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The National Comprehensive Cancer Network-Functional Assessment of Cancer Treatment (NCCN-FACT) Advanced Cancer Symptom Indices, the Need for Better Health-Related Quality of Life HRQOL) Measuring in Palliative Care

Ahmet Deniz

There is a need for improved measurement of clinically significant advanced cancer-specific symptoms that are sensitive to intervention-related changes and that reflect the symptoms that both oncology clinicians and patients believe are most important to measure, given the growing importance placed upon Health-Related Quality Of Life (HRQOL) as an endpoint when evaluating advanced cancer treatment outcomes. The National Comprehensive Cancer Network-Functional Assessment of Cancer Therapy (NCCN-FACT) advanced cancer symptom indexes were created in response to this need for better HRQOL measurement using a strict, multi-step methodology that complies with regulatory guidance for patient-reported outcome measures. The most significant symptoms as identified by oncology doctors and people with advanced cancer were measured using eleven NCCN-FACT advanced cancerspecific symptom indices. In this study, we provide a brief overview of the NCCNFACT scales' development as well as a list of its benefits over earlier measures, such as their brevity, clinical relevance, and higher regulatory acceptance. We discuss the possible clinical and academic uses of these measures in palliative care as well as interpretabilityrelated concerns. In order to demonstrate how results from the NCCN-FACT symptom indexes may be utilised and interpreted in clinical practise, we also provide the NCCN-FACT-Ovarian Symptom Index-18 (NFOSI-18) and its predecessor, the Functional Assessment of Cancer Therapy-Ovarian (FACT-O) Treatment Outcome Index (TOI). We recommend that published clinical trial data using cancer-specific FACT measures can inform planning for future use of the NCCN-FACT symptom indexes in research and clinical practise given the preliminary status of research reporting the use of the NCCN-FACT symptom indexes and their content overlap with precursor disease-specific measures from the FACT measurement system.