Future outlook for the project for quality assurance of indication and outcome in interventional cardiology and gynaecology

In the last few years the basis for national guidelines for the indications of coronary angiography, coronary revascularisation and hysterectomy has b een established. The guidelines have been published and are accessible to m edical doctors and patients on the Internet using a database system called "Second Opinion System": http://sos.inf.ethz.ch Dissemination, implementation and validation of the guidelines will be of m ajor importance in the near future. With reference to validation, the quest ion remains whether the established guidelines are correct for the everyday treatment of patients. A suitable method of answering this important quest ion is comparison between the appropriateness and necessity rates of the va rious indication groups, combined with outcome measurements. The Internet-b ased second opinion system (SOS) may be used for data collection in order t o verify hypotheses. Because of the database architecture, only relevant in formation about the patients is collected via Internet, independent of time and place. In addition, the system allows users to evaluate their individu al data, and special attention is given to data protection. The discussion about priorities in health care (rationing) will be increasi ngly important in the near future. The present project may offer a way of m aintaining adequate access to health care services for patients. Therefore, the participation of as many institutions as possible in the project "qual ity assurance of indication and outcome in interventional cardiology and in gynaecology" is of great importance.