Gulf War Veterans Treating Symptoms and Syndromes (2001) / Chapter Skim
Currently Skimming:
1. Introduction
1. Introduction
Pages 11-22
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From page 11... ...
The congressional legislation specifically requested that the IOM study address undiagnosed illnesses as well as any other chronic illness deemed to warrant review. The committee is composed of experts in internal medicine, neurology, gastroenterology, rheumatology, psychiatry, epidemiology, treatment efficacy and effectiveness research, outcomes assessment, and clinical practice guideline development.
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From page 12... ...
Additionally, the committee held a public meeting and solicited testimony from Gulf War veterans about their illnesses and the treatments they have received. The remainder of this chapter provides the context within which the committee charge was carried out.
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From page 13... ...
This work includes clinical efforts aimed at understanding the nature of the illnesses and the effectiveness of potential treatments, population-based studies on the health status of Gulf War veterans, research on the potential health effects of the agents that were present in the Gulf War, advocacy efforts, and policy efforts on compensation and health care for Gulf War veterans. CLINICAL REGISTRIES In response to concern about possible illnesses, the VA and DoD developed special diagnostic programs.
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From page 14... ...
In 1993 GAO criticized the Army's preparation for and response to depleted uranium exposure during the Gulf War (GAO 1993~. A report on the health concerns of Gulf War veterans from the 123rd Army Reserve Command headquartered in Indianapolis found that veterans were either dissatisfied with the medical services received from DoD and VA or were unaware such services were available (GAO 1995~.
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From page 15... ...
. A subsequent report observed that "while the number of Gulf War veterans who participated in the military operations known as Desert Shield and Desert Storm is well established at almost 700,000, the number who actually suffer, or believe they suffer, from illnesses related to their Gulf War service remains uncertain 7 years after the war" (GAO, 1998b:2~.
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From page 16... ...
Recommendations called for the development of clinical practice guidelines for the difficult-to-diagnose or unexplained symptom constellations and for the establishment of a system of feedback and continuous quality improvement to monitor the care received by Gulf War veterans. The IOM Committee on Measuring the Health of Gulf War Veterans was charged with developing a study design and methods for measuring important aspects of the health status of Gulf War veterans.
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From page 17... ...
Additionally, the committee concluded that there is limited evidence of no association between exposure to uranium and kidney disease and between exposure to low levels of uranium and lung cancer. Although the committee was not charged with determining increased risk of illness to veterans due to their potential exposures, the paucity of data regarding the actual agents and doses to which individual Gulf War veterans were exposed meant that the committee could not measure the likelihood that Gulf War veterans' health problems are associated with or caused by these agents.
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From page 18... ...
implementing strategies aimed at deployment-related health issues, record keeping, health risk communication, and research (EOP 1998~. GULF WAR VETERANS' HEALTH: RESEARCH SUMMARY Extensive scientific research has been undertaken on the health of Gulf War veterans.
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From page 19... ...
According to a 1999 IOM report, Gulf War Veterans: Measuring Health, several conclusions can be drawn from results of recent research: · Military personnel who served in the Gulf War have had a significantly higher risk of suffering one or more of a set of symptoms that include fatigue, memory loss, difficulty concentrating, pains in muscles and joints, and rashes. Other symptoms are noted with reduced frequency but still may be experienced more often by deployed than nondeployed veterans.
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From page 20... ...
The second federally funded clinical trial (conducted in collaboration with Pfizer Pharmaceuticals, which is donating the antibiotic and matching placebo) is designed to test the hypothesis that antibiotic treatment directed against Mycoplasma species will improve the functional status of patients with Gulf War veterans' illnesses who have tested mycoplasma-positive at baseline.
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From page 21... ...
Chapter 3 provides a discussion of the study designs that can be used to evaluate the effectiveness and efficacy of interventions in medicine and health care, while Chapter 4 explores general approaches to treating a patient, regardless of diagnosis. Chapter 5 reviews the treatments evaluated for each identified condition and provides the committee's treatment recommendations.
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