Poster Presentation Cancer Survivorship Conference 2023

A systematic review of the psychometric properties of instruments/tools used for measuring financial toxicity in people with cancer (#165)

Lebogang Thomy 1 , Megan Crichton 2 , Raymond Chan 3 , Nicolas Hart 1 , Patsy Yates 4 , Lee Jones 5
  1. College of nursing and health sciences, Flinders University, Adelaide, South Australia, Australia
  2. School of nursing, Queensland University of Technology, Brisbane, Queensland, Australia
  3. College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
  4. Centre for Healthcare Transformation , Queensland University of Technology, Brisbane , Queensland, Australia
  5. QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia

Background

The impact of financial toxicity is increasingly recognised in Australia and worldwide. However, a well-validated, comprehensive tool for assessing financial toxicity internationally and in Australia is lacking. This systematic review examines the validity and reliability of the currently available cancer-specific measures of financial toxicity and their suitability for the Australian healthcare system.

 

Objective

To identify cancer-specific instruments designed for assessing financial toxicity and evaluate their content validity, structure validity and other measurement properties, and to provide an analysis of the domains of financial toxicity.

 

Methods

This systematic review was registered with the International Prospective Registry of Systematic Reviews (PROSPERO), registration ID: CRD42021285726. The review was reported according to the Consensus-Based Standards for the Selection of Health Measurement Instrument (COSMIN) methodology.

 

Results

The literature search returned a total of 4,295 articles. From these, 14 were included after the application of an eligibility assessment. The 14 articles informed our evaluation of four instruments/tools designed explicitly for assessing financial toxicity, which is the: Comprehensive Score for financial toxicity (COST), the Patient-Reported Outcome for Fighting Financial Toxicity (PROFFIT) instrument, the Financial Index of Toxicity (FIT) instrument, Subjective Financial Distress Questionnaire (SFDQ). Our initial findings indicate that the COST measure was superior, especially regarding internal consistency and reliability.  

 

Conclusion

Overall, very few measures of cancer-related financial toxicity have adequate data to support robust psychometrics, and most do not assess all the domains of financial toxicity. No single tool was designed to comprehensively cover all relevant domains of financial toxicity as a construct. Ongoing work is required to standardise the measurement of financial toxicity and develop instruments/tools specific to the different healthcare systems worldwide to understand the constructs of financial toxicity better. This is particularly relevant to the Australian health care system, which is different from the USA, where the COST measure was initially developed.