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. 2025 Sep 24.
doi: 10.1007/s10654-025-01300-2. Online ahead of print.

Evaluating the physical and psychosocial impact of serious physical combat injuries in UK armed forces personnel-the ADVANCE cohort study

Daniel Dyball  1 , Susie Schofield  2 , Howard Burdett  3 , Christopher J Boos  4 , Anthony M J Bull  5 , Paul Cullinan  6 , Nicola T Fear  3   7 , Alexander N Bennett  5   8 ; ADVANCE Study
Collaborators, Affiliations

Evaluating the physical and psychosocial impact of serious physical combat injuries in UK armed forces personnel-the ADVANCE cohort study

Daniel Dyball et al. Eur J Epidemiol. .

Abstract

The ADVANCE cohort study is a prospective cohort study investigating the impact of sustaining a serious physical combat injury whilst on deployment to Afghanistan on long-term health outcomes. The cohort will provide essential data on medical/psychosocial risk factors and outcomes associated with combat injury and establish injury-specific mechanisms of disease. Participants include UK Armed Forces personnel who sustained serious physical combat injuries and a frequency-matched comparison group who sustained no such injuries (uninjured group). The cohort consists of 1145 participants, with a baseline response rate of 59.6% for the injured group (n = 579) and 56.3% for the uninjured group (n = 566). The first follow up of this cohort retained 92% of the sample (n = 1053/1145). This cohort profile describes the baseline and first follow up demographics for ADVANCE, as well as details on published research projects spanning military epidemiology, physical health, including cardiovascular, respiratory, musculoskeletal and neurological, mental health and health-related behaviours. These projects comprise identification of early risk factors for disease and observed differences in health-characteristics between groups. Since baseline assessment of the cohort, ADVANCE has expanded investigations across physical and mental health domains, utilising advice from participant engagement and an international scientific advisory group. Researchers working on the ADVANCE cohort continue to engage with policy makers, clinicians and participants to ensure a wide-ranging impact from work conducted.Registration: The ADVANCE Study is registered at ISRCTN ID: ISRCTN57285353.

Keywords: ADVANCE cohort; Disease; Epidemiologic studies; Heart disease risk factors; Mental health; Military; Wounds and injuries.

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Conflict of interest statement

Declarations. Competing interests: N.T. Fear is part funded by a grant from the UK Ministry of Defence and is a trustee (nonpaid) of a charity supporting the health and wellbeing of service personnel, veterans and their families. A. Bennett is a serving member of the Royal Air Force. D.Dyball, S.Schofield, H.Burdett, C. Boos, A. Bull and P. Cullinan declare that they have no conflicts of interest. The views expressed are those of the author(s) and not necessarily those of the UK Ministry of Defence. Ethics approval/consent to participate: All procedures were undertaken in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. The UK Ministry of Defence Research Ethics Committee approved the study (ref: MODREC protocol No:357/PPE/12). All participants provided written informed consent.

References

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