CHAMP initiates subspecialty evaluations of exertion-related illnesses (ERIs) through the Multidisciplinary Case Review Committee (MDCRC). MDCRC is made up of DoD leaders, researchers, and clinicians, including more than a dozen physicians and other experts who have appointments at either the Uniformed Services University of the Health Sciences (USU) or Walter Reed National Military Medical Center. Members of MDCRC have expertise in sports medicine, family medicine, neuromuscular medicine, genetics, cardiology, pulmonology, nutrition, or combinations of these.
Upon receiving a referral from a treating physician at a military treatment facility, MDCRC reviews the Service Member’s record and makes a joint clinical recommendation about whether the patient should be rested and returned to duty or sent for further evaluation. For those who require further evaluation, MDCRC typically recommends more tests, which might include neurologic examination with electromyography (EMG), exercise intolerance panel (EIP), muscle biopsy with caffeine-halothane contracture testing (CHCT), myoglobinuria panel, exercise testing (such as heat tolerance testing [HTT], step testing, and VO2max testing), or combinations of these. Results from these tests help MDCRC and a Service Member’s physician make treatment and return-to-duty decisions.
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