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Outcome measures are routinely used in child and adolescent mental health services to demonstrate the effectiveness or otherwise of interventions. We followed up a consecutive sample from a large teaching hospital's Obsessive Compulsive Disorder (OCD) service for young people, comparing improvements using instruments of differing broadness. The effect size of improvement decreased as the breadth of the questionnaire increased. Specialist clinics are recommended to use two questionnaires: a broad one to facilitate comparability with other clinics, and a narrow one to maximise power to detect significant changes.