Burden of Musculoskeletal Injuries in U.S. Active Duty Service Members: A 12-Year Study Spanning Fiscal Years 2010-2021.

Background: Musculoskeletal injuries (MSKIs) represent the most substantial and enduring threat to U.S. military readiness.

Musculoskeletal Injury Surveillance in the U.S. Military: Analysis of the ICD-10-CM Transition and Descriptive Report of Health Care Utilization at Four Sites Adopting MHS GENESIS.

Introduction: The U.S. Military Health System (MHS) transitioned to the ICD-10-CM coding scheme in October 2015 and began the phased rollout of a new electronic health record system, MHS GENESIS, in October 2017.

Capturing and Categorizing the Burden of Musculoskeletal Injuries in U.S. Active Duty Service Members: A Comprehensive Methodology.

Background: Musculoskeletal injuries (MSKIs) represent the most common, costly, and impactful medical conditions affecting active duty service members (ADSMs) of the United States Armed Forces. Inconsistent, variable MSKI surveillance methods and often incompletely described criteria for cohort selection, injuries, incidence, and prevalence have limited efforts to observe longitudinal trends, identify gaps in care, or highlight specific military branches or sites that could benefit from enhanced MSKI intervention protocols. The purpose of this manuscript is to present a comprehensive, well-documented, and reproducible framework for capturing and categorizing MSKI burden, healthcare utilization, and private sector costs for ADSMs across a 12-year period spanning the International Classification of Diseases, 10th Revision, Clinical Modification transition.

Musculoskeletal Spine Injuries in U.S. Active Duty Service Members: Prevalence/Incidence, Healthcare Utilization, and Cost Analysis Spanning Fiscal Years 2016-2021.

Background: Low back pain and musculoskeletal injuries (MSKIs) of the Spine are the most common reason for U.S. active duty service members (ADSMs) to seek medical care.

Lower Extremity Musculoskeletal Injuries in United States Active Duty Service Members: Prevalence/Incidence, Health Care Utilization, and Cost Analysis Spanning Fiscal Years 2016-2021.

Introduction: Lower Extremity musculoskeletal injuries (LE MSKIs) represent a significant portion of overuse injuries in active duty service members (ADSMs). However, variations in study methods and research gaps related to LE MSKIs have prevented Department of Defense (DoD) leaders from assessing the burden of these conditions. The purpose of this study was to report the incidence, prevalence, and types of LE MSKIs sustained by ADSMs across four branches of service and describe associated health care utilization and private sector costs.

Musculoskeletal Injuries in Female U.S. Active Duty Service Members: Prevalence/Incidence, Health Care Utilization, and Cost Analysis Spanning Fiscal Years 2016-2021.

Introduction: Musculoskeletal injuries (MSKIs) are highly prevalent and costly conditions among active duty service members (ADSMs), and female service members sustain these injuries at a higher rate than men. However, lack of women-specific research regarding MSKIs in the U.S.

Musculoskeletal Head and Neck Injuries in U.S. Active Duty Service Members: Prevalence/Incidence, Health Care Utilization, and Cost Analysis Spanning Fiscal Years 2016-2021.

Background: Active duty service members (ADSMs) of the U.S. Armed Forces are uniquely at risk for musculoskeletal injuries (MSKIs) of the Head/Neck region, including the eye and face, from training with head gear, donning Kevlar, operating aircraft, and maintaining sitting or standing postures for prolonged durations.

Upper Extremity Musculoskeletal Injuries in United States Active Duty Service Members: Prevalence/Incidence, Health Care Utilization, and Cost Analysis Spanning Fiscal Years 2016-2021.

Introduction: Upper Extremity musculoskeletal injuries (UE MSKIs) represent a major threat to the overall health and readiness of U.S. active duty service members (U.

Time to Gender-Affirming Hormone Therapy Among US Military-Affiliated Adolescents and Young Adults.

Importance: Use of exogenous sex steroid hormones, when indicated, may improve outcomes in adolescents and young adults with gender incongruence. Little is known about factors associated with the time from diagnosis of gender dysphoria to initiation of gender-affirming hormone therapy. Identification of inequities in time to treatment may have clinical, policy, and research implications.

Incidence and prevalence of eating disorders among U.S. military service members, 2016-2021.

Objective: Despite unique experiences that may increase eating disorder risk, U.S. military service members are an understudied population.

Variation in Time-to-Gender-Affirming Hormone Therapy in US Active Duty Service Members.

Background: Beginning in July 2016, transgender service members in the US military were allowed to receive gender-affirming medical care, if so desired.

Objective: This study aimed to evaluate variation in time-to-hormone therapy initiation in active duty Service members after the receipt of a diagnosis indicative of gender dysphoria in the Military Health System.

Research Design: This retrospective cohort study included data from those enrolled in TRICARE Prime between July 2016 and December 2021 and extracted from the Military Health System Data Repository.

Health Care Utilization During the First 5½ Years of Authorized Service by Transgender U.S. Service Members (2016-2021).

This study examined the utilization of gender-affirming health care by active-duty service members during the initial 5½ years that transgender and gender-diverse (TGD) individuals were authorized to serve in the U.S. military.

Incidence and prevalence of eating disorders among active duty US military-dependent youth from 2016 to 2021.

Objective: The offspring of US military service members may be at increased risk for eating disorders. However, no epidemiological studies to date have evaluated eating disorder incidence rates and prevalence estimates among military-dependent youth.

Method: This retrospective cohort study examined eating disorder diagnoses in the military healthcare system (MHS) from 2016 through 2021.

Survival of anterior cruciate ligament reconstructions in active-duty military populations.

Purpose: Anterior cruciate ligament tears and anterior cruciate ligament reconstruction (ACLR) are common in young athletes. The modifiable and non-modifiable factors contributing to ACLR failure and reoperation are incompletely understood. The purpose of this study was to determine ACLR failure rates in a physically high-demand population and identify the patient-specific risk factors, including prolonged time between diagnosis and surgical correction, that portend failure.

Illustration of Continuous Enrollment and Beneficiary Categorization in DoD and VA Infrastructure for Clinical Intelligence.

Introduction: The DoD and VA Infrastructure for Clinical Intelligence (DaVINCI) data-sharing initiative has bridged the gap between DoD and VA data. DaVINCI utilizes the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) to map DoD and VA-specific health care codes to a standardized terminology. Although OMOP CDM provides a standardized longitudinal view of health care concepts, it fails in capturing multiple and changing relationships beneficiaries have with DoD and VA as it has a static (vs.

Active Duty Service Members Newly Presenting With Low Back Pain in Fiscal Year 2017: Health Care Utilization, Access to Care, and Private Sector Costs Over 2-year Follow-up.

Introduction: Low back pain (LBP) has accounted for the most medical encounters every year for the past decade among Active Duty Service Members (ADSMs) of the U.S. Armed Forces.

Characterization of Cartilage Injury and Associated Treatment at the Time of Primary Anterior Cruciate Ligament Reconstruction.

Anterior cruciate ligament (ACL) tears with concomitant cartilage injuries resulting in ACL reconstruction (ACLR) with cartilaginous procedures are common in the young, high-demand population. The purpose of this study was to report and characterize cartilage treatments performed at the time of index ACLR reconstruction and to determine if those treatments are associated with revision surgery (of any kind) in the 4-year follow-up. We performed a consecutive series of active duty service members in the Military Health System Data Repository with ACLR with and without concomitant cartilage procedures done at military facilities between October 2008 and September 2011.

Lessons Learned in Providing Claims-Based Data to Participants in Health Care Innovation Models.

The Centers for Medicare & Medicaid Services (CMS) has been providing data to organizations participating in a range of innovation models to help them implement interventions and to provide feedback on performance. The authors studied 18 CMS models to gain a better understanding of factors contributing to model participants' use or nonuse of CMS-provided data. Factors that contribute to greater use include providing data that participants view as actionable, some type of accountability for performance, robust learning support, participants having resources to work with the data, and soliciting ongoing feedback about the data and related learning needs.