Armed Services Trauma and Rehabilitation Outcome Study, 2015-2023

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The ArmeD SerVices TrAuma RehabilitatioN OutComE (ADVANCE) Study a is a lifetime prospective cohort study which aims to determine the long-term effects on both physical and psychosocial health of servicemen surviving severe combat related trauma. Approximately 1,200 Afghanistan-deployed male UK military personnel and veterans have been recruited and will attend regular study visits. Half of the participants have sustained combat trauma, and the other half act as the control group. Participants undergo a series of physical health tests and questionnaires through which information is collected on cardiovascular disease (CVD), CVD risk factors, musculoskeletal disease, TBI, mental health, functional and social outcomes, quality of life, employment and more. The Study has a Ministry of Defence Research Ethics Committee approval. The objective of the ADVANCE Study is to investigate the long-term medical and psychosocial outcomes of UK military personnel who sustained combat trauma. We hypothesise that combat trauma casualties will have an increased incidence of adverse medical, psychosocial and vocational long-term outcomes compared with equivalent but non-injured service personnel. The ADVANCE Study is, worldwide, the only longitudinal cohort study evaluating the effect of combat trauma on a range of health indicators in military personnel who served in the Afghanistan war. ADVANCE will provide a wide range of longitudinal data across sociodemographic, physical health and mental health outcomes, providing evidence for incidence and risk of disease and non-disease outcomes. ADVANCE will provide high levels of evidence that will influence future healthcare of combat and major trauma patients. Participants were injured between 5 and 16 years prior to baseline data collection, and the length of time since injury may have an effect on various physical and mental health indicators. As with any cohort study, there is potential for response bias.

The ADVANCE study is a prospective cohort study of British male military personnel who were deployed on combat operations to Afghanistan between 2003 and 2014. The sample includes serving and former personnel; a group which sustained severe combat-related trauma during the Afghanistan conflict (injured) and a comparison group of the same size matched based on deployment to Afghanistan, age, sex, service, regiment, rank, and role-in-theatre (uninjured).