I just had a quick look at the rapid responses to this article in a recent BMJ. As you know, I recently did a BLOG on Predicting Mental Illness in Soldiers (http://bmjjournals.wordpress.com/2007/09/21/mental-illness-in-deployed-soldiers/ ).
It is obviously very important indeed to see what can be done to avoid MENTAL Illness in general and in Soldiers in particular as we send them on missions. Now obviously the first thing in soldiers that you could do, is stop going to silly, avoidable conflicts. Something the authors didn’t mention. But we all know that there are too many conflicts and many are about what????
Furthermore, deployment is an essential ingredient of military life, is considered a valuable feature of a military career, and for many is the reason for joining up. But at some stage any human being has reached its point of no return and will break if pushed any further. You don’t need to be a psychiatrist to know that.
An interesting response was the following comment by Dr Abraham George, SpR Public Health, Manchester :
“However, we would also like to raise a number of methodological issues: · In the Methods section, the authors stated a total 10,272 personnel (4722 deployed plus 5550 non deployed personnel) followed by sample of 5547 regulars. However, the results section states “ Overall 5547 (63.9%) out of 8686 regulars who completed the questionnaire had participated in at least one deployment in the past 3 years.” A flow chart describing the recruitment process of the study participants would have helped explain the inclusion, exclusion and response rate details. · No mention was made how the authors calculated the expected sample size of the study. · Considering that only two of the outcomes measured showed a marginal association with operational tempo, could it have been possible that sample size was found to be inadequate even though the overall response rate was good? ·
Under the Discussion section, the authors state that information bias is unlikely because the outcome measurements were objective. This is incorrect because self reported responses are subjective measures.”
Now you would think that a professor etc would know this. So I would say, a very important issue to study, but too many flaws in the study itself. Unfortunately.
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