Table 3.
Summary of key clinical outcomes and strength of evidence.
| Outcome | Study design/number of studies | Findings and direction | Overall strength of evidence |
|---|---|---|---|
| Cardiovascular mortality | |||
| -CTI | Cohort 2, x-sectional 0 | 2 Positive 0 Negative | Moderate ROB; low SOE |
| -Combat only | Cohort 4, x-sectional 0 | 3 Neutral; 1 Negative (lower risk in combat vs control) | Moderate ROB; insufficient SOE |
|
| |||
| CHD mortality | |||
| -CTI | Cohort 2, x-sectional 0 | 2 Positive | Moderate ROB; low SOE |
| -Combat only | Cohort 1, x-sectional 0 | 1 Negative (lower risk in combat vs control) | Moderate ROB; insufficient SOE |
|
| |||
| CHD/myocardial infarction | |||
| -CTI | Cohort 1, x-sectional 3 | 2 Positive; 2 Neutral | High ROB, Insufficient SOE |
| -Combat only | Cohort 2, x-sectional 4 | 3 Positive: 3 Neutral | High ROB, Insufficient SOE |
|
| |||
| Stroke | |||
| -CTI | Cohort 1, x-sectional 1 | 2 Neutral | High ROB, Insufficient SOE |
| -Combat only | Cohort 1, x-sectional 4 | 3 Positive and 2 Neutral | High ROB, Insufficient SOE |
|
| |||
| Aortic aneurysm | |||
| -Combat only | Cohort 0, x sectional 2 | 2 Positive | High ROB, Insufficient SOE |
| -CTI | Cohort 0, x-sectional 0 | No studies | Insufficient |
|
| |||
| Carotid intimal thickness (CIMT) | |||
| -CTI | Cohort 0, x-sectional 0 | No studies | Insufficient |
| -Combat only | Cohort 1, x-sectional 0 | 1 x Positive; No blinding; No difference in carotid plaque | Moderate ROB, Insufficient SOE |
|
| |||
| Diabetes mellitus | |||
| -CTI | Cohort 2, x-sectional 6 | 4 Positive 4 Neutral | High ROB, Insufficient SOE |
| -Combat only | Cohort 2, x-sectional 5 | 2 Positive, 3 Neutral, 2 Negative | High ROB, Insufficient: high ROB |
|
| |||
| Hypertension | |||
| -CTI | Cohort 1, x-sectional 9 | 5 Positive; 5 Neutral | High ROB, Insufficient SOE |
| -Combat only | Cohort 3, x-sectional: 6 | 4 Positive, 4 Neutral, 1 Negative | High ROB, Insufficient SOE |
|
| |||
| Metabolic syndrome | x-sectional: 1 | CTI: 1 x Neutral | CTI: Insufficient |
| -CTI | Cohort 0, x-sectional 1 | 1 Positive | Very high ROB, Insufficient |
| -Combat only | No studies | Insufficient | |
|
| |||
| Hyperlipidaemia | |||
| -CTI | Cohort 2, x-sectional 6 | 2 Positive, 6 Neutral (variable or unreported case definition) | High ROB, insufficient SOE |
| -Combat only | Cohort 1, x-sectional 2 | 1 Positive, 2 Neutral | High ROB, insufficient SOE |
CTI, combat related traumatic injury; CHD, coronary heart disease; SOE, strength of evidence; ROB, risk of bias; RR relative risk; OR, odds ratio; Negative studies refer to significantly lower risk of outcome vs control in active group.