Background Mild traumatic brain injury (mTBI) occurs at a higher frequency among military personnel than among civilians. A common symptom of mTBIs is cognitive dysfunction. Health care professionals use neuropsychological assessments as part of a multidisciplinary and best practice approach for mTBI management. Such assessments support clinical diagnosis, symptom management, rehabilitation, and return-to-duty planning. Military health care organizations currently use computerized neurocognitive assessment tools (NCATs). NCATs and more traditional neuropsychological assessments present unique challenges in both clinical and military settings. Many research gaps remain regarding psychometric properties, usability, acceptance, feasibility, effectiveness, sensitivity, and utility of both types of assessments in military environments. Objective The aims of this study were to explore evidence regarding the use of NCATs among military personnel who have sustained mTBIs; evaluate the psychometric properties of the most commonly tested NCATs for this population; and synthesize the data to explore the range and extent of NCATs among this population, clinical recommendations for use, and knowledge gaps requiring future research. Methods Studies were identified using MEDLINE, Embase, American Psychological Association PsycINFO, CINAHL Plus with Full Text, Psych Article, Scopus, and Military & Government Collection. Data were analyzed using descriptive analysis, thematic analysis, and the Randolph Criteria. Narrative synthesis and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews) guided the reporting of findings. The psychometric properties of NCATs were evaluated with specific criteria and summarized. Results Of the 104 papers, 33 met the inclusion criteria for this scoping review. Thematic analysis and NCAT psychometrics were reported and summarized. Conclusions When considering the psychometric properties of the most commonly used NCATs in military populations, these assessments have yet to demonstrate adequate validity, reliability, sensitivity, and clinical utility among military personnel with mTBIs. Additional research is needed to further validate NCATs within military populations, especially for those living outside of the United States and individuals experiencing other conditions known to adversely affect cognitive processing. Knowledge gaps remain, warranting further study of psychometric properties and the utility of baseline and normative testing for NCATs.

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BACKGROUND Mild traumatic brain injuries (mTBI) occurs at a higher frequency among military personnel than civilians. A common symptom caused by mTBI is cognitive dysfunction. Neuropsychological assessments are used by healthcare professionals as part of a multidisciplinary and best practice approach for mTBI management. Such assessments support clinical diagnosis, symptom management, rehabilitation, and return-to-duty planning. Military healthcare organizations currently use computerized neurocognitive assessment tools (NCATs). NCATs and more traditional “pen and paper” neuropsychological assessments present unique challenges both in clinical and military settings. Many research gaps remain regarding psychometric properties, usability, acceptance, feasibility, effectiveness, sensitivity, and utility of both types of assessments in military environments. OBJECTIVE (1) To explore what evidence exists regarding the use of NCATs among military personnel who have sustained mTBI; (2) evaluate the psychometric properties of the most commonly tested NCATs for this population, and; (3) synthesize the data to explore the range and extent of NCATs among this population, clinical recommendations for use, and knowledge gaps requiring future research. METHODS Studies were identified using MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica dataBASE), APA (American Psychological Association) PsycINFO, CINAHL (Cumulative Index of Nursing and Allied Health Literature) Plus with Full Text, Psych Article, Scopus, and Military & Government Collection. Data were analyzed via descriptive analysis, thematic analysis, and the Randolph Criteria. Narrative synthesis and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guided reporting of findings. Criteria proposed by Randolph et al. (2005) were utilized to evaluate the psychometrics of currently utilized NCATs. RESULTS Of 104 articles, 33 studies met the inclusion criteria for this scoping review. Thematic analysis and NCAT psychometrics were reported and summarized. CONCLUSIONS The psychometric properties of the most commonly used NCATs in military populations have yet to demonstrate adequate validity, reliability, sensitivity, and clinical utility among military personnel with mTBI. Additional research is needed to further validate NCATs within military populations, especially for (1) those living outside of the US and (2) individuals experiencing other conditions known to adversely affect cognitive processing. Knowledge gaps remain warranting further study of psychometric properties and the utility of baseline and normative testing for NCATs.