Gulf War illnesses : improved monitoring of clinical progress and reexamination of research emphasis are needed : report to the Chairmen and Ranking Minority Members of the Senate Committee on Armed Services and the House Committee on National Security / United States General Accounting Office.

  • United States. General Accounting Office
Date:
[1997]
Catalogue details

Licence: Public Domain Mark

Credit: Gulf War illnesses : improved monitoring of clinical progress and reexamination of research emphasis are needed : report to the Chairmen and Ranking Minority Members of the Senate Committee on Armed Services and the House Committee on National Security / United States General Accounting Office. Source: Wellcome Collection.

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    B-276835 With an expert epidemiological consultant, we devised a questionnaire to assess critical elements of these studies (including the quality of exposure measurement, specificity of case definition, and steps to ensure adequate sample size) and to identify specific problems that the primary investigators may have encountered in implementing their studies. Of the 43 ongoing epidemiological studies identified by PGvcB in the November 1996 plan, we interviewed primary investigators for 31 (72 percent). We also reviewed and categorized descriptions of all 91 projects identified by April 1997, based on their apparent focus and primary objective. Finally, to review the progress of major ongoing research efforts, we visited the Walter Reed Army Institute of Research, the Naval Health Research Center, and two of va’s Environmental Hazards Research Centers. To address the third objective, we reviewed major conclusions of the PGvcB and the Presidential Advisory Committee to determine the strength of evidence supporting these conclusions. The purpose of this review was not to critique PGvcB’s or the Presidential Advisory Committee’s efforts, per se, but rather to describe the amount of knowledge about Gulf War illnesses that has been generated by research 6 years after the war. We reviewed these conclusions because they were the strongest statements that we had come across on these matters by any official body. The Presidential Advisory Committee’s report was significant because the panel included a number of recognized experts in the scientific questions at issue who were assisted by a large staff of scientists and attorneys. In addition, the Committee conducted an extensive review of the research. Thus, evaluating these conclusions provided important evidence about how fruitful the federal research had been thus far. To address this objective, we reviewed scientific literature cited by the Presidential Advisory Committee as well as others. We also consulted experts in the fields of epidemiology, toxicology, and medicine and interviewed officials of DOD, vA, and the Central Intelligence Agency. We checked our own interpretation of key study findings with the authors and had independent experts review our draft report. Because of the scientific and multidisciplinary nature of this issue, we ensured that staff conducting the work had appropriate backgrounds in the fields of epidemiology, statistics, psychology, environmental health, toxicology, engineering, weapon design, and program evaluation and methodology. In addition, we used in-house expertise in chemical and biological warfare and in military and veterans health care systems. Also, experts who reviewed our work had backgrounds in medicine, public health, and research methods. Moreover, we held extensive discussions
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