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design future studies of treatment effectiveness that include outcomes research and effectiveness randomized clinical trials; and
develop a standard language for describing Gulf War veterans' symptoms, including their severity and temporal patterns, and that this standard language should be used in conducting treatment effectiveness studies and developing treatment guidelines.
Further, the committee recommends that those conducting ongoing cohort studies of veterans' health (e.g., the national VA study, the Iowa follow-up study on Gulf War veterans, and the Millennium Cohort Study being implemented by DoD) include collection of data on treatments and health-related quality of life.
The committee also recommends that current VA and DoD Gulf War registries be used as one way to identify patient samples and serve as a sampling frame for future treatment effectiveness studies.
(NOTE: The current information collected and analyzed in the Gulf War registries does not include basic data on treatment approaches, health status, or outcomes. Addition of such information to the registries would greatly increase their value as a basis for identifying patient samples for more in-depth study.)
Despite the fact that treatment effectiveness studies have not been conducted for the population of Gulf War veterans, there are approaches to treatment that have been shown to be beneficial across diagnostic categories. The following chapter explores a patient-centered approach to care that can be used with all patients, regardless of diagnosis, but which may prove especially beneficial to those who are experiencing symptoms but have no identifiable diagnosis.