Adequacy of the VA Persian Gulf Registry and Uniform Case Assessment Protocol (1998) / Chapter Skim
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Appendix B: Health Consequences of Service During the Persian Gulf War: Recommendations for Research and Information Systems
Appendix B: Health Consequences of Service During the Persian Gulf War: Recommendations for Research and Information Systems
Pages 67-78
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From page 67... ...
These findings and recommendations were taken from the Institute of Medicine report, Health Consequences of Service During the Persian Gulf War: Recommendations for Research and Information Systems, Washington, D.C.: National Academy Press, 1996.
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From page 68... ...
in this report regarding the collection and maintenance of information that is potentially useful for assessing the health consequences of military service in the POW. These recommendations support completion of certain data sets, prompt reporting of research findings and submission for publication in peerreviewed journals, strengthened medical and epidemiologic research capabilities of the aimed forces, and strengthening the decision-making processes for study selection.
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From page 69... ...
FINDINGS AND RECOMMENDATIONS Finding Recent military deployments, especially in Vietnam and in the Persian Gulf, have demonstrated that concerns about the health consequences of participation in military action may arise long after deployment has ended and that the evaluation of those concerns and the provision of health care to affected personnel may present formidable challenges both to epidemiologists and to medical caregivers. Although some of these challenges can be attributed to the intrinsic difficulty of evaluating poorly understood clusters of events that were not among the expected consequences of combat or of environmental conditions, they also may be attributed in part to limitations of the systems used to collect and manage data regarding the health and service-related exposures of military personnel.
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From page 70... ...
, allow linkage to exposure and other data sets, and have He capability to incorporate relevant medical data from beyond DoD and DVA institutions (e.g., U.S. Public Health Service facilities, civilian medical providers, and other health care institutions)
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From page 71... ...
The DoD should ensure that military medical preparedness for deployments includes detailed attempts to monitor natural and man-made environmental exposures and to prepare for rapid response, early investigation, and accurate data collection, when possible, on physical and natural environmental exposures that are known or possible in the specific theater of operations. Enwinding National Guard and reserve component personnel may differ substantially from active duty personnel in average age, level of training, occupational specialties, family status, and readiness for deployment.
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From page 72... ...
The DVA should exert greater effort to improve understanding of the reasons for excess mortality from unintentional injury. Detailed evaluation is needed beyond death certificate data concerning the circumstances surrounding fatal injury through more focused case-control studies to identify both individual risk factors and remediable causes.
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From page 73... ...
The DoD should complete development of information systems to expeditiously and directly pinpoint unit locations at a high level of disaggregation in space and time (that is, fine detail) and to document local environmental conditions, including appropriate data quality checks, with direct data entry into the system.
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From page 74... ...
Worthwhile data are being collected and prepared, and the studies should be completed promptly, with the necessary personnel and funding to collect the additional data needed, to conduct appropriate analyses, and to evaluate potential biases. Findings from these studies are likely to provide leads as to whether or not additional research along these lines is required to produce more specific findings (Charges 1 and 3~.
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From page 75... ...
may provide useful information as to what objectively measurable factors contribute to selfselection into the registry. In addition to the proposed analysis of associations among demographics, past health experiences, and health behaviors as possible predictors of enrollment, information on the eligibility of individuals for health care, as well as the type of health care, could generate additional hypotheses to be investigated.
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From page 76... ...
The epidemiologic capabilities of the armed forces should be strengthened rather than reduced. The command structure should be kept informed about the reasons for and the results of this recommendation and its relevance to military preparedness and effectiveness, and should be encouraged to support appropriate epidemiologic work in the theater of operations and in the postdeployment period.
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From page 77... ...
The Congress, DVA, and DoD should adopt a policy that unless there are well-specified, openly stated reasons to the contrary, requests for proposals for research related to unexplained illnesses or other needed health-related research will be publicly announced and open to the scientific community at large, that proposals will be reviewed by panels of appropriately qualified experts, and that funding will follow the recommendations of those experts.
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