title: A brief symptom index for advanced lung cancer.
abstract: BACKGROUND
  Advanced lung cancer is often symptomatic; thus the goals of treatment include maintenance of function and palliation of symptoms. Symptom management requires accurate systematic symptom assessment. This study, which focused on lung cancer, is part of a larger study to obtain patient input that, in combination with previously obtained physician and nurse input, was used to develop symptom indexes for 11 advanced cancers.
  
  
  METHODS
  Fifty patients with advanced lung cancer were recruited from National Comprehensive Cancer Network (NCCN) member institutions and community support agencies; 10 physician experts were recruited from NCCN institutions. Patients reported symptoms associated with their disease in open-ended format and then completed a checklist of symptoms, rating their 5 most important symptoms. Patient and provider ratings of symptom importance were tabulated to construct the NCCN-Functional Assessment of Cancer Therapy (FACT) Lung Symptom Index-17 (NFLSI-17). Patients also completed the Functional Assessment of Cancer Therapy-Lung (FACT-L), which was used to preliminarily validate the NFLSI-17.
  
  
  RESULTS
  Based on combined patient, physician, and nurse input, the NFLSI-17 is composed of 17 priority symptoms, 11 that are disease related, 3 that are treatment related, and 3 that are related to general functional well-being (FWB). Data on 15 of 17 NFLSI-17 symptoms showed good internal consistency (alpha = 0.74) and strong association with the FACT-L total and most subscale scores (r = 0.42-0.92). Both the NFLSI-15 (F(2,47) = 4.46; P = .017) and the NFLSI-disease related subscale (DRS) (F(2,47) = 5.56; P = .007) significantly discriminated patients among performance status groups.
  
  
  CONCLUSIONS
  The NFLSI-17 reflects the most important patient- and clinician-rated targets of chemotherapy for advanced lung cancer; further validation will follow.
authors: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. s-yount@northwestern.edu
authors: Susan
authors: S
authors: Yount
authors: Jennifer
authors: J
authors: Beaumont
authors: Sarah
authors: S
authors: Rosenbloom
authors: David
authors: D
authors: Cella
authors: Jyoti
authors: J
authors: Patel
authors: Thomas
authors: T
authors: Hensing
authors: Paul B
authors: PB
authors: Jacobsen
authors: Karen
authors: K
authors: Syrjala
authors: Amy P
authors: AP
authors: Abernethy
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000706:statistics & numerical data; D010361:Patients / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data; D011379:Prognosis; D011788:Quality of Life; D011795:Surveys and Questionnaires