Redefining Gulf War Illness Using Longitudinal Health Data: The Fort Devens Cohort
Abstract
Current estimates suggest that 25 percent of Gulf War (GW) veterans (nearly 170,000) have reported some type of persisting multi-symptom illness. Currently used GW Illness (GWI) case definitions have been found to be lacking in sensitivity and specificity with many veterans falling in the false positive and false negative ranges. These GWI definitions, based on cross-sectional studies, allow for reporting of health symptoms only once, and do not consider that symptoms can emerge over time (or remit); thus they likely provide inaccurate representations of veterans health. Reliance solely on cross-sectional studies or on follow-ups with different methodologies results in the lack of a consensual definition of GWI, and has limited the ability to determine appropriate treatment options or to compare results among studies. Only through the use of longitudinal data, where health symptoms were first measured shortly after deployment and then repeatedly over the following 20 years, would consideration of symptom trajectories (patterns of change over time) be possible. We believe that the use of longitudinal data, which allows consideration of relapsing, remitting and late emerging symptoms, is necessary to refine the case definition of GWI. This will allow for comparison of competing existing case definitions by considering symptom change, and can lead to a consensual definition. The Ft. Devens, MA cohort was designed as a longitudinal cohort and as such will be useful in ameliorating the existing problems with case definition. The ultimate goal for this study is to provide a consistent case definition of GWI, which can serve future studies and treatment trials as a valid outcome.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 01, 2019
- Accession Number
- AD1110698
Entities
People
- Maxine H Krengel
Organizations
- Boston VA Research Institute