ccep critique

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Press Release -- For Immediate Release, Thursday 9 March 1995 page 1 of 2

For more information, call Albert Donnay, 410-448-3319

Independent Researchers Accuse Department of Defense

of Covering Up True Extent of Unexplained Illness in Persian Gulf Troops

The Department of Defense (DoD) greatly downplayed the true extent of "unexplained illness" in its Preliminary Report on the first 1,000 patients seen by its Comprehensive Clinical Evaluation Program (CCEP). Instead of finding unexplained illness in just 14% of the Persian Gulf veterans examined by the CCEP, as the DoD reported last December, it actually found that at least 70%-80% of those with illness of some kind were reporting at least one of the "unexplained" symptoms associated with Persian Gulf Syndrome.

The DoD's report dilutes the true extent of unexplained illness by including the 82 healthy veterans who did not have any symptoms (8% of the total) in its statistical calculations. It also misrepresents the CCEP's findings by ranking only each patient's primary diagnostic category. It offers no analysis of the multiple diagnoses that it admits are usually given to Persian Gulf veterans. The DoD reports that only 3%, for example, fell into the primary diagnostic category of fatigue, when--in reality--of the 92% who were sick, 65% reported this symptom. [See comparison table on reverse] It is not known what other diagnostic categories these cases of fatigue may have been assigned to since the DoD refuses to publicly release any further information.

These findings are documented by independent researchers Dr. Grace Ziem and Albert Donnay in a detailed critique of the DoD's report distributed in February to several Congressional and independent oversight committees. Based on the DoD's own data, Ziem and Donnay report that the average Persian Gulf veteran examined by the CCEP--regardless of diagnosis--suffers from 4 of the 9 most common "unexplained" symptoms associated with Persian Gulf Syndrome. Even though any one of these symptoms is sufficient to qualify for "unexplained illness" compensation (as defined by the Veterans' Administration latest rules), the DoD still insists that only 14% have "unexplained illness." Furthermore, what the DoD calls "unexplained" may really only be undiagnosed, as the symptom pattern being reported is strikingly similar to that seen in civilian patients with multiple chemical sensitivity and disorders of porphyrin metabolism.

Over 50,000 Persian Gulf veterans have already complained of health problems (10K to the CCEP and 40K to the VA). "The true extent of this syndrome obviously is much greater than the DoD appears willing to acknowledge, " said Dr. Ziem, who has tried unsuccessfully to get the DoD to diagnose or even track the multiple chemical sensitivities that she and other physicians are finding in so many sick veterans. She and Mr. Donnay recommend that DoD record all diagnoses being given to each patient (currently, it records only the first six) and that they rank these diagnoses by overall frequency, regardless of the primary diagnostic category. They also plan to closely monitor the DoD's next CCEP report, due out later this spring. "The only chance to restore any confidence in the CCEP," said Donnay, "is for the DoD to code all of its diagnostic data anonymously and make it available to independent researchers for peer review."

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2326 Pickwick Road, Baltimore, MD 21207-6631, 410-448-3319, fax 448-3317

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Press Release -- For Immediate Release, Thursday 9 March 1995 page 2 of 2

For more information, call Albert Donnay, 410-448-3319

Independent Researchers Accuse Department of Defense

of Covering Up True Extent of Unexplained Illness in Persian Gulf Troops

Comparison Table:

Frequency Distribution of Commonly Reported Symptoms vs. Primary Diagnosis Category Among The First 1,019 Persian Gulf Veterans Seen by the DoD's Comprehensive Clinical Evaluation Program; Showing Symptom Prevalence Obscured by DoD focus on Primary Diagnostic Category and Extent to Which Both Reported Symptoms and Diagnoses Are Diluted by Inclusion of 82 Healthy Veterans

Frequency Distribution of Commonly Reported Symptoms Percentages of Total approximated from DoD Figure 3; degree of overlap not discussed by the DoD.	% of Total* CCEP includes 8% Healthy (see DoD Table 1)	% of Sick CCEP(based on 92% of total with illness)	Frequency Distribution of Primary Diagnosis Categories That May Account for Commonly Reported Symptom Selected from DoD Table 1 based on the most obvious correlation(s) with the commonly reported symptom (we assume, for example, that the musculoskeletal diagnoses should account for the symptom of joint pains)	% of Total* CCEP includes 8% Healthy (see DoD Table 1)	% of Sick CCEP(based on 92% of total with illness)	% of Sick CCEP with Common Symptom Unrelated to Primary Diagnosis Category (obscured by the DoD's focus on Primary Diagnosis Categories)
Fatigue	60%	65%	Fatigue (listed under 14% "Other")	3%	3%	at least 62% of sick CCEP patients(=65-3)
Joint Pains	55%	60%	Musculoskeletal	16%	17%	at least 43% (=60-17)
Headache	50%	54%	Headache/CNS/Memory Loss (under "14% Other") and Tension Headache (under 24% "Psychological Conditions")	3% 5%	3% 7%	at least 51% (=54-3)
Memory Loss	44%	48%	Headache/CNS/Memory Loss (under 14% "Other")	3%	3%	at least 45% (=48-3)
Sleep Disturbances	43%	47%	Sleep Disorders (under 14% "Other")	3%	3%	at least 44% (=47-3)
Concentration [Impaired]	40%	44%	Headache/CNS/Memory Loss (under 14% "Other") and Nervous System	3% 6%	3% 7%	at least 41% (=44-3)
Rash	38%	41%	Skin & Subcutaneous	5%	5%	at least 36% (=41-5)
Muscle Pain	30%	33%	Musculoskeletal	16%	17%	at least 16% (=33-17)
Depression	30%	33%	Depression (under "Psychological")	8%	9%	at least 24% (=33-9)
Total % Reporting	390%	425%	=> These symptoms average 3.9 per CCEP patient but 4.25 per sick vet, regardless of primary diagnostic category.

Excerpted from:

"Critique of the Department of Defense's Comprehensive Clinical Evaluation Program for Gulf War Veterans, Preliminary Status Report on the First 1000 Patients (December 1994)"

by Donnay and Ziem, 22 February 1995.

Complete 6-page critique available from

MCS Referral & Resources, 2326 Pickwick Rd, Baltimore, MD 21207-6631; 410-448-3319.

For more information, contact Albert Donnay.
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Last Modified: 7/4/98