Badr Hoda, Han Jessie, Mims Martha
Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Cancer Med. 2024 Aug;13(15):e7306. doi: 10.1002/cam4.7306.
This study aimed to develop and validate FinTox, a concise tool for screening and managing financial toxicity in oncology settings.
Development involved qualitative interviews with healthcare providers and patients, and feedback from a 7-member expert panel resulting in a 5-item measure that evaluates financial strain, psychological responses, and care modifications. Psychometric evaluations examined factor structure, internal consistency, test-retest reliability, and concurrent and convergent validity. Associations between FinTox scores and sociodemographic/medical factors were also analyzed using univariate and multivariable regression models.
Twelve healthcare providers and 20 patients were interviewed, and 268 patients (69.8% female, 47.4% non-Hispanic White) completed surveys including FinTox, the Comprehensive Score for Financial Toxicity (COST), health-related quality of life (HRQOL) measures, and sociodemographic questions. FinTox demonstrated excellent internal consistency (Cronbach's alpha = 0.90) and test-retest reliability (ICC = 0.95). Significant correlations with the COST (r = -0.62, p < 0.001) and HRQOL measures corroborated content and convergent validity. Diagnostic accuracy was evidenced by a sensitivity of 72.3%, specificity of 85.2%, positive predictive value of 83.2%, and negative predictive value of 70.3%. Higher FinTox scores were also associated with receiving care at a safety-net hospital, Black race, household income <600% of the federal poverty level, and Stage 4 cancer.
FinTox's robust psychometric properties and diagnostic accuracy position it as a reliable tool for detecting financial toxicity. Future research should evaluate its responsiveness to changes over time and integration into clinical workflows.
本研究旨在开发并验证FinTox，这是一种用于筛查和管理肿瘤环境中财务毒性的简明工具。
开发过程包括对医疗服务提供者和患者进行定性访谈，以及来自一个7人专家小组的反馈，从而形成了一个包含5个条目的量表，用于评估财务压力、心理反应和护理调整。心理测量评估检验了因子结构、内部一致性、重测信度以及同时效度和聚合效度。还使用单变量和多变量回归模型分析了FinTox评分与社会人口统计学/医学因素之间的关联。
对12名医疗服务提供者和20名患者进行了访谈，268名患者（69.8%为女性，47.4%为非西班牙裔白人）完成了包括FinTox、财务毒性综合评分（COST）、健康相关生活质量（HRQOL）测量以及社会人口统计学问题的调查。FinTox表现出出色的内部一致性（Cronbach's α = 0.90）和重测信度（ICC = 0.95）。与COST（r = -0.62，p < 0.001）和HRQOL测量的显著相关性证实了内容效度和聚合效度。诊断准确性表现为灵敏度72.3%、特异度85.2%、阳性预测值83.2%和阴性预测值70.3%。较高的FinTox评分还与在安全网医院接受治疗、黑人种族、家庭收入低于联邦贫困水平的600%以及IV期癌症相关。
FinTox强大的心理测量特性和诊断准确性使其成为检测财务毒性的可靠工具。未来的研究应评估其对随时间变化的反应性以及纳入临床工作流程的情况。
