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Objectives: This paper evaluates the usefulness of a set of PROMs data collected prospectively, in a relationaldatabase, over several years. The data were collected as part of routine practice, to audit patients undergoing shouldersurgery. Methods: Data, rendered anonymous, which included all upper limb surgical procedures and all outcome questionnaires(including Oxford Shoulder Score, OSS) data, were downloaded, prepared and analysed to produce the shoulder surgerystudy population. Details of procedures and questionnaires were merged by shoulder and analysed for completeness andaccuracy. Pre- and post-operative OSS scores, with repeated observations from individual patients, were analysed usingmaximum likelihood mixed effects linear regression models. Results: Data preparation and cleaning was intensive. The final dataset contained 2110 questionnaires representing 815surgical procedures and 755 patients. In relation to procedures, only 538 (66%) had a pre- and post-operative OSS score:78 (9.5%) a pre-operative OSS only, 199 (24.4%) a post-operative OSS only, and 31 (3.8%) no OSS completed. OSSquestionnaires had been completed in varying numbers and at varying times per procedure. There was a considerableamount of ‘missing’ data that was not missing completely at random. Missing data had a significant influence on OSSscores. Conclusions: In the absence of a research question (eg. exploratory research, descriptive audits, registers), a reason forcollecting PROMs data should be stipulated and methods of data collection and storage standardised. Poor data cannot be‘fixed’ in statistical analysis; statistical advice should be sought during the planning stages.

Using Patient-Reported Outcome Measures (PROMs) Routinely: An Example in the Context of Elective Shoulder Surgery