ORIGINAL ARTICLE Psychometric validation of the functional assessment of cancer therapy—brain (FACT-Br) for assessing quality of life in patients with brain metastases Nemica Thavarajah & Gillian Bedard & Liying Zhang & David Cella & Jennifer L. Beaumont & May Tsao & Elizabeth Barnes & Cyril Danjoux & Arjun Sahgal & Hany Soliman & Edward Chow Received: 15 May 2013 /Accepted: 15 November 2013 /Published online: 28 November 2013 # Springer-Verlag Berlin Heidelberg 2013 Abstract Objective This study aimed to test the reliability, psychomet- ric, and clinical validity of the use of the Functional Assessment of Cancer Therapy—Brain (FACT-Br) in patients with brain metastases. Methods Patients with brain metastases were interviewed using the FACT-Br (including the FACT-general) 1 week prior to treatment. All patients completed a follow-up assessment 1 month post-treatment. Patients with a good performance status and receiving stereotactic radiosurgery completed an additional 1 week follow-up assessment after the initial base- line interview to assess test–retest reliability. Results Forty patients had complete 1 month follow-up data. Ten of these patients also completed the 1 week follow-up assessment from baseline. The median Karnofsky perfor- mance status of patients was 80 and the median age was 64 years. All subscales of the FACT-Br were found to be conceptually related (except for two correlations) using the following subscales: physical well-being (PWB), social/ family well-being (SWB), emotional well-being (EWB), functional well-being (FWB), FACT-G total score, brain can- cer subscale (BrC), and the FACT-Br total score. All FACT-Br scores demonstrated excellent reliability, except for the SWB scale which revealed good reliability. The FACT-Br scores showed no significant change in the quality of life (QoL) of patients from baseline to 1 month follow-up. Conclusion The use of the combined FACT-G and FACT-Br Subscale to assess QoL specifically in patients with brain metastases has successfully undergone psy- chometric validation. Future clinical trials should use the FACT-G and FACT-Br Subscale to assess QoL in this patient population. Keywords Quality of life . Brain metastases . Questionnaire . Psychometric validation . FACT-Br . FACT-G . Field-testing Introduction Brain metastases are a significant complication of advanced cancer, affecting approximately 20–40 % of cancer patients during the course of their disease [1]. The most common primary sites of cancer from which brain metastases arise from include lung, breast, skin, kidney, and colon [2]. With the improvement in imaging modalities and screening techniques available, the detection and incidence of brain metastases continues to increase [3]. Newly diagnosed brain metastases patients often present with some degree of neuro-cognitive dysfunction, including symptoms such as speech impediment, seizures, weakness, headaches, and lack of muscle coordina- tion, to name a few [2, 4, 5]. Various treatment modalities exist for the treatment of brain metastases and are ultimately targeted at improving quality of N. Thavarajah : G. Bedard : L. Zhang : M. Tsao : E. Barnes : C. Danjoux : A. Sahgal : H. Soliman : E. Chow Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada D. Cella : J. L. Beaumont Northwestern University, Chicago, IL, USA E. Chow (*) Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada M4N3M5 e-mail: Edward.Chow@sunnybrook.ca Support Care Cancer (2014) 22:1017–1028 DOI 10.1007/s00520-013-2060-8