Reformulating the Question Posted on December 3, 2007 Ihsan M. Salloum (bio) describes the problem of participant selection.

Sometimes people say, "Well I want to deal with this," but then they have this other problem, and that other problem, and things get very complicated. So reformulating the question and looking at comorbidity as kind of one problem.

It could be difficult. It depends on the criteria that you establish for inclusion and exclusion, so the more your criteria are strict, then the more difficult to find people. I'll give you an example of what I am doing.

Lots of my patients at least they should have two illnesses, either substance use and a bipolar disorder. And then because I do medication studies, I want these people to hopefully don’t have any major medical problem and any major other kind of neurological problems, and so the more you narrow your selection, the harder it becomes. If somebody has one substance use, usually they have more than one.

Some people say well, "I want to study alcohol," but then it’s almost impossible to find just pure people who use alcohol, but they don’t use, for example, marijuana. Or almost everybody smokes, so you can’t say let’s just study alcoholics who don’t smoke. You wouldn’t find any patients. So I guess just the reality, apply [it] just to kind of widen it within the region of safety.

Some people might have, let’s say, stable medical problem, a medical problem that they don’t have to deal with, that has been stable for a long time. Then they could be included. Obviously, if somebody has a major thing, I think the research has to be safe first and put the interest of the patients first. And then work around it.

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