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Dear Friends The last year has seen Cases for Comment continuing to grow - I'm retrospectively amazed that 76 Cases have now been distributed. I've lost count of the number of individual participants, but I think these now involve around 27 countries, the two latest recruits being from South Korea and from Pakistan. Sincere thanks to Li Ping who helped me to keep these Cases going during 1999, to all participants, to all who have sent me messages of support, and particularly to my '7 wise men and women' who have added so much to the educational value of these Cases. I am pleased to announce that I have received a small grant from CPA (UK) Ltd to enable me to set up a pilot National External Quality Assurance Scheme for clinical interpretation, based on Cases for Comment. This will inevitably mean some changes in the format of Cases for Comment - I think these will have to be based on a web page to make logging of participants and assessing of comments easier, but I will be keeping you all informed and circulating some of the ideas for your feedback. I am also pleased that Jacquie Osypiw will be joining me to help with this project. With this change, perhaps some of the fun will go out of these Cases, but I am determined that they will retain a high educational value, since I think that we have all learned from them (particularly me!). With best wishes to all for Christmas and the new millennium. Gordon Challand %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%