Outcomes Research and Quality Improvement in Neurosurgery: Metrics, Registries, and Evidence-Based Practice

The maturation of neurosurgical outcomes research — encompassing patient-reported outcomes, national registry data, risk-stratification models, and quality improvement initiatives — has provided the field with an increasingly rigorous foundation for evidence-based decision-making. This chapter reviews the landscape of neurosurgical outcomes measurement, including condition-specific and generic health-related quality-of-life instruments, the role of national and international registries such as the National Neurosurgery Quality and Outcomes Database, and the application of risk-adjustment methodologies. It also addresses the integration of outcomes evidence into surgical training, credentialing, and health system policy.