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Invited Commentary
November 9, 2009

Back Pain: The Silent Military Threat: Comment on “Back Pain During War”

Arch Intern Med. 2009;169(20):1923-1924. doi:10.1001/archinternmed.2009.385

Before making any other comment, I wish to congratulate the authors for shedding light on a particularly significant but often underplayed aspect of modern military medicine. To this end, the US Medical Command should be applauded for allowing these data to be brought into the public domain. They should also be congratulated on their development of an electronic medical record that has allowed such comprehensive data collection. The fact that 1410 casualties have been followed up in such detail over thousands of miles and a number of medical facilities is a testament to its utility. The early data collection, with its loss of 97% of all missing variables, highlights the problems faced with epidemiological studies performed without such a system.