RT Journal Article
SR Electronic
T1 Validity of the COmprehensive Score for financial Toxicity (COST) in patients with gynecologic cancer
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP ijgc-2022-003410
DO 10.1136/ijgc-2022-003410
A1 Yusuke Kajimoto
A1 Takashi Shibutani
A1 Shoji Nagao
A1 Satoshi Yamaguchi
A1 Shiro Suzuki
A1 Masahiko Mori
A1 Hirofumi Tsubouchi
A1 Kohshiro Nakao
A1 Anri Azuma
A1 Takahiro Koyanagi
A1 Izumi Kohara
A1 Shuko Tamaki
A1 Midori Yabuki
A1 Lida Teng
A1 Kazunori Honda
A1 Ataru Igarashi
YR 2022
UL http://ijgc.bmj.com/content/early/2022/04/20/ijgc-2022-003410.abstract
AB Objective Financial toxicity is a financial burden of cancer care itself, which leads to worse quality of life and higher mortality and is considered an adverse effect. The COmprehensive Score for financial Toxicity (COST) tool is a patient-reported outcome measurement used to evaluate financial toxicity. We aimed to validate the internal consistency and reproducibility of the COST tool in patients with gynecologic cancer.Methods In this multicenter study covering the period April 2019 to July 2021, using the COST tool in Japan, patients diagnosed with ovarian, cervical, or endometrial cancer receiving systemic anti-cancer drug therapy for more than 2 months were eligible. Patients with no out-of-pocket costs for direct medical costs were excluded. The patients answered the initial test and a retest, which was completed from 2 to 14 days after the initial test. Internal consistency and reproducibility were assessed using Cronbach’s alpha and intraclass correlation coefficient (ICC), respectively. Cronbach’s alpha ≥0.8 indicates good internal consistency, and ICC ≥0.8 is highly reliable.Results A total of 112 patients (ovarian: 50, cervical: 26, endometrial: 36) responded to the initial test, and 89 patients answered the retest from 2 to 14 days after the initial test. The median patient age was 58 (range, 28–78) years. The median COST score was 19. Cronbach’s alpha showed good internal consistency at 0.83 (95% CI 0.78 to 0.87). The ICC at 0.850 (95% CI 0.777 to 0.900) showed high reliability.Conclusions The COST tool has good internal consistency and reliable reproducibility in patients with gynecologic cancer in Japan. The COST tool quantifies financial toxicity in the insurance system, where patients have limited out-of-pocket direct medical costs. The results support the use of the COST tool in patients with gynecologic cancer.Data are available upon reasonable request. Individual participant data that underlie the results reported in this article after deidentification and study materials of the study is available upon reasonable request.