[Indicators for quality of care. Severe problems with methods of observation].

Recently, there has been increasing concern about indicators for quality of care systems. Much energy has been devoted to the development of these indicators, but after a couple of years many professionals in the care organizations are complaining that the validity is extremely doubtful. In this editorial a fundamental problem is discussed, namely the reliability of the observations.

Multiple levels on LLETZ biopsies do not contribute to patient management.

Aim: Cervical large loop excision of the transformation zone (LLETZ) specimens are performed both to treat and to diagnose or exclude cervical pre-neoplasia. Examination of these specimens forms a significant part of the routine histological work load of the pathologist, yet histological confirmation of squamous intraepithelial lesion (SIL) or completeness of excision, does not alter the treatment of SIL. When the LLETZ procedure is done, the treatment is complete, the dysplasia having been subject to excision as well as diathermy during the procedure.

[A neglected research topic: powerlessness of old people].

There is much research into problems of the elderly in The Netherlands. It seems however that studies from a macro-sociological perspective are scarce. This is discussed in greater detail focusing on the concept of power.

[Raising the retirement age will be disadvantageous to many people].

In The Netherlands and in several other countries as well it is proposed to increase the retirement age from 65 to 67 years of age or over. However, early mortality is not being taken into account. If the retirement age is increased, many people will be unable to benefit from pensions, simply because they will not live to enjoy them.

[Research into human problems: lower social strata and the aged underrepresented].

The quality of social science research is probably much lower than that of the sciences. Firstly, this is due to the quality of the observations. For example: the measurement of a temperature is encompassed in many more precautions than the measurement of attitudes, loneliness or even the number of friends.

[Gene-expression analysis using DNA microarrays].

Parallel to the efforts to unravel the human genome code, techniques are currently being developed to analyse the activity of all genes and proteins in a cell population or tissue. The most advanced of these functional genomic techniques is that used to study gene expression using DNA microarrays, also known as 'DNA chips'. This allows the expression of thousands of different genes to be compared in two different samples (for example, one from a sick person and one from a healthy one).