Beyond Publication Counts: Trends in Neurosurgical Publishing via a Retrospective Analysis of the Arms Race Control Score

BACKGROUND AND OBJECTIVES: Research productivity has become increasingly emphasized in neurosurgery residency applications, and applicant publication counts continue to rise. The Arms Race Control Score (ARCS) was proposed to standardize research effort, but its temporal stability and predictive value for future output remain unclear. Among board-certified US neurosurgeons, we sought to retrospectively examine how the ARCS has evolved temporally across 20 residency cohorts (1995-2014) and evaluate the predictive value of the ARCS on postresidency research productivity. METHODS: Publication data for neurosurgeons certified by the American Board of Neurological Surgery between 2009 and 2024 were extracted from Scopus. Leveraging large-language model analysis of Scopus's document type, title, journal, and abstract, publications were categorized based on ARCS criteria. For each surgeon, ARCS was calculated at the time of residency start. Distributions were analyzed across 5-year residency cohorts. Correlations and multivariable regressions tested associations between ARCS and long-term outputs (postresidency publication total, citation total, and h-index), adjusting for years since residency graduation and pre-residency publication count. RESULTS: This cohort included 1776 board-certified neurosurgeons who began residency between 1995 and 2014 and had a total of 96 249 publications. ARCS steadily increased over time ( P < .001), with the most recent cohort (2010-2014) having a significantly higher ARCS than all previous cohorts on post hoc comparisons. ARCS was positively correlated with all long-term research metrics, even when controlling for duration since residency graduation (all P < .001). In multivariable regression, both ARCS and pre-residency publication count predicted postresidency publication total and h-index. However, only ARCS predicted postresidency citation total. CONCLUSION: In a retrospective cohort, ARCS moderately increased in more recent residency cohorts and is a modest, independent predictor of long-term research productivity. These findings support ARCS as a complementary metric—alongside holistic review—for interpreting applicant research beyond raw counts.