• Stephanie Schipmann, Michael Schwake, Eric Suero Molina, Norbert Roeder, Wolf-Ingo Steudel, Nils Warneke, and Walter Stummer.
• Department of Neurosurgery, University Hospital Muenster, Muenster, Germany. Electronic address: stephanie.schipmann@ukmuenster.de.
• World Neurosurg. 2017 Aug 1; 104: 104-112.

BackgroundOwing to the rising costs of health care delivery, the quality of delivered care has become a central issue across all medical specialties. Consequently, there is increasing pressure to create standardized frameworks for measuring quality of care. In the field of cranial neurosurgery, health care administrators have begun applying quality measures that are easily available but might be inaccurate in measuring the quality of care.MethodsWe performed a systematic literature review on quality indicators (QIs) that are presently used in this field, aiming to elucidate which QIs are scientifically founded and thus potentially justifiable as measures of quality. We found a total of 8 QIs, and methodologically evaluated published studies according to the AIRE (Appraisal of Indicators through Research and Evaluation) criteria. These criteria include length of hospital stay, all-cause readmission rate, and unplanned reoperation rate.ResultsOur review indicates that these presently used or proposed QIs for neurosurgery lack scientific rigor and are restricted to rudimentary measures, and that further research is necessary.ConclusionsNeurosurgeons need to define their own QIs and actively participate in the validation of these QIs to provide the best possible patient outcomes. More reliable clinical registries, obligatory for all neurosurgical services, should be established as a basis for establishing such indicators, with risk adjustment being an important element of any such indicators.Copyright © 2017 Elsevier Inc. All rights reserved.

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