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°1812

AllthOT

Eisner, Seth

Corporate Author
RBDOrt/APtldB Tltte Typescript: Report of Contact - contacted by Larry
Hobson, February 27, 1984

Journal/Book Title
Year
Month/Day
Color
Number of forages
DBSCrlptOn NOtOS

Alvin L Youn

9filed tnis item under "Vietnam Veterans
Twin Study." Discusses Hobson's Option and Decision
Paper regarding continuation of the study.

Wednesday, July 11, 2001

Page 1813 of 1870

��REPORT OF CONTACT
Contacted by: Larry Hobson
Date of Contact: February 27, 1984
Hobson has been asked to prepare an Option and Decision
Paper for review by the CMD. He was calling to read his current
draft to me for my comments. The various options that Hobson will
present are:
1. Discontinue the VETS, including withdrawing from Twinfind
Pro - money will be saved
Con - the VA will be subject to adverse criticism
2. Direct that a non-VA contractor perform the entire study
Pro - claims of possible VA bias in the data collection and
analysis will be eliminated
Con - bias does not appear to be a major issue (note the
Ranch Hand study's relative freedom from the bias
criticism), the cost of the project under contract
will markedly increase, there will be a demoralizing
effect on the project's principal investigators, and
the VA will appear to lack confidence in the quality
of its own research
3. Continue the NAS Twinfind and questionnaire survey but abandon
the St. Louis intensive health assessment portion
Pro - money will be saved and the twin register concept and
its future scientific value will be retained
Con - the NAS questionnaire is so limited in scope that its
value to the VA will be m i n i m a l , and the VA will be
subject to the criticism of refusing to support
quality research because of what might be revealed
4. Support only the NAS Twinfind but expand the detail in the
mailed questionnaire, perhaps including a telephone survey
Pro - the cost of the project will be reduced and the
expanded questionnaire will increase the usefulness of
the data
Con - the data will be of questionable reliability, its
usefulness will be quite limited, and the cost savings
will be reduced because of the increased cost of the
expanded questionnaire survey
5. Retain the VETS in its c u r r e n t f o r m a t , w i t h or w i t h o u t
modification. The following are possible modifications:
a. P e r f o r m the psychological assessment under contract
Pro - the c r i t i c i s m of b i a s in the d a t a c o l l e c t i o n w i l l be
reduced

�Con - the cost will be increased
b. E l i m i n a t e some of the proposed e x p e n s i v e m e d i c a l tests but
r e t a i n the p e r f o r m a n c e of the psychological assessment by the VA
Pro - the cost of the project will be reduced
Con - t h e V A m a y s t i l l b e c r i t i c i z e d f o r
p e r f o r m i n g an incomplete research p r o j e c t

purposely

c. C o n t i n u e the present VETS plan in an u n m o d i f i e d form
Pro - an excellent s t u d y , a p p r o v e d by the CSP, will thereby
result and be subject to the least c r i t i c i s m from the
s c i e n t i f i c c o m m u n i t y and the general public
Con - the s t u d y w i l l be s u b j e c t to the c r i t i c i s m of b i a s and
high cost
Hobson said that his own position is option 5b. He will r e c o m m e n d
e l i m i n a t i n g tests such as the e n d o c r i n e and i m m u n o l o g i c studies,
and t h e c y t o g e n e t i c a n a l y s e s . H e p e r s o n a l l y i s i n f a v o r o f
r e t a i n i n g the sleep study. I m e n t i o n e d to him that this would
r e d u c e t h e o v e r a l l cost o f t h e p r o j e c t b y o n l y s e v e r a l h u n d r e d
thousand dollars. He agreed and pointed out that he purposely
p r o j e c t e d n o cost s a v i n g f i g u r e s i n t h e O p t i o n a n d D e c i s i o n
Paper. He hoped that a n t a g o n i s t s w i t h i n the VA w i l l be s a t i s f i e d
w i t h a n a p p a r e n t cost r e d u c t i o n v i c t o r y w h i l e t h e s t u d y w i l l
a c t u a l l y r e m a i n essentially intact. He agreed that he had little
idea of how well this strategy might work. "I d o n ' t know the best
way to play this," he said. Hobson said there is supposed to be a
m e e t i n g with Custis later this week to discuss the VETS.
SOME PERSONAL

COMMENTS

In response to one of my questions, Hobson noted that Greene
i s t h e m a i n a n t a g o n i s t t o t h e VETS. " G r e e n e h a s b e e n t a l k i n g
quite loudly." Hobson noted, however, that Boren had not yet
taken any public stand. Greene is a r g u i n g that the study does not
have s u f f i c i e n t statistical power. H o w e v e r , our sample size
a n a l y s i s ( w h i c h no one has c r i t i c i z e d ) d e m o n s t r a t e s that this is
not v a l i d . Greene is also a r g u i n g that the t w i n concept is not
appropriate to the questions being addressed. But our review
groups, who include some of the most p r e s t i g i o u s m e m b e r s of the
s c i e n t i f i c c o m m u n i t y , do not agree.
It seems to me that Greene's o b j e c t i o n s may be based, in
p a r t , on a " h i d d e n a g e n d a " . Hobson noted t h a t in a r e c e n t
m e e t i n g , G r e e n e b e c a m e v e r y angry a n d a c c u s e d t h e A g e n t O r a n g e
P r o j e c t s O f f i c e (AOPO) of not i n f o r m i n g him about every aspect of
the progress of the p r o j e c t . Perhaps this r e p r e s e n t s one aspect
of t h e t r u e p r o b l e m . T h a t i s , G r e e n e f e e l s t h a t t h e AOPO i s
e x e r c i s i n g t o o m u c h p o w e r i n G r e e n e ' s d o m a i n . P e r h a p s t h e real
conflict is a "turf battle".

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