[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.