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       changes of the system, as were made in October and again in
       November, were perhaps inevitable. These changes did not take
       place without some confusion and misreporting. For example,
       three MTFs did not receive the October message and continued to
       report "miscellaneous medical conditions" under the code that had
       been changed (by the October message) to "sexually transmitted
       diseases" (SID). The resulting high SID rate was not only
       surprising,  it was inaccurate,

       3. The USCENTAF reporting system didn't include case
       definitions This caused some confusion and perhaps some
       reporting inconsistencies and data inaccuracies. For example,
       sunburn may have been reported as a dermatological condition
       rather than a heat injury

       4. Communication between MTFs and USCENTAF was by message
       and telephone. Messages were not always received. This was in
       part because until an AIG was created for all deployed MTFs, the
       location of each deployed MTF, including squadron medical
       elements, had to be known and listed individually on each
       message. In some cases SMEs redeployed and in others, the unit
       designation changed as wings grew and host units changed.
       Commercial and TAC telephone lines were set up and steadily
       improved, but were always completely overwhelmed by the volume of
       calls.

       5. The USCENTCOM report format caused some confusions
       especially regarding its "special categories".  For example, the
       data collector would have to count a diarrhea case three times;
       once as a "GI", once as a "SPEC CAT", as once as "diarrheal
       disease".

       VII. RECOMMENDATIONS:

       1. Define and publish a USAF DNBI reporting system for use
       by deployed MTFs. Compliment this system with computer software
       for MTFs and command use. This system should address the
       following Issues:

	a. Report communicable/environmental conditions only.
       Specifically,  consider deletion of "medical illnesses" as a
       category

	b. Specify which category of patients should be reported
       (e.g. USAF only compared to USAF base populations or report cases
       of all services but indicate the service of each patient]

	c. Include case definitions for each syndrome.

	d. The report format should permit only on, syndrome per
       line number to avoid confusion. There should be no double
       counting of cases.


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