Development and validation of a simplified financial toxicity screening tool for use in clinical practice Journal Article
| Authors: | Thom, B.; Tin, A. L.; Chino, F.; Vickers, A. J.; Aviki, E. M. |
| Article Title: | Development and validation of a simplified financial toxicity screening tool for use in clinical practice |
| Abstract: | PURPOSE: Cancer-related financial toxicity occurs frequently and is a key driver of inequities in access to care and disparities in treatment outcomes. Current practices to screen for financial toxicity are inconsistent because of the lack of a validated and clinically integrated screening tool. This analysis aimed to create and assess an abbreviated version of the validated Comprehensive Score for Financial Toxicity (COST) tool, a measure of financial toxicity used for research purposes, which could easily be added into often-lengthy clinical screening workflows. METHODS: At an urban comprehensive cancer center with suburban satellite locations, a financial toxicity screening quality improvement project was conducted from June 2022 to August 2023 as part of routine clinical care: 57,526 longitudinal COST surveys were completed by 38,249 patients with cancer. An iterative algorithm selected the items with highest correlation with the total score. Using a separate validation data set, positive and negative predictive values (PPV and NPV, respectively) of the abbreviated tool (two-item) were assessed against the full COST score, with varying risk thresholds. RESULTS: Inclusion of two COST questions (Q3: "I worry about the financial problems I will have in the future as a result of my illness or treatment"; Q6: "I am satisfied with my current financial situation") yielded a score that had a correlation of 0.922 with the full instrument score. For the two-item scale, PPV ranged from 74% to 91%, and NPV ranged from 91% to 98% when compared with the full COST tool. CONCLUSION: This analysis of a large data set finds that a simplified COST tool has high predictive value when compared with the full validated measure. An abbreviated COST measure of two questions is suitable for implementation into clinical screening workflows. |
| Keywords: | middle aged; neoplasm; neoplasms; questionnaire; humans; human; male; female; surveys and questionnaires |
| Journal Title: | JCO Oncology Practice |
| Volume: | 21 |
| Issue: | 1 |
| ISSN: | 2688-1527 |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2025-01-01 |
| Start Page: | 12 |
| End Page: | 19 |
| Language: | English |
| DOI: | 10.1200/op-24-00598 |
| PUBMED: | 39793553 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Bridgette Thom -- Source: Scopus |
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