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A randomized validation study comparing embedded versus extracted FACT Head and Neck Symptom Index scores

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Abstract

Objective

To evaluate the impact of administration context (embedded versus stand-alone) on the reliability and validity of the FACT Head and Neck Symptom Index (FHNSI).

Methods

Ninety-eight patients with head and neck cancer were randomized to one of two assessment conditions to evaluate the FHNSI’s context (items administered embedded within the FACT-H&N or as stand-alone scale) and order of administration in the battery.

Results

Planned comparisons on the item and scale levels revealed no systematic order or context differences. The embedded and stand-alone versions of the FHNSI showed high internal consistency (Cronbach's alpha 0.79–0.87). Correlations were high between the FHNSI versions and the physical and functional well-being scales of the FACT-H&N (0.70–0.84) and measures of pain intensity (−0.73, −0.74) and depression (−0.71, −0.74); moderate to large with the Performance Status Scale for Head and Neck subscales (PSS-HN; 0.46–0.71); and low with an anxiety measure (0.30, 0.34). Both FHNSI versions differentiated patients grouped by performance status (p < .0001, p < .0001) and global rating of change (p < .0001, p < 0.01). The FHNSI's minimally important difference range was 3–4 points.

Conclusion

The FHNSI is a reliable and valid symptom index, which can be administered alone or scored using items embedded within the FACT-H&N.

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Abbreviations

HRQL:

Health-related quality of life

FACT-G:

Functional Assessment of Cancer Therapy-General

EORTC:

European Organization for Research and Treatment of Cancer

FACT-H & N:

FACT-Head and Neck

FHNSI:

FACT Head and Neck Symptom Index

KPS:

Karnofsky Performance Score

ECOG PSR:

Eastern Cooperative Oncology Group Performance Status Rating

PWB:

Physical well-being

SWB:

Social/family well-being

EWB:

Emotional well-being

FWB:

Functional well-being

HNCS:

Head and Neck Cancer Subscale

PSS-HN:

Performance Status Scale for Head and Neck

BPI:

Brief Pain Inventory

CES-D:

Center for Epidemiological Studies-Depression Scale

HADS-A:

Anxiety and Depression Scale-Anxiety Component

MCSDS:

Marlowe–Crowne Social Desirability Scale

GRCS:

Global Rating of Change Scale

MIDs:

Minimally Important Differences

SEM:

Standard error of measurement

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Acknowledgment

This study was supported by an unrestricted grant from AstraZeneca Pharmaceuticals.

Author information

Authors and Affiliations

  1. Center on Outcomes, Research and Education (CORE), Evanston Northwestern Healthcare, 1001 University Place, Suite 100, Evanston, IL, 60201, USA

    Susan Yount, Hongyan Du, Kathleen Yost, Rita Bode, Veronica Valenzuela, Jacquelyn George & David Cella

  2. Department of Medicine, Evanston Northwestern Healthcare, Evanston, IL, USA

    Bruce Brockstein

  3. Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA

    Susan Yount, Kathleen Yost & David Cella

  4. University of Chicago Cancer Research Center, Chicago, IL, USA

    Marcy List, Everett Vokes, Ezra E. W. Cohen, Robyn Egan & Jessica Chen

  5. University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Athanassios Argiris

  6. Medical College of Wisconsin, Milwaukee, WI, USA

    Bruce Campbell

  7. AstraZeneca Pharmaceuticals, Macclesfield, UK

    David Meddis

Authors
  1. Susan Yount
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  2. Marcy List
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  3. Hongyan Du
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  10. Bruce Campbell
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  14. Jessica Chen
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  15. David Meddis
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  16. David Cella
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Corresponding author

Correspondence to Susan Yount.

Additional information

Athanassios Argiris—Formerly of Feinberg School of Medicine, Northwestern University, Chicago, IL.

Appendix: Functional Assessment of Cancer Therapy Head and Neck Symptom Index

Appendix: Functional Assessment of Cancer Therapy Head and Neck Symptom Index

Below is a list of statements that other people with your illness have said are important. By circling one number per line, please indicate how true each statement has been for you during the past 7 days

  

Not at all

A little bit

Some-what

Quite a bit

Very much

GP4

I have pain

0

1

2

3

4

GP1

I have a lack of energy

0

1

2

3

4

H & N7

I can swallow naturally and easily

0

1

2

3

4

H & N 12

I have pain in my mouth, throat, or neck

0

1

2

3

4

H & N3

I have trouble breathing

0

1

2

3

4

H & N10

I am able to communicate with others

0

1

2

3

4

GP2

I have nausea

0

1

2

3

4

H & N11

I can eat solid foods

0

1

2

3

4

GE6

I worry that my condition will get worse

0

1

2

3

4

GF7

I am content with the quality of my life right now

0

1

2

3

4

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Yount, S., List, M., Du, H. et al. A randomized validation study comparing embedded versus extracted FACT Head and Neck Symptom Index scores. Qual Life Res 16, 1615–1626 (2007). https://doi.org/10.1007/s11136-007-9270-9

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  • DOI: https://doi.org/10.1007/s11136-007-9270-9

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