Evidence map›Paper›PMID 42295511›Full record

Observational studyJournal of patient-reported outcomes2026

Evaluation of the comprehensive score for financial toxicity measure in a multicenter cohort of adults with advanced liver disease.

Chengbo Zeng, Elizabeth S Aby, Grace Bizup, Enya Zhu, Ron D Hays, Maria O Edelen, Nneka N Ufere, on the behalf of the PACE-LT Consortium

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of patient-reported outcomes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

8 authors.

Chengbo ZengPatient Reported Outcomes, Value and Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA, 02120, USA. czeng8@bwh.harvard.edu.ORCID http://orcid.org/0000-0002-3512-1115
Elizabeth S AbyDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Grace BizupLiver Center, Gastrointestinal Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Enya ZhuSchool of Medicine, Duke University, Durham, NC, USA.
Ron D HaysDivision of General Internal Medicine, Department of Medicine, University of California, Los Angeles, CA, USA.
Maria O EdelenPatient Reported Outcomes, Value and Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA, 02120, USA.
Nneka N UfereLiver Center, Gastrointestinal Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
on the behalf of the PACE-LT Consortium

Funding

Robert Wood Johnson Foundation Robert Wood Johnson Foundation
6 · The paper itself

Abstract

backgroundThis study evaluates the psychometric properties of the COmprehensive Score for financial Toxicity (COST) measure in a multicenter cohort of patients with advanced liver disease (AdvLD).

methodsBetween April 12, 2023, and April 30, 2024, a sample of adults undergoing liver transplantation evaluation was recruited from 13 U.S. transplant centers. We evaluated structural validity using factor analysis and internal consistency reliability using Cronbach's alpha. Construct validity was assessed by examining correlations between the COST measure, health-related unmet social needs, and EQ-5D-5L scores.

resultsAmong the 459 participants, more than half were male (59%), White (82%), and not Hispanic or Latino (77%). Approximately 44% were unable to work due to illness or disability, and over 44% had an annual household income below $50,000. The COST measure demonstrated suboptimal structural validity based on both one- and two-factor models. Cronbach's alpha for the COST measure was 0.84. The total COST score showed mild to moderate correlations with health-related unmet social needs (r: -0.21 to -0.41) and small correlations with the EQ-5D-5 L visual analogue scale (r = 0.24) and pattern scores (r = 0.34). DISCUSSION: Caution may be warranted when applying COST to patients with AdvLD, as suboptimal structural and construct validity compromise score interpretation and clinical utility. Future studies should systematically review evidence on its psychometric properties and evaluate content validity through cognitive interviews with patients with AdvLD.

Indexed as

Cost of IllnessLiver DiseasesLiver TransplantationAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedPsychometricsQuality of LifeReproducibility of ResultsSurveys and QuestionnairesUnited StatesCostFinancial burdenFinancial toxicityLiver diseasePatient-reported outcome (PRO)

Identifiers

PMID42295511
PMCPMC13500444

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Registered trials

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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.