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Functional Assessment Short Test (FAST)

The FAST is a 24-item instrument to assess six areas of functional impairment or disability, particularly in patients with bipolar disorder.1
 
Description: The FAST is a 24-item instrument to assess six areas of functional impairment or disability, particularly in patients with bipolar disorder.1
 
Disease States: Bipolar disorder, General
Validated Uses: Treatment Monitoring & Evaluation, Symptom Severity
Administration Method: Clinician-report
Time to administer: 5-10 minutes
Commonly used in: Clinical Trials & Research, Clinical Practice
Detailed Description: The FAST is a 24-item tool to assess six areas of functioning over the last 15 days before assessment, including autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships and leisure time.1
 
All items are rated on a 4-point scale from 0 (no difficulty) to 3(severe difficulty). The total FAST score is the sum of each item.1 Lower scores indicate good functioning, higher scores indicate increased disability and specific areas of impairment.1
 
FAST demonstrates strong psychometric properties and is able to detect differences between euthymic patients and patients with acute bipolar disorder.1
Scale Validity: Validity was assessed based on a discriminant measure to detect differences between euthymic patients and patients with acute bipolar disorder.1 Concurrent validity was assessed based on the Global Assessment Functioning scale(GAF); highly significant negative correlation was observed.1 Test-retest reliability between the two measures, carried out a week apart, also showed a strong correlation.1
 
The instrument had a sensitivity of 72% and specificity of 87%, which was found at a cut-off value higher than 11.1
 
Alternative Versions: The instrument is also available in Spanish and Portuguese.1
Cited Limitations: The FAST cut-off values determined by the researchers had no corresponding cut-off values from the GAF with which they could be compared, and no prior literature exists for FAST’s 4-point classification of functional outcomes.Another suggested limitation is that medications and comorbidities that may impact functional outcomes were not assessed as part of the original study.2 Future studies should include a larger sample size to confirm results.2

Footnotes:

Supporting references are as follows:
Disease State: General, Bipolar1; Validated uses: Evaluation and Symptom Severity1; Populations: Adult1; Administration Method: Clinician1; Time to administer: 5-10 minutes1; Commonly used in: Research and clinic1

References:

  1. Rosa AR, et al. Validity and reliability of the Functioning Assessment Short Test (FAST) in bipolar disorder. Clin Pract Epidemiol Ment Health. 2007;3:5. Published 2007 Jun 7. doi:10.1186/1745-0179-3-5
  2. Bonnin CM, Martinez-Aran A, et al. Thresholds for severity, remission and recovery using the functioning assessment short test (FAST) in bipolar disorder. J Affect Disord. 2018; 240:57-62. doi: 10.1016/j.jad.2018.07.045. Epub 2018 Jul 17.

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