TABLE 5.8 Amyotrophic Lateral Sclerosis (ALS)
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Reference
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Design
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Population
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Outcome
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Results
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Adjustment
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Comments or Limitations
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Horner et al. 2003
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Retrospective cohort
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All active, Gulf War-deployed military personnel (1990-1991), compared withnon-Gulf War-deployed veterans
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ALS
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All deployed forces, significant increased risk of ALS
RR = 1.92% 95% CL -1.29-2.84
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Age-adjusted average, annual
10-year incidence; attributable risk
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Case ascertainment method through screening of VA and DOD medical databases and benefit files (and TriCare) by ICD-9 code for ALSor riluzole use; toll-free telephone enrollment; Internetnotices; mass mailings to neurologists, VA centers, and veteran service organizations
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Coffman et al. 2005
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Capture-recapture reanalysis of Horner et al. cohort
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See Horner et al. 2003
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ALS
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Found no under as certainment of ALS cases among deployed
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Log-linear models; sample coverage; ecologic models
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Possible slight undercounts not likely to substantively affect results
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NOTE: DOD= Department of Defense; VA =Department of Veterans Affairs.
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