epoetin alfa on quality of life and anemia in patients with low-risk myelodysplastic syndrome. Ann Hematol 2005; 84: 167–176. doi: 10.1007/s00277-004-0961-9.
Steensma, D., Heptinstall, K., Johnson, V., Novotny, P., Sloan, J., Camoriano, J., Niblack, J., Bennett, J., & Mesa, R. Common troublesome symptoms and their impact on quality of life in patients with myelodysplastic syndromes (MDS): Results of a large internet-based survey. Leukemia Research 2008; 32: 691-698. doi: 10.1016/j.leukres.2007.10.015.
Trudeau, J.J., He, J., Rose, E. et al. Content validity of patient-reported outcomes for use in lower-risk myelodysplastic syndromes. J Patient Rep Outcomes 4, 69 (2020). doi.org/10.1186/s41687-020-00235-4.
Yellen, S.B., Cella, D.F., Webster, K.A., Blendowski, C., & Kaplan, E. Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) Measurement System. Journal of Pain and Symptom Management 1997; 13(2): 63-74.
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.
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