Patient-reported outcome scores get collected because audits need them, and they get ignored in clinic because they are collected for the audit. The score that changes a consultation is the one the patient chose.
At the first visit, ask for two activities: the thing they have stopped doing and the thing they most want back. Write both in the notes in the patient's words — climbing to a first-floor flat, sitting cross-legged on the floor, forty minutes of standing at a counter. At every review, ask about those two.
It takes a minute and it does three things a Harris Hip Score cannot: it sets a shared target before surgery, it detects the patient whose score has improved while their life has not, and it makes the follow-up conversation about function rather than about the radiograph.
- Record two named activities at the first consultation, in the patient's own words.
- Ask about those two at every review, before looking at the imaging.
- In Indian practice, floor-level activities — squatting, cross-legged sitting, using an Indian toilet — should be named explicitly; Western scores do not ask.
- Flag the mismatch when scores improve but the named activities have not returned.
- Use the named activities to frame realistic expectations before arthroplasty, not after.
Why it matters
A validated score can improve while the thing the patient came for has not.
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