ABSTRACT

Before proceeding to consideration of particular findings, certain generalities concerning methodology may be examined. That the “combined-operations” procedure developed for the first Columbia-Greystone project represented a progressive step in the evolution of medical, and particularly psychiatric, research is suggested by the adoption of a very similar protocol by the Group for the Advancement of Psychiatry (’48) as a theoretical ideal for research in this field. Actual project experience has revealed that certain tests and procedures planned in our original protocol and included in that of the GAP were irrelevant and should be dropped or needed modification. It is now clear that research of this sort is best conducted in a very large institution with a large bed-capacity and adequate physical space. It is also necessary to draw up a protocol which considers the limitations which time imposes upon activities and the possibilities of interactivity interference. In practice the character of a combined-operations project is determined by necessity. Whether a combined-operations project gets done at all frequently depends upon the willingness of the group to compromise with theoretical ideals. It is easy enough to affirm that a particular list of criteria should be met by all the patients in a project but from a practical point of view one is limited by the material available at a particular moment. Furthermore, in the effort to achieve uniformity and standardization there is always the danger (which is difficult to anticipate and hard to perceive until it is too late to rectify) that one or more of the criteria set up for the sake of uniformity may preclude the possibility of change in some one of the variables which it is the object of the investigation to study.