Abstract
We thank Dr Iserson for his thoughtful letter and the opportunity to further comment on the findings of our study.1,2 His letter highlights challenges recognized across operational medicine, including underdisclosure during medical screening and imperfect adherence to preventive measures during deployment.3–8 In Antarctica, as in other austere settings, these challenges arise within complex operational systems and may shape patterns of medical evacuation. They are not always fully reflected in the records available for retrospective study.
Within the scope of data that could be assembled, our objective was to improve visibility across the Antarctic medical evacuation continuum by reconciling available Department of Defense and civilian records. That approach allowed us to describe broad patterns of medical evacuation, source overlap, and documentation differences while also clarifying that each system captures a different part of the continuum. The dataset was suited to describing overall medical evacuation activity but less able to reliably resolve upstream contributors at the individual level, particularly given archival data stewardship and linkage constraints across systems. We agree that more standardized and integrated datasets will be important for future study of potentially modifiable contributors to medical evacuation risk. We believe that the analysis provides a unified descriptive framework for Antarctic medical evacuation activity within a civilian–military partnership operating under severe environmental constraints.
Note
The views expressed in this letter are those of the authors and do not reflect the official views or policy of the Department of Defense, its components, the National Science Foundation, the University of Texas Medical Branch, or the University of Virginia. The views of any manufacturer are not necessarily the official views of, or endorsed by, the US government, the Department of Defense, or the Department of the Air Force. No federal endorsement of any manufacturer is intended.
