Embedding Lived Expertise into Military and Veteran Medical Research

Abstract Military and Veterans health research has substantially advanced in recent decades, particularly in terms of analytic sophistication aimed at characterizing the biopsychosocial complexity of health through biomarkers, neuroimaging, and predictive modeling. However, formal models (e.g., governance structures) for including individuals with lived experiences to guide this work have not evolved at the same pace. Drawing on our collective perspectives as Veterans, Caregivers, and academic partners, this commentary examines the structural limitations of current engagement processes. Although community advisory boards or similar mechanisms have become increasingly common, engagement often occurs after key design decisions have been established, limiting meaningful influence on investigative topics, hypothesis formation, confounder identification, endpoint prioritization, and analytic strategy. Caregivers, including those supporting service members with traumatic brain injuries and post-traumatic stress disorder, remain even less integrated, despite their critical role in long-term recovery. Here, we propose a Patient-Researcher model characterized by upstream integration, sustained engagement, and structured mentorship. Embedding individuals with lived experiences throughout the research process strengthens construct validity, improves translational relevance, and better aligns research with the realities of military and Veteran life.