10.

1177/0163278705275341
Evaluation & the Health Professions / June 2005
Brucker et al. / FACT-G NORMATIVE DATA

Given the number of new cancer cases diag- GENERAL POPULATION

nosed each year and the increases in survival AND CANCER PATIENT
rates, the importance of having a clinically NORMS FOR THE
useful health-related quality of life (HRQOL)
instrument has increased. The Functional FUNCTIONAL
Assessment of Cancer Therapy–General ASSESSMENT OF
(FACT-G) is one such instrument that has been CANCER THERAPY–
used worldwide to assess HRQOL. Previ-
ously, the use of the FACT-G had been limited
GENERAL (FACT-G)
because of a lack of published normative data.
Normative data are useful for consumers to
PENNY S. BRUCKER
place their results in an appropriate context by
Feinberg School of Medicine at
comparing their scores of individuals or Northwestern University
group of individuals to a reference group.
KATHLEEN YOST
Here, we present normative data for the
FACT-G for two reference groups: (a) a sam- JOHN CASHY
ple of the general U.S. adult population and KIMBERLY WEBSTER
(b) a large, heterogeneous sample of adult DAVID CELLA
patients with cancer. In addition, we dem- Center on Outcomes Research and
onstrate various uses of the normative data. Education (CORE) at Evanston
Northwestern Healthcare, Feinberg School
of Medicine at Northwestern University
Keywords: quality of life; reference values;
cancer; normative data

AUTHORS’NOTE: Inquires concerning this

article should be directed to Penny Brucker,
Ph.D., at the Center on Outcomes Research
and Education, Evanston Northwestern
Healthcare, 1001 University Place, Evanston,
IL 60201; e-mail: p-brucker@northwestern.
edu

EVALUATION & THE HEALTH PROFESSIONS, Vol. 28 No. 2, June 2005 192-211
DOI: 10.1177/0163278705275341
© 2005 Sage Publications

192
 Brucker et al. / FACT-G NORMATIVE DATA 193

A n important therapeutic goal for patients with cancer and their

health care providers is improving health-related quality of life
(HRQOL). Given the increases in the number of people diagnosed
with cancer each year (American Cancer Society, 2005) and the num-
ber of new cancer treatments that are continuously being developed,
the importance of having a clinically useful HRQOL assessment has
increased.
The Functional Assessment of Cancer Therapy–General (FACT-G;
http://www.facit.org) is one such instrument that has been used to
assess HRQOL. The FACT-G was first developed and validated sev-
eral years ago (Cella et al., 1993). Now in its fourth version, the
FACT-G has been translated into nearly 50 different languages and
has been used extensively worldwide (Cella, 2004). The FACT-G
comprises four subscales: Physical Well-Being (PWB), Social/Family
Well-Being (SWB), Emotional Well-Being (EWB), and Functional
Well-Being (FWB). Consumers of the FACT-G are able to generate
an overall score and four subscale scores with ranges and distributions
that are sample specific. However, interpretation of one’s results is
difficult because the scores obtained in any given study are not easily
referenced to a larger population. By themselves, they are simply
numbers representing a sample-specific central tendency and distri-
bution. External reference data on the same instrument in larger sam-
ples, which are representative of a meaningful group, can place one’s
small group results in context. We have developed normative refer-
ence data for the FACT-G to aid in the interpretation and understand-
ing of clinical and research data. The purpose of this article is to pres-
ent FACT-G normative data and to give examples of how this data can
be used.
We present normative data for the FACT-G for two reference
groups: (a) a sample of the general U.S. adult population and (b) a
sample of adult patients with cancer. Although normative data for the
FACT-G may be revised on the receipt of additional data, the norms
presented here make possible opportunities for important advance-
ments in the interpretation of HRQOL data for patients with cancer.
The presentation of these norms enhances the usefulness of the
questionnaire.
194 Evaluation & the Health Professions / June 2005

There are several ways normative data can facilitate the interpreta-
tion of HRQOL assessment scores. The raw score means and standard
deviations of HRQOL assessment scores for an individual patient
with cancer or for a sample of patients with cancer can be compared to
the normative data of a reference group to determine whether the
patient’s or sample’s HRQOL score is lower, higher, or similar to that
of the reference group. Comparing the percentage of scores at the ceil-
ing and floor, percentiles, and the minimum and maximum values for
a study sample to a reference group can provide useful information on
the distribution of the study sample data relative to the reference
groups. In addition, T-scores, which rescale raw scores into standard-
ized scores with a mean of 50 and a standard deviation (SD) of 10, can
be generated allowing consumers to make direct comparison of scores
that are measured on different scales. Finally, standardized effect
sizes, which allow effect sizes to be compared across studies, can be
computed by using the normative data. We provide examples of how
the normative data can facilitate the interpretation of the FACT-G
assessment scores.
Interpretation of differences or change scores should take into con-
sideration whether the reported differences are statistically significant
and/or clinically meaningful. When reviewing difference or change
scores, consumers of HRQOL information (e.g., clinicians) are often
more interested in clinical than statistical significance. One sugges-
tion that an effect size of .5 (or one half SD) is a relatively stable
important difference (Norman, Sloan, & Wyrwich, 2003; Sloan,
Symonds, Vargas-Chanes, & Fridley, 2003) may best be understood
as a conservative estimate of a minimally important difference (MID).
In the case of the FACT-G, the .5 SD benchmark appears to be some-
what larger than our estimated MID. Based on our work on MIDs,
using raw scores and clinical anchors to guide interpretation (Cella,
Eton, Lai, Peterman, & Merkel, 2002a; Webster, Cella, & Yost, 2003;
Yost & Eton, 2005), we have determined a two-point difference on the
FACT-G subscale scores and a five-point difference on the FACT-G
total score to be associated with meaningful differences on clinical
and subjective indicators. These differences are closer to one third SD.
This has led us to conclude that MIDs for FACT-G often fall in the
range of 0.3 to 0.5 SDs.
 Brucker et al. / FACT-G NORMATIVE DATA 195

METHOD

GENERAL U.S. ADULT POPULATION SAMPLE

The FACT-G normative sample data for the general U.S. adult pop-
ulation reference group were collected by Knowledge Networks (KN;
Menlo Park, CA), a marketing information and decision support sys-
tem. KN drew a random sample of 1,400 people, age 18 years and
older, from more than 100,000 individuals who were members of an
Internet-based survey panel. According to KN, the panel was a demo-
graphically representative sample of the general U.S. adult popula-
tion. Members of the survey panel responded to one survey per month
in exchange for free installation of WebTV Internet service. The
FACT-G (Version 4) was one such survey that was presented electron-
ically to the panel members who completed the survey in their homes
(Cella et al., 2003).

ADULT CANCER PATIENT SAMPLE

The FACT-G sample data used for the adult patient with cancer ref-
erence group were generated by combining two data sets from previ-
ous studies. The first study, referred to as the Bilingual Intercultural
Oncology Quality of Life (BIOQOL) project (National Institutes of
Health [NIH] Grant #CA 61679), was a 3-year validation study of the
FACT measurement system. The core aim of the current study, from
which the sample data were drawn, was to test the psychometric prop-
erties and statistical equivalence of FACT scales across language, cul-
ture, literacy, and mode of administration. Data were collected from
patients located in three cities: Atlanta, Georgia; Chicago, Illinois;
and San Juan, Puerto Rico. Patients were recruited from public care
settings and private care settings. To be eligible, patients were
required to be older than age 17 years and have had one of the follow-
ing diagnoses: breast cancer, lung cancer, colorectal cancer, head
and/or neck cancer, and/or HIV-related malignancy. Institutions
recruited eligible patients consecutively to obtain a reasonable repre-
sentative sample of patients with respect to performance status, socio-
economic status, age, and gender. Participants provided
196 Evaluation & the Health Professions / June 2005

sociodemographic and treatment information. They also completed a

small battery of questionnaires, including the FACT-G (Version 3).
Depending on the language preference, participants completed either
a Spanish or English version of the assessment battery.
The second study, referred to as the Q-Score project (NIH Grant
#CA 60068), was a 3-year effort to cocalibrate five commonly used
HRQOL questionnaires. The primary aim was to enable use of a com-
mon HRQOL metric, or Q-Score. Data were collected from patients
with cancer in four cities: Philadelphia, Pennsylvania; Baltimore,
Maryland; Toledo, Ohio; and Chicago, Illinois. To be eligible,
patients were required to be older than age 17 years, have a diagnosis
of any particular cancer or HIV, have a period of at least 2 months after
diagnosis, have a life expectancy of at least 3 months, and have suffi-
cient fluency in English to read and complete forms. Participants pro-
vided sociodemographic and treatment information and completed
quality of life instruments including the FACT-G (Version 3).
Data from the BIOQOL and Q-Score projects were combined and
used to generate normative data for the FACT-G total score and
subscale scores (PWB, SWB, EWB, FWB) for adult patients with
cancer. Exclusion criteria for the normative data analyses included an
HIV diagnosis, Spanish language preference, and insufficient data to
calculate the FACT-G scores.

SCORING THE FACT-G

Participants representing the two reference groups completed the

FACT-G. The FACT-G (Version 4) comprises 27 items that evaluate
quality of life (see www.facit.org for full description and scoring).
The total FACT-G score, which is the sum of the scores for the four
subscales, is computed if the total item response is greater than 80%.
The PWB, SWB, EWB, and FWB subscales and the FACT-G total
score have a lowest possible score of 0. The highest possible score is
28 for the PWB, SWB, and FWB subscales; 24 for the EWB subscale;
and 108 for the FACT-G total score. Data from samples that com-
pleted the 28-item Version 3 were scored using rules applying to Ver-
sion 4. Reliability and validity, including responsiveness, of the
FACT-G have been well documented in cancer clinical trials and clini-
cal settings (e.g., Cella et al., 1993; Overcash, Extermann, Parr, Perry, &
Balducci, 2001; Webster et al., 2003; Winstead-Fry & Schultz, 1997).
 Brucker et al. / FACT-G NORMATIVE DATA 197

Respondents from the U.S. general population sample did not com-
plete 6 of the 27 FACT-G items because these items addressed issues
specific to illness or treatment and were not considered appropriate to
administer to a general U.S. adult population sample. To ensure that
the range of scores for this 21-item version of the FACT-G would be
equivalent to scores for the complete 27-item instrument, the 4
subscales scores (PWB, SWB, EWB, FWB) were prorated. For exam-
ple, the SWB subscale has 7 items; however, only 5 were administered
to the general U.S. adult population sample. Assuming all 5 of the
administered items were answered, the prorated score for the SWB
would be computed by multiplying the sum of individual SWB items
by 7 and then dividing the sum by 5.
 5 
 ∑ SWBi  × 7
 i =1 
SWB subscale score =
5

RESULTS AND DISCUSSION

GENERAL U.S. ADULT POPULATION SAMPLE

Of the 1,400 panel members who were randomly selected and

administered the FACT-G, 1,078 (77%) responded. The respondents
were older, slightly less educated, and more likely to have been mar-
ried than nonresponders (all p < .05). Complete FACT-G data were
available for 1,075 of the respondents, and normative data are based
on these individuals. Characteristics of this sample are summarized in
Table 1.
To assess how well our sample of 1,075 panel members represented
the U.S. population, we compared the age, race, gender and education
of our sample to data from the 2000 U.S. Census. Our general U.S.
adult population sample did not differ significantly from the 2000
U.S. Census with respect to age, race, or gender. Our sample did differ,
however, from the 2000 U.S. Census by education level in that our
sample had a smaller proportion of individuals with low education
levels (i.e., less than a high school education), a smaller proportion of
individuals with high educational levels (i.e., more than some col-
lege), and a larger proportion of individuals with moderate education
levels.
198 Evaluation & the Health Professions / June 2005

TABLE 1
General U.S. Adult Population Sample Characteristics (N = 1,075)

n (Percentage)

Age 18 to 34 years 308 (28.7)

(Range = 18 35 to 44 years 219 (20.4)
to 91 years) 45 to 54 years 225 (20.9)
55 to 64 years 157 (14.6)
65 years and older 164 (15.3)
Missing 2 (.2)
Sex Female 544 (50.6)
Race and/or ethnicity White 816 (75.9)
African American 110 (10.2)
American Indian and/or Alaska Native 16 (1.5)
Asian and/or Pacific Islander 25 (2.3)
Other 50 (4.7)
Missing 58 (5.4)
Education Some high school or less 124 (11.5)
High school or GED 393 (36.7)
Some college and/or associate degree 340 (31.6)
Bachelor’s degree 140 (13.0)
Graduate or professional degree 71 (6.6)
Missing 7 (0.7)
Self-reported health Excellent 205 (19.1)
a
(MOS SF-1) Very good 387 (36.0)
Good 328 (30.5)
Fair 113 (10.5)
Poor 26 (2.4)
Missing 16 (1.5)

a. MOS SF-1 = First item (measuring general health perceptions) from the Medical Outcomes
Study 36-item Short Form (SF-36; Ware, Snow, & Kosinski, 2000)

ADULT PATIENTS WITH CANCER SAMPLE

Data were collected from 1,615 patients who participated in the

BIOQOL study and 1,714 patients who participated in the Q-Score
study. Characteristics of the participants who met the eligibility crite-
ria and were included in the normative data analyses are summarized
in Table 2 (N = 2,236).
To assess how well our adult patient with cancer sample in the com-
bined data set represented the cancer population, we compared our
proportions of gender, age, and cancer site to those proportions in the
November 2003 submission of Surveillance, Epidemiology and End
 Brucker et al. / FACT-G NORMATIVE DATA 199

TABLE 2
Adult Cancer Patient Sample Characteristics (N = 2,236)

n (Percentage)

Age 18 to 34 years 135 (6.0)

(Range = 18 35 to 44 286 (12.8)
to 92 years) 45 to 54 494 (22.1)
55 to 64 607 (27.1)
65 years and older 711 (31.8)
Missing 3 (0.1)
Sex Female 1271 (56.8)
Race and/or Ethnicity Non-Hispanic White 1534 (68.6)
Non-Hispanic Black 610 (27.3)
Hispanic 69 (3.1)
Other 21 (0.9)
Missing 2 (0.1)
Cancer site Breast 658 (29.4)
Colorectal 281 (12.6)
Head and neck 235 (10.5)
Lung 384 (17.2)
Non-Hodgkin’s lymphoma 151 (6.8)
Prostate 191 (8.5)
Hodgkin’s lymphoma 40 (1.8)
Other, unknown, or missing 296 (13.2)
ECOG performance 0 765 (34.2)
a
status 1 626 (28.0)
2 618 (27.6)
3 205 (9.2)
4 16 (0.7)
Missing 6 (0.3)

NOTE: EGOC = Eastern Cooperative Oncology Group

a. ECOG Status: 0 = fully ambulatory without symptoms; 1 = ambulatory with symptoms; 2 = re-
quires rest less than one half of the waking day; 3 = requires rest more than one half of the waking
day; and 4 = bedridden.

Results (SEER, 2004) Program. We limited our comparison to cancer

cases in the SEER database diagnosed between 1997 and 2001. The
proportions in our adult cancer sample and the SEER sample differed
with respect to gender, age, and cancer site. Our normative sample had
a greater proportion of women and greater proportions of patients in
the younger than age 50 and age 50 to 64 categories. Our normative
sample had a smaller proportion of patients in the age 64 and older cat-
egory. In addition, our normative sample had greater proportions of
patients with breast cancer, colon cancer, head and/or neck cancer,
200 Evaluation & the Health Professions / June 2005

lung cancer, non-Hodgkin’s lymphoma, and Hodgkin’s disease. Our

sample had smaller proportions of patients with prostate cancer and
missing, unknown, or other cancers.
To determine if differences in the proportions of gender, age, and
cancer site between the SEER data and our adult cancer sample were
meaningful in terms of the FACT-G subscale and total scores, we com-
puted weighted means from our cancer sample. The sample was
weighted by cancer type, and then by gender and age group within
cancer type, to match the proportions in the SEER data. We compared
these weighted means to the means from our normative cancer sam-
ple. Using our criteria for what is considered a MID (i.e., > 2-point dif-
ference on the FACT-G subscale scores and > 5-point difference on
the FACT-G total score) (Cella et al., 2002; Webster et al., 2003; Yost
et al., 2005), we found that average SEER-weighted scores were con-
sistently within the MID range of the unweighted averages. There-
fore, unweighted FACT-G subscale and total scores are provided as
general cancer norms. Any relatively minor differences in FACT-G
scores associated with variables such as gender, age and cancer type
can be explored in future investigations.1

NORMATIVE DATA

Raw scores. We present the raw scores of the normative data in the
Appendix (see Tables A1 and A2). The following descriptive statistics
are provided for each of the subscale scores (PWB, SWB, EWB,
FWB) and the FACT-G total score: mean, standard deviation, percent-
age at floor (i.e., percentage scoring the lowest possible score), per-
centage at the ceiling (i.e., percentage scoring the highest possible
score), the lowest and highest observed scores, the 25th, 50th
(median), and 75th percentiles. Descriptive statistics are presented
separately for each of the reference samples (i.e., the general U.S.
adult population sample and the adult patient with cancer sample). In
addition, normative data are presented separately for men and women
within each reference sample.
To illustrate the usefulness of normative raw data, we compared
previously published raw score FACT-G data to our general U.S. adult
population norms (see Table 3). Cella, Hahn, and Dineen (2002) pub-
lished the baseline means and standard deviations for FACT-G
 Brucker et al. / FACT-G NORMATIVE DATA 201

TABLE 3
Comparing a 2002 Study Sample With the General U.S. Adult
Population Norms (Standard Deviations in Parentheses)

General U.S. Adult

a
Scale 2002 Study Sample Population Normsb

Physical well-being 21.2 (6.2) 22.7 (5.4)

Social well-being 22.3 (4.8) 19.1 (6.8)
Emotional well-being 18.1 (4.5) 19.9 (4.8)
Functional well-being 18.8 (6.4) 18.5 (6.8)
FACT-General Total 80.4 (15.9) 80.1 (18.1)

a. Example sample data taken from Cella, Hahn, & Dineen (2002) sample of 308 male and female
patients with mixed cancer diagnoses.
b. Data taken from Table A1.

subscales and FACT-G total score for a sample of 308 patients with
mixed cancer diagnoses. We compared these mean scores to the nor-
mative mean scores found in the general U.S. adult population sample
taken from Table A1. We found that the patients with cancer in Cella,
Hahn, and Dineen’s (2002) study had comparable scores to the gen-
eral U.S. adult population sample. Small differences in PWB, EWB,
FWB, and total FACT-G scores were noted but did not exceed our cri-
teria for a MID. There was a meaningful difference (i.e., > 2 points) on
the SWB subscale between Cella, Hahn, and Dineen’s (2002) sample
(M = 22.3) and the general U.S. adult population norms (M = 19.1).
This suggests that the people with cancer from Cella, Hahn, and
Dineen’s (2002) study may actually be comparable to those in the gen-
eral population in regard to physical, emotional, functional, and over-
all well-being. In addition, participants in the Cella, Hahn, and Dineen
(2002) study may actually have more social support than what is
reported in the general population, which may be explained by the
social support need caused by serious illness.

T-scores. Two conversion tables are provided to allow one to easily

look-up the T score that corresponds to a given raw score (see Tables
A3 and A4). T score conversion tables are provided for each of the ref-
erence samples. Additional T scores can be generated by using the
corresponding data from Tables A1 and A2 and by using the following
formula where the T-score is a linear conversion of raw scores.
202 Evaluation & the Health Professions / June 2005

 Raw score − Raw Score Mean 

T score =   × 10 + 5
 Raw Score SD 

To illustrate a possible use of T scores, assume that an oncologist’s

patient scored a 14 on the PWB subscale, a 14 on the EWB subscale,
and a 63 on the FACT-G total scale. Initially, without remembering the
means, standard deviations, and possible ranges of each subscale,
developing a useful HRQOL profile on this patient may be difficult
given that these scores on are different scales. The T-score conversion
allows one to place all scores on the same scale, with a common mean
and standard deviation. Using the T-score conversion table for the
adult patient with cancer sample (see Table A4), the oncologist can
determine that the patient’s standardized PWB subscale score is 37.8,
the standardized EWB subscale score is 39.6, and the standardized
FACT-G subscale score is 39.5. Remembering that all these scores
now have a mean of 50 and a standard deviation of 10 and knowing
that the T-score conversions placed the raw scores on the same scale,
the oncologist can make more meaning out of the patients HRQOL
profile while concluding that the patient’s physical, emotional, and
overall well-being are substantially below average.
Comparisons also can be made graphically with raw scores over-
laid on a T-score template. We present T-score templates for the gen-
eral U.S. adult population sample and for the adult patient with cancer
sample (see Figures A1 and A2). We use Figure A3 to illustrate the
scores for the 308 cancer patients taken from Cella, Hahn, and Dineen
(2002) study plotted on a T score template for the general U.S. adult
population sample. A diamond indicates the raw mean scores for the
patients with cancer. Raw scores below a T score of 50 indicate that the
score for the patient with cancer is below average compared to our
general U.S. adult population sample, whereas a raw score above a T
score of 50 indicates that score for the patient with cancer is above
average compared to our general U.S. adult population sample.
A difference in T scores of one half standard deviation, or 5 points
on the T score template can be interpreted as likely to reflect a mean-
ingful difference, with the understanding that the MID is likely less
than 5 points. Thus, in our T-score template example, if the mean raw
score for the sample of 308 patients with cancer corresponds to a T
score less than 45 (i.e., at least one half standard deviation lower than
the mean) or greater than 55 (i.e., at least one half standard deviation
 Brucker et al. / FACT-G NORMATIVE DATA 203

higher than the mean), one might conclude that the scores for the
patients with cancer are meaningfully different from the general U.S.
population scores. In our example, the mean raw PWB score of 21.2
for the patients with cancer corresponds to a T score of 47.2, which
would not be considered meaningfully different while comparing this
score to a patient without cancer reference group (see Figure A3).

Effect sizes. Effect sizes are useful for interpreting the magnitude of
a difference in FACT-G scores between two groups or of changes in
FACT-G scores over time in one group. Although there are many ways
of computing effect sizes, one approach is to divide the difference in
FACT-G scores for two groups by the overall standard deviation. Nor-
mative data are useful here because they can be used to compute stan-
dardized effect sizes where the differences in FACT-G scores for two
groups are divided by the standard deviation in a reference population.
Standardized effect sizes are valuable because they allow effect size
information to be comparable across studies.
For example, assume two separate studies, A and B, reported dif-
ferences in FACT-G total scores between groups of patients (e.g.,
early stage vs. late state). Assume that the FACT-G mean scores and
mean score differences across stage of diagnosis for the two studies
are exactly the same (mean score = 82.0; mean score difference = 10),
although the two samples have different standard deviations (e.g.,
Study A’s SD = 20.0; Study B’s SD = 16.0). If the standard deviation in
each study was used to compute effect sizes, they would be 0.50
(10.0/20.0) for Study A and 0.63 (10.0/16.0) for Study B. Thus,
slightly different interpretations regarding the magnitude of the
10-point difference would arise for the two studies. However, by using
the standard deviation from a normative data table, a consistent inter-
pretation would result. For the purpose of illustration, we use the stan-
dard deviation for FACT-G scores for the general U.S. population,
which is 18.1 as reported in Table A1. The standardized effect sizes
associated with a 10-point difference for both Studies A and B would
be 0.55 (10/18.1).
In summary, HRQOL has become an important endpoint in cancer
care. With the widespread use of HRQOL measures comes a need for
enhancing the interpretability of the scores generated from these
assessments. Comparing HRQOL scores for a group of patients or for
an individual patient to normative data facilitates meaningful
204 Evaluation & the Health Professions / June 2005

interpretation of results. This article provides general population and

patient with cancer normative data for the FACT-G and its subscales.
Interpretation guidelines and examples are provided to aid clinicians
and researchers when interpreting the magnitude and meaning of their
own results with the FACT-G.

APPENDIX

TABLE A1
Normative Data of General U.S. Adult Population

Physical Social/Family Emotional Functional FACT-

Well-Being Well-Being Well-Being Well-Being General

Total Sample (N = 1075)

Mean 22.7 19.1 19.9 18.5 80.1
Standard Deviation 5.4 6.8 4.8 6.8 18.1
Percentage at floor 0.2 1.0 0.7 1.8 0.0
Percentage at ceiling 13.2 13.1 32.0 8.8 2.1
Minimum observed score 0.0 0.0 0.0 0.0 15.4
25th percentile 21.0 14.0 18.0 14.0 69.7
50th percentile (Median) 24.5 19.6 21.0 19.6 82.9
75th percentile 26.8 24.5 24.0 23.3 93.1
Maximum observed score 28.0 28.0 24.0 28.0 108.0

Males (n = 516)
Mean 23.3 18.4 20.5 18.6 80.9
Standard Deviation 5.1 6.7 4.4 6.7 17.4
Percentage at floor 0.2 1.0 0.8 1.6 0.0
Percentage at ceiling 16.1 9.9 34.9 9.1 1.9
Minimum observed score 0.0 0.0 0.0 0.0 17.1
25th percentile 22.2 14.0 18.0 14.0 71.2
50th percentile (Median) 25.7 19.6 22.5 19.8 83.0
75th percentile 26.8 23.8 24.0 23.3 93.2
Maximum observed score 28.0 28.0 24.0 28.0 108.0

Females (n = 544)
Mean 22.1 19.8 19.4 18.3 79.6
Standard Deviation 5.4 6.8 5.1 6.9 18.6
Percentage at floor 0.0 0.9 0.7 1.8 0.0
Percentage At ceiling 10.5 16.4 28.9 8.6 2.2
Minimum observed score 3.5 0.0 0.0 0.0 15.4
25th percentile 19.8 15.4 18.0 12.8 68.4
50th percentile (Median) 23.3 21.0 21.0 18.7 83.0
75th percentile 25.7 25.2 24.0 23.3 93.2
Maximum observed score 28.0 28.0 24.0 28.0 108.0

SOURCE: Copyright 2004, David Cella, Ph.D.

 Brucker et al. / FACT-G NORMATIVE DATA 205

TABLE A2
Normative Data of Cancer Sample

Physical Social/Family Emotional Functional FACT-

Well-Being Well-Being Well-Being Well-Being General

Total Sample (N = 2236)

Mean 21.3 22.1 18.7 18.9 80.9
Standard Deviation 6.0 5.3 4.5 6.8 17.0
Percentage at floor 0.2 0.0 0.1 0.4 0.0
Percentage at ceiling 11.8 15.6 12.6 9.5 0.8
Minimum observed score 0.0 0.0 0.0 0.0 19.8
25th percentile 18.0 19.0 16.0 14.0 70.0
50th percentile (Median) 23.0 23.3 20.0 20.0 83.4
75th percentile 26.0 26.0 22.0 25.0 95.0
Maximum observed score 28.0 28.0 24.0 28.0 108.0

Males (n = 964)
Mean 20.8 21.8 18.6 18.1 79.3
Standard Deviation 6.2 5.4 4.5 7.0 17.7
Percentage at floor 0.2 0.0 0.1 0.6 0.0
Percentage at ceiling 10.6 12.8 11.5 8.8 0.7
Minimum observed score 0.0 4.7 0.0 0.0 19.8
25th percentile 17.0 18.8 16.0 13.0 68.0
50th percentile (Median) 22.0 23.3 20.0 19.0 81.3
75th percentile 26.0 26.0 22.0 24.0 93.2
Maximum observed score 28.0 28.0 24.0 28.0 108.0

Females (n = 1271)
Mean 21.6 22.3 18.7 19.5 82.1
Standard Deviation 5.8 5.3 4.5 6.6 16.3
Percentage at floor 0.2 0.1 0.1 0.3 0.0
Percentage at ceiling 12.7 17.7 13.4 10.0 0.8
Minimum observed score 0.0 0.0 0.0 0.0 28.7
25th percentile 19.0 19.6 16.0 15.0 71.0
50th percentile (Median) 23.0 23.3 20.0 21.0 85.0
75th percentile 26.0 26.8 22.0 25.0 95.0
Maximum observed score 28.0 28.0 24.0 28.0 108.0

SOURCE: Copyright 2004, David Cella, Ph.D.

206 Evaluation & the Health Professions / June 2005

TABLE A3
T-score Conversion Table for the General
U.S. Adult Population (N = 1075)

Physical Social/Family Emotional Functional

Well-Being Well-Being Well-Being Well-Being FACT-General

Raw T- Raw T- Raw T- Raw T- Raw T- Raw T- Raw T-

Score Score Score Score Score Score Score Score Score Score Score Score Score Score

0 8.0 0 21.9 0 8.5 0 22.8 0 5.7 37 26.2 74 46.6

1 9.8 1 23.4 1 10.6 1 24.3 1 6.3 38 26.7 75 47.2
2 11.7 2 24.9 2 12.7 2 25.7 2 6.9 39 27.3 76 47.7
3 13.5 3 26.3 3 14.8 3 27.2 3 7.4 40 27.8 77 48.3
4 15.4 4 27.8 4 16.9 4 28.7 4 8.0 41 28.4 78 48.8
5 17.2 5 29.3 5 19.0 5 30.1 5 8.5 42 29.0 79 49.4
6 19.1 6 30.7 6 21.0 6 31.6 6 9.1 43 29.5 80 49.9
7 20.9 7 32.2 7 23.1 7 33.1 7 9.6 44 30.1 81 50.5
8 22.8 8 33.7 8 25.2 8 34.6 8 10.2 45 30.6 82 51.0
9 24.6 9 35.1 9 27.3 9 36.0 9 10.7 46 31.2 83 51.6
10 26.5 10 36.6 10 29.4 10 37.5 10 11.3 47 31.7 84 52.2
11 28.3 11 38.1 11 31.5 11 39.0 11 11.8 48 32.3 85 52.7
12 30.2 12 39.6 12 33.5 12 40.4 12 12.4 49 32.8 86 53.3
13 32.0 13 41.0 13 35.6 13 41.9 13 12.9 50 33.4 87 53.8
14 33.9 14 42.5 14 37.7 14 43.4 14 13.5 51 33.9 88 54.4
15 35.7 15 44.0 15 39.8 15 44.9 15 14.0 52 34.5 89 54.9
16 37.6 16 45.4 16 41.9 16 46.3 16 14.6 53 35.0 90 55.5
17 39.4 17 46.9 17 44.0 17 47.8 17 15.1 54 35.6 91 56.0
18 41.3 18 48.4 18 46.0 18 49.3 18 15.7 55 36.1 92 56.6
19 43.1 19 49.9 19 48.1 19 50.7 19 16.2 56 36.7 93 57.1
20 45.0 20 51.3 20 50.2 20 52.2 20 16.8 57 37.2 94 57.7
21 46.9 21 52.8 21 52.3 21 53.7 21 17.3 58 37.8 95 58.2
22 48.7 22 54.3 22 54.4 22 55.1 22 17.9 59 38.3 96 58.8
23 50.6 23 55.7 23 56.5 23 56.6 23 18.5 60 38.9 97 59.3
24 52.4 24 57.2 24 58.5 24 58.1 24 19.0 61 39.4 98 59.9
25 54.3 25 58.7 25 59.6 25 19.6 62 40.0 99 60.4
26 56.1 26 60.1 26 61.0 26 20.1 63 40.6 100 61.0
27 58.0 27 61.6 27 62.5 27 20.7 64 41.1 101 61.5
28 59.8 28 63.1 28 64.0 28 21.2 65 41.7 102 62.1
29 21.8 66 42.2 103 62.7
30 22.3 67 42.8 104 63.2
31 22.9 68 43.3 105 63.8
32 23.4 69 43.9 106 64.3
33 24.0 70 44.4 107 64.9
34 24.5 71 45.0 108 65.4
35 25.1 72 45.5
36 25.6 73 46.1

SOURCE: Copyright 2004, David Cella, Ph.D.

 Brucker et al. / FACT-G NORMATIVE DATA 207

TABLE A4
T-score Conversion Table for the Adult
Cancer Patient Sample (N = 2236)

Physical Social/Family Emotional Functional

Well-Being Well-Being Well-Being Well-Being FACT-General

Raw T- Raw T- Raw T- Raw T- Raw T- Raw T- Raw T-

Score Score Score Score Score Score Score Score Score Score Score Score Score Score

0 14.5 0 8.3 0 8.4 0 22.2 0 2.4 37 24.2 74 45.9

1 16.2 1 10.2 1 10.7 1 23.7 1 3.0 38 24.8 75 46.5
2 17.8 2 12.1 2 12.9 2 25.1 2 3.6 39 25.4 76 47.1
3 19.5 3 14.0 3 15.1 3 26.6 3 4.2 40 25.9 77 47.7
4 21.2 4 15.8 4 17.3 4 28.1 4 4.8 41 26.5 78 48.3
5 22.8 5 17.7 5 19.6 5 29.6 5 5.4 42 27.1 79 48.9
6 24.5 6 19.6 6 21.8 6 31.0 6 5.9 43 27.7 80 49.5
7 26.2 7 21.5 7 24.0 7 32.5 7 6.5 44 28.3 81 50.1
8 27.8 8 23.4 8 26.2 8 34.0 8 7.1 45 28.9 82 50.6
9 29.5 9 25.3 9 28.4 9 35.4 9 7.7 46 29.5 83 51.2
10 31.2 10 27.2 10 30.7 10 36.9 10 8.3 47 30.1 84 51.8
11 32.8 11 29.1 11 32.9 11 38.4 11 8.9 48 30.6 85 52.4
12 34.5 12 30.9 12 35.1 12 39.9 12 9.5 49 31.2 86 53.0
13 36.2 13 32.8 13 37.3 13 41.3 13 10.1 50 31.8 87 53.6
14 37.8 14 34.7 14 39.6 14 42.8 14 10.6 51 32.4 88 54.2
15 39.5 15 36.6 15 41.8 15 44.3 15 11.2 52 33.0 89 54.8
16 41.2 16 38.5 16 44.0 16 45.7 16 11.8 53 33.6 90 55.4
17 42.8 17 40.4 17 46.2 17 47.2 17 12.4 54 34.2 91 55.9
18 44.5 18 42.3 18 48.4 18 48.7 18 13.0 55 34.8 92 56.5
19 46.2 19 44.2 19 50.7 19 50.1 19 13.6 56 35.4 93 57.1
20 47.8 20 46.0 20 52.9 20 51.6 20 14.2 57 35.9 94 57.7
21 49.5 21 47.9 21 55.1 21 53.1 21 14.8 58 36.5 95 58.3
22 51.2 22 49.8 22 57.3 22 54.6 22 15.4 59 37.1 96 58.9
23 52.8 23 51.7 23 59.6 23 56.0 23 15.9 60 37.7 97 59.5
24 54.5 24 53.6 24 61.8 24 57.5 24 16.5 61 38.3 98 60.1
25 56.2 25 55.5 25 59.0 25 17.1 62 38.9 99 60.6
26 57.8 26 57.4 26 60.4 26 17.7 63 39.5 100 61.2
27 59.5 27 59.2 27 61.9 27 18.3 64 40.1 101 61.8
28 61.2 28 61.1 28 63.4 28 18.9 65 40.6 102 62.4
29 19.5 66 41.2 103 63.0
30 20.1 67 41.8 104 63.6
31 20.6 68 42.4 105 64.2
32 21.2 69 43.0 106 64.8
33 21.8 70 43.6 107 65.4
34 22.4 71 44.2 108 65.9
35 23.0 72 44.8
36 23.6 73 45.4

SOURCE: Copyright 2004, David Cella, Ph.D.

208 Evaluation & the Health Professions / June 2005

70

108 107
28 106 105
One SD 28 104
AB OVE 27 102 103
27 26 100 101
the M
60 28 26 98 99
25 97
25 24 96 95
27 24 94
24 93
26 23 23 92 91
23 22 90
22 88 89
25 22 21 87
21 86 85
24 21 20 84
20 83
M EA N 23 19 82 81
50 19 20 80
18 79
22 18 78 77
19 17 76
21 17 74 75
16
T Scores for General Population Norms

18 72 73
20 16 15 71
One SD 15 17 70 69
19 14 68
B ELOW 14 66 67
18 16 13 65
the M 13 64 63
40 15 12 62
17 12 61
11 60
11 14 58 59
16 10 57
10 56 55
15 13 9 54
9 8 53
14 52 51
8 12 7 50
48 49
13 7 6 47
11 46
12 6 45
30 5 44 43
5 10 42
11 4 41
4 9 3 40 39
10 3 38 37
8 2 36
9 2 34 35
1 33
1 7 32 31
8 0 30
0 29
7 6 28 27
20 26 25
6 5 24
22 23
5 4 20 21
18 19
4 17
3 16
3 14 15
2 12 13
2 10 11
1 8 9
10 1 7
0 6 5
0 4 3
2 1
0

0
g

-G
g

g
in
in

in

in

T
Be
Be

Be

Be

AC
l
l

lF
l
el
el

el

el
W
W

lW
lW

ta
To
ily
l
ca

na

na
am
si

io

tio
y

ot
/F

nc
Ph

Em
al

Fu
ci
So

Figure A1: T-score Template for the General U.S. Adult Population (N = 1075)
SOURCE: Copyright 2004, David Cella, Ph.D.
 Brucker et al. / FACT-G NORMATIVE DATA 209

70

108 107
106
One SD 104 105
28 103
AB OVE
27 102
28 24 100 101
the M 28 99
60 26 98
27 27 23 25 97
96
26 94 95
26 22 24 93
25 23 92
25 90 91
21 22 89
24 88
24 21 87
23 20 86 85
22 23 20 84 83
M EA N 19 19 82 81
50 21 22 80
18 18 79
20 21 78 77
17 76
19 20 17 75
74
T Scores for Cancer Population Norms

16 73
18 19 15 72 71
One SD 16 70
17 14 68 69
B ELOW 18 15 67
the M 16 13 66
17 64 65
40 15 14 12 63
16 11 62
14 60 61
13 10 59
13 15 58
9 56 57
14 12 55
12 8 54
52 53
11 13 11 7 51
10 50 49
12 10 6 48
30 5 47
9 11 46 45
8 9 4 44
10 43
3 42 41
7 8 40
9 2 39
6 38 37
7 1 36
5 8 35
0 34
4 7 6 32 33
30 31
20 3 6 5 29
28
2 5 26 27
4 25
1 24
4 22 23
3 21
0 3 20
18 19
2 17
2 16
1 15
1 14 13
10 12
0 11
0 10 9
8 7
6 5
4 3
2 1
0

0
g

G
ng

ng

g
in

T-
in
ei

ei
Be

Be

AC
lB

lB
l

lF
l
el
el

el

el
W
W

lW
lW

ta
To
ily
l
ca

na

na
am
si

io

tio
y

ot
/F

nc
Ph

Em
al

Fu
ci
So

Figure A2: T-score Template for Adult Cancer Patients (N = 2236)

SOURCE: Copyright 2004, David Cella, Ph.D.
210 Evaluation & the Health Professions / June 2005

70

108 107
28 106 105
One SD 28 104
AB OVE 27 102 103
27 26 100 101
the M
60 28 26 98 99
25 97
25 24 96 95
27 24 94
24 93
26 23 23 92 91
23 22 90
22 88 89
25 22 21 87
21 86 85
24 21 20 84
20 83
M EA N 23 19 82 81
50 19 20 80
18 79
22 18 78 77
19 17 76
21 17 74 75
16
T Scores for General Population Norms

18 72 73
20 16 15 71
15 17 70 69
One SD 14 68
19 67
B ELOW 14 16 13 66
18 64 65
the M 13 63
40 15 12 62
17 12 61
11 60
11 14 58 59
16 10 57
10 56 55
15 13 9 54
9 8 53
14 52 51
8 12 7 50
48 49
13 7 6 47
11 46
12 6 45
30 5 44 43
5 10 42
11 4 41
4 9 3 40 39
10 3 38 37
8 2 36
9 2 34 35
1 33
1 7 32 31
8 0 30
0 29
7 6 28 27
20 26 25
6 5 24
22 23
5 4 20 21
18 19
4 17
3 16
3 14 15
2 12 13
2 10 11
1 8 9
10 1 7
0 6 5
0 4 3
2 1
0
a
Cancer Patient Sample Data

0
ng

ng

ng
ng

G
ei
ei

ei

-
ei

CT
lB

lB

B
lB

A
l
el
el

el
el

lF
W
W

lW
W

ta
l
il y
al

na

na

To
am
ic

io

t io
ys

ot
/F

nc
Ph

Em
al

Fu
ci
So

Figure A3: An Example Plotting a Cancer Sample on the General U.S. Adult Norms
Templatea
NOTE: Mean scores for the subscales and total FACT-G are indicated with a diamond in the fig-
ure above and are as follows: Physical Well-Being = 21.2, Social/Family Well-Being = 22.3,
Emotional Well-Being = 18.1, Functional Well-Being = 18.8, and FACT-General Total = 80.4.
SOURCE: Copyright 2004, David Cella, Ph.D.
a. Example sample data taken from Cella, Hahn, and Dineen (2002) sample of 308 male and fe-
male patients with mixed cancer diagnoses.
 Brucker et al. / FACT-G NORMATIVE DATA 211

NOTE

1. Further information on subgroup norms is posted at www.facit.org.

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