FORT LAUDERDALE, Fla--Although many quality of life measures for cancer have been validated, eg, the FLIC (Functional Living Index-Cancer) and the FACT (Functional Assessment of Cancer Therapy), use of a single instrument facilitates analysis of data obtained at different sites, David F. Cella, PhD, said at the first annual conference of the National Comprehensive Cancer Network (NCCN).
However, it is now possible to convert the total or aggregate score from a specific assessment tool to a "Q" score that provides "a reasonable estimate of a person's quality of life," he said, adding that Q score can also potentially be used as a modifier of survival time.
Dr. Cella and his colleagues at Rush Medical College, Chicago, where is he associate professor of psychology and internal medicine, have shown that the total scores obtained with FLIC or FACT (developed by Dr. Cella) are equivalent.
"This means that you can take the total score from either instrument and convert it to a standardized Q score," he said, "and then use that standardized score as the basis for discussion and comparison across trials, across physicians, or between physician and patient." The Rush researchers have devised a table that converts a raw FACT score to a FLIC score and a Q score.
About a dozen subscales are available for use with the FACT-G, a 34-item general quality of life measure, targeted to specific treatments, disease symptoms, issues (such as treatment satisfaction), and even protocols, Dr. Cella said.
The ovarian cancer subscale, for example, asks about problems specific to ovarian cancer such as abdominal swelling, cramps, mobility, weight loss, and bowel control. An ovarian cancer therapy might not be deemed effective measured by the FACT-G, he said, but could be shown to have a pronounced impact on symptom relief, measured by the subscale.
"The better you're able to chart quality of life benefits, the more ammunition you're going to have to justify a treatment," Dr. Cella said, especially in the era of managed care. He said that physicians should not assume that the impact of treatments on quality of life will be negative if the treatment has no measurable effect on response rate and survival.