Crowdsourcing to measure financial toxicity in gynecologic oncology

Objective. To utilize a novel crowdsourcing method to measure financial toxicity and its effects among a na-tional cohort of gynecologic cancer patients. Methods. Crowdsourcing methods were used to administer an online survey to women in the United States with gynecologic cancers. We used the Comprehensive Score for Financial Toxicity (COST) tool to measure finan-cial toxicity and the EQ-5D-3L to measure quality of life (QOL). Based on prior work, we defined high financial toxicity as a COST score <= 23. We assessed correlation of COST scores with QOL. We used log-binomial regression to examine associations between high financial toxicity and cost-coping strategies. Results. Among the final study sample of 334 respondents, 87% were white, median age at diagnosis was 55 (interquartile range 47-63), 52% had stage III or IV disease and 90% had private insurance or Medicare. Median COST score was 24 (interquartile range 15-32) and 49% of respondents reported high financial toxicity. Greater financial toxicity was correlated with worse QOL (p < 0.001). Participants reporting high financial toxicity were more likely to use cost-coping strategies, including spending less on basic goods (RR: 3.3; 95% CI: 2.1-5.1), bor -rowing money or applying for financial assistance (RR: 4.0; 95% CI: 2.4-6.9), and delaying or avoiding care (RR: 5.6; 95% CI: 2.6-12.1). Conclusions. Crowdsourcing is an effective tool to measure financial toxicity. Nearly half of respondents re-ported high financial toxicity, which was significantly associated with worse QOL, utilization of cost-coping strat-egies and delays or avoidance of care. (c) 2021 Published by Elsevier Inc.

Automated summary

Utilizing crowdsourcing to measure financial toxicity among gynecologic cancer patients, the study found that high financial toxicity was significantly associated with worse quality of life, utilization of cost-coping strategies, and delays or avoidance of healthcare.