Urdu Translation and Validation of the COST-FACIT Tool for Assessing Financial Toxicity Among Patients Diagnosed with Cancer in Pakistan.

Introduction: Cancer treatment can impose a significant financial burden on patients, impacting their quality of life. The COST-FACIT tool is commonly used to assess financial toxicity (FT) in cancer patients. This study aimed to translate and validate an Urdu version of the COST-FACIT tool in Pakistan.

Materials and methods: A cross-sectional validation study was conducted at four tertiary care hospitals in Karachi, Pakistan, from October to December 2023. We translated and back-translated the 12-item COST-FACIT tool and validated it in accordance with FACIT guidelines. The study included 10 native Urdu-speaking cancer patients as recommended in the guidelines. The analysis included descriptive statistics, content validity indices, and assessment of internal consistency using Cronbach's alpha, analyzed with Stata MP v.14 software.

Results: The study population included 6 females (60%) and 4 males (40%), with most participants aged between 40 and 60 years (4 patients, 40%). The mean FACIT COST score was 16.3 (SD = 11.255, range 4-40), with 6 (60%) patients experiencing moderate (Grade 2) financial toxicity. Internal consistency was good, with a Cronbach's alpha of 0.90, and content validity indices indicated items were relevant and clear (average expert CVI = 0.82 for relevance, 0.90 for clarity).

Conclusion: We have translated and validated an Urdu version of the COST-FACIT tool. It is a valid and reliable instrument to assess financial toxicity experienced by cancer patients in Pakistan.