Translation and validation of the Traditional Chinese version of the COmprehensive Score for financial Toxicity-Functional Assessment of Chronic Illness Therapy (Version 2)

Abstract

Background Cancer patients often experience severe financial distress due to the high cost of their treatment, and strategies are needed to objectively measure this financial distress. The COmprehensive Score for financial Toxicity-Functional Assessment of Chronic Illness Therapy (COST-FACIT) is one instrument used to measure such financial distress. This study aimed to translate the COST-FACIT (Version 2) [COST-FACIT-v2] instrument into traditional Chinese (COST-FACIT-v2 [TC]) and evaluate its psychometric properties. Methods The Functional Assessment of Chronic Illness Therapy (FACIT) translation method was adopted. The translated version was reviewed by an expert panel and by 20 cancer patients for content validity and face validity, respectively, and 640 cancer patients, recruited from three oncology departments, completed the translated scale. Its reliability was evaluated in terms of internal consistency and test–retest reliability. Confirmatory factor analysis has been used to evaluate the one- and two-factor structures of the instrument reported in the literature. The convergent validity was examined by the correlation with health-related quality of life (HRQoL) and psychological distress. Known-group validity was examined by the difference in the COST-FACIT-v2 (TC) total mean score between groups with different income levels and frequency of health care service use. Results The COST-FACIT-v2 (TC) showed good content and face validity and demonstrated high internal consistency (Cronbach’s alpha, 0.86) and acceptable test–retest reliability (intraclass correlation coefficient, 0.71). Confirmatory factor analysis showed that the one- and two-factor structures of the instrument that have been reported in the literature could not be satisfactorily fitted to the data. Psychological distress correlated significantly with the COST-FACIT-v2 (TC) score (r = 0.47; p < 0.001). HRQOL showed a weak to moderate negative correlation with the COST-FACIT-v2 (TC) score (r = − 0.23 to − 0.46; p < 0.001). Significant differences were seen among the COST-FACIT-v2 (TC) scores obtained in groups of different income level and frequency of health care service use. Conclusions The COST-FACIT-v2 (TC) showed some desirable psychometric properties to support its validity and reliability for assessing cancer patients’ level of financial toxicity.

Psychometric properties of self-reported financial toxicity measures in cancer survivors: a systematic review

“…After duplications were removed, a total of 11 731 articles were retained, 11 669 articles were deleted after reading the title and abstract, and 39 were deleted after full-text reading. Finally, a total of 23 articles (21 PROMs) were eligible for inclusion in this study 12 14 16 23–42…”

“…Among the 21 PROMs, 7 were FT-related domains of quality of life PROMs and 14 were independent PROMs focusing on FT. All PROMs were validated in cancer survivors. Fifteen PROMs were in English,12 14 16 23 25–31 35 37 38 40–42 and two were in Chinese 24 39. Other languages included French,36 Portuguese,32 Italian,33 42 Hindi25 26 and Persian 34.…”

“…Table 2 shows the methodological quality of the 23 included studies by using the COSMIN checklist. In the PROM development domain, only one study was rated as adequate,42 three studies were rated as doubt12 24 27 29 and the others were rated as inadequate. Two studies reported adequate information in testing the relevance, comprehensiveness and comprehensibility of PROMs 12 27 29.…”

“…Among all studies, the most reported domain was internal consistency, except one study 36. Limited information could be retrieved on cross-cultural validity (3 studies),31 32 36 criterion validity (6 studies),16 23 33 35 38 40 reliability (10 studies),12 16 24 27 28 33 35 38–40 42 and responsiveness (2 studies) 31 39. No data were identified as measurement error.…”

“…Only the Persian version of the COST-v2 and Subjective Financial Distress Questionnaire (SFDQ) were rated as ‘+’ in structural validity 26 34. There were 17 PROMs rated as ‘+’ in internal consistency 12 14 16 23 24 26–29 31 32 34 35 37–39 41 42. Eight PROMs were rated as ‘+’” in reliability 12 24 26–29 31 35.…”