MSI affects approximately 800,000 service members annually, resulting in 25 million days of limited duty. These conditions are the primary reasons for medical discharge and downgrade, and result in 34% of medical evacuations from theatre. Most concerning is that the disability discharge rate for MSI has increased 13x between 1981 and 2005 (70 vs. 950 per 100,000 persons), which negatively impacts cost, care, and utilization within the military health system.
Given the strict requirements for physical fitness in the military, and impact of MSI on combat readiness, the Defense Health Agency has supported the creation of MIRROR, which will provide critical infrastructure, operational and research support to advance the treatment and preventive care for service members with non-combat related MSI. Headquartered at the Uniformed Services University, MIRROR will coordinate inter-service partnerships with the primary military treatment facilities, and other sites that experience a high volume of MSI, but lack a robust infrastructure to conduct rigorous clinical studies.