• J M Ribaudo, D Cella, E A Hahn, S R Lloyd, N S Tchekmedyian, J Von Roenn, and W T Leslie.
• Center on Outcomes Research and Education, Evanston Northwestern Healthcare, IL, USA.
• Qual Life Res. 2000 Jan 1; 9 (10): 1137-46.

PurposeThe original Functional Assessment of Anorexia/Cachexia Therapy (FAACT) was designed to measure general aspects of quality of life (QOL) as well as specific anorexia/cachexia-related concerns. Our primary purpose was to reduce the number of anorexia/cachexia subscale items in a manner that either retains or improves reliability, validity and precision.MethodsThe FAACT was administered using an interactive computer program that allowed immediate entry of the data. A total of 213 patients were recruited.ResultsA combined empirical and conceptual approach led to the reduction of the anorexia/cachexia subscale (A/CS) from 18 to 12 items. A 26-item trial outcome index (TOI) combining physical well-being (PWB), functional well-being (FWB), and the A/CS-12 was highly reliable and sensitive to change in performance status rating (PSR). We found that PWB, FWB, and A/CS-12 subscales performed differently. Specifically, PWB and FWB scores decreased in patients whose (PSR) worsened. However, although A/CS-12 scores were responsive to change in PSR over time, average A/CS-12 scores of all patients, even those whose PSR worsened, improved over the course of treatment.ConclusionsElimination of six items from the anorexia/cachexia subscale of the FAACT was accomplished without loss of internal consistency or sensitivity to change in performance status. The A/CS-12 subscale provides unique, important information not captured by a generic chronic illness questionnaire.

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