A number of research studies using Gulf War veteran health registry data are being sponsored by DoD and VA. The Naval Health Research Center (NHRC) in San Diego has three ongoing epidemiological studies, focusing in whole or in part, on CCEP and VA health registry data. The first study is an extension of work already published where the investigators sought to identify demographic, deployment, and exposure predictors of registry participation.140 The original study included data from 74,000 registry participants and demonstrated that older, Army, National Guard, enlisted, and female troops were most likely to have participated in a Gulf War health registry. The new study of risk factors will include data from over 100,000 registry participants. Statistical methods used to determine predictors of registry participation include logistic regression modeling and multivariate polychotomous logistic regression model analysis.
In a second study, researchers at NHRC are employing time series analytic techniques to predict participation in the DoD CCEP based on news events regarding Gulf War veterans health problems. The study will determine whether major news media programs on Gulf War health issues prompted veterans to seek clinical evaluation. These two DoD-directed investigations are in the final drafting stages.
In a third NHRC study, an investigation is underway to determine if registry participants were more likely than non-participants to be hospitalized in DoD medical treatment facilities during the immediate post-war period (3 years from August 1, 1991 to June 6, 1994) for: 1) all causes, 2) diagnoses in major ICD-9-CM categories, and 3) specific diagnoses of special interest to veterans.
VAs Environmental Epidemiology Service (EES), Washington, DC, also is involved in a number of analyses of the data contained in the combined Gulf War clinical registries. Nested case-control analyses are being conducted for selected diagnoses, including post traumatic stress disorder (PTSD), dermatitis, lumbago, all cancers combined, migraine headaches, peripheral neuropathy, chronic obstructive pulmonary disease (COPD), and asthma. Multiple logistic analyses are being run for each of these diagnoses with adjustments for various demographic and military characteristics. Potential exposures to be explored in these logistic models include nerve gas, oil well fire smoke and particulates, anthrax vaccinations, self- reported exposures, and combat military assignments.
VAs EES additionally is conducting longitudinal analyses of registry data. Longitudinal evaluations are focusing on changes over time in disease and symptom patterns, and in the patterns of VA health care utilization and compensation for the registry participants. A final area of investigation is a detailed comparison of symptoms and diagnoses between CCEP and VA registry data for the 2,922 individuals who had a medical examination in both the VA and DoD clinical evaluation programs.
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