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Matthew J. McGirt, Theodore Speroff, Robert S. Dittus, Frank E. Harrell Jr. and Anthony L. Asher

more valuable care. As these methods evolve, there exists an opportunity for physicians to impact the form and method by which the quality and value of health care is defined. In March 2012, the AANS launched the National Neurosurgery Quality and Outcomes Database (N 2 QOD) ( http://www.neuropoint.org/NPA%20N2QOD.html ). 2 The lumbar module was released as the initial 12-month pilot project to determine the feasibility of a nationwide, prospective longitudinal neurosurgical outcomes registry and assess the utility of its data. While the N 2 QOD lumbar spine pilot

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Jian Guan, Vijay M. Ravindra, Meic H. Schmidt, Andrew T. Dailey, Robert S. Hood and Erica F. Bisson

these patients, but concern over repeat RLDH may lead many surgeons to advocate instrumented fusion in the absence of instability. To our knowledge, there are no direct comparisons of clinical outcomes and hospital charges for these patients in the literature. We sought to compare the clinical and patient-reported outcomes for patients undergoing repeat discectomy versus instrumented fusion for RLDH by using the National Neurosurgery Quality and Outcomes Database (N 2 QOD). N 2 QOD is a national clinical registry that enables the prospective collection of data for a

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Leah Y. Carreon, Steven D. Glassman, Zoher Ghogawala, Praveen V. Mummaneni, Matthew J. McGirt and Anthony L. Asher

valid measures of health state utility in patients with low-back pain, they cannot be used interchangeably. 22 , 24 , 25 , 32 , 33 Differences in the health state utility values derived from the EQ-5D and SF-6D are substantial enough that several cost-effectiveness studies present their results using both the EQ-5D and the SF-6D as part of the sensitivity analysis. 34 , 35 The purpose of this study was to determine for patients with spondylolisthesis enrolled in the National Neurosurgery Quality and Outcomes Database (N 2 QOD) 2 , 26 , 27 at what threshold of

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Matthew J. McGirt, Scott L. Parker, Silky Chotai, Deborah Pfortmiller, Jeffrey M. Sorenson, Kevin Foley and Anthony L. Asher

. To date, there has been no comprehensive, prospective analysis of patient data with the primary intent of understanding the factors associated with increased risk of hospital LOS, need for inpatient rehabilitation, and hospital readmission after lumbar spine surgery. We set out to develop a grading scale that effectively stratifies risk of these costly events after elective surgery for degenerative lumbar pathologies. Methods Patient Population The Quality and Outcomes Database (QOD) is a prospective patient-reported outcomes registry that enrolls patients

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Anthony L. Asher, Clinton J. Devin, Brandon McCutcheon, Silky Chotai, Kristin R. Archer, Hui Nian, Frank E. Harrell Jr., Matthew McGirt, Praveen V. Mummaneni, Christopher I. Shaffrey, Kevin Foley, Steven D. Glassman and Mohamad Bydon

I n the modern era, data scientists are able to amass ever-larger quantities of clinically relevant data at rapidly increasing rates. The Quality Outcomes Database (QOD), formerly known as the National Neurosurgery Quality and Outcomes Database (N 2 QOD), is a manifestation of this trend. 2 , 24 While administrative data sets historically provided researchers with large sample sizes, they often lacked important clinical information. Conversely, at their individual institutions, researchers had the power to generate highly granular clinical data but at the cost

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Anthony L. Asher, John Knightly, Praveen V. Mummaneni, Mohammed Ali Alvi, Matthew J. McGirt, Yagiz U. Yolcu, Andrew K. Chan, Steven D. Glassman, Kevin T. Foley, Jonathan R. Slotkin, Eric A. Potts, Mark E. Shaffrey, Christopher I. Shaffrey, Regis W. Haid Jr., Kai-Ming Fu, Michael Y. Wang, Paul Park, Erica F. Bisson, Robert E. Harbaugh and Mohamad Bydon

healthcare stakeholders and to apply those systems in high-yield value environments, such as spine care. 10 , 11 Between 2010 and 2012, the NeuroPoint Alliance (NPA), a not-for-profit corporation initially formed by the AANS and CNS in 2008, worked with relevant national stakeholders to develop a centralized, nationally coordinated effort to allow neurosurgeons and practice groups to collect, measure, and analyze practice patterns and neurosurgical outcomes. This effort was termed the “National Neurosurgery Quality Outcomes Database” (N 2 QOD), later called the “Quality

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Joseph Laratta, Leah Y. Carreon, Avery L. Buchholz, Andrew Y. Yew, Erica F. Bisson, Praveen V. Mummaneni and Steven D. Glassman

-BP) and leg pain (NRS-LP) in patients with and without obesity and PD undergoing spinal fusion for grade 1 degenerative spondylolisthesis. Although the effects of obesity and PDs on outcomes after lumbar surgery have been reported in prior studies, to our knowledge this is the first study in the literature to define MCID thresholds after lumbar fusion for grade 1 degenerative spondylolisthesis in these patient populations. Methods Patient Sample We queried the Quality Outcomes Database (QOD) registry for patients who underwent surgical intervention for grade 1

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Clinton J. Devin, Mohamad Bydon, Mohammed Ali Alvi, Panagiotis Kerezoudis, Inamullah Khan, Ahilan Sivaganesan, Matthew J. McGirt, Kristin R. Archer, Kevin T. Foley, Praveen V. Mummaneni, Erica F. Bisson, John J. Knightly, Christopher I. Shaffrey and Anthony L. Asher

various demographic, occupation-related, and clinical variables in determining the probability of return to work after cervical spine surgery. To address this knowledge gap, this study used data from a national spine registry to construct a predictive model as well as a nomogram to predict return to work after cervical spine surgery among patients who were employed preoperatively. Methods Data Source For this project, we queried the cervical spine module of the Quality Outcomes Database (QOD) registry. The QOD is a prospective registry that was designed to evaluate risk

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Praveen V. Mummaneni, Mohamad Bydon, John Knightly, Mohammed Ali Alvi, Anshit Goyal, Andrew K. Chan, Jian Guan, Michael Biase, Andrea Strauss, Steven Glassman, Kevin T. Foley, Jonathan R. Slotkin, Eric Potts, Mark Shaffrey, Christopher I. Shaffrey, Regis W. Haid Jr., Kai-Ming Fu, Michael Y. Wang, Paul Park, Anthony L. Asher and Erica F. Bisson

predictors of a nonroutine discharge for a homogeneous subset of patients undergoing 1- to 2-level decompression or 1-level fusion surgery for grade I spondylolisthesis. Methods Patient Cohort The Quality Outcomes Database (QOD) was queried for patients undergoing surgery for Meyerding grade I degenerative lumbar spondylolisthesis between July 1, 2014, and June 30, 2016. The QOD spine registry is the largest prospective multiinstitutional registry in North America. The registry was established in 2012; the overarching objective behind its inception was to assess risk

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Erica F. Bisson, Praveen V. Mummaneni, John Knightly, Mohammed Ali Alvi, Anshit Goyal, Andrew K. Chan, Jian Guan, Michael Biase, Andrea Strauss, Steven Glassman, Kevin Foley, Jonathan R. Slotkin, Eric Potts, Mark Shaffrey, Christopher I. Shaffrey, Regis W. Haid Jr., Kai-Ming Fu, Michael Y. Wang, Paul Park, Anthony L. Asher and Mohamad Bydon

patients lost to follow-up at 2 years with those who successfully underwent follow-up. Methods Cohort For this study, the Quality Outcomes Database (QOD), formerly known as the National Neurosurgical Quality and Outcomes Database (N 2 QOD), was queried for patients undergoing surgery for Meyerding grade I degenerative lumbar spondylolisthesis between July 1, 2014, and June 30, 2016. The QOD is a prospective multiinstitutional registry, established in 2012 with the objective of assessing risk-adjusted expected morbidity and 30-day and 12-month patient-reported outcomes