Correspondence
Correspondence HEALTH NUT IN "DON'T DESPAIR OVER DISPARITIES"(March 1), Sally Satel and Jonathan Klick misquote the Kaiser Family Foundation (KFF) and the American College of Cardiology Foundation...
...Such studies are invaluable to understand the meaning and impact of treatment differences...
...As Gen...
...Moreover, now that the redesigned V-22 is performing superbly in its congressionally mandated flight test program, it is time for the Army to consider acquiring it to support both near-term operations and the activities of the future force...
...Cody himself explained: "The Longbow with full block III [upgrade] capability gives us all the digital connectivity, the battlefield awareness, the battlefield situational understanding that we would get with block I Comanche...
...True, the Army will have to invest heavily in UAVs, which are costly...
...This alone makes it important that the Osprey program proceed...
...We did report that the majority of studies (68 of the 81) found racial/ethnic differences in cardiac care for at least one of the minority groups included in each study...
...Another system that the Army must acquire is the Aerial Common Sensor (ACS), a smallish commercial jet loaded with advanced sensors and communications gear...
...AMERICAN CHOPPER JOHN R. GUARDIANO may be right when he concludes in "A Fitting End for the Comanche" that terminating the Comanche helicopter program was necessary, given all the other needs confronting the U.S...
...That's why both the aerial common sensor and Apache Longbow upgrades are important to the Army...
...We did...
...The KFF/ACCF review of the evidence did not result in a finding that "the overwhelming majority of studies found no mortality differences between races despite lower rates of procedures for blacks," as reported by Satel and Klick...
...in 2, mortality was greater for black patients...
...Upgrading the Apache attack helicopter or older utility helicopters is important, but this will not enhance the Army's tactical reconnaissance capabilities...
...Moreover], the fire-control radar on Longbow block III is the same fire-control radar [that would have been used on the] block I Comanche...
...indeed, many of the same types of "advanced sensors and communications gear" that Goure touts as justification for the aerial common sensor can and will be used on the Apache Longbow...
...The ACS will replace several aging Army intelligence, surveillance, and reconnaissance platforms...
...That's the beauty of joint, interservice procurements: They are more economical and beneficial since they exploit larger economies of scale...
...Army UAvs performed very well in Operation Iraqi Freedom...
...Racial/ethnic differences in care were found when examining all studies, as well as the subset of studies classified as the methodologically strongest...
...But because UAVs are a pentagon priority that involves all of the services, the Army can capitalize on the military's entire UAV investment in a way that would not have been possible with Comanche...
...The question of racial differences in the outcomes of cardiac care warrants further investigation, but that research should not delay the uniform application of guidelines for optimal cardiac care across racial/ethnic groups...
...DAN GOURE Arlington, VA JOHN R. GUARDIANO RESPONDS: Dan Goure is right about the transformational significance of the V-22 Osprey transport rotocraft...
...As Guardiano points out, investing in unmanned aerial vehicles (UAVs) will be part of the solution...
...There's no question that more studies need to focus on morbidity and mortality outcomes...
...That's what we found when we examined the 11 studies cited in the report that specifically looked at mortality differences following cardiac procedures (in 9 of them mortality between white and black patients were comparable or less in blacks than whites...
...aerial surveillance programs...
...Finally, with the cancellation of the Comanche, the United States has one and only one transformational rotocraft program left: the V-22 Osprey...
...Innovative UAV concepts like the Fire Scout, an unmanned rotocraft based on the popular Schweizer helicopter that can take off and land vertically, are important projects ready for funding...
...Lots of the money saved on the Comanche program will have to be spent to develop and deploy UAVs...
...The KFF/ACCF review did not assess health outcomes, such as mortality, related to cardiac care, in part because too few studies systematically addressed the issue to form a conclusion...
...But that decision leaves open the question of what is to be done with U.S...
...These latter studies are important because they controlled for critical variables (such as age, severity of heart disease, and insurance coverage) that could otherwise account for racial/ethnic differences in care...
...However, he is mistaken when he says that "upgrading the Apache . . . will not enhance the Army's tactical reconnaissance capabilities...
...Kaiser itself did not state that "the overwhelming majority found no mortality differences between races despite lower rates of procedures for blacks...
...But UAVs and armed helicopters will not be sufficient to provide the transformed Army with the surveillance and reconnaissance capabilities needed in the 21st century...
...MARSHA LILLIE-BLANTON Henry J. Kaiser Family Foundation Washington, DC SATEL AND KLICK RESPOND: Marsha Lillie-Blanton is right...
...Army (March 8...
...Correspondence HEALTH NUT IN "DON'T DESPAIR OVER DISPARITIES"(March 1), Sally Satel and Jonathan Klick misquote the Kaiser Family Foundation (KFF) and the American College of Cardiology Foundation (ACCF) report on racial differences in cardiac care...
Vol. 9 • March 2004 • No. 27
