術前情報が患者報告アウトカムに果たす役割の評価：因果推論による分析

Breast cancer poses a global burden on individuals and healthcare systems, with millions of women undergoing surgery annually. Recently, there has been growing recognition of the importance of patient-centered care, leading to increased interest in Patient-Reported Outcome Measures (PROMs). In oncology, this has translated into the use of validated tools such as the BREAST-Q survey, which is designed for a range of breast surgery procedures, and it is specifically applicable in breast cancer. Using BREAST-Q data collected at the University Hospital of Pisa (Italy) between 2018 and 2022 from a sample of 482 women, this study explores the causal relationship between the pre-operative information provided by the breast surgeon and patients' post-surgery satisfaction.

We employ Item Response Theory models to estimate patient-level satisfaction with pre-surgery information and with breast outcomes. Using these estimated latent traits, we assess the causal effect of satisfaction with pre-surgery information on post-surgery breast satisfaction through an exposure-response curve, accounting for various pre-exposure individual characteristics.

Findings show a strong, positive, and statistically significant causal relationship between pre-operative information and post-operative satisfaction.

In a healthcare landscape increasingly constrained by time and resources, healthcare organizations should note the causal link between communication and patient-reported outcomes and strive to create environments that support meaningful patient-centered interactions.