Functional Assessment of Cancer Therapy - General (FACT-G)

The FACT-G (Version 4) is a patient-reported outcome measure used to assess health-related quality of life in patients undergoing cancer therapy. The FACT-G is the original questionnaire that led to the development of the larger Functional Assessment of Chronic Illness Therapy (FACIT) collection of quality of life instruments. The survey assesses the impacts of cancer therapy in four domains: physical, social/family, emotional, and functional. The FACT-G is also offered with additional questions measuring cancer-specific factors that may affect quality of life, leading to the creation of the Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N), the Functional Assessment of Cancer Therapy - Lung (FACT-L), and 18 others.

The Fact-G was developed by Dr. David Cella, now president and Chief Scientific Officer of FACIT.org and Chair of the Department of Medical Social Sciences at Northwestern University Feinberg School of Medicine. It was developed to assess the quality of life in cancer patients undergoing clinical trials for cancer therapy. Dr. Cella argues for the value of quality of life measures in general because "implicitly, the relief of a symptom is valued because of its associated benefit to patient function and well-being. Explicitly, it is essential to determine whether any supportive-care intervention is producing a benefit that outweighs its cost." Since development began in 1987, the initial 33-item Fact-G published in 1993 has undergone multiple revisions, with the latest version (Fact-G Version 4) "designed to enhance clarity and precision of measurement" through "formatting simplification, item-reduction, and rewording," resulting in the 27-item scale used today. In addition to revisions and refinement, the FACT-G has been translated into over 60 languages.

The FACT-G Version 4 has 27 questions, each of which is answered using a 5-point Likert scale ranging from 0 (Not at all) to 4 (Very much). Questions are phrased so that higher numbers indicate a better health state, leading to some items being reverse-scored. Questions measure the respondents' health state over the last 7 days in four subscales: Physical Well-Being (PWB, 7 questions), Social/Family Well-Being (SWB, 7 questions), Emotional Well-Being (EWB, 6 questions), and Functional Well-being (FWB, 7 questions). Disease-specific versions of the FACT-G contain these four core subscales, with additional questions appended to address disease-specific factors.

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