Any researcher knows that the quality of the data can make or break a research project. At the risk of committing misdemeanor anecdote (I watch TV cop shows), let me say that the basic thesis underlying the paper by Jack Rouff and Carroll Child, "Application of Quality Improvement Theory and Process in a National Multicenter HIV/AIDS Clinical Trials Network," resonated with me. Over years of experience performing studies and directing health care quality management projects in the United States and other countries, I saw the impact inaccurate data and sloppy reporting can have on everything from physicians' evaluations to Joint Commission assessments to the reliability of demographic and epidemiological statistics. Rouff and Child give us a report illustrating how the application of the principles and techniques of continuous quality improvement to the tasks of data collection and reporting can result in significant improvement in data quality.

In their study assessing sickness-related quality of life reported by patients with pituitary tumors, Baird, Sullivan, Zafar, and Rock surveyed a sample of 43 patients using two instruments. One was a list of symptoms and problems specific to patients with pituitary tumors and the other was the Sickness Impact Profile, a life quality index. The participants took part in nominating items for inclusion in the survey questionnaire list. The authors had found that many patients who had received treatment for pituitary tumors reported delays and difficulties in obtaining treatment for their symptoms. This situation was ascribed to a view prevalent among providers that long-term sequelae of pituitary tumors are rare or minor. One of the objectives of the study team was to generate information about the difficulties reported to facilitate diagnosis, treatment, and research on the issues. This study will provide a basis for further studies designed for the exploration of the existence, gravity, and bases of the reported problems, and for the planning of effective interventions.

Cordelia Wagner and Maureen van Oort, of the Netherlands Institute of Health Services Research, and Godfridus G. van Merode, of the University of Maastricht, address the tantalizing issue of the costs of devising and implementing quality management plans in the long-term care setting. Using methods for measuring and reporting the costs of quality management systems that are consistent with those outlined by the U.S.-based Institute of Management Accountants, they conducted their research by means of case studies and focus groups in 11 long-term care facilities and a questionnaire survey sent to 696 long-term care providers with a mean response rate of 70%. The authors hold that it will be necessary to assess the costs associated with adverse events ("failures") to arrive at a valid assessment of the cost effectiveness of a quality management system.

A winner of the 2001 Premier Clinical Performance Initiative's Quality Award, East Alabama Medical Center (EAMC) reports on its ongoing project for the improvement of clinical data. The project was initiated in EAMC's cardiovascular service with the objective of collecting data at the point of care delivery to facilitate rapid-cycle performance improvement studies. Jane Robertson describes the changes in technology and in the data collection process.

Duncan Neuhauser has revisited a 1967 expose of poor patient care in a mental hospital that took the form of a film. In his essay, he discusses the film, "Titicut Follies," and the quality of patient treatment it documented. Neuhauser describes the ongoing efforts of Massachusetts courts to prevent the showing of this revealing documentary film.

QMHC offers its condolences to the family and colleagues of our Editorial Board member, Marian Gray Secundy, PhD, who passed away on December 27, 2002. Dr. Secundy was Director of Tuskegee University's National Center for Bioethics in Research and Health Care. Her contributions to the international study of ethical issues in health care are memorable and valued.