Returning Home from Iraq and Afghanistan Assessment of Readjustment Needs of Veterans, Service Members, and Their Families (2013) / Chapter Skim
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10 Proposed Data Analyses
10 Proposed Data Analyses
Pages 457-470
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From page 457... ...
On the basis of its investigations, the committee determined that it should expand its initial approach in responding to its task by proposing data analyses that could be conducted by using existing government databases. Very limited quantitative characterization of the issues described in the legislation existed in the published literature, so the committee proposed using available government data and linking them.
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From page 458... ...
. For example, the outcomes, treatment, family, and economic work groups wished to understand how the number of deployments affected outcomes of the conditions of interest, such as posttraumatic stress disorder (PTSD)
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From page 459... ...
an assessment of the particular impacts of multiple deployments in Operation Iraqi Freedom or Operation Enduring Freedom on such members and former members and their families; (C) an assessment of the full scope of the neurological, psychiatric, and psychological effects of traumatic brain injury on members and former members of the Armed Forces, including the effects of such effects on the family members of such members and former members, and an assessment of the efficacy of current treatment approaches for traumatic brain injury in the United States and the efficacy of screenings and treatment approaches for traumatic brain injury within the Department of Defense and the Department of Veterans Affairs; (D)
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From page 460... ...
Does the course of screening, diagnosis, and treatment vary by branch of military, where processed through the immediate postdeployment period, ZIP code of postdeployment residence, urban vs rural setting, rank, race or ethnicity, sex, marital status, waivers granted to allow enlistment, Armed Forces Qualification Test (AFQT) or General Classiification Test, pre-enlistment disorders, or predeployment disorders?
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From page 461... ...
an assessment of the full scope of the neurological, psychiatric, and psychological effects of traumatic brain injury on members and former members of the Armed Forces, including the effects of such effects on the family members of such members and former members, and an assessment of the efficacy of current treatment approaches for traumatic brain injury in the United States and the efficacy of screenings and treatment approaches for traumatic brain injury within the Department of Defense and the Department of Veterans Affairs; (I) an assessment of the impacts of increasing numbers of older and married members of the Armed Forces on readjustment requirements.
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From page 462... ...
Data Files Required DMDC ID data DMDC DMDC VA VA TriCare Demographic Deployment Rx Vital status Rx data Sample Questions to Be Answered by the Data How many people are deployed or redeployed while on antidepressants, antianxiety agents, or narcotic pain medications? How does the answer to the above question vary by sex, ethnicity, marital status, age, service, rank, education attained, criminal record, home of record on service entry, aptitude, occupational category, or branch of service?
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From page 463... ...
an assessment of the effects of undiagnosed injuries such as post-traumatic stress disorder and traumatic brain injury, an estimate of the long-term costs associated with such injuries, and an assessment of the efficacy of screenings and treatment approaches for post-traumatic stress disorder and other mental health conditions within the Department of Defense and Department of Veterans Affairs; (E) an assessment of the gender- and ethnic group-specific needs and concerns of members of the Armed Forces and veterans.
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From page 464... ...
an assessment of the effects of undiagnosed injuries such as post-traumatic stress disorder and traumatic brain injury, an estimate of the long-term costs associated with such injuries, and an assessment of the efficacy of screenings and treatment approaches for post-traumatic stress disorder and other mental health conditions within the Department of Defense and Department of Veterans Affairs; (H) an assessment of the impacts on communities with high populations of military families, including military housing communities and townships with deployed members of the National Guard and Reserve, of deployments associated with Operation Iraqi Freedom and Operation Enduring Freedom, and an assessment of the efficacy of programs that address community outreach and education concerning military deployments of community residents; (I)
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From page 465... ...
an assessment of the full scope of the neurological, psychiatric, and psychological effects of traumatic brain injury on members and former members of the Armed Forces, including the effects of such effects on the family members of such members and former members, and an assessment of the efficacy of current treatment approaches for traumatic brain injury in the United States and the efficacy of screenings and treatment approaches for traumatic brain injury within the Department of Defense and the Department of Veterans Affairs. Data Files Required DMDC DMDC Demographic Deployment data DMDC ID data VBA VHA TriCare C&P OPC/PTF Procedures Procedures Sample Questions to Be Answered by the Data How many people who receive diagnoses of TBI, PTSD, or both receive military or VA disability compensation?
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From page 466... ...
, TRICARE, the Defense Enrollment Eligibility Reporting System, the PDHA, and the PDHRA; by VA, specifically, by the Veterans Benefit Administration and Veterans Health Administration, such as Patient Treatment Files, Outpatient Clinic Visits, and Compensation and Pension; by the Centers for Disease Control and Prevention, such as the National Death Index and the Behavioral Risk Factor Surveillance System; by the Health Resources and Services Administration (data on homelessness) ; by the Department of Health and Human Services
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From page 467... ...
The DMDC files constituted the sampling frame from which multiple cohorts would be selected -- initially with deidentified files that contained no names and no Social Security numbers and then, after selection, with unique person identifiers that permitted linkage to records from the different DMDC databases. Veterans Health Veterans Benefit Health Resources Uniform code of R135 AdministraƟon AdministraƟon (VBA VBA)
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From page 468... ...
Through that process, data would be collected from the DOD military health system and from the VA health system, which would allow classification of personnel according to ICD codes of interest for this study (such as codes for TBI, PTSD, depression, suicide and suicidal ideation, and substance-use disorders) , as well as other records and outcome data.
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From page 469... ...
The committee's preliminary work in this area has provided a clear rationale, justification, and roadmap for comprehensive data analyses. Comprehensive data analyses will require establishment of systematic, timely processes for using available government data and linking them in such a way as to improve the characterization of issues of interest.
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From page 470... ...
The committee recommends that clear procedures be developed for accessing data held by the Department of Defense, the Department of Veterans Affairs, and other federal agencies. The procedures should appear on each agency's website with access to its data dictionaries.
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