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Validation of a Research Case Definition of Gulf War Illness in the 1991 US Military PopulationIannacchione V.G.a · Dever J.A.a · Bann C.M.a · Considine K.A.a · Creel D.a · Carson C.P.a · Best H.a · Haley R.W.b
aRTI International, Research Triangle Park, N.C., and bDivision of Epidemiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Tex., USA Corresponding Author
Prof. Robert W. Haley, MD
Division of Epidemiology, Department of Internal Medicine
University of Texas Southwestern Medical Center
5323 Harry Hines Blvd, Dallas, TX 75390-8874 (USA)
Tel. +1 214 648 3075, E-Mail Robert.Haley@UTSouthwestern.edu
Background: A case definition of Gulf War illness with 3 primary variants, previously developed by factor analysis of symptoms in a US Navy construction battalion and validated in clinic veterans, identified ill veterans with objective abnormalities of brain function. This study tests prestated hypotheses of its external validity. Methods: A stratified probability sample (n = 8,020), selected from a sampling frame of the 3.5 million Gulf War era US military veterans, completed a computer-assisted telephone interview survey. Application of the prior factor weights to the subjects’ responses generated the case definition. Results: The structural equation model of the case definition fit both random halves of the population sample well (root mean-square error of approximation = 0.015). The overall case definition was 3.87 times (95% confidence interval, 2.61–5.74) more prevalent in the deployed than the deployable nondeployed veterans: 3.33 (1.10–10.10) for syndrome variant 1; 5.11 (2.43–10.75) for variant 2, and 4.25 (2.33–7.74) for variant 3. Functional status on SF-12 was greatly reduced (effect sizes, 1.0–2.0) in veterans meeting the overall and variant case definitions. Conclusions: The factor case definition applies to the full Gulf War veteran population and has good characteristics for research.
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