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Validation of the functional assessment of cancer therapy-gastric module for the Chinese population

Hui Jun Zhou1, Jimmy BY So2, Wei Peng Yong3, Nan Luo1, Feng Zhu4, Nasheen Naidoo1, Shu Chuen Li5 and Khay Guan Yeoh4*

Author Affiliations

1 Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, Block MD3, Singapore 117597, Singapore

2 Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore 119228, Singapore

3 Department of Haematology-Oncology, National University Cancer Institute, Singapore 14 Medical Drive, #12-01, Singapore 117599, Singapore

4 Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E, Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228, Singapore

5 Discipline of Pharmacy & Experimental Pharmacology, School of Biomedical Sciences & Pharmacy, Room 607c, Medical Sciences Building, University of Newcastle, Callaghan, N.S.W, 2308, Australia

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Health and Quality of Life Outcomes 2012, 10:145  doi:10.1186/1477-7525-10-145

Published: 30 November 2012



Quality of life (QoL) assessment has become an important aspect of the clinical management of gastric cancer (GC), which poses a greater health threat in Chinese populations around the world. Functional Assessment of Cancer Therapy-Gastric Module (FACT-Ga), a questionnaire developed specifically to measure QoL of patients with GC, has never been validated in Chinese subjects. The current study was designed to examine the psychometric properties of FACT-Ga as a GC specific QoL instrument for its future use in Chinese populations.


A sample of 67 Chinese patients with GC in the National University Hospital, Singapore was investigated cross-sectionally. The participants independently completed either English or Chinese versions of the FACT-Ga and the European Quality of Life-5 Dimensions (EQ-5D). Reliability was measured as the Cronbach’s α for EQ-5D, and five subscale scores and two total scores of FACT-Ga. The sensitivity to patients’ clinical status was evaluated by comparing EQ-5D and FACT-Ga scores between clinical subgroups classified by Clinical Stage and Treatment Intent. The construct validity of FACT-Ga was assessed internally by examining the item-to-scale correlations and externally by contrasting the FACT-Ga subscales with the EQ-5D domains.


For both FACT-Ga and EQ-5D, patients treated with curative intent rated their QoL higher than those treated for palliation, and early stage patients scored higher than those in the late stage. The sensitivity to clinical status of FACT-Ga scores were differential as four of seven FACT-Ga scores were significant for Treatment Intent while only one subscale score was significant for Clinical Stage. Six FACT-Ga scores had Cronbach’s α of 0.8 or above indicating excellent reliability. For construct validity, 45 of 46 items converged about their respective subscales. The monotrait-multimethod correlations between QoL constructs of FACT-Ga and EQ-5D were stronger than the multitrait-multimethod correlations as theoretically hypothesized, suggesting good convergent and discriminant validities.


Given the excellent reliability and good construct validity, FACT-Ga scores are able to distinguish patient groups with different clinical characteristics in the expected direction. Therefore FACT-Ga can be used as a discriminative instrument for measuring QoL of Chinese patients with GC.

Gastric cancer; Functional assessment of cancer therapy- gastric; Quality of life; Reliability; Validity; Chinese