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Charles C. Engel, Jr, MD, MPH
Uniformed Services University of the Health Sciences Bethesda, Md

Zhongren Jing, PhD
Walter Reed Army Medical Center Washington, DC

JAMA. 1997;278(5):383-384.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Although Dr Haley and coinvestigators¹ have made a valiant attempt to define Gulf War-related syndromes among Gulf War veterans, a key methodological limitation of their study is the inability to support a link between service in the Gulf War and the syndromes that were uncovered.

To conclude that syndromes are related to service in the Gulf War because they are found among Gulf War veterans is premature. The possibility that the same methods applied to a sample of nondeployed, Gulf War-era veterans would find a similar proportion of veterans reporting the same syndromes cannot be excluded. The authors note their sample consists of healthy and ill Gulf War veterans. However, to link syndromes to Gulf War service, this distribution of subjects cannot substitute for a non-Gulf War veteran control group. Similarly, observing relationships among exposures reported by veterans, clinically derived case criteria, or biological factors cannot substitute for an . . . [Full Text PDF of this Article]

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