患者報告アウトカムとは

Basics of Patient-Reported Outcomes

はじめに

　患者報告アウトカム（patient-reported outcome：以下，PRO）とは，QOLなどを含む患者の視点からの評価を指す。従来の医療提供者の視点からの客観的評価に対して，測定不可能な漠然とした概念と長く捉えられていたが，現在は計量心理学に基づいて定量的に測定可能であり，科学的なエビデンスとして医療で広く用いられている。本稿では，PROの基礎的な知識を紹介する。

　In the past, subjective evaluation from patientsʼ perspectives was regarded as vague and not measurable in health care. The development of psychometrics (psychology that “measures” human minds) enabled a scientifically sound assessment of subjective evaluation. Patient-reported outcomes (PROs) refer to the health outcomes directly reported by the patient, without interpretation by clinicians or others. Unlike traditional objective assessments by healthcare providers, PROs focus on the patientsʼ perspective on their health condition and treatment. They measure symptom severity, impact on daily life, and satisfaction with treatment outcomes. Patient-reported outcome measure (PROM) is a questionnaire to collect PRO. For PROM to be used as a clinical tool to produce scientific evidence, its validity and reliability must be established based on guidelines backed by psychometrics. PROs are widely used as scientific evidence in clinical research and practice, as well as policy making, such as decisions on health insurance reimbursement. By incorporating the patientʼs voice into decision-making, PROs contribute to more patient-centered care and better health outcomes. They are essential tools for clinicians to understand the effectiveness of treatments from the patientʼs viewpoint, ultimately leading to enhanced patient satisfaction and improved healthcare services.