Health Consequences of Service During the Persian Gulf War Recommendations for Research and Information Systems (1996) / Chapter Skim
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Charge to the Committee: Its Findings and Recommendations
Charge to the Committee: Its Findings and Recommendations
Pages 26-35
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From page 26... ...
Recommendations follow each of the findings. The committee was charged as follows: THE COMMITTEE'S CHARGE Charge 1 Assess the effectiveness of actions taken by the Secretary of Veterans Affairs and the Secretary of Defense to collect and maintain information that is potentially useful for assessing the health consequences of military service referred to subsection (a)
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The committee believes that there is indeed a sound basis for epidemiologic studies, and eight recommendations follow (recommendations 2, 3, 5-7, and 11-13~.~ However, the committee does not recommend an additional nationwide epidemiologic study of PG veterans, because such a study is likely to be of limited scientific value at this time. Those large studies that are currently under way should be completed as quickly as possible, while meeting high scientific standards, including a high response rate and a thorough investigation of potential biases, as recommended below.
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, allow linkage to exposure and other data sets, and have the 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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Also needed are studies of risk factors in modern deployments predictive of combat stress reactions, posttraumatic stress disorder (PTSD) , and other psychiatric disorders of military personnel and veterans.
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If there are associations, strategies necessary to prevent or reduce these adverse health effects should be developed. Finding Completed studies have described the mortality experience of troops deployed to the PG during the period of deployment and in the 2-year period after deployment.
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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. 31 Finding The armed services and the DVA together are developing a shared basic epidemiological data system, the Defense Medical Epidemiological Database (DMED)
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Recommendation 11. The DoD and DVA should ensure that studies of the health effects of deployment, including effects on POW veterans, include evaluation of exposures, experiences, and situations of both women and men, with attention to their age, prior military service, marital and parental status, and other gender-specific parameters.
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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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Finding The armed forces have had small but high-quality and effective capabilities in epidemiology. Recent cutbacks have reduced these capabilities, with potentially serious effects on both military preparedness and the health care of veterans.
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Recommendation 16. 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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