The Medical Follow-up Agency The First Fifty Years, 1946-1996 (1999) / Chapter Skim
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4 Recent Decades
4 Recent Decades
Pages 53-76
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From page 53... ...
The Executive Committee of the National Research Council's (NRC's) Division of Medical Sciences Executive Committee echoed Beebe's sentiments, urging him to go slow, not to risk the flexibility that the MFUA's current organization gave it.
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From page 54... ...
The task of attempting to develop methods applicable nationally would be very large, and is probably beyond the strength of the Follow-up Agency." Beebe did note some interest within CEVFUS in morbidity studies on a smaller scale and some flexibility on the question of extending the MFUA program beyond the veteran population in cases "where the value and feasibility of studies on other groups were assured." NHLI, however, chose to consider the book closed on MFUA involvement in this effort on any scale.~4i Despite this decision, NHLI played a key role in funding the assembly and maintenance of the NAS-NRC Twin Registry for many years. Although MFUA spurned NHLI's proposal, the agency and the committee did gain some important additions in 1972.
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From page 55... ...
A non-twins study that was approved was part of the continuing work on amyotrophic lateral sclerosis, a follow-up effort to chart its course and that of other motor neuron diseases over time and to search for prognostic indicators. Other ongoing studies included one on body build and mortality, using a study of 105,000 men being discharged from military service in 1946 developed by a group of physical anthropologists.
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From page 56... ...
In particular, the study entitled "Prospective Studies of Mortality from Cerebrovascular Disease in Selected Groups of Pre-World War II and World War II Veterans," proposed by former MFUA staffer Dean Nefzger, required that no fewer than 120,000 records be examined over a period of three to four years. After lengthy discussions, the MFUA staff concluded that there was no way the agency could commit so much staff time to this effort without a fundamental reordering of its priorities.
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From page 57... ...
Louis was forced to relocate during the laborious process of cleaning and restoring the building. In May 1974, Seymour Jablon surveyed the situation for the committee: 80 percent of the Army personnel and medical records from World War II and the Korean War were lost.
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From page 58... ...
Although the committee expressed its regret that no greater effort was being made to standardize examination procedures, yielding universally applicable data, it was encouraged by the fact that the new record system might make it possible to maintain a data base on those who had been rejected. Such a data base would be useful in controlling for the so-called healthy veteran syndrome, which postulated that men on the MFUA's veteran rosters were less susceptible to disease than the general population since they had passed the physical examination on induction.
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From page 59... ...
Three new studies were approved in late 1973, including a longitudinal study of cardiovascular disease, an examination of childhood cancer in relation to prenatal irradiation, and a series of related epidemiologic studies of various conditions for evidence of later death from cancer among World War II veterans.~50 In 1974, despite the damage done to the MFUA program by the St. Louis fire, the agency made important strides in other areas.
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From page 60... ...
On the positive side, such developments as the creation of magnetic tape files, the development of epidemiologic knowledge, the creation of BIRLS, the adoption of the Social Security number as the military service serial number, the growing number of veterans, and increasing concern with the effects of environmental factors on human health aided the MFUA program. One matter that occupied Beebe's attention was the passage of the 1974 Privacy Act by Congress.~55 Beebe prevailed on National Academy of Sciences (NAS)
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From page 61... ...
experienced as much trouble getting used to the MFUA as had some of its predecessors in the Division of Medical Sciences. In examining the MFUA program in 1976, the Executive Committee called particular attention to the ongoing surgical adjuvant cancer therapy trials, probably the most atypical part of the agency's program.
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From page 62... ...
Stallones presented his report on cardiovascular disease and the MFUA program, recommending that a summary of the agency' s usefulness as a resource be reprinted periodically in the American Journal of Epidemiology and that the agency seek special funding from the NHLBI for planning cardiovascular disease studies. DeBakey presented a number of potential surgical studies that could be undertaken by the agency, including follow-up of studies done in its earliest days, as well as some new ideas such as a study of men with spinal cord injuries.
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From page 64... ...
which found excessive mortality from cardiovascular disease, were completed. CEVFUS also approved pilot studies on alcoholism among veterans and the potential relationship between household pets and multiple sclerosis.
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From page 65... ...
The National Cancer Institute decided, after 25 years, to terminate the cancer chemotherapy trials that had caused such enmity between the MFUA and the ALS. Studies in progress in 1983 included a morbidity update for World War II and Korean War POWs, a prospective study of testicular cancer, study of the possible long-term effects of short-term exposure to chemical agents in a series of tests at Edgewood Arsenal (see Box 13)
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From page 66... ...
Jablon' s experience with the ABCC and some related, smaller-scale studies in the 1970s, gave him and his staff experience needed to carry out such work. Beginning in 1978, the Medical Follow-up Agency and the Defense Department's Defense Nuclear Agency entered into a series of contracts that would last into the 1990s.
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From page 67... ...
Both processes were easy enough to automate, but the Social Security Administration refused to cooperate on grounds of legal difficulties over the matter of disclosure. Failure to obtain these data made using the National Death Index and obtaining a mailing address from the Internal Revenue Service more difficult.
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From page 69... ...
Chaired by Brian MacMahon, it produced a laudatory report, calling the MFUA a "national resource which should be maintained and strengthened." It recommended keeping the agency within the NRC, securing core funding from the NIH, the VA, and other key governmental agencies, and suggested an immediate search for a new director with the retirement of Seymour Jablon in October 1987. The task force also mentioned the need for greater ties to investigators in academia and government agencies, as well as the possibility of changing the agency's name to reflect the breadth of its mission.~7i WILLIAM PAGE'S INTERIM With Jablon leaving, Alvin Lazen, executive director of the Commission on Life Sciences (the new functional equivalent of the former ALS)
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From page 70... ...
The agency sought to determine the prevalence in victims of various hepatitis markers and to estimate their mortality rates, especially from liver cancer and other liver diseases. Various multiple sclerosis and twin projects were under way or planned, and planning was also being undertaken on a 33-year follow-up of Army recruits immunized with adjuvant influenza vaccine to determine if long-term problems could be associated with this vaccine.
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From page 71... ...
, a study of multiple sclerosis, three twin studies, and a follow-up of nuclear veterans. In addition, the committee heard discussions of the body build registry, posttraumatic stress disorder in World War II riflemen, Alzheimer's disease, and head injury.~79
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From page 72... ...
Two years later, this was again jeopardized by indifference within the funding agencies, but a follow-up OTA study in 1994 persuaded all three agencies to provide the money. In 1991, the agency completed its study of Army recruits immunized with oil adjuvant influenza vaccine, finding no statistically signifi
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From page 73... ...
cat advcrsc coca of the oH a~uv~t. Tab corc Waning in band, Papa urged the com~ttcc to broaden the apcncy's bodzons.
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From page 74... ...
Miller continued efforts begun under both Page and Howson. One especially notable study begun under Howson was designed to monitor the health status of Persian Gulf veterans (see Box 16~.
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From page 75... ...
Michael DeBakey. DeBakey and Gilbert Beebe sensed the opportunity to create a medical organization that would be a force for good in post-World War II America by channeling the experience of the war into useful medical knowledge.
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From page 76... ...
Seymour Jablon; front row: Dr. Michael DeBakey and Dr.
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