%0 Journal Article %T The perils of PROMs: question 5 of the Oxford Hip Score is ambiguous to 10% of English %A George Murphy %A Gian C Singer %A Katherine Butler %A Pierre H M P¨¦chon %J HIP International %@ 1724-6067 %D 2019 %R 10.1177/1120700018775317 %X The Oxford Hip Score (OHS) is a commonly used patient-reported outcome measure (PROM), comprising 12 questions. We present the incidental finding that one of the 12 questions is ambiguous. As part of a 10-year follow-up of patients treated with hip resurfacing the OHS was posted to 148 patients; 135 (91%) replied. Scores were read by 2 orthopaedic surgery trainees and entered into a database. It was noted that Question 5 was frequently mis-interpreted. Thirteen patients¡¯ questionnaires (10%) showed the same inconsistency: question 5 was scored as 0 points but the other 11 questions were scored as either 3 or 4 in 97% of cases. The ethnic group of all 13 patients was recorded in hospital data as being White-British. Question 5 of the OHS is ambiguous to 10% of native English-speakers. These patients rated their hip function highly, as reflected by the fact that 97% of the questions other than question 5 scored 3 or 4, indeed 87% of them scored 4. We hypothesise that the wording of the zero score option ¡°Not at all¡± is being mis-interpreted as a response indicating that the patient does not suffer any pain at all. The effect is an error of 4 points out of 48 (8%); this may under-estimate the patient¡¯s hip score. Surgeons are under great scrutiny to prove efficacy of surgical interventions; this is often provided by PROMs. We should strive to formulate the most accurate, reproducible and least ambiguous PROMs questionnaires %K Arthroplasty %K hip %K incidental finding %K orthopaedics %K patient outcome assessment %K patient-reported outcome measures %U https://journals.sagepub.com/doi/full/10.1177/1120700018775317