Neurosurgery, like most domains of surgery, has long focused on technical success and clinician-reported global functional outcomes. This convention fails to capture the most important perspective, the patients. Health-related quality of life (HRQOL) metrics provide a much better insight into the patient experience. These questionnaires explore various dimensions of the state of the patient’s quality of life (mental, physical, social, etc.). ^{Reference Ware and Sherbourne1} While this results in arguably a better metric of success, it adds more complexity to aggregate analysis of large patient cohorts, beyond typical coarse outcome measures such as the modified Rankin Scale or Glasgow Outcome Scale. ^{Reference Rumsfeld, Alexander and Goff2}

In their article, Levitan and colleagues present their meticulously collected HRQOL outcomes in a population of patients treated surgically for Cushing’s disease. ^{Reference Levitan, Sethi, Ammar, Goguen and Cusimano3} This report is a courageous endeavor, delving beyond biochemical cure as a metric of surgical success and examining more deeply the patient’s experience of the disease and their course through treatment.

Certain subspecialties of neurosurgery, such as neurosurgical oncology and functional neurosurgery, have been leading the way in reporting success through the patient perspective aided by HRQOL metrics. ^{Reference Coomans, Taphoorn and Aaronson4,Reference Diamond and Jankovic5} Perhaps, it is about time that neurosurgery and the clinical neurosciences follow this lead. In the future, such patient focused assessment tools will hopefully become common aspects of the neurosurgical literature and become incorporated as quality assurance metrics in neurosurgical practice.