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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council (NRC), whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. Ordinarily, the NRC appoints a committee of experts to produce a report, which then undergoes independent review according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. In the case of this report, the Medical Follow-up Agency’s (MFUA) general oversight body, the Committee on Epidemiology and Veterans’ Follow-up Studies, has provided overall guidance; the study, however, was conducted by MFUA staff and the report written by an MFUA staff officer. Although this report has been reviewed in accordance with established NRC procedures, it represents the views of its author and not the deliberations of an expert NRC committee.
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This project was supported by funds from the Department of Veterans Affairs under contract V101(93)P-1225.
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Preface
The beginnings of the Medical Follow-up Agency (MFUA) study of former prisoners of war (POWs) can be found in the early 1950's when the Veterans Administration (now the Department of Veterans Affairs) initiated a program of studies of the medical status of POWs compared with non-POW controls. The latest follow-up component of this long-term study was begun in August 1986 under a contract with the National Research Council (NRC) to conduct a medical examination survey of these groups. Ordinarily, the NRC appoints a committee of experts to produce a report, which then undergoes independent review according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. In the case of this report, the MFUA's general oversight body, the Committee on Epidemiology and Veterans' Follow-up Studies—chaired by the late Richard D. Remington—has provided overall guidance; the study, however, was conducted by MFUA staff and the report written by an MFUA staff officer. Although this report has been reviewed in accordance with established NRC procedures, it represents the views of its author and not the deliberations of an expert NRC committee.
It is in the nature of long, complicated longitudinal studies such as this one that recent work builds on the foundation of earlier efforts. For that reason, I am especially appreciative of the soundness of earlier work by Cohen, Cooper, Nefzger, Beebe, and Keehn (see the reference list later in this volume). The staff of the MFUA likewise deserve acknowledgment
and a great share of the credit for careful, tireless work in collecting and organizing the data on which this report is based. Special thanks go to Chiquita Benson, Harriet Crawford, and Mary Williams for their assistance.
The support of such a long, complex study—indeed, the entire series of studies—by Department of Veterans Affairs (VA) staff is also greatly appreciated. I would be remiss if I did not make special mention of project officer David Thomas and his successor, Robert Meci, as well as numerous VA Central Office staff in the Medical Research program. Space limitations prevent my thanking individually the many VA field personnel who contributed their time and experience on behalf of this study; I am particularly indebted to those VA personnel who met with me during visits to their stations. (A list of site visits can be found in Appendix B.) I would also like to thank Brian Engdahl and Steven Oboler for their helpful comments on an earlier version of this manuscript and Susan Solomon and Ellen Gerrity of the National Institute of Mental Health for their support and sponsorship of the last-minute supplemental psychological data collection.
Finally, of course, I am indebted to those former POWs and combat veterans who volunteered to come to a nearby VA medical center to be examined. Not only were the examinations themselves arduous because they were so extensive, but it was no doubt difficult to relive sometimes extraordinarily unpleasant past experiences. To our gratitude for their earlier sacrifices in wartime we must add our thanks for their recent efforts in this study.
William Frank Page
