Quality-of-life assessment in neurosurgical patients

The increasing consideration being given to the assessment of patients' quality of life (QOL) in contemporary neurosurgical clinical studies can be attributed to several factors, including technologic advances with escalating costs, the lack of a clear benefit in terms of length of survival (a traditional outcome measure) in several recent clinical trials of different treatment modalities, and the obvious need to rationalize the practice of neurosurgery by adopting an evidence-based approach. The current emphasis on patients' subjective experiences, satisfaction, and preferences as the goal of health care delivery also warranted development and psychometric validation of QOL instruments to assess these experiences and preferences. Our review shows that QOL research currently progressing in neurosurgery is wide ranging, although at a different pace in the subspecialties, with more utilization of disease-specific instruments in neuro-oncology than in the other subspecialties. The prospects are therefore encouraging for improving the quality of health care in neurosurgery, the ultimate goal of outcomes measurement.