Ethical issues relating to naturalistic evaluation are addressed, focusing on the role of the evaluator, problems of privacy and data gathering techniques, and issues relating to the use/abuse of findings. Benefits and costs of the naturalistic approach to program evaluation are also identified. (EGS)

The evaluation of a fellowship program in the health sciences for 60 Philippine graduates at the University of Hong Kong highlights areas of conflict. Twenty-six fellows were interviewed. Value judgments about a program's worth ultimately depend on the evaluation's perspective, whether that of participants or an outside party. (SLD)

The concept of risk-adjusted measures of quality is discussed, and a methodology is proposed for risk-adjusting and integrating multiple adverse outcomes of anesthesia services into measures for quality assurance and quality improvement programs. Although designed for a new anesthesiology database, the methods should apply to other health…

The use of qualitative data in the refinement of a research program in human immunodeficiency virus studies in a military population is described. Three mechanisms of patient participation (a protocol advisor, a participant advisory panel, and focus groups) provided important feedback for adapting the research process. (SLD)

The institutional self-study required by a university hospital's reaccreditation process is explored, with a discussion of benefits and costs. A reaction by C. F. Waltz and A. Belcher reaffirms the value of reaccreditation studies and discusses ways of minimizing costs without compromising comprehensiveness and utility of results. (SLD)