[Development of a Japanese version of the Outcome Prioritization Tool (OPT) for clarifying the treatment goal...

In older adults with multimorbidity, clarifying the treatment goals is essential. The Outcome Prioritization Tool (OPT) is an internationally used four-item questionnaire (Independence, Staying alive, Pain relief, and Symptom relief). This study aimed to create a linguistically valid Japanese version of the OPT and to assess its content validity.

With permission from the original author, the OPT was translated using cross-cultural adaptation. Two native Japanese speakers produced forward translations that were reconciled into a single draft. A native English speaker generated a back-translation, and thrn the draft was reviewed by the original author and three geriatric specialists. Semi-structured cognitive interviews were conducted with nine adults aged 65 years of age or older with multimorbidity (three each from community clinics, a university hospital, and home medical care). Content validity, including cognitive validity, face validity, and clarity of wording, was thereafter evaluated.

Participants (median age, 82 years) generally rated face validity and clarity favorably (median score, 4). However, cognitive validity for the Japanese translation of "Symptom relief" was lower (median 2) than that for the other items (median: 4). Participants' comments indicated uncertainty about whether psychological distress was included, leading to the revision of the introductory explanation. After final approval from the original author, the Japanese OPT was finalized with four items: "Jiritsu shita seikatsu," "Nagaiki suru koto," "Itami o yawarageru," and "Itami igai no tsurasa o raku ni suru."

A Japanese version of the OPT with confirmed linguistic and content validity was developed for this study. This tool may support patient-centered prioritization of the treatment goals in older adults with multimorbidity in clinical settings.