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Coughlin SS, McNeil RB, Provenzale DT, et al. Method Issues in Epidemiological Studies of Medically Unexplained Symptom-based Conditions in Veterans. J Mil Veterans Health. 2013;21(2):4-10
Coughlin, S. S., McNeil, R. B., Provenzale, D. T., Dursa, E. K., & Thomas, C. M. (2013). Method Issues in Epidemiological Studies of Medically Unexplained Symptom-based Conditions in Veterans. Journal of military and veterans' health, 21(2), 4-10.
Coughlin, Steven S, et al. "Method Issues in Epidemiological Studies of Medically Unexplained Symptom-based Conditions in Veterans." Journal of military and veterans' health vol. 21,2 (2013): 4-10.
Coughlin SS, McNeil RB, Provenzale DT, Dursa EK, Thomas CM. Method Issues in Epidemiological Studies of Medically Unexplained Symptom-based Conditions in Veterans. J Mil Veterans Health. 2013 May 01;21(2):4-10. PMID: 24683425; PMCID: PMC3968909.
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J Mil Veterans Health. 2013 May 01;21(2):4-10.

Method Issues in Epidemiological Studies of Medically Unexplained Symptom-based Conditions in Veterans.

Journal of military and veterans' health

Steven S Coughlin, Rebecca B McNeil, Dawn T Provenzale, Erin K Dursa, Catherine M Thomas

Affiliations

  1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
  2. Durham Epidemiologic Research and Information Center, Veterans Affairs Medical Center, Durham, NC.
  3. Durham Epidemiologic Research and Information Center, Veterans Affairs Medical Center, Durham, NC ; Division of Gastroenterology, Duke University Medical Center, Durham, NC.
  4. Epidemiology Program, Post-deployment Health Group, Office of Public Health, Department of Veterans Affairs, Washington, DC.

PMID: 24683425 PMCID: PMC3968909

Abstract

Symptom-based conditions such as chronic fatigue syndrome (CFS) and medically unexplained multi-symptom illness (MSI) are fairly common in the general population and are also important veteran's health concerns due to their higher frequency among U.S. veterans who served during the 1990-1991 Gulf War. CFS, MSI, and other symptom-based conditions are often associated with considerable morbidity due to fatigue, chronic pain, neurologic symptoms, and other symptoms that can impair the quality of life. This article discusses several important issues of methodology that arise in population studies of CFS and MSI. These include the exclusion criteria that have been used in population studies to define CFS-like illness and unexplained MSI, the potential for false positive and false negative assessments of illness status, the potential for sex differences, and the poorly understood natural history of these symptom-based conditions across the life span. As an empirical example of these methodology issues, we examined existing data from a 2005 follow-up survey. We found that 64.9% (762 of 1,175) of female Gulf War veterans and 53.4% (2,530 of 4,739) of male Gulf War veterans had 1 or more exclusionary medical conditions. The prevalence among veterans with one or more exclusionary medical conditions increased markedly by age among females and those with a low income.

Keywords: Gulf War; chronic fatigue syndrome; epidemiologic methods; medically explained multi-symptom illness; menopause; survey; veterans

References

  1. Am J Epidemiol. 2006 Jan 1;163(1):66-75 - PubMed
  2. JAMA. 1998 Sep 16;280(11):981-8 - PubMed
  3. Open Epidemiol J. 2011;4:140-146 - PubMed
  4. J Occup Environ Med. 2009 Apr;51(4):401-10 - PubMed
  5. Autoimmun Rev. 2012 May;11(6-7):A430-6 - PubMed
  6. Environ Health Perspect. 2012 Jan;120(1):112-8 - PubMed
  7. J Womens Health (Larchmt). 2011 Jan;20(1):21-8 - PubMed
  8. Obesity (Silver Spring). 2011 Jul;19(7):1482-91 - PubMed
  9. Am J Epidemiol. 2009 Oct 15;170(8):1048-56 - PubMed
  10. J Intern Med. 2011 Oct;270(4):327-38 - PubMed
  11. Ann Intern Med. 2005 Jun 7;142(11):881-90 - PubMed
  12. JAMA. 1996 Nov 13;276(18):1473-9 - PubMed
  13. Maturitas. 2010 Dec;67(4):316-20 - PubMed
  14. Am J Epidemiol. 2011 Oct 1;174(7):761-8 - PubMed
  15. J Occup Environ Med. 2000 May;42(5):491-501 - PubMed
  16. Mil Med. 2008 Jun;173(6):544-9 - PubMed
  17. Ann Intern Med. 1994 Dec 15;121(12):953-9 - PubMed
  18. Popul Health Metr. 2009 Oct 05;7:17 - PubMed
  19. Psychosom Med. 1999 Jul-Aug;61(4):532-40 - PubMed
  20. J Occup Environ Med. 2002 Mar;44(3):271-81 - PubMed
  21. Environ Res. 1999 Oct;81(3):215-23 - PubMed
  22. Metabolism. 2010 Sep;59(9):1351-7 - PubMed
  23. Obesity (Silver Spring). 2012 Feb;20(2):434-9 - PubMed
  24. Public Health Rep. 2004 May-Jun;119(3):263-70 - PubMed
  25. J Occup Environ Med. 2001 Dec;43(12):1041-56 - PubMed
  26. Prev Chronic Dis. 2011 May;8(3):A52 - PubMed

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