title: A randomized validation study comparing embedded versus extracted FACT Head and Neck Symptom Index scores.
abstract: OBJECTIVE
  To evaluate the impact of administration context (embedded versus stand-alone) on the reliability and validity of the FACT Head and Neck Symptom Index (FHNSI).
  
  
  METHODS
  Ninety-eight patients with head and neck cancer were randomized to one of two assessment conditions to evaluate the FHNSI's context (items administered embedded within the FACT-H&N or as stand-alone scale) and order of administration in the battery.
  
  
  RESULTS
  Planned comparisons on the item and scale levels revealed no systematic order or context differences. The embedded and stand-alone versions of the FHNSI showed high internal consistency (Cronbach's alpha 0.79-0.87). Correlations were high between the FHNSI versions and the physical and functional well-being scales of the FACT-H&N (0.70-0.84) and measures of pain intensity (-0.73, -0.74) and depression (-0.71, -0.74); moderate to large with the Performance Status Scale for Head and Neck subscales (PSS-HN; 0.46-0.71); and low with an anxiety measure (0.30, 0.34). Both FHNSI versions differentiated patients grouped by performance status (p < .0001, p < .0001) and global rating of change (p < .0001, p < 0.01). The FHNSI's minimally important difference range was 3-4 points.
  
  
  CONCLUSIONS
  The FHNSI is a reliable and valid symptom index, which can be administered alone or scored using items embedded within the FACT-H&N.
authors.affiliation: Center on Outcomes, Research and Education (CORE), Evanston Northwestern Healthcare, Evanston, IL 60201, USA. s-yount@northwestern.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Yount
authors.forename: Marcy
authors.initials: M
authors.lastname: List
authors.forename: Hongyan
authors.initials: H
authors.lastname: Du
authors.forename: Kathleen
authors.initials: K
authors.lastname: Yost
authors.forename: Rita
authors.initials: R
authors.lastname: Bode
authors.forename: Bruce
authors.initials: B
authors.lastname: Brockstein
authors.forename: Athanassios
authors.initials: A
authors.lastname: Argiris
authors.forename: Everett
authors.initials: E
authors.lastname: Vokes
authors.forename: Ezra E W
authors.initials: EE
authors.lastname: Cohen
authors.forename: Bruce
authors.initials: B
authors.lastname: Campbell
authors.forename: Veronica
authors.initials: V
authors.lastname: Valenzuela
authors.forename: Jacquelyn
authors.initials: J
authors.lastname: George
authors.forename: Robyn
authors.initials: R
authors.lastname: Egan
authors.forename: Jessica
authors.initials: J
authors.lastname: Chen
authors.forename: David
authors.initials: D
authors.lastname: Meddis
authors.forename: David
authors.initials: D
authors.lastname: Cella
mesh_terms: D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014481:United States