While both the put-call open interest ratio and the skew indicate the same thing, the latter is more reliable, according to Ardern, given it calculates real-time data and is not affected by open contracts. Historically, the six-month call-put skew has been more reliable as a contrary indicator, showing put bias near price bottoms, as observed after the March 2020 crash and the May 2021 slide.
Source: https://www.coindesk.com/markets/2022/01/31/bitcoins-put-call-ratio-hits-6-month-high-as-negativity-rules/