History of outcomes measures in neurosurgery

This article provides a brief overview of the history of the origin of surg ical outcomes studies in North America as exemplified by the career of E. A . Codman, MD. The influence of Harvey Gushing on Codman's interest in docum enting the end results of surgical care is reported. The lessons gained fro m Codman's experience and difficulties are related to the efforts of the Am erican Association of Neurological Surgeons/Congress of Neurological Surgeo ns Outcomes Committee to develop an international neurosurgical outcome rep orting system.