Coffman et al., 2005 (Vol. 4)

Capture–recapture reanalysis of Horner et al., cohort

See Horner et al., 2003


Found no underascertainment of ALS cases among deployed

Log-linear models; sample coverage; ecologic models

Possible slight undercounts not likely to substantively affect results

Horner et al., 2008 (Update)

Retrospective cohort, follow-up from 1991-2001 (follow-up of Horner et al., 2003)

All active, Gulf War-deployed military personnel (n = 696,118), compared with NDVs


Deployed (48 cases) vs nondeployed (76 cases), no significant difference in SIR during additional follow-up period Similar percentage of young onset between deployed (69%) and controls (64%)

Age-adjusted average, annual 10-year incidence; attributable risk

Small number of cases and short follow-up period limit the ability of the study to determine long-term trends

NOTES: CI = confidence interval; GWV = Gulf War veteran; MRR = mortality rate ratio; NDV = nondeployed veteran; NIS = Neuropathy Impairment Score (Mayo Clinic version); OR = odds ratio; PB = pyridostigmine bromide; RoM = ratio of means; sd = standard deviation; SF-12 = 12-item Short Form Health Survey; SIR = standardized incidence ratio.

aAlthough the study defined distal symmetric polyneuropathy as distal sensory or motor neuropathy identified on basis of neurologic examination, nerve conduction study, or both, the committee defined it by nerve-conduction study alone.

bAlcohol dependence, diabetes mellitus, renal insufficiency, hypothyroidism, AIDS/HIV, collagen vascular disease, and neurotoxic medications.

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