Evidence map›Paper›PMID 25768060›Full record

ArticleMedical care2015

Long-term disability associated with war-related experience among Vietnam veterans: retrospective cohort study.

Philip M Clarke, Robert Gregory, Joshua A Salomon

Open access · hybridAbstract read
In one paragraph

Article in Medical care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Observational
  9. Review
  10. Article
  11. Disability and Mental Disorders in the Canadian Armed Forces.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2016
    Article
  12. The impact of war on mental health: lest we forget.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2015
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 2 countries.

Philip M Clarke*Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, VIC †Research School of Economics, Australian National University, Canberra, ACT, Australia ‡Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA.
Robert Gregory
Joshua A Salomon
Australian National University · AUHarvard Global Health Institute · USUniversity of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent combat operations have involved large numbers of personnel. Long-term health effects of military deployment remain largely unknown.

objectivesTo examine patterns and trends in long-term disability among combat veterans and to relate disability to aspects of wartime experience.

participantsA total of 60,228 Australian military personnel deployed between 1962 and 1975 during the Vietnam War, and 82,877 military personnel who were not deployed overseas. OUTCOME MEASURES: Accepted physician-assessed disability claims were evaluated over follow-up periods up to 50 years after deployment, and compared with age-matched controls. Multivariable analysis was used to examine differences by service branch, rank, age, and deployment duration.

resultsThe steepest rise in disability incidence was observed among Vietnam veterans starting in the 1990s, around 20-30 years after deployment for most veterans. After 1994, when Statements of Principles were introduced to guide evaluation of disability claims, the hazard ratio for disability incidence was 1.53 (95% confidence interval, 1.32-1.77) compared with the prior period. By January 2011, after an average follow-up of 42.5 years, 69.7% (95% confidence interval, 69.4%-70.1%) of veterans had at least 1 war-related disability. Many veterans had multiple disabilities, with leading causes being eye and ear disorders (48.0%), mental health conditions (47.9%), and musculoskeletal disorders (18.4%). For specific categories of disability, relative risks for accepted claims among veterans compared with controls were highest for mental health disorders, at 22.9 (21.9-24.0) and lowest for injuries, at 1.5 (1.4-1.6) with a relative risk for any disability of 3.7 (3.7-3.8). Veterans with service of >1 year were 2.5 (2.2-2.7) times more likely to have a mental health disability than those who served <100 days, and 2.3 (2.1-2.5) times more likely to have other disabilities.

conclusionsLong-term effects of deployment into military conflicts are substantial, and likelihood of war-related disability is associated with service history. If similar patterns follow from more recent conflicts, significant additional resources will be needed to prevent and treat long-term health conditions among veterans.

Indexed as

Vietnam ConflictWarfareAgedAge FactorsAustraliaDisability EvaluationFemaleHealth StatusHumansIncidenceMaleMental HealthMiddle AgedPersons with DisabilitiesRetrospective StudiesTime Factors

Identifiers

PMID25768060
PMCPMC4396733
OpenAlexW2049495380

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.