 
                        20030201.00
Consider the consequences of the following proposed research
project:

1)  You identified the risk  factors  (severe  hypertension,
diabetes,  etc) for chronic severe renal disease with a high
probability of leading to renal decompensation; 2)  In  col-
laboration with members of your department, designed a logi-
tudinal prospective epidemiologic study of the pathophysiol-
ogy and therapy of such disease.  3) Mailed letters, repeat-
ed at appropriate intervals, to a large  number  of  greater
Boston  internists,  inviting  them  to suggest to their pa-
tients to enlist as participants in such a study.  There  is
no  reason  why  patients  should not be offered payment for
their cooperation.  4) All contact with the  sudy  would  be
initiated  by patients themselves. The patients would be in-
formed of the availability of the study by their internists,
and  interested patients would request to participate in the
study.  5) Data would be gathered by periodic telephone  in-
terviews by sympathetic and knowledgeable medical personnel.
(Telephone interviews to be recorded for  data  content  and
quality  control.)   5)  Referring physicians might be given
the opportunity to contribute data  from  their  records  as
well  as  their observations and opinions.  6) If necessary,
enrollment in the study could be boosted  by  advertisements
in local newspapers.

                         * * * * *
Copyright 2005, Ernst Jochen Meyer
