The FACT-Melanoma quality-of-life instrument: comparison of a five-point and four-point response scale using the Rasch measurement model

Julie B Winstanley, Robyn Saw, Frances Boyle, John Thompson
Melanoma Research 2013, 23 (1): 61-9
The FACT-Melanoma (FACT-M) is one of only two validated quality-of-life instruments designed specifically for use in patients with melanoma. The instrument incorporates FACT-G, followed by a set of questionnaire items that are specific to melanoma; all items are scored on a five-point response scale. The primary aim of this study was to evaluate the five-point response format of the FACT-M for goodness of fit to the Rasch measurement model, and to investigate whether rescoring the instrument using a four-point response format improved the psychometric properties. Two data sets of similar patient sample sizes (n=127 and 123) were used to test the reliability and validity of the generic instrument (FACT-G) to measure quality of life for patients with melanoma. The Additional Concerns and Melanoma Surgery subscales were subjected to a more detailed analysis using a combination of confirmatory factor analysis and Rasch analysis techniques. The Rasch model fit of the FACT-M was improved by the use of a four-point response format, together with the deletion of three items. Principal components analysis suggested that two melanoma-specific subscales existed within the Additional Concerns subscale and each could be reduced to seven items, respectively, with improved goodness of fit to the Rasch model. The FACT-M instrument showed improved fit to the Rasch model specifications when the items adopted a four-point response format. These results point to possible improvements in the content and structure of the FACT-M for use in future melanoma clinical trials. However, further study should be conducted with larger samples, selected by disease and treatment status.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"