# Presentation: 671572

## 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

**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

**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)

**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. 12)

**Personnel **
**Data**

**DMSS**

**Medical Data**
** ****In-patient**
** ****Ambulatory**
** ****Reportable Events**
** ****Immunizations**

## DMSS Structure and Functional Relationships(Adapted from: AJPH, Dec 2002, Vol 92, No. 12)

**DMSS**

**Serologic Data**
** ****Serum Specimens**

**PersonnelData**

**Medical Data**

## Slide 8

## 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)**

**DMSS**

**PersonnelData**

**Medical Data**

**Serologic Data**

**Deployment Data**
** ****Deployment**** ****Rosters**
** ****Pre/Post Health   **
**   ****Assessment**
** ****Disease & **
**   ****non-battle  **
**   ****injury (aggregate)**

## DMSS Structure and Functional Relationships(Adapted from: AJPH, Dec 2002, Vol 92, No. 12)

**MSMR**
**Ad hoc Requests**
**Studies/Analyses**
**Reports**

**Defense Medical Epidemiology Database (DMED)**

**DMSS**

**PersonnelData**

**Medical Data**

**Serologic Data**

**Deployment Data**

## 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**

## AMSA

** ****Internal Steering Committee**

**AMSA**

**FOH **
**Hiring & Administrative Support**

** ****Vaccine Analytic Unit**** (VAU) CDC/DoD/FDA**

**DMSS**

***IRBs***

**DATA**
**Outside**

**External Consultative Committee**

## Mission for theExternal 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

** ****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

**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**