Development of a melanoma-specific subscale for the Functional Assessment of Cancer Therapy (FACT-Melanoma)

Abstract

8122 Background: A systematic review of the quality of life (QOL) literature in melanoma patients suggests an overwhelming need for a disease specific subscale. A melanoma subscale for the Functional Assessment of Cancer Therapy (FACT) was developed to address this need. Methods: A three-phase process was utilized for item generation, reduction and scale construction. First, a comprehensive review of the literature was performed as well as examination of over 300 cancer specific items from the Functional Assessment of Chronic Illness Therapy (FACIT) item bank. All questions with potential relevance for patients with melanoma were selected for further evaluation. Phase II consisted of a survey and evaluation of potential items by twenty melanoma experts, including physicians, nurses, physician assistants, and social workers. Phase III involved administration of the pilot questionnaire to 40 patients with various stages of melanoma and a semi-structured interview to assess item comprehension, relevance and overall content. Results: A total of 97 items were pooled from the literature and the FACIT item bank. Item review and reduction resulted in a 44-item questionnaire. Expert evaluations were collated and frequencies of responses summarized. Items identified as “quite relevant” or “very relevant” by at least 70% of experts were retained. Further refinement resulted in a pilot questionnaire consisting of 25 items. A majority of patients determined the content of the pilot questionnaire to be relevant (95%), comprehensive (60%), and easy to understand (88%). Final revisions, based on patient input, resulted in the omission of 3 items, modification of 6 items, and the addition of 4 new items. The FACT-Melanoma consists of 26 items encompassing 3 QOL domains: 19 items related to physical well-being; 5 related to social/emotional well-being; and 2 items related to functional well-being. Conclusions: The face and content validity of the FACT-Melanoma has been confirmed by melanoma patients and professionals. Formal validation and reliability testing is currently underway in a prospective cohort of 300 melanoma patients with all disease stages. No significant financial relationships to disclose.