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Batuman F, Bean-Mayberry B, Goldzweig C, et al. Health Effects of Military Service on Women Veterans [Internet]. Washington (DC): Department of Veterans Affairs (US); 2011 May.

METHODS

TOPIC DEVELOPMENT

This project was nominated by Patricia Hayes, PhD, Chief Consultant for the Women Veterans Health Strategic Health Care Group, with input from a technical expert panel.

The final key questions are:

  • Key Question #1: What research has been published on the effects of deployment on post-deployment reproductive outcomes?
    We operationalized “reproductive effects” to encompass the following: fertility issues, birth defects, menstrual effects (e.g., change in cycles, loss of cycles), urinary tract infections, sexually transmitted infections, and reproductive cancers (e.g., cervical, ovarian, etc).
  • Key Question #2: What research has been published on post-trauma sequelae in OEF/OIF women Veterans, including: mental health problems, suicide, cardiovascular disease, risky health behaviors (including: tobacco use, hazardous alcohol use, substance abuse, homicide, assaultive behavior, and eating disorders), and other post-trauma sequelae?

SEARCH STRATEGY

The broader topic of research on women Veterans' health has been the subject of two previous systematic reviews from our group. Those reviews included articles meeting our eligibility criteria through the end of their respective search dates. Goldzweig et al. (2006)3 covered women Veterans' health and health care issues through 2004. In that systematic review, we identified 182 studies, including two randomized controlled studies and 180 studies with observational designs. Bean-Mayberry et al. (2010)4 updated the Goldzweig et al. search from 2004 through 2008. In that review, we identified 195 articles, with five articles describing results of randomized controlled trials. We assessed the original articles identified in these reviews for eligibility for inclusion in the current systematic review (as described below). We also developed a search strategy specific to the key questions for this review, covering the period from 2008 to the present. The search terms and Medical Subject Headings (MeSH) for the various search strategies are found in Appendix 1. Searches were conducted through August 2010.

STUDY SELECTION

Two team members (IML and PGS) reviewed the list of titles and selected articles for further review. Eligible articles had as their subject U.S. women Veterans, with a clear indication that they had been deployed, and reported outcomes on reproductive effects (including fertility issues, birth defects, menstrual effects, urinary tract infections, sexually transmitted diseases, and reproductive cancers); or had as their subject U.S. women Veterans of OEF/OIF and reported outcomes on post-trauma sequelae. Post-trauma sequelae included mental health problems, suicide, cardiovascular disease, risky health behaviors (including tobacco use, hazardous alcohol use, substance abuse, homicide, assaultive behavior, and eating disorders), and other post-trauma sequelae.

Because reviews of the effects of Agent Orange5 and Gulf War Syndrome6 already exist, we did not review their effects in any more detail in this review. Similarly, in our prior reports, we devoted sections to the literature on military sexual trauma (MST) and post-traumatic stress disorder (PTSD), and did not repeat that information here.

Because of the emerging nature of this particular literature, we did not require any restrictions on study design. Therefore, this review includes a wide range of observational and descriptive studies.

DATA ABSTRACTION

We abstracted the following data from included studies: sample characteristics, sample size, design, objectives, main measures, and main findings.

DATA SYNTHESIS

We constructed evidence tables showing the study characteristics and results for all included studies, organized by key question. (See Appendix 2 and Appendix 3.) We analyzed studies to compare their characteristics, methods, and findings. We compiled a summary of findings for each key question or clinical topic, and drew conclusions based on qualitative synthesis of the findings.

PEER REVIEW

A draft version of this report was sent to five peer reviewers and the report was extensively revised based on their input.

Cover of Health Effects of Military Service on Women Veterans
Health Effects of Military Service on Women Veterans [Internet].
Batuman F, Bean-Mayberry B, Goldzweig C, et al.
Washington (DC): Department of Veterans Affairs (US); 2011 May.

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