Towards a Validated European Instrument to Measure the Socio-Economic Consequences of a Cancer Diagnosis

OBJECTIVES: A cancer diagnosis can cause serious financial distress among patients. However, European instruments that measure the socio-economic consequences of a cancer diagnosis still lack. To fill this gap, the multi-center SEC (Socio-Economic consequences of Cancer)-study collected data from 2454 patients in 10 countries. The questionnaire included sociodemographic/treatment characteristics, personal finances, coping behavior and two validated questionnaires (Financial Index of Toxicity (FIT) & EQ-5D-5L). The primary outcome was the level of financial distress measured by the FIT-score. This instrument, developed and validated in the Canadian healthcare setting with head & neck cancer patients, additionally calculates three subscale scores (financial stress, financial strain and lost productivity).

Our objective is to asses the validity of the Canadian FIT-questionnaire for European countries, and to explore relevant items for a tailored instrument to measure socio-economic consequences of a cancer diagnosis for European patients.

METHODS: To assess the validity of the FIT for European patients, the three Canadian subscales are tested using a confirmatory factor analysis (CFA) per country. To identify and confirm relevant items and subscales in our questionnaire, an exploratory factor analysis (EFA) and a CFA is performed at EU-level. Internal reliability(Cronbach’s α) and construct validity are assessed. Known group validity is tested examining the difference in FIT-score between two groups.

RESULTS: The model fit of the CFA for the FIT-(subscales) per country as well as the outcomes of the EFA, CFA, Cronbach’s α and known group validity for the questionnaire at EU-level will be presented at the ISPOR Europe conference. This will show for which countries the questionnaire and FIT are valid and if additional country-specific items should be considered.

CONCLUSIONS: Elements of the questionnaire (including the FIT) tailored for European countries, considering stratification by cancer type, will be presented. This will provide a basis to measure socio-economic consequences of a cancer diagnosis for European patients.