title: Content validity of the NCCN-FACT ovarian symptom index-18 (NFOSI-18).
abstract: OBJECTIVE
  This study examined the content validity of the NCCN-FACT Ovarian Symptom Index-18 (NFOSI-18), an advanced ovarian cancer symptom index comprised of symptoms perceived as most important by clinical experts and women with advanced ovarian cancer.
  
  
  METHODS
  Eighteen women with advanced ovarian cancer completed the NFOSI-18 and participated in cognitive interviews to assess: (a) the understandability of the NFOSI-18; and (b) the things patients have in mind when responding to the item, "I am bothered by side effects of treatment;" and (c) the interpretation patients place on items relating to fatigue and lack of energy. Interviews were recorded and transcribed for qualitative analysis.
  
  
  RESULTS
  All but 2 (89%) participants indicated that each item was clear and understandable and the same proportion (89%) stated they were "very confident" or "confident" about providing accurate answers to all but one item. When responding to the item, "I am bothered by side effects of treatment," fatigue, nausea, and neuropathy constituted the most frequently mentioned concerns. Among the participants who were asked, eight participants responded that "fatigue" and "lack of energy" were the same concept and nine responded they were different. Participants associated "fatigue" with tiredness and associated "lack of energy" with the inability to perform daily tasks and activities.
  
  
  CONCLUSIONS
  The findings support the content validity of the NFOSI-18. Item revisions, deletions or additions do not appear warranted. Future research can address the reliability and validity of the NFOSI-18 in clinical research.
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633N. St. Clair 19th Floor, Chicago, IL 60611, United States; Department of Surgery (Organ Transplantation), Northwestern University Feinberg School of Medicine, 676N. St. Clair 19th Floor, Chicago, IL 60611, United States.
authors.forename: Sally E
authors.initials: SE
authors.lastname: Jensen
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633N. St. Clair 19th Floor, Chicago, IL 60611, United States.
authors.forename: Karen
authors.initials: K
authors.lastname: Kaiser
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633N. St. Clair 19th Floor, Chicago, IL 60611, United States.
authors.forename: Leilani
authors.initials: L
authors.lastname: Lacson
authors.affiliation: Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, 675N. St. Clair 21st Floor, Chicago, IL 60611, United States; Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E. Superior St., Suite 3-2303, Chicago, IL 60611, United States.
authors.forename: Julian
authors.initials: J
authors.lastname: Schink
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633N. St. Clair 19th Floor, Chicago, IL 60611, United States; Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, 675N. St. Clair 21st Floor, Chicago, IL 60611, United States. Electronic address: d-cella@northwestern.edu.
authors.forename: David
authors.initials: D
authors.lastname: Cella
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000145:classification / Q000175:diagnosis*; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Content validity; Ovarian cancer; Patient-reported outcome; Quality of life; Symptom index