Validation of a research case definition of Gulf War illness in the 1991 US military population

Neuroepidemiology. 2011;37(2):129-40. doi: 10.1159/000331478. Epub 2011 Oct 7.

Abstract

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.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Validation Study

MeSH terms

  • Female
  • Gulf War*
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical*
  • Persian Gulf Syndrome / diagnosis
  • Persian Gulf Syndrome / epidemiology*
  • Population Surveillance / methods*
  • Random Allocation
  • Surveys and Questionnaires / standards*
  • United States / epidemiology
  • Veterans*