Table 1

Methodological considerations in selected military veteran mortality studies

Study [Reference No]

Conflict

Source of Veteran Status

Source of Conflict Zone Status

Source of Vital Status

Cause of Death Coding

ICD Codebook Revisionc

Methodological Quality Score


Proportionate Mortality Investigations


Kogan & Clapp 1985 [7]

Vietnam

MA state bonus listb

MA state bonus listb

MA state mortality records

As listed in MA state mortality records and/or MA death certificates

ICD9

73


Lawrence et al. 1985 [20]

Vietnam

1. NY state vital records

2. DMDC

DMDC

1. VA-BLIRS

2. NY state vital records

3. Interviews

As listed in NY state vital records

ICD8

83


Anderson et al. 1986 [38]

Vietnam

1. WI state death certificate

2. VA-BIRLS

3. WI VA graves registration

4. Military service separation file (DD Form 214)

1. Military service separation file (DD Form 214)

2. WI VA graves registration

1. WI state mortality records

2. WI VA graves registration

3. VA-BIRLS

As listed on WI state death certificate

ICD7 (1960–67)

ICD8 (1968–78)

ICD9 (1979–85)

84


Breslin et al. 1988 [39]

Vietnam

VA-BIRLS

NPRC

VA-BIRLS

Nosologist used death certificate from VA files, state vital records (supplemented by SSA, IRS, & NDI

for location of death), or DD casualty office

ICD8

80


Bullman et al. 1990 [40]

Vietnam

VA-BIRLS

NPRC

VA-BIRLS

Nosologist used death certificate from VA files or state vital offices

ICD8

79


Watanabe et al. 1991 [24]

Vietnam

VA-BIRLS

NPRC

VA-BIRLS

Nosologist used death certificate from VA files, federal archive records, or state vital offices

ICD8

79


Visintainer et al. 1995 [41]

Vietnam

MI state bonus listb

MI state bonus listb

MI death certificate database

As listed on MI death certificate

not stated

73


Watanabe & Kang 1996 [26]

Vietnam

VA-BIRLS

NPRC

VA-BIRLS

Nosologist used death certificate from VA files, federal records centers, or state vital offices

ICD8

80


Retrospective Cohort Investigations


Fett et al. 1984 [42]

Vietnam

Australian national military service records

Australian national military service records

1. State & territory death registers

2. Electoral records

3. Arrival & departure records

4. Army records

5. Driver license records

6. Police/correction records

7. Welfare/credit records

Nosologist used death certificate supplemented with medical records, autopsy reports, legal reports, & coroner findings

ICD8

96


Boyle et al. 1987 [9]

Vietnam

NPRC

NPRC

1. VA-BIRLS

2. SSA

3. IRS

4. NDI

5. Army files

6. Interviews

Nosologist used death certificate

ICD8

ICD9

92


Thomas et al. 1991 [23]

Vietnam

1. VN group provided by respective services (see conflict zone status)

2. NVN group: Army-morning reports from 90 facilities; all other services-random sample of women never serving in VN

Provided by respective Services:

1. Army-morning reports from 91 VN facilities

2. Navy-muster rolls of the 4 VN naval facilities

3. Air Force-list of all women serving in VN

4. Marines-list of all women serving in VN

1. VA-BIRLS

3. SSA

4. IRS

5. NDI

6. Military Records

Nosologist used death certificate from VA files or state vital records offices

ICD8

88


Watanabe et al. 1995 [25]

Vietnam

Marine Corps file of all Marines on active duty

NPRC

VA-BIRLS

Nosologist used death certificate from VA files, federal records centers, or state vital offices

ICD8

84


Dalager & Kang 1997 [27]

Vietnam

1. DMDC (Chemical MOS)

2. Army Chemical School class rosters

Morning reports of chemical units in VN

1. VA-BIRLS

2. SSA

3. NDI

Nosologist used death certificate from VA files, federal records centers, or state vital offices

ICD9

85


Boehmer et al. 2004 [29]

Vietnam

NPRC

NPRC

1. VA-BIRLS

2. SSA

3. NDI Plus

1. NDI Plus

2. Nosologist used death certificate if cause of death not in NDI Plus

ICD9

(with NCHS modifications)

93


Cypel & Kang 2008 [51]

Vietnam

Rosters & personnel records from previous studies [23,27]

Rosters & personnel records from previous studies [23,27]

1. VA-BIRLS

2. SSA

1. NDI Plus

2. Nosologist used death certificate from VA files or federal records center

ICD9

82


Kang & Bullman 1996 [28]

Gulf

DMDC

DMDC

1. VA-BIRLS

2. SSA

Nosologist used death certificate from VA files or state vital offices

ICD9

89


Kang & Bullman 2001 [57]

Gulf

DMDC

DMDC

1. VA-BIRLS

2. SSA

Nosologist used death certificate from VA files, federal records centers or NDI

ICD9

87


MacFarlane et al. 2000 [32]

Gulf

UK Ministry of Defense

UK Ministry of Defense

Office for National Statistics, National Health Service Central Registers

1. Office for National Statistics performed coding

2. Defense Analytical Service Agency

3. Military sources in country of death

ICD9

83


MacFarlane et al. 2005 [59]

Gulf

UK Ministry of Defense

UK Ministry of Defense

Office for National Statistics, National Health Service Central Register

Office for National Statistics performed coding

ICD10

83


Sim et al. 2003 [61]

Gulf

Australian Defense Force

Australian Department of Veterans Affairs Nominal Roll for the Gulf War

Australian Institute of Health & Welfare NDI

As coded in Australian NDI

ICD9 (1990–1996)

ICD10 (1997–2000)

86


aAbbreviations in table: VA-BIRLS = Veterans Administration-Beneficiary Identification and Record Locator Subsystem; NPRS = National Personnel Records System; DMDC = Defense Manpower Data Center; SSA = Social Security Administration; IRS = Internal Revenue Service; NDI = National Death Index; VA = Veterans Administration; NCHS = National Center for Health Statistics; VN = Vietnam veteran; NVA = not Vietnam veteran; MOS = military occupational specialty; DD = Department of Defense; MA = Massachusetts; MI = Michigan; WI = Wisconsin; UK = United Kingdom

bBonus lists contain Vietnam-era service members who applied for and received money for service in the Vietnam era.

cICD = International Classification of Diseases. The number after "ICD" indicates the codebook revision

Knapik et al. BMC Public Health 2009 9:231   doi:10.1186/1471-2458-9-231

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