mission as a combination of advisory, stimulative, and protective functions, to "bridge the gap between the program and the investigator that derived from the composition of the Follow-up Agency and its location" in the NAS. Following a discussion of the methods and resources of the agency, the committee heard a summary, of the studies in progress. Research efforts were being directed at heart disease, multiple sclerosis, and the consequences of occupational exposure to ionizing radiation.
Ongoing efforts in fiscal year 1965. included the study of long-term survival in Hodgkin's disease, the long-term follow-up of testicular tumors, the natural history of multiple sclerosis, and the follow-up of more than a thousand World War II veterans diagnosed with herniated lumbar disks (the agency's only clinical project then in operation). Agency staff noted that "two or three projects usually terminate each year," leaving room for "two or three" new projects each fiscal year, figures that would remain fairly consistent for the next decade. In 1965, planning began on at least five new studies: the possible influence of blood type on the incidence of salivary cancers, the link between early incidence of heat stroke and heat exhaustion and later-in-life heart and circulatory disease, the causes of chronic kidney diseases and disorders, a pilot study of amyotrophic lateral sclerosis (also known as Lou Gehrig's disease), and the treatment of thyroid nodules.108
At its second meeting, in early 1966, the committee began the task of agency oversight. MFUA staff described an important trend in the program, the shift from clinical follow-up studies to epidemiologic studies. This trend accentuated the emphasis on record studies at the expense of clinical examinations. Similarly, studies of mortality (as opposed to morbidity) became more frequent as the World War II cohort continued to age. Even in studies of morbidity, the distance from military service made it more difficult to locate some of the men.109
The agency's program development had suffered during its financial uncertainty in the early 1960s. In the meantime, agency staff had focused on ongoing efforts, such as the study of the epidemiology of multiple sclerosis. This study proved especially fruitful in 1966 and produced a paper given at the American Academy of Neurology, as well as publications in both domestic and international neurological journals. MIFUA researchers found geographic variation in preservice environment, as well as more important differences associated with urbanization, socioeconomic status, and race, to be significant variables in identifying veterans with multiple sclerosis. Other ongoing projects included studies of the epidemiology of coronary heart disease, the Hodgkin's disease project, and the study of occupational exposure to x-rays.110
One of the most important ongoing projects in 1966 was the study of prisoners of war (POWs) (see Box 8), an effort to follow the experience of World War