On the basis of the results presented in this study, intervention against suicidal behavior would benefit from screening for certain childhood issues, drug abuse, and poor financial situation before deployment. During deployment, measures should be taken to minimize the amount of meaningless tasks and heavy workloads. At the same time, efficient ways of communicating with home should be ensured. After deployment, good athletic and recreation programs should be warranted for all military personnel-including repatriated soldiers. Finally, priority should be given to ensure public appreciation of what deployed soldiers accomplish.

Introduction:Uncertainty in interpreting laboratory results has been reported for 8% of tests, and may be even more common for infrequently ordered laboratory analyses, e.g. for rare diseases. We therefore aimed to evaluate whether a computerized clinical decision support (CCDS) tool can aid interpretation of specialized porphyria laboratory results, leading to faster diagnostic workup and fewer errors. Method:Our CCDS tool consisted of an algorithm made in Statistical Analysis System® (SAS) that automatically generate an Excel® file with a suggested interpretation of the laboratory results.We evaluated the efficacy and accuracy of the CCDS tool, by comparing time and interpretation before and after introduction of the CCDS. Results:Based on 965 workups investigated, we found that the required interpretation time by the medical doctor was reduced by 33% after introduction of the CCDS tool, Accuracy was 92% for diagnostic workups using the CCDS tool, compared to 88% for manual interpretation. None of the 8% (n=5) CCDS tool interpretation errors were critical. In conclusion, we proved that a CCDS tool for interpretation of laboratory results for a rare disease can be implemented safely and with a reduction in interpretation workload.