-10- These demand further study and resolution if we are to meet the basic tenets of screening: 1. Do NOTscreen unless: You are prepared to follow-up and resolve false positive and false negative findings. 2.° The screening process will result in some benefit for the patient. From a moral and medicolegal standpoint, we should insure adequate follow-up and treatment of all treatable conditicns. To. identify disease, inform the patient of the disease and then fail to treat: it, would run the risk of 2 serious Joss of credibility for the medical team: and more importantly, a disservice to the patient. For example, if a patient is told he is hypertensive (e.g., diastolic over 105 mmHg), and is not treated, he can assume that: 1. the findings are of little importance because..."the doctors did nothing about it..."3 2. the doctors don't care enough about the patients te try to treat. the condition. Either result is undesirable. _These problems in. the "philosophy" of screening are notminor.. They shkowid not be ignored in planning this program. A close examinatian of the actual - field conditions reveals that the unavailability cf adequate treatment and f£ollow-up is the critical preliminary determinant of exactly what should be done in planning the details of medical and biochemical screening for primary care. Screening for research operates under different constraints, usually protected by a committee to inform and protect the research subject (A Human Studies Review Committee). Failure to comply with either the research or primary care requisites 90922249