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Suggested Citation:"Conclusion." Institute of Medicine. 1998. Adequacy of the VA Persian Gulf Registry and Uniform Case Assessment Protocol. Washington, DC: The National Academies Press. doi: 10.17226/6084.
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Page 51
Suggested Citation:"Conclusion." Institute of Medicine. 1998. Adequacy of the VA Persian Gulf Registry and Uniform Case Assessment Protocol. Washington, DC: The National Academies Press. doi: 10.17226/6084.
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Page 52

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6 Conclusion Change is inevitable, and as such, it is important to plan for that change on the basis of new information and techniques that have emerged from past experiences and scientific investigation. The committee believes that the changes recommended in this report build on the strengths and lessons learned through research, the implementation of the Registry and the UCAP, and advances made in the field of clinical practice evaluation. It is with the intent to assist VA with better serving Persian Gulf veterans that these recommendations are offered. The committee believes that the recommendations to adopt the described diagnostic pathway, to eliminate the distinction between Phase I and Phase II, to add to the collection of exposure information, and to develop appropriate clinical practice guidelines and pathways with feedback mechanisms on their usefulness will facilitate better and more timely provision of diagnostic services to Persian Gulf veterans. The concomitant changes in data collection and reporting and the collection of information on patient satisfaction will elicit information that can be used to assist in focusing efforts aimed at continuously improving the system. It is important to note that the system remains a diagnostic program, not a research study, and it is therefore not reasonable to expect the Registry and UCAP to identify a new syndrome or syndromes. The current excellent approaches to outreach and provider education will be supplemented by the committees' recommendations for the exploration of additional avenues and the involvement of additional practitioners. Although it will take thoughtful effort and time to plan for and implement these recommendations, the committee urges VA to make the implementation of these recommendations a priority. 51

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As mandated in Public Law 103-446, the Department of Veterns Affairs (VA) asked the Institute of Medicine (IOM) to review its Uniform Case Assessment Protocol (UCAP) for Persian Gulf veterans. The purpose of the program is to provide a systematic, comprehensive medical protocol for the diagnosis of health problems of Persian Gulf veterans. This report is the third in a series of studies by IOM reviewing the protocols used by the VA and the Department of Defense to diagnose the health complaints of Gulf veterans. The committee reviews and makes recommendations concerning the adequacy of the medical protocol and its implementation by the VA, as well as the VA's outreach and education efforts aimed at informing Persian Gulf veterans and their care providers of the purpose and availability of this program. In addition, the report contains as appendixes the findings and recommendations of the previous reports, as well as those of two related IOM reports on Health Consequences of Service During the Persian Gulf War.

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