The Health of Former Prisoners of War Results from the Medical Examination Survey of Former POWs of World War II and the Korean Conflict (1992) / Chapter Skim
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From page 1... ...
POW protocol program to obtain information most efficiently. In brief, subjects in the MFUA study cohort were invited to a nearby VA medical center to undergo the VA protocol exam, a comprehensive physical and psychiatric examination conducted by VA medical personnel.
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From page 2... ...
Later, these original samples were augmented with several others: a group of prisoners from the European theater who were sampled from POW admissions to Army hospitals for malnutrition immediately following repatriation, a group of Korean conflict prisoners of war, and a group of comparable nonprisoner controls, selected from a file of all known U.S. Army casualties wounded in action and returned to duty in Korea.
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From page 3... ...
The MFUA study was designed to use the VA's existing protocol program as the primary vehicle for data collection by simply inviting members of MFUA's longitudinal cohort to undergo a protocol examination at a nearby VA hospital. Thus, the VA's ongoing program was to do double duty first, as an outreach program to all former POWs and second, as a data collection mechanism for a research study.
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However carefully the original sample was assembled, there can be no confidence with response rates as low as this that the group of respondents accurately reflects the composition of the group of all former POWs. Yet neither are such low response rates proof, in themselves, that the group of respondents is nonrepresentative.
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From page 5... ...
Because the VA protocol examination program began before the MFUA study, a sizable proportion of the POWs in the study had been examined previously by the VA. Knowing this, study designers matched the MFUA cohort against the VA's file of completed examinations, and lists of MFUA study POWs who had already been examined were produced and sent to VA medical centers.
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From page 6... ...
While data collection was under way in the field, MFUA staff made a number of site visits to VA medical facilities to observe the examination process. The examination of members of the MFUA study cohort was identical to the usual VA protocol examination except that both POWs and controls underwent additional psychological testing and a more intensive psychiatric interview.
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From page 7... ...
Lifetime prevalence rates for selected conditions were compared with similar rates from Eberly and Engdahl's 1991 study of POW examinations at the Minneapolis VA Medical Center. The MFUA data showed elevated rates of prevalence among POWs for medical conditions related to prison camp treatment—for example, dysentery, malaria, and frozen feet- as well as for psychiatric illness.
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From page 8... ...
The case series of PWEM who were examined displayed a markedly higher lifetime prevalence of dysentery, beriberi, frozen feet, peripheral nerve disease, and gastroenteritis than was found among PWE. The latter two conditions, which were not as clearly related to war camp treatment as the others, were studied in further diagnostic detail.
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From page 9... ...
reported, and the number of other symptoms reported—and considered along with percent weight loss. The logistic regression analyses showed that among POWs with completed exams and earlier data on weight loss and prison camp symptoms, edema was significantly associated with a higher prevalence of ischemic heart disease and peripheral nerve disease; visual symptoms were associated with higher prevalences of cerebrovascular disease, ulcers, asthma, and PTSD; and other symptoms were associated with higher prevalences of intermittent claudication, gastroenteritis, depressive disorder, and generalized anxiety.
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From page 10... ...
In many cases, the organspecific findings based on medical examination data were anticipated. The increased prevalence of depressive disorder, PTSD, and generalized anxiety was not unexpected, and similar findings regarding peripheral nerve disease, ulcer, and gastroenteritis likewise were not surprising.
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From page 11... ...
. The specificity of association between localized edema and the only two medical conditions with well-established acute relationships to thiamin deficiency raises intriguing questions about the association between earlier nutritional deprivation in prison camp and subsequent chronic ischemic heart disease even in the absence of a satisfactory explanatory biological mechanism to link the two.
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