Sponsoring Section/Society: ASA General Methodology
Session Slot: 8:30-10:20 Tuesday
Estimated Audience Size: xx-xxx
AudioVisual Request: xxx
Session Title: Statistical Investigation Of Gulf War Syndrome
Theme Session: Yes/No
Applied Session: Yes/No
Session Organizer: Gaver, Donald P. Naval Postgraduate School
Address: Code OR/GV Naval Postgraduate School Monterey, CA 93943
Phone: 408-656-2605
Fax: 408-656-2595
Email: DGaver@wposmtp.nps.navy.mil
Session Timing: 110 minutes total (Sorry about format):
Opening Remarks by Chair - 5 or 0 minutes First Speaker - 30 minutes (or 25) Second Speaker - 30 minutes Third Speaker - 30 minutes Discussant - 10 minutes (or none) Floor Discusion - 10 minutes (or 5 or 15)
Session Chair: Gaver, Donald P. Naval Postgraduate School
Address: Code OR/GV Naval Postgraduate School Monterey, CA 93943
Phone: 408-656-2605
Fax: 408-656-2595
Email: DGaver@wposmtp.nps.navy.mil
1. Fundamental Statistical Questions Arising From Gulf War Syndrome Investigations
Bailar, John C. III, University of Chicago
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Abstract: To establish a physical basis for the Gulf War Syndrome it is necessary to have (1) a precise operational definition of the outcome to be examined, (2) evidence of exposure to the agent in question, and (3) evidence (possibly from non-human studies) that exposure is likely to affect human health. The latter raises issues of the actual levels of exposure, human variation in response (e.g. sensitive persons), the shape of the dose-response relationship, possible interactions with other risk factors, and many other things. To date, (2) has been discussed in extenso, but (1) and (3) have been largely ignored. Without them, no inferences about exposure and health can be considered valid.
2. The Stress Theory of Gulf War Syndrome: A Political Misstep due to Errors in Measurement
Haley, Robert W., Southwestern Medical School
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Abstract: After treating large numbers of Vietnam veterans with post-traumatic stress disorder (PTSD) resulting from intense combat experiences, mental health professionals expectantly screened large groups of military personnel returning from the 1991 Persian Gulf War (GW) with psychometric PTSD tests, though without the usual psychiatric confirmation. Finding higher, though mostly subdiagnostic, scores in GW veterans than in referents who were not deployed, the authors of 16 published studies concluded that diverse physical symptoms, called GW Syndrome, were due to ``mild PTSD,'' reflecting the small amount and mild nature of combat exposure. This led to a national political consensus that GW Syndrome was a psychological condition due to stress and not a physical illness or injury. Correcting the observed PTSD prevalence rates (range 0% to 36%, mean 9%) for measurement errors with previously determined values of the sensitivity (range 0.77 to 0.96) and specificity (range 0.62 to 0.89) of the psychometric tests, however, yields estimated true PTSD rates of 0% for 18 of the 20 reported rates. Mean scores on the Mississippi PTSD Scale in all subgroups of Gulf War veterans were within the range of values for well-adjusted Vietnam veterans (50-89) and far below that of Vietnam veterans with psychiatrically confirmed PTSD (120-140). Most PTSD and ``stress-related symptoms'' reported in studies of Gulf War veterans appear to represent false-positive errors of measurement reflecting nonspecific symptoms of other conditions. Recently, psychiatrists performing full examinations are finding little to no PTSD, and clinical epidemiologic and animal studies suggest that neurotoxic brain damage from chemical exposures is the explanation.
3. Health Consequences of Service in the Persian Gulf War: Medical, Policy and Media Syndromes
Louis, Tom, Division of Biostatistics, University of Minnesota
Address: Thomas A. Louis, Division of Biostatistics, University of Minnesota, School of Public Health
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Abstract: Membership on the Institute of Medicine's Persian Gulf War Health Consequences Committee and attention to media coverage revealed medical, policy and media syndromes. I review evidence on health effects and the steps/missteps of federal agencies and the media. I discuss statistical issues and statistician roles needed for effective participation in such high-profile, high-impact enterprises.
Discussant: Seglie, Ernest Office of Sec. of Defense; DOT&E
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List of speakers who are nonmembers: None