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An Overview of the Defense Medical Surveillance System The DMSS Project. Laura H. Franzke, PhD, MPH National Immunization Program NVAC, June 4 th , 2003. Background.

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An Overview of theDefense Medical Surveillance System The DMSS Project

Laura H. Franzke, PhD, MPH

National Immunization Program

NVAC, June 4th, 2003


Background
Background

  • CDC was charged by Congress to undertake collaborative studies regarding the safety and efficacy of the anthrax vaccine adsorbed (AVA)

  • NIP is working collaboratively with the DoD and FDA to investigate potential adverse events associated with AVA using the DoD’s Defense Medical Surveillance System (DMSS) database


Purpose
Purpose

  • To perform hypothesis testing and hypothesis generation with the DMSS

  • Examine the possibility that long term adverse effects are associated with AVA


Institute of Medicine (An Assessment of the CDC Anthrax Vaccine Safety and Efficacy Research Program, IOM of the National Academies, 2003)

  • “HIGH PRIORITY: Linkages of the Defense Medical Surveillance Systems and other databases for longer-term follow-up of military personnel who received AVA”


Dmss structure and functional relationships adapted from ajph dec 2002 vol 92 no 12
DMSS Structure and Functional Relationships(Adapted from: AJPH, Dec 2002, Vol 92, No. 12)

  • Personnel Data

  • Active Duty

  • Reserve Component

  • Active Duty Casualty

  • Military Entrance

  • Processing Stations

DMSS


Dmss structure and functional relationships adapted from ajph dec 2002 vol 92 no 121
DMSS Structure and Functional Relationships(Adapted from: AJPH, Dec 2002, Vol 92, No. 12)

Personnel

Data

  • Medical Data

  • In-patient

  • Ambulatory

  • Reportable Events

  • Immunizations

DMSS


Dmss structure and functional relationships adapted from ajph dec 2002 vol 92 no 122
DMSS Structure and Functional Relationships(Adapted from: AJPH, Dec 2002, Vol 92, No. 12)

PersonnelData

Medical Data

  • Serologic Data

  • Serum Specimens

DMSS


Dmss structure and functional relationships adapted from ajph dec 2002 vol 92 no 123
DMSS Structure and Functional Relationships(Adapted from: AJPH, Dec 2002, Vol 92, No. 12)

  • Deployment Data

  • DeploymentRosters

  • Pre/Post Health

  • Assessment

  • Disease &

    non-battle

  • injury (aggregate)

PersonnelData

Medical Data

Serologic Data

DMSS


Dmss structure and functional relationships adapted from ajph dec 2002 vol 92 no 124
DMSS Structure and Functional Relationships(Adapted from: AJPH, Dec 2002, Vol 92, No. 12)

PersonnelData

Medical Data

Serologic Data

Deployment Data

DMSS

MSMR

Ad hoc Requests

Studies/Analyses

Reports

Defense Medical Epidemiology Database (DMED)


Medical Surveillance Monthly Report (MSMR)

DMED: Defense Medical Epidemiological Database

http://amsa.army.mil


  • AMSA: Army Medical Surveillance Activity

  • FOH: Federal Occupational Health

  • VAU: Vaccine Analytic Unit

  • Internal Steering Committee: CDC, DoD, FDA

  • External Consultative Committee:

    • National Vaccine Advisory Committee


DMSS Project Organizational Structure

External Consultative Committee

Internal Steering Committee

FOH

Hiring & Administrative Support

AMSA

IRBs

Vaccine Analytic Unit (VAU) CDC/DoD/FDA

DATA

Outside

DMSS


Mission for the external consultative committee
Mission for theExternal Consultative Committee

  • The External Consultative Committee will act as an “Advisory” scientific committee providing expert advice regarding the development and growth for the DMSS Project.


Roles and responsibilities for the external consultative committee
Roles and Responsibilities for theExternal Consultative Committee

  • Make recommendations about priority

    hypotheses to study

  • Provide advice and comment on study

    protocols

  • Periodically updated about study procedures

  • and progress

  • Review results from analyses of DMSS data

  • Provide advice on study results manuscripts

    and dissemination


External consultative committee
External Consultative Committee

  • Time Commitment: 3-5 years

  • Meetings: Twice a year in-person (during NVAC meetings) and occasionally by teleconference

  • Members: Requesting approximately 5 members from NVAC

  • Expertise: Epidemiology, internal medicine, immunology, vaccine safety, military medicine


Acknowledgements

DOD

Mark Rubertone

John Grabenstein

John Brundage

Jeff Lange

DMSS Staff

CDC

Ben Schwartz

Mike McNeil

Bruce Tierney

Phil Rhodes

Stacey Martin

Paul Stehr-Green

Betsy Cadwell

Roseanne English-Bullard

Kelly Bell

FDA

Bob Ball

Dale Burwen

Jane Woo

FOH

Wayne Grant

Richard Horn

AVEC


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