rience of the prisoners. Preliminary computations indicated that those who had been prisoners of war in Japan experienced an excess of mortality compared to the U.S. white male population in the period between 1945 and 1951; prisoners in Europe had a significantly lower mortality rate than U.S. white males for this period. Excited by this finding, the staff believed that record follow-up projects deserved a more important place in the committee program than they had received. As Bernard Cohen put it, "the medical records of the armed forces and the Veterans Administration provide unparalleled materials and opportunities for follow-up studies."52

Donald Mainland, a professor of medical statistics at New York University, produced a more sober evaluation of the Follow-up Agency in a report for the NRC that appeared in March 1953. He lauded the work of Gilbert Beebe and his staff. Still, he found much to criticize. In the excitement at the beginning of the program, studies had begun without sufficient planning. Few people understood that clinical competence did not imply statistical competence. The agency did not do enough small pilot studies. Instead, it undertook too many large projects, too quickly. The clinical investigators failed to appreciate the importance of statistical expertise. All in all, the relative value of the program would have been greater "if those responsible (investigators and committee members) had been better acquainted with the principles and limitations of statistical surveys." Mainland argued that if the program continued, it should do so on a diminished scale. In the meantime, the NRC might consider establishing a statistical advisory unit to serve a wide variety of purposes.53

With Mainland's report in hand, the Committee on Veterans Medical Problems discussed the future of the follow-up program in April 1953. The committee decided that applications for new follow-up studies should have an adequate experimental plan, an estimate of the "feasibility of the proposal from a statistical viewpoint," and investigators "with enthusiasm, competence, and dependability in regard to completion of the study." In other words, they proposed to interpret existing standards in a rigorous manner. The committee looked with particular skepticism on projects that involved multiple research locations. 54



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