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Health and Human Services Department of Defense Veterans Affairs Health and Human Services Gulf War Information Department of Defense Gulf War Information Veterans Affairs Gulf War Information Home Home Advanced Search Glossary FAQs Site Map Contact Us
 Research Topics    |    Major Focus Areas
Research Topics
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General
Project Summary

Title: Defining Gulf War Illness
Synopsis: This study looks at several prevailing definitions of Gulf War Illness in order to characterize and identify an alternative classification system that will encompass all symptoms and functional disabilities which remains medically unexplained.
Overall Project Objective: To characterize and identify alternative classifications for symptoms and functional disability which remain medically unexplained in Gulf War veterans.
Status/Results to Date: Data collection through CATI telephone interviews began in pilot operations in February 2000, and reached full scale as of June 2000. Interviewing was completed by October 31, 2001. We completed 3,099 interviews among the 4 subject subgroups. This represents a 75% completion rate among those subjects who were located. Preliminary data analysis has been completed, including analyses comparing various definitions of illness among Gulf War veterans and a comparison of the four previously published factor analytic descriptions of Gulf War illness. We anticipate that the final results will be available by October 2002.
Project:HHS-6
Agency:Department Of Health And Human Services
Location:CDC, University of Medicine and Dental of Robert Wood Johnson Med School
P.I. Name:Howard Kipen, M.D., MPH
Research Type:Epidemiology
Research Focus:Symptoms & General Health
Focus Category:General Health & Physical Symptoms
Status:Ongoing
Study Start Date:November 01,1997
Estimated Completion Date:October 30,2001
Specific Aims: 1) To assess the persistence and stability of symptoms over time, and to compare the performance of data-driven case definitions previously derived from two samples of Gulf War veterans (the New Jersey Center for Environmental Hazards Research (NJCEHR) sample of Department of Veterans Affairs Gulf War Registry participants and a CDC sample of Air Force veterans.) Standard or existing case definitions for unexplained multi-symptom illnesses (such as chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivity) will be simultaneously evaluated to determine if these definitions or data-driven definitions better characterize Gulf War veterans' unexplained illnesses. 2) To assess the generalizability of derived and existing case definitions in a new random sample of deployed and non-deployed Gulf war era veterans' and active duty soldiers. 3) To assess the role of psychiatric conditions in Gulf War veterans' unexplained illnesses. 4) To compare our derived definitions to others previously published, focusing on the effects of variations in methodology and cohorts.
Methodology: All subjects from the NJCEHR cohort (N=1,161) and a sample of the CDC cohort (N=1,200) will be asked to complete a telephone survey assessment of symptoms and medical conditions. The stability of symptoms will be assessed by comparing the previous assessment (Time 1) with the current assessment (Time 2). Case definitions derived using factor analytic procedures with Time 1 data will be compared to case definitions derived from Time 2 data. Generalizability of the case definitions will be determined by asking a new randomly selected national sample of Gulf War veterans and era controls (N=3,000) to complete the telephone survey. Psychiatric conditions will be assessed by including the Brief Symptom Inventory (BSI) and the Short form of Composite International Diagnostic Interview (CIDI-SF) in the telephone survey. In order to validate self-reports of serious organic medical conditions, medical record reviews will be completed on a random sample of 70 veterans from the NJCEHR cohort and 70 matched controls who report no serious medical conditions. As the original NJCEHR study was conducted using a mail survey, one-third of the NJCEHR sample will be asked to complete a short mail survey as well as the telephone survey in order to assess potential bias of the method of data collection. We will compare the symptom patterns of data-derived definitions in our data sets to those published by other researchers. We will use the statistical methods reported by these researchers and apply them to our data. Correlations between derived factors will be explored to see how methodology differences affect variability in derived definitions.
Most Recent Publications:

Kipen H, Hallman WK, Boyd K, Wartenberg D. Medically Unexplained Symptoms Associated with Environmental Exposures: Progress in Defining and Explaining Illness. Epidemiology, 12 (Supplement): S84, Jul 2001. Article

Kipen H, Hallman WK, Fiedler N, Wartenberg D. Medically Unexplained Symptoms in Gulf War Veterans: Searching for Definitions. Epidemiology, 10(Supplement):S44, 1999. Abstract

Hallman WK, Kipen H, Boyd K, Wartenberg D. Patterns of Symptoms Among Gulf War Health Registry Veterans Epidemiology, 12 (Supplement): S85, Jul 2001. Article

Boyd K, Hallman WK, Wartenberg D, Kipen H. Predicting Sick Group Membership in Gulf War Registry Veterans. Epidemiology, 12 (Supplement): S84, Jul 2001. Article

Boyd K, Wartenberg D, Hallman WK, Kipen H. Stability of derived definitions of medically unexplained symptoms: Gulf War illness. Epidemiology, 11 (Supplement): S128, 2000. Abstract

Hallman WK, Kipen H, Diefenbaach M, Boyd K, Kang HK, Leventhal H, Wartenberg D. Symptom pattern among Gulf War registry veterans. American Journal of Public Health, In press. Article

Wartenberg D, Boyd K, Hallman WK, Kipen H. The Use of Exploratory Factor Analysis for the Study of Medically Unexplained Symptoms. Epidemiology, 12 (Supplement): S85, Jul 2001. Article