2 
As a result of that review, I have selected a number of issues that I ask 
you to consider at your next committee meeting. I would most appreciate 
your providing me with a rationale for the committee's having adopted a 
stated position in the guidelines as it relates to each of the issues raised 
by the commentators. Further, I ask in your response to the issue raised 
that you explain why you would accept or reject certain suggested changes 
in the guidelines. The issues are stated in the enclosed document, and are 
arranged according to the appropriate section of the guidelines. The docu- 
ment does not include some revisions and extensions being developed in the 
implementation section. It does include all substantive changes considered 
in all other portions of the proposed guidelines. Your responses to the 
issues I have selected will be taken into account when I make my decision 
within the month. 
Thank you for your continued and invaluable contributions to this extra- 
ordinarily important matter. 
Cordially, 
/s/ Donald S. Fredrickson 
Donald S. Fredrickson, M.D. 
Director 
Enclosure 
i 
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