Title of measure: Functional Assessment of Cancer Therapy-Brain (FACT-Br)

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1 Title of measure: Functional Assessment of Cancer Therapy-Brain (FACT-Br) This summary was last revised 5 October Brief overview: The Functional Assessment of Cancer Therapy-Brain (FACT-Br) is a commonly used instrument measuring general quality of life (QOL) that reflects symptoms or problems associated with brain malignancies across 5 scales [1]. The measure yields information about total QOL, as well as information about the dimensions of physical well-being, social/family well-being, emotional well being, functional well-being, and diseasespecific concerns. The FACT-Br is written at the 4th grade reading level, and patients can filled out it in 5-10 minutes. The self-report of quality of life can be completed by the patient or with the assistance of the examiner and does not require pre-certification. Validated (Yes/No): Yes [2]. The Functional Assessment of Cancer Therapy (FACT) scale has been developed following principles of test construction and evaluation and, recently, has undergone through psychometric testing for validity and reliability [1, 2]. The FACT-G (General version) was developed to provide information about health status that is specific to cancer patients. FACT-BR (brain) was developed as a new combined brain subscale questionnaire and checked for validation and reliability by Weitzner and coworkers [2] in Psychometric properties and references: FACT-Br subscale, brain tumor specific version, is a 23-item questionnaire that can be completed in 5 to 10 minutes with little or no assistance in patients who are not neurologically incapacitated. This brain subscale is usually used along with the core (general) questionnaire [2] that includes 27 items. Patients rate all 5 items using a five-point Likert scale ranging from 0 "not " to 4 "very." Overall, higher ratings suggest higher QOL. Items are totaled to produce the following subscales, along with an overall QOL score: physical well-being (7 items); social/family well-being (7 items); emotional well-being (6 items); functional well-being (7 items); and concerns relevant to patients with brain tumors (23 items). Clinically significant changes: specifically available for FACT-Br. Website or how to register to use: Go to and click on Registration+Requests to use one or more of the FACT scales, which can be obtained by completing a User s Agreement and completing one Collaborator s Project Information Form per project. This information can be found under the User s Agreement link on the website. The permission information should be given to RTOG headquarters for each RTOG QOL study. List any fees for usage: Currently, there are no fees for use of any of the English versions of the FACT questionnaires.. Languages available: The FACT has been translated into many languages, and translations are accessible at the FACIT web site, Please check the website for the specific languages available for FACT-BR.

2 Instructions for CRAs and or credentialing for administration: There is no credentialing needed for administration. Each protocol has instructions for the Clinical Research Associates. As well, a variety of information to assist in the administration of the FACT questionnaires is available from the website (under the administration and scoring guidelines link). Quality assurance for administration (if needed): None. Scoring of instrument: The website has a repository of information that assists in the scoring of the FACT questionnaires and in the interpretation of the results. References: 1. Cella DF, Tulsky DS, Gray G, et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 1993;11: Weitzner MA, Meyers CA, Gelke CK, et al 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 75(5):

3 FACT-BR (Version 4) Below is a list of statements that other people with your illness have said are important. By circling one (1) number per line, please indicate how true each statement has been for you PHYSICAL WELL-BEING a GP1 I have a lack of energy GP2 I have nausea GP3 Because of my physical condition, I have trouble meeting the needs of my family GP4 I have pain GP5 I am bothered by side effects of treatment GP6 I feel ill GP7 I am forced to spend time in bed SOCIAL/FAMILY WELL-BEING a GS1 I feel close to my friends GS2 I get emotional support from my family GS3 I get support from my friends GS4 My family has accepted my illness GS5 I am satisfied with family communication about my illness GS6 I feel close to my partner (or the person who is my main support) Q1 Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please check this box and go to the next section. GS7 I am satisfied with my sex life

4 By circling one (1) number per line, please indicate how true each statement has been for you EMOTIONAL WELL-BEING a GE1 I feel sad GE2 I am satisfied with how I am coping with my illness GE3 I am losing hope in the fight against my illness GE4 I feel nervous GE5 I worry about dying GE6 I worry that my condition will get worse FUNCTIONAL WELL-BEING a GF1 I am able to work (include work at home) GF2 My work (include work at home) is fulfilling GF3 I am able to enjoy life GF4 I have accepted my illness GF5 I am sleeping well GF6 I am enjoying the things I usually do for fun GF7 I am content with the quality of my life right now

5 By circling one (1) number per line, please indicate how true each statement has been for you ADDITIONAL CONCERNS a Br1 I am able to concentrate Br2 I have had seizures (convulsions) Br3 I can remember new things Br4 I get frustrated that I cannot do things I used to Br5 I am afraid of having a seizure (convulsion) Br6 I have trouble with my eyesight Br7 I feel independent NTX 6 I have trouble hearing Br8 I am able to find the right word(s) to say what I mean Br9 I have difficulty expressing my thoughts Br10 I am bothered by the change in my personality Br11 I am able to make decisions and take responsibility Br12 I am bothered by the drop in my contribution to the family Br13 I am able to put my thoughts together Br14 I need help in caring for myself (bathing, dressing, eating, etc.) Br15 I am able to put my thoughts into action Br16 I am able to read like I used to Br17 I am able to write like I used to Br18 I am able to drive a vehicle (my car, truck, etc.) Br19 I have trouble feeling sensations in my arms, hands, or legs Br20 I have weakness in my arms or legs Br21 I have trouble with coordination An 10 I get headaches