The study of reproductive outcome and the health of offspring of UK veterans of the Gulf war: methods and description of the study population

Maconochie, Noreen; Doyle, Pat; Davies, Graham; Lewis, S. M.; Pelerin, M; Prior, Susan; Sampson, Patrick

doi:10.1186/1471-2458-3-4

Cited by 18 publications

(21 citation statements)

References 10 publications

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“…Surveys and invitation letters may not have reached all potential survey participants. Despite these challenges, our 61.8 percent response rate compares favorably with other studies (typical response rates 47%-59%) of combat-injured veterans and servicemembers [90][91].…”

Section: Discussionsupporting

confidence: 52%

Servicemembers and veterans with major traumatic limb loss from Vietnam war and OIF/OEF conflicts: Survey methods, participants, and summary findings

Reiber¹,

McFarland²,

Hubbard³

et al. 2010

JRRD

162

167

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Abstract-Care of veterans and servicemembers with major traumatic limb loss from combat theaters is one of the highest priorities of the Department of Veteran Affairs. We achieved a 62% response rate in our Survey for Prosthetic Use from 298 Vietnam war veterans and 283 servicemembers/veterans from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/ OEF) who sustained major traumatic limb loss. Participants reported their combat injuries; health status; quality of life; and prosthetic device use, function, rejection, and satisfaction. Despite the serious injuries experienced, health status was rated excellent, very good, or good by 70.7% of Vietnam war and 85.5% of OIF/OEF survey participants. However, many health issues persist for Vietnam war and OIF/OEF survey participants (respectively): phantom limb pain (72.2%/76.0%), chronic back pain (36.2%/42.1%), residual-limb pain (48.3%/ 62.9%), prosthesis-related skin problems (51.0%/58.0%), hearing loss (47.0%/47.0%), traumatic brain injury (3.4%/33.9%), depression (24.5%/24.0%), and posttraumatic stress disorder (37.6%/58.7%). Prosthetic devices are currently used by 78.2% of Vietnam war and 90.5% of OIF/OEF survey participants to improve function and mobility. On average, the annual rate for prosthetic device receipt is 10.7-fold higher for OIF/OEF than for Vietnam war survey participants. Findings from this crossconflict survey identify many strengths in prosthetic rehabilitation for those with limb loss and several areas for future attention.

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Section: Discussionsupporting

confidence: 52%

Servicemembers and veterans with major traumatic limb loss from Vietnam war and OIF/OEF conflicts: Survey methods, participants, and summary findings

Reiber¹,

McFarland²,

Hubbard³

et al. 2010

JRRD

162

167

View full text Add to dashboard Cite

show abstract

“…In many studies the response rate to mailed questionnaires is about 60-65% [27][28][29][30][31][32][33][34]. In our study the response rate of patients that underwent both radiography and MRI was within that range, but the response rate of patients that only underwent radiography was lower, most likely because they were disappointed not to get an extra MRI examination during randomization and less willing to fill in the questionnaires.…”

Section: Discussionmentioning

confidence: 50%

Costs and effectiveness of a brief MRI examination of patients with acute knee injury

et al. 2008

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The aim of this study was to assess the costs and effectiveness of selective short magnetic resonance imaging (MRI) in patients with acute knee injury. A model was developed to evaluate the selective use of MRI in patients with acute knee injury and no fracture on radiography based on the results of a trial in which 208 patients were randomized between radiography only and radiography plus MRI. We analyzed medical (diagnostic and therapeutic) costs, quality of life, duration of diagnostic workup, number of additional diagnostic examinations, time absent from work, and time to convalescence during a 6-month follow-up period. Quality of life was lowest (EuroQol at 6 weeks 0.61 (95% CI 0.54-0.67)); duration of diagnostic workup, absence from work, and time to convalescence were longest; and the number of diagnostic examinations was largest with radiography only. These outcomes were more favorable for both MRI strategies (EuroQol at 6 weeks 0.72 (95% CI 0.67-0.77) for both). Mean total costs were 2,593 euros (95% CI 1,815-3,372) with radiography only, 2,116 euros (95% CI 1,488-2,743) with radiography plus MRI, and 1,973 euros (95% CI 1,401-2,543) with selective MRI. The results suggest that selective use of a short MRI examination saves costs and potentially increases effectiveness in patients with acute knee injury without a fracture on radiography.

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“…Detailed information about the study is given elsewhere 9 10. This was a retrospective cohort study of the reproductive health of all UK armed forces personnel deployed to the Gulf region between August 1990 and June 1991 (51 581 men, 1230 women) and a comparison group (stratum matched on service, sex, age, fitness to be deployed, serving status, and rank) who were in service at that time (January 1991) but were not deployed (51 688 men, 1236 women).…”

Section: Methodsmentioning

confidence: 99%

Infertility among male UK veterans of the 1990-1 Gulf war: reproductive cohort study

Maconochie

Doyle

Carson

2004

BMJ

Self Cite

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Objectives To examine the hypothesis that, theoretically at least, exposure to toxicants of the type present in the Gulf war could affect spermatogenesis, which might be observed as increased levels of infertility. Design Retrospective reproductive cohort analysis. Setting Male UK Gulf war veterans and matched comparison group of non-deployed servicemen, surveyed by postal questionnaire. Participants 42 818 completed questionnaires were returned, representing response rates of 53% for Gulf veterans and 42% for non-Gulf veterans; 10 465 Gulf veterans and 7376 non-Gulf veterans reported fathering or trying to father pregnancies after the Gulf war. Main outcome measures Failure to achieve conceptions (type I infertility) or live births (type II infertility) after the Gulf war, having tried for at least a year and consulted a doctor; time to conception among pregnancies fathered by men not reporting fertility problems. Results Risk of reported infertility was higher among Gulf war veterans than among non-Gulf veterans (odds ratio for type I infertility 1.41, 95% confidence interval 1.05 to 1.89; type II 1.50, 1.18 to 1.89). This small effect was constant over time since the war and was observed whether or not the men had fathered pregnancies before the war. Results were similar when analyses were restricted to clinically confirmed diagnoses. Pregnancies fathered by Gulf veterans not reporting fertility problems also took longer to conceive (odds ratio for > 1 year 1.18, 1.04 to 1.34). Conclusions We found some evidence of an association between Gulf war service and reported infertility. Pregnancies fathered by Gulf veterans with no fertility problems also reportedly took longer to conceive.

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The study of reproductive outcome and the health of offspring of UK veterans of the Gulf war: methods and description of the study population

Abstract: Background: The aim of this study is to determine whether Gulf war veterans and their partners are at increased risk of adverse reproductive events and whether their children have increased risk of serious health problems. Methods and response to the study are reported here.

Cited by 18 publications

References 10 publications

Servicemembers and veterans with major traumatic limb loss from Vietnam war and OIF/OEF conflicts: Survey methods, participants, and summary findings

Servicemembers and veterans with major traumatic limb loss from Vietnam war and OIF/OEF conflicts: Survey methods, participants, and summary findings

Costs and effectiveness of a brief MRI examination of patients with acute knee injury

Infertility among male UK veterans of the 1990-1 Gulf war: reproductive cohort study

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