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Download this measure in English. BACK FAPSI English Downloads Download PDF Download DOC

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

View all available languages for this measure. BACK PROMIS SF v1.0-Dyspnea-Functional Limitations 5a Languages Arabic Afrikaans Bengali Bulgarian Chinese - Simplified Chinese - Traditional Czech Danish Dutch English Finnish French German Greek Gujarati Hebrew Hindi Hungarian Italian Japanese Kannada Korean Malay Malayalam Marathi Norwegian Polish Portuguese Punjabi Romanian Russian Serbian Slovak Slovene Spanish Swedish Tagalog Tamil Telugu Thai Turkish Ukrainian Urdu Xhosa Zulu

FACIT-Pal-14 Functional Assessment of Chronic Illness Therapy - Palliative Care 14 Item Version LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FACIT-Pal-14 measure: MEASURE NAME: Functional Assessment of Chronic Illness Therapy - Palliative Care 14 Item Version (FACIT-Pal-14) VERSION: 4 NUMBER OF ITEMS: 14 PATIENT POPULATION: Palliative care patients 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: Palliative Care Index TIME FOR COMPLETION: Less than 5 minutes SCORING: Manual scoring template, some items are reverse scored. Total scores possible. RELATED MEASURES: FACIT-Pal , FACIT-Sp-12 , FACIT-Sp-EX DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACIT-Pal-14 can be obtained by registering for permission. Users are not permitted to translate the FACIT-Pal-14 without permission from FACIT.org. Permission from FACIT.org to translate the FACIT-Pal-14 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 King, M., Agar, M., Currow, D., Hardy, J., Fazekas, B., & McCaffre, N. Assessing quality of life in palliative care settings: head-to-head comparison of four patient-reported outcome measures (EORTC QLQ-C15-PAL, FACT-Pal, FACT-Pal-14, FACT-G7). Supportive Care in Cancer 2020; 28:141–153. doi: 10.1007/s00520-019-04754-9. Moldón-Ballesteros E, Llamas-Ramos I, Calvo-Arenillas JI, Cusi-Idigoras O, Llamas-Ramos R. Validation of the Spanish Versions of FACIT-PAL and FACIT-PAL-14 in Palliative Patients. Int J Environ Res Public Health 2022;19:10731. doi:10.3390/ijerph191710731. Zeng, L., Bedard, G., Cella, D., Thavarajah, N., Chen, E., Zhang, L., Bennett, M., Peckham, K., DeCosta, S., Beaumont, J., Tsao, M., Danjoux, C., Barnes, E., Sahgal, A. & Chow, E. Preliminary results of the generation of a shortened quality of life assessment for patients with advanced cancer: the FACIT-Pal-14. Journal of Palliative Medicine 2013; 16(5): 509-515. doi: 10.1089/jpm.2012.0595. 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-Pal Functional Assessment of Chronic Illness Therapy - Palliative Care LEARN MORE FACIT-Sp-12 Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being 12 Item Scale LEARN MORE FACIT-Sp-EX Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Expanded Version LEARN MORE

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

View all available languages for this measure. BACK FAIT-F Languages English German

FACT-Bl-Cys Functional Assessment of Cancer Therapy – Bladder – Cystectomy For patients undergoing cystectomy (formerly FACT-VCI) LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview The Functional Assessment of Cancer Therapy – Bladder – Cystectomy (FACT-Bl-Cys), originally developed as the FACT – Vanderbilt Cystectomy Index (FACT-VCI), is a condition-specific instrument for patients undergoing radical cystectomy (RC) and urinary diversion (UD) for bladder cancer that measures five domains: Physical, social, emotional, functional well-being, and a bladder/cystectomy subscale. The initial draft was administered to patients with bladder cancer undergoing RC and UD at two major cancer centers. Statistical methods included principal components analysis, Cronbach’s coefficient alpha, and nonparametric correlation coefficients. The FACT-G was used to test criterion-related validity and a linear mixed model tested the effects of time and diversion type on longitudinal scores. The bladder/cystectomy subscale produced a reliable and valid summary score for bladder cancer patients undergoing RC and UD. MEASURE NAME: Functional Assessment of Cancer Therapy – Bladder – Cystectomy (FACT-Bl-Cys) VERSION: 4 NUMBER OF ITEMS: 44 PATIENT POPULATION: Bladder cancer patients 18 years and older undergoing radical cystectomy and urinary diversion 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, Bladder/Cystectomy Subscale TIME FOR COMPLETION: 10-15 minutes SCORING: Manual scoring template, some items are reverse scored. Subscale scores and total scores possible. RELATED MEASURES: FACT-Bl , FBlSI , NCCN/FACT FBlSI-18 DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACT-Bl-Cys can be obtained by registering for permission. Users are not permitted to translate the FACT-Bl-Cys without permission from FACIT.org. Permission from FACIT.org to translate the FACT-Bl-Cys 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 Anderson C.B., Feurer I.D., Large M.C., Steinberg G. D., Barocas D.A., Cookson M.S., Penson D.F. Pychometric characteristics of a condition-specific health-related quality-of-life survey: The FACT-Vanderbilt Cystectomy Index. Urology; 80(1): 77-83. 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-Bl Functional Assessment of Cancer Therapy – Bladder LEARN MORE FBlSI Functional Assessment of Cancer Therapy Bladder Cancer Symptom Index - 7 Item Version LEARN MORE NCCN-FACT FBlSI-18 NCCN/FACT Bladder Symptom Index 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

Download this measure in English. BACK BESS English Downloads Download PDF Download DOC

View all available languages for this measure. BACK OMDQ Languages English

FACT-Th18 Functional Assessment of Cancer Therapy - Thrombocytopenia 18 Item Version For patients with Thrombocytopenia LICENSE THIS MEASURE Overview Language Availability Licensing Selected References Related Measures Overview Overview Below are the details for the FACT-Th18 measure: MEASURE NAME: Functional Assessment of Cancer Therapy - Thrombocytopenia 18 Item Version (FACT-Th18) VERSION: 4 NUMBER OF ITEMS: 45 PATIENT POPULATION: Cancer patients 18 and older with thrombocytopenia 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, Thrombocytopenia 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-Th6 , FACT-Th11 , FACT-G DOWNLOAD MEASURE IN ENGLISH DOWNLOAD SCORING DOCUMENT Language Availability Available translations of the FACT-Th18 can be obtained by registering for permission. Users are not permitted to translate the FACT-Th18 without permission from FACIT.org. Permission from FACIT.org to translate the FACT-Th18 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-Th6 Functional Assessment of Cancer Therapy - Thrombocytopenia 6 Item Version LEARN MORE FACT-Th11 Functional Assessment of Cancer Therapy - Thrombocytopenia 11 Item Version LEARN MORE FACT-G Functional Assessment of Cancer Therapy – General LEARN MORE

Download scoring documents for this measure. BACK PROMIS SF v1.0-Dyspnea-Severity 5b Scoring Downloads http://www.healthmeasures.net/score-and-interpret/ calculate-scores/scoring-instructions