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Exploring Best Practices for Screening for Financial Toxicity in Patients With Sarcoma: A Single-Institution Study.

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A brief four-item tool accurately screens for financial toxicity in sarcoma patients. This abbreviated Comprehensive Score for Financial Toxicity (COST) tool can help identify patients needing financial support.

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Area of Science:

  • Oncology
  • Health Economics
  • Patient-Reported Outcomes

Background:

  • Financial toxicity significantly impacts sarcoma patients, affecting three-quarters of them.
  • The Comprehensive Score for Financial Toxicity (COST) is validated but complex for routine use in sarcoma care.
  • Simpler screening methods are needed to identify patients experiencing financial toxicity.

Purpose of the Study:

  • To characterize financial toxicity in sarcoma patients.
  • To evaluate the effectiveness of shorter screening tools in identifying high-risk patients.
  • To assess the correlation between the Worry about Affording Healthcare Scale (WAHS) and COST.

Main Methods:

  • A retrospective cohort study involving 205 sarcoma patients treated at an academic center.
  • Patients completed the full COST questionnaire and the shorter WAHS.
  • Statistical analyses included descriptive statistics, Pearson's correlation, and Spearman correlations for abbreviated COST versions.

Main Results:

  • The mean COST score was 20/44, indicating significant financial toxicity.
  • Job loss and family finances were primary concerns for patients.
  • A four-item abbreviated COST tool showed high correlation with the total COST (ρ = 0.906) with 96% sensitivity and 75% specificity.

Conclusions:

  • An abbreviated four-item COST tool is a feasible and accurate screening method for financial toxicity in sarcoma patients.
  • External validation is recommended for the abbreviated tool.
  • Routine screening can improve early detection and referral to financial navigation resources.