Evidence map›Paper›PMID 31046080›Full record

SynthesisAnnals of oncology : official journal of the European Society for Medical Oncology2019

Methods for measuring financial toxicity after cancer diagnosis and treatment: a systematic review and its implications.

J Witte, K Mehlis, B Surmann, R Lingnau, O Damm, W Greiner, E C Winkler

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of oncology : official journal of the European Society for Medical Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07279350 (Health Advocate for Children After Liver Transplant), which is not on this map. Cited by 149 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
149citing papers in PubMed, 18 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07279350 narecruitingnot on this mapstarted 2026, after this paper: background citation

Health Advocate for Children After Liver Transplant: A Hybrid Implementation Effectiveness RCT

TypeinterventionalSponsorUniversity of California, San FranciscoRan2026 to 2030Enrolled108ConditionsPediatric Liver Transplanted RecipientsArmsHealth advocate, Enhanced Control
3 · Its place in the literature

Who cites it

149 citing papers in PubMed, 18 syntheses or guidelines pooled it.

  1. Financial toxicity among families of children with cancer: a qualitative systematic review and meta-aggregation.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Pooled it
  2. Pooled it
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  4. Towards the assessment of financial distress among cancer patients: a conceptual model of the financial effects of a tumour disease.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Pooled it
  5. Pooled it
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  8. Measures of financial toxicity in cancer survivors: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Pooled it
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  11. Measuring financial toxicity in head and neck cancer: a systematic review.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2024
    Pooled it
  12. Pooled it
  13. Evaluation of financial toxicity and associated factors in female patients with breast cancer: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
    Pooled it
  14. Pooled it
  15. Financial toxicity of cancer care in low- and middle-income countries: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
    Pooled it
  16. Pooled it
  17. Pooled it
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  19. Constructing the scale to measure financial toxicity in cancer patients for Low-middle income countries (FT-LM) by using the modified Delphi method.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  20. Article

89 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

J WitteDepartment of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld.
K MehlisDepartment of Medical Oncology, Programme for Ethics and Patient Oriented Care, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.
B SurmannDepartment of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld.
R LingnauDepartment of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld.
O DammDepartment of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld.
W GreinerDepartment of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld.
E C WinklerDepartment of Medical Oncology, Programme for Ethics and Patient Oriented Care, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany. Electronic address: Eva.Winkler@med.uni-heidelberg.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients experiencing financial distress as a side-effect of cancer are not only reported in the United States, but also in third-party payer healthcare systems in Europe. Since validated survey instruments are a prerequisite for robust and comparable results, we aimed to compile and classify available instruments to enable both a better understanding of the underlying construct of financial toxicity and to facilitate further studies that are adjustable to various healthcare systems. We did a systematic literature search on studies that provide data on perceived cancer-related financial distress experienced by adult patients using PubMed, CINAHL and Web of Science databases up to 2018. We analyzed all detected instruments, items domains and questions with regard to their wording, scales and the domains of financial distress covered. Among 3298 records screened, 41 publications based on 40 studies matched our inclusion criteria. Based on the analysis of 352 different questions we identified 6 relevant subdomains that represent perceptions of and reactions to experienced financial distress: (i) active financial spending, (ii) use of passive financial resources, (iii) psychosocial responses, (iv) support seeking, (v) coping with care or (vi) coping with ones' lifestyle. We found an inconsistent coverage and use of these domains that makes it difficult to compare and quantify the prevalence of financial distress. Moreover, some existing instruments do not reflect relevant domains for patients in third-party payer systems. There is neither a consistent understanding of the construct of financial burden nor do available instruments cover all relevant aspects of a patients' distress perception. We encourage using the identified six domains to further develop survey instruments and adjust them to different health systems.

Indexed as

Adaptation, PsychologicalAsiaAustraliaCanadaCost-Benefit AnalysisCost of IllnessDelivery of Health CareEuropeHumansLife StyleNeoplasmsPatient Reported Outcome MeasuresQuality of LifeSurveys and QuestionnairesUnited Statescancercostfinancial distressfinancial toxicityoncologypoverty risk

Identifiers

PMID31046080
PMCPMC6637374

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.