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Adequacy of the Comprehensive Clinical Evaluation Program : Nerve Agents.

By: Contributor(s): Publisher: Washington, D.C. : National Academies Press, 1997Copyright date: ©1997Description: 1 online resource (64 pages)Content type:
  • text
Media type:
  • computer
Carrier type:
  • online resource
ISBN:
  • 9780309590402
Subject(s): Genre/Form: Additional physical formats: Print version:: Adequacy of the Comprehensive Clinical Evaluation Program : Nerve AgentsDDC classification:
  • 616.98023
LOC classification:
  • DS79.744.H42 -- A34 1997eb
Online resources:
Contents:
Adequacy of the Comprehensive Clinical Evaluation Program -- Copyright -- Contents -- Executive Summary -- Introduction -- The Comprehensive Clinical Evaluation Program -- OVERVIEW -- IMPLEMENTATION -- CCEP: THE INITIAL IOM REPORT -- CCEP: IOM REVIEW CONTINUED -- Testing for and Identifying Health Effects of Exposure to Nerve Agents -- Recommendations -- References -- Appendixes -- Appendix A Recommendations of the Initial CCEP Committee -- 1.) Overall Assessment of the CCEP Goals Procedures -- 2.) General Recommendations for the Implementation of the CCEP -- 2.1.) Referrals of Patients from Phase I to Phase II of the CCEP -- 2.1.1.) Structure and Revise the CCEP Protocol and Logistics to Allow the Majority of Patients to Receive a Final Diagnosis… -- 2.1.2.) Curtail Diagnostic Work-ups in Patients Not Seriously Disabled with Minor Complaints -- 2.1.3.) Require Additional Efforts to Provide More Care at the Primary Care Level -- 2.1.4.) Continue Referral of Subgroups of Patients Whose Illnesses Are Difficult to Diagnose -- 2.2.) Systematic Guidelines for Psychiatric Referrals and Adequacy of Psychiatric Resources -- 2.2.1.) Develop Explicit Guidelines for the Identification of Phase I Patients Who Would Benefit fro... -- 2.2.2.) Alert Primary Care Physicians About the High Prevalence of Psychiatric Disorders -- 3.) Specific Observations of and Recommendations for the Implementation of the CCEP -- 3.1.) Analysis and Interpretation of the CCEP Results -- 3.1.1.) Symptoms and Diagnoses in the CCEP Population -- 3.1.1.1.) No Evidence Has Been Found that the DoD Has Been Trying To Avoid Reaching a Single Unifyin... -- 3.1.1.2.) Signs and Symptoms in Many Patients Can Be Explained by Well Recognized Conditions -- 3.1.1.3.) Provide More Detailed Information on Specific Diagnoses in Future Reports.
3.1.1.4.) Investigate the Diagnosis in Patients with Disability Processing Actions -- 3.1.1.5.) Don't View CCEP Results as Estimates of the Prevalence of Disability Related to Persian Gu... -- 3.1.2.) Evidence of a New, Unique Persian Gulf Syndrome -- 3.1.2.1.) There is a Lack of Clinical Evidence of a Unique Persian Gulf Syndrome -- 3.1.2.2.) Share the Entire CCEP Data Set with Qualified Researchers Outside of the DoD -- 3.1.3.) Potential Relationship of Illnesses in CCEP Patients to Service in the Persian Gulf -- 3.1.3.1.) Discuss the Issue of Causality Explicitly and Unambiguously in its Future Reports -- 3.1.3.2.) Determine the Timing of the Onset of Disease -- 3.1.4.) Comparison of the CCEP Population with Other Populations -- 3.1.4.1.) Be Cautious About Comparison with Other Populations -- 3.1.4.2.) It's Difficult to Establish Causal Relationships by Relying on CCEP Data Alone -- 3.1.4.3.) Consider the CCEP Data to Have High Clinical Utility -- 3.2.) Specific Medical Diagnosis -- 3.2.1.) Psychiatric Conditions -- 3.2.1.1.) Make Patients Aware of Psychiatric Conditions and Their Prevalence and Morbidity -- 3.2.1.2.) Emphasize Effects and Diagnosis of Psychosocial Stressors -- 3.2.1.3.) Identify People with Risk of Developing Depression or Post-Traumatic Stress Disorder (PTSD) -- 3.2.1.4.) Improve Standardization of Psychiatric Evaluations -- 3.2.1.5.) Document and Investigate the Onset and Course of Symptoms and Psychosocial Stressors -- 3.2.1.6.) Standardize Neuropsychological Evaluations -- 3.2.1.7.) Standardize Classification and Coding of Diseases -- 3.2.1.8.) Document Headache Categories Differently -- 3.2.1.9.) Add Explicit Written Instruction on Medical Record-Keeping and Coding -- 3.2.1.10.) Expand Discussion of Psychological Stressors -- 3.2.1.11.) Utilize Results of On-Going Studies to Revise CCEP -- 3.2.2.) Musculoskeletal Conditions.
3.2.2.1.) Provide More Details of Diagnostic Categorization of Musculoskeletal Conditions -- 3.2.2.2.) Place More Emphasis on Musculoskeletal Conditions -- 3.2.3.) Signs, Symptoms and Ill-Defined Conditions -- 3.2.3.1.) Clarify Types of Disorders Included in the ICD-9 Category -- 3.2.4.) Infectious Diseases -- 3.2.4.1.) Infectious Disease is Not a Frequent Cause of Serious Illness -- 3.2.4.2.) Veterans are not Likely Afflicted With Some Previously Unknown Pathogen -- 3.2.5.) Chronic Fatigue Syndrome, Fibromyalgia, and Multiple Chemical Sensitivity -- 3.2.5.1.) Estimating Prevalence of Chronic Fatigue Syndrome, Fibromyalgia, and Multiple Chemical Sen... -- 3.2.5.2.) Collect Data Using Established Diagnostic Criteria for CFS and FM -- 3.2.5.3.) Established Diagnostic Criteria Does Not Exist for MCS -- 3.2.5.4.) Include CFS, FM, and MCS in On-Going and Future Epidemiological Research Studies -- 3.2.5.5.) Continue Thorough Workup to Diagnose Sleep Disturbances and Fatigue -- 3.3.) Use of the CCEP Results for Education Improvements in the Medical Protocol, and Outcome Evalua... -- 3.3.1.) Use of the CCEP Results for Education -- 3.3.1.1.) Continue Public Release of Analysis Results of the CCEP on an On-Going, Periodic Basis -- 3.3.1.2.) Distribute CCEP Findings to all Primary Care Physicians at MTFs and RMCs -- 3.3.1.3.) Develop a More Concise Version of the DoD Report for Active-Duty Service Personnel and Vet... -- 3.3.1.4.) Develop a More Comprehensive Document Describing Potential Exposures in More Detail -- 3.3.2.) Use of the CCEP Results to Improve the Medical Protocol -- 3.3.2.1.) Use CCEP Examination Results to Improve Standardization Practices -- 3.3.2.2.) Refine Questions Related to Potential Psychological Stressors -- 3.3.2.3.) Determine if Lab Tests or Specialty Consultations Should be Added to Phase I.
3.3.2.4.) Compare and Coordinate Methods and Clinical Results of the CCEP and UCAP -- 3.3.3.) Use of the CCEP Results for Patient Outcome -- 3.3.3.1.) Perform Targeted Patient Evaluations -- 3.3.3.2.) Communicate Successful Treatment Methods Between RMCs -- 3.3.3.3.) Review Disorders Among CCEP Patients who Have Applied for Disability Payments of for Medic... -- 3.3.4.) Specialized Care Center (SCC) -- 3.3.4.1.) The DoD has Made Serious Efforts to Develop an SCC Program that has Ambitious Goals -- 3.3.4.2.) Provide Multidisciplinary Treatment Modalities -- 3.3.4.3.) Need for Individualized Follow-Up and Therapeutic Regimens -- 3.3.4.4.) Develop Objective Measure of Functional Status for Follow-Up Evaluation -- 3.3.4.5.) Evaluate the SCC Program Itself -- 3.3.4.6.) DoD Has Taken a Serious Approach to the Treatment and Rehabilitation of these Patients in... -- 3.3.4.7.) Investigate Costs and Benefits of the SCC Program -- 3.3.4.8.) Identify the Most Effective Elements of the SCC Program -- 3.4.) Research Relevant to the CCEP -- 3.4.1.) Epidemiological Research Relevant to the CCEP -- 3.4.1.1.) Utilize On-Going Epidemiological Studies for Revising or Improving the CCEP -- 3.4.1.2.) Acknowledge the Serious Limitations of the CCEP Data for Epidemiological Purposes -- 3.4.2.) Exposure Assessment Research Relevant to the CCEP -- 3.4.2.1.) Investigate Experiences of Individuals in UICs with Higher Rates of CCEP Participation -- 3.4.2.2.) Investigate Exposures Restricted to Particular Locations or Special Occupational Groups -- COMMITTEE ON THE DOD PERSIAN GULF SYNDROME COMPREHENSIVE CLINICAL EVALUATION PROGRAM -- Staff -- Appendix B Outline of the CCEP Medical Protocol -- Form Requirements -- Medical Protocols -- Medical Treatment Facility (Phase I) -- Appendix C Workshop on the Adequacy of the CCEP for Evaluating Individuals Potentially Exposed to N...
Agenda -- Appendix D DoD Memorandum for Persian Gulf War Veterans Concerning Khamisiyah, Iraq -- Appendix E Persian Gulf War-Related Events: Timeline.
Holdings
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Ebrary Ebrary Egypt Available
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Adequacy of the Comprehensive Clinical Evaluation Program -- Copyright -- Contents -- Executive Summary -- Introduction -- The Comprehensive Clinical Evaluation Program -- OVERVIEW -- IMPLEMENTATION -- CCEP: THE INITIAL IOM REPORT -- CCEP: IOM REVIEW CONTINUED -- Testing for and Identifying Health Effects of Exposure to Nerve Agents -- Recommendations -- References -- Appendixes -- Appendix A Recommendations of the Initial CCEP Committee -- 1.) Overall Assessment of the CCEP Goals Procedures -- 2.) General Recommendations for the Implementation of the CCEP -- 2.1.) Referrals of Patients from Phase I to Phase II of the CCEP -- 2.1.1.) Structure and Revise the CCEP Protocol and Logistics to Allow the Majority of Patients to Receive a Final Diagnosis… -- 2.1.2.) Curtail Diagnostic Work-ups in Patients Not Seriously Disabled with Minor Complaints -- 2.1.3.) Require Additional Efforts to Provide More Care at the Primary Care Level -- 2.1.4.) Continue Referral of Subgroups of Patients Whose Illnesses Are Difficult to Diagnose -- 2.2.) Systematic Guidelines for Psychiatric Referrals and Adequacy of Psychiatric Resources -- 2.2.1.) Develop Explicit Guidelines for the Identification of Phase I Patients Who Would Benefit fro... -- 2.2.2.) Alert Primary Care Physicians About the High Prevalence of Psychiatric Disorders -- 3.) Specific Observations of and Recommendations for the Implementation of the CCEP -- 3.1.) Analysis and Interpretation of the CCEP Results -- 3.1.1.) Symptoms and Diagnoses in the CCEP Population -- 3.1.1.1.) No Evidence Has Been Found that the DoD Has Been Trying To Avoid Reaching a Single Unifyin... -- 3.1.1.2.) Signs and Symptoms in Many Patients Can Be Explained by Well Recognized Conditions -- 3.1.1.3.) Provide More Detailed Information on Specific Diagnoses in Future Reports.

3.1.1.4.) Investigate the Diagnosis in Patients with Disability Processing Actions -- 3.1.1.5.) Don't View CCEP Results as Estimates of the Prevalence of Disability Related to Persian Gu... -- 3.1.2.) Evidence of a New, Unique Persian Gulf Syndrome -- 3.1.2.1.) There is a Lack of Clinical Evidence of a Unique Persian Gulf Syndrome -- 3.1.2.2.) Share the Entire CCEP Data Set with Qualified Researchers Outside of the DoD -- 3.1.3.) Potential Relationship of Illnesses in CCEP Patients to Service in the Persian Gulf -- 3.1.3.1.) Discuss the Issue of Causality Explicitly and Unambiguously in its Future Reports -- 3.1.3.2.) Determine the Timing of the Onset of Disease -- 3.1.4.) Comparison of the CCEP Population with Other Populations -- 3.1.4.1.) Be Cautious About Comparison with Other Populations -- 3.1.4.2.) It's Difficult to Establish Causal Relationships by Relying on CCEP Data Alone -- 3.1.4.3.) Consider the CCEP Data to Have High Clinical Utility -- 3.2.) Specific Medical Diagnosis -- 3.2.1.) Psychiatric Conditions -- 3.2.1.1.) Make Patients Aware of Psychiatric Conditions and Their Prevalence and Morbidity -- 3.2.1.2.) Emphasize Effects and Diagnosis of Psychosocial Stressors -- 3.2.1.3.) Identify People with Risk of Developing Depression or Post-Traumatic Stress Disorder (PTSD) -- 3.2.1.4.) Improve Standardization of Psychiatric Evaluations -- 3.2.1.5.) Document and Investigate the Onset and Course of Symptoms and Psychosocial Stressors -- 3.2.1.6.) Standardize Neuropsychological Evaluations -- 3.2.1.7.) Standardize Classification and Coding of Diseases -- 3.2.1.8.) Document Headache Categories Differently -- 3.2.1.9.) Add Explicit Written Instruction on Medical Record-Keeping and Coding -- 3.2.1.10.) Expand Discussion of Psychological Stressors -- 3.2.1.11.) Utilize Results of On-Going Studies to Revise CCEP -- 3.2.2.) Musculoskeletal Conditions.

3.2.2.1.) Provide More Details of Diagnostic Categorization of Musculoskeletal Conditions -- 3.2.2.2.) Place More Emphasis on Musculoskeletal Conditions -- 3.2.3.) Signs, Symptoms and Ill-Defined Conditions -- 3.2.3.1.) Clarify Types of Disorders Included in the ICD-9 Category -- 3.2.4.) Infectious Diseases -- 3.2.4.1.) Infectious Disease is Not a Frequent Cause of Serious Illness -- 3.2.4.2.) Veterans are not Likely Afflicted With Some Previously Unknown Pathogen -- 3.2.5.) Chronic Fatigue Syndrome, Fibromyalgia, and Multiple Chemical Sensitivity -- 3.2.5.1.) Estimating Prevalence of Chronic Fatigue Syndrome, Fibromyalgia, and Multiple Chemical Sen... -- 3.2.5.2.) Collect Data Using Established Diagnostic Criteria for CFS and FM -- 3.2.5.3.) Established Diagnostic Criteria Does Not Exist for MCS -- 3.2.5.4.) Include CFS, FM, and MCS in On-Going and Future Epidemiological Research Studies -- 3.2.5.5.) Continue Thorough Workup to Diagnose Sleep Disturbances and Fatigue -- 3.3.) Use of the CCEP Results for Education Improvements in the Medical Protocol, and Outcome Evalua... -- 3.3.1.) Use of the CCEP Results for Education -- 3.3.1.1.) Continue Public Release of Analysis Results of the CCEP on an On-Going, Periodic Basis -- 3.3.1.2.) Distribute CCEP Findings to all Primary Care Physicians at MTFs and RMCs -- 3.3.1.3.) Develop a More Concise Version of the DoD Report for Active-Duty Service Personnel and Vet... -- 3.3.1.4.) Develop a More Comprehensive Document Describing Potential Exposures in More Detail -- 3.3.2.) Use of the CCEP Results to Improve the Medical Protocol -- 3.3.2.1.) Use CCEP Examination Results to Improve Standardization Practices -- 3.3.2.2.) Refine Questions Related to Potential Psychological Stressors -- 3.3.2.3.) Determine if Lab Tests or Specialty Consultations Should be Added to Phase I.

3.3.2.4.) Compare and Coordinate Methods and Clinical Results of the CCEP and UCAP -- 3.3.3.) Use of the CCEP Results for Patient Outcome -- 3.3.3.1.) Perform Targeted Patient Evaluations -- 3.3.3.2.) Communicate Successful Treatment Methods Between RMCs -- 3.3.3.3.) Review Disorders Among CCEP Patients who Have Applied for Disability Payments of for Medic... -- 3.3.4.) Specialized Care Center (SCC) -- 3.3.4.1.) The DoD has Made Serious Efforts to Develop an SCC Program that has Ambitious Goals -- 3.3.4.2.) Provide Multidisciplinary Treatment Modalities -- 3.3.4.3.) Need for Individualized Follow-Up and Therapeutic Regimens -- 3.3.4.4.) Develop Objective Measure of Functional Status for Follow-Up Evaluation -- 3.3.4.5.) Evaluate the SCC Program Itself -- 3.3.4.6.) DoD Has Taken a Serious Approach to the Treatment and Rehabilitation of these Patients in... -- 3.3.4.7.) Investigate Costs and Benefits of the SCC Program -- 3.3.4.8.) Identify the Most Effective Elements of the SCC Program -- 3.4.) Research Relevant to the CCEP -- 3.4.1.) Epidemiological Research Relevant to the CCEP -- 3.4.1.1.) Utilize On-Going Epidemiological Studies for Revising or Improving the CCEP -- 3.4.1.2.) Acknowledge the Serious Limitations of the CCEP Data for Epidemiological Purposes -- 3.4.2.) Exposure Assessment Research Relevant to the CCEP -- 3.4.2.1.) Investigate Experiences of Individuals in UICs with Higher Rates of CCEP Participation -- 3.4.2.2.) Investigate Exposures Restricted to Particular Locations or Special Occupational Groups -- COMMITTEE ON THE DOD PERSIAN GULF SYNDROME COMPREHENSIVE CLINICAL EVALUATION PROGRAM -- Staff -- Appendix B Outline of the CCEP Medical Protocol -- Form Requirements -- Medical Protocols -- Medical Treatment Facility (Phase I) -- Appendix C Workshop on the Adequacy of the CCEP for Evaluating Individuals Potentially Exposed to N...

Agenda -- Appendix D DoD Memorandum for Persian Gulf War Veterans Concerning Khamisiyah, Iraq -- Appendix E Persian Gulf War-Related Events: Timeline.

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Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2019. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.

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