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MICHAEL MCGARVEY: It certainly has occurred to me that managed care organizations would be the ideal places to tap in order to identify patients for enrollment in such controlled studies. I did some work last year reviewing operations at the National Institutes of Health Clinical Center. One of the recommendations, in fact, was that the clinical center be a little more aggressive about contacting managed care organizations for case finding. If things were structured properly and if people understood the ground rules, this it would be a very fertile area for patient identification.