{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T11:11:17Z","timestamp":1661512277521},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"9-10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,25]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>American military personnel in U.S. Africa Command (AFRICOM) operate in a continent triple the size of the USA without mature medical facilities, requiring a substantial transportation network for medical evacuation. We describe medical transportation based on ophthalmic complaints analyzed from the U.S. Transportation Command Regulating and Command and Control Evacuation System (TRAC2ES) database from 2008 to 2018.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective review of all TRAC2ES records for medical evacuations for ophthalmic complaints from the AFRICOM theater of operations conducted between January 1, 2008 and December 31, 2018. We analyzed free-text data in TRAC2ES for ophthalmic diagnostic and therapeutic interventions performed before established patient movement requests. An expert panel analyzed evacuations for their indications and interventions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Nine hundred and sixty-one total records originating within AFRICOM were identified in TRAC2ES. Forty-three cases (4%) had ophthalmic complaints. The majority of transports were routine (72%) and originated in Djibouti (83%), and all were transported to Landstuhl Regional Medical Center. The majority of patients were evacuated without a definitive diagnosis (60%). Leading ophthalmic diagnoses were chalazion (14%), corneal abrasion\/ulcer (14%), and posterior vitreous detachment (12%). More than one-quarter of patients were transported without recorded evaluation and approximately half (51%) did not receive any intervention before evacuation. Consultation with an ophthalmologist occurred in only 16 (37%) cases. By majority, the expert panel deemed 12 evacuations (28%) potentially unnecessary.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Evacuations were primarily routine often for disease etiology and further diagnostic evaluation. These findings support opportunities for telemedicine consultation to avoid potentially unnecessary transportation. Increased ophthalmic care and enhanced data collection on transports would support process improvement, optimize ophthalmic care by ensuring proper disposition of patients thus limiting unnecessary evacuations, and ultimately strengthen the entire fighting force.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usab134","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T20:45:48Z","timestamp":1617828348000},"page":"e1148-e1152","source":"Crossref","is-referenced-by-count":0,"title":["A Sub-Analysis of U.S. Africa Command Area of Operations Transportations for Ophthalmic Concerns, 2008\u20132018"],"prefix":"10.1093","volume":"187","author":[{"given":"Adam H H","family":"Altman","sequence":"first","affiliation":[{"name":"Brooke Army Medical Center , Joint Base San Antonio\u2014Fort Sam Houston, TX 78234, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon M","family":"Carius","sequence":"additional","affiliation":[{"name":"Brooke Army Medical Center , Joint Base San Antonio\u2014Fort Sam Houston, TX 78234, USA"},{"name":"121 Field Hospital, Camp Humphreys , APO, AP 96205, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grant A","family":"Justin","sequence":"additional","affiliation":[{"name":"Brooke Army Medical Center , Joint Base San Antonio\u2014Fort Sam Houston, TX 78234, USA"},{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven G","family":"Schauer","sequence":"additional","affiliation":[{"name":"Brooke Army Medical Center , Joint Base San Antonio\u2014Fort Sam Houston, TX 78234, USA"},{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD, USA"},{"name":"U.S. Army Institute of Surgical Research , JBSA Fort Sam Houston, TX 78234, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mireya A","family":"Escandon","sequence":"additional","affiliation":[{"name":"59th Medical Detachment Wing , Joint Base San Antonio\u2014Lackland, San Antonio, TX 78236, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph K","family":"Maddry","sequence":"additional","affiliation":[{"name":"Brooke Army Medical Center , Joint Base San Antonio\u2014Fort Sam Houston, TX 78234, USA"},{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD, USA"},{"name":"59th Medical Detachment Wing , Joint Base San Antonio\u2014Lackland, San Antonio, TX 78236, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A","family":"Mazzoli","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD, USA"},{"name":"Madigan Army Medical Center , Tacoma, WA 98431, 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