Psychometric Properties of Self-Reported Financial Toxicity Measures in Cancer Survivors: An Overview of Systematic Reviews

Abstract

Aim(s): To assess the methodological quality and psychometric properties of self-reported financial toxicity measures for cancer survivors, to offer evidence-based guidance for the selection of these measures in clinical practice, and to supply methodological references for the enhancement and development of related measures in the future. Design: An overview of systematic reviews. Methods: Four academic databases were searched to conduct an overview of systematic reviews published from inception to August 2024. The Overview Quality Assessment Questionnaire (OQAQ) was employed to evaluate the methodological quality of the research included. The consensus-based standards for the selection of health measurement instruments checklist (COSMIN) and the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) system were employed to assess the methodological and psychometric quality of the financial toxicity measures included. Results: Six systematic reviews satisfied the inclusion criteria. The OQAQ results indicated that six studies exhibited significant methodological quality defects, each receiving a score of 3 points. COST-v1, COST-v2, HARDS, ENRICh, and FinTox were classified as level A. Ten measures were classified as level B, lacking evidence to support content validity and internal consistency as ‘+’. Seven measures were classified at level C, supported by high-quality evidence indicating certain domains as ‘−’. Conclusion: COST is advised as the best appropriate measurement standard for research and clinical practice across many global contexts. HARDS and ENRICh were advised to select only after thoroughly evaluating the local socio-economic context. FinTox is particularly suggested for the assessment of severe FT. SFDQ and FIT are advised for selection following an evaluation of therapy alternatives and the cancer's location. Implications for the Patient Care: Healthcare professionals can implement evidence-based measures in clinical practice to effectively assess the financial toxicity experienced by cancer survivors, offer policy-oriented interventions, and enhance patient-reported outcomes.