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Suggested Citation:"Appendix A: Power Calculations." Institute of Medicine. 2003. Characterizing Exposure of Veterans to Agent Orange and Other Herbicides Used in Vietnam: Interim Findings and Recommendations. Washington, DC: The National Academies Press. doi: 10.17226/10687.
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Suggested Citation:"Appendix A: Power Calculations." Institute of Medicine. 2003. Characterizing Exposure of Veterans to Agent Orange and Other Herbicides Used in Vietnam: Interim Findings and Recommendations. Washington, DC: The National Academies Press. doi: 10.17226/10687.
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Page 18

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Appendix A Power Calculations The Columbia University researchers have performed power calcula- tions to estimate the number of subjects that would be needed to conduct an informative study of health outcomes in US veterans of Vietnam. Such calculations comprise many variables, including the incidence rate of the disease being studied, the age of the subjects, the proportion of exposed subjects in the cohort, the statistical confidence levels considered accept- able, and the magnitude of the difference in incidence rates that could be detected. Illustrative calculations were made for non-Hodgkin's lymphoma (NHL).1 The sample sizes were estimated on the basis of a 1-tailed chi- square test with alpha = 0.05 and beta = 0.80, an unequal sample size for the exposed and comparison groups (1:4 ratio), and a 587.75/100,000 cu- mulative NHL incidence in the comparison group. They are given below in terms of the relative risk (RR, also known as the risk ratio) that could be detected. 1 The committees responsible for the Veterans and Agent Orange series of reports have found sufficient evidence of an association between exposure to the herbicides used in Vietnam and NHL. 17

18 EXPOSURE OF VETERANS TO AGENT ORANGE AND OTHER HERBICIDES RR Number Number Sample exposed comparison size needed 1.25 23,310 93,240 116,550 1.50 6,356 25,422 31,778 1.75 3,057 12,227 15,283 2.00 1,849 7,395 9,243 2.50 936 3,742 4,677 3.00 590 2,359 2,948 4.00 319 1,273 1,591 5.00 211 842 1,052 All else equal, diseases that are more common than NHL among individuals in the same age bracket as US veterans of Vietnam would require smaller sample sizes to detect the same RR; less common diseases would require larger sample sizes. Using a larger percentage of exposed individuals would also decrease the sample size needed to detect the same RR.

Next: Appendix B: Public Meetings Held by the Committee on the Assessment of Wartime Exposure to Herbicides in Vietnam »
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From 1962 to 1971, US military forces sprayed more than 19 million gallons of herbicides over Vietnam to strip the thick jungle canopy that helped conceal opposition forces, to destroy crops that enemy forces might depend on, and to clear tall grass and bushes from around the perimeters of US base camps and outlying fire-support bases. Most large-scale spraying operations were conducted from airplanes and helicopters, but herbicides were also sprayed from boats and ground vehicles, and by soldiers wearing back-mounted equipment. After a scientific report concluded that a contaminant of one of the primary chemicals used in the herbicide called Agent Orange could cause birth defects in laboratory animals, US forces suspended use of the herbicide; they subsequently halted all herbicide spraying in Vietnam in 1971.

At the request of the Veteran's Administration, the Institute of Medicine established a committee to oversee the development and evaluation of models of herbicide exposure for use in studies of Vietnam veterans. That committee would develop and disseminate a request for proposals (RFP) consistent with the recommendations; evaluate the proposals received in response to the RFP and select one or more academic or other nongovernmental research groups to develop the exposure reconstruction model; provide scientific and administrative oversight of the work of the researchers; and evaluate the models developed by the researchers in a report to VA, which would be published for a broader audience. Characterizing Exposure of Veterans to Agent Orange and Other Herbicides Used in Vietnam is the IOM's report that evaluates models of herbicide reconstruction to develop and test models of herbicide exposure for use in studies of Vietnam veterans.

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