Postdeployment traumatic brain injury screening questions: Sensitivity, specificity, and predictive values in returning soldiers.

Terrio, Heidi; Nelson, Lonnie A.; Betthauser, Lisa M.; Harwood, Jeri E. F.; Brenner, Lisa A.

doi:10.1037/a0022685

Cited by 47 publications

(25 citation statements)

References 21 publications

(39 reference statements)

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“…Of note, the VA TBI screen missed 15% of veterans who were diagnosed with a military TBI during OEF/OIF/OND deployment on the BAT-L. Given that the goal of the VA TBI screen is to identify those with current symptoms who have not previously been diagnosed with TBI for further evaluation, this reinforces the finding of Terrio and colleagues 3 that the VA TBI screen may not be as sensitive to TBIs as initially intended. However, at least in this sample, this does not appear to be a result of the focus of the screening questions on current postconcussive symptoms (eg, item 4).…”

Section: Discussionsupporting

confidence: 60%

“…As suggested by Terrio et al, 3 we also investigated the incidence of a positive TBI screen when the assessment was limited to only items 1 and 2 on the screen. Results were similar to the 4-item screen, with only a slight increase in sensitivity to 0.86 and a decrease in specificity to 0.75 (see Table 5).…”

Section: Resultsmentioning

confidence: 99%

“…Terrio and colleagues 3 reported poorer sensitivity (60%) than specificity (96%). However, the sensitivity increased to 80%, with a slight decrease in specificity to 93%, for positive TBI screening when affirmative responses to only questions 1 and 2 were included.…”

Section: The Va Tbi Screening Processmentioning

confidence: 96%

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Correspondence of the Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) Clinical Interview and the VA TBI Screen

Fortier

Amick

Kenna

et al. 2015

Journal of Head Trauma Rehabilitation

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Objective Mild traumatic brain injury is the signature injury of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND), yet its identification and diagnosis is controversial and fraught with challenges. Setting In 2007, the Department of Veterans Affairs (VA) implemented a policy requiring traumatic brain injury (TBI) screening on all individuals returning from deployment in the OEF/OIF/OND theaters of operation that lead to the rapid and widespread use of the VA TBI screen. The Boston Assessment of TBI-Lifetime (BAT-L) is the first validated, postcombat semistructured clinical interview to characterize head injuries and diagnose TBIs throughout the life span, including prior to, during, and post–military service. Participants Community-dwelling convenience sample of 179 OEF/OIF/OND veterans. Main measures BAT-L, VA TBI screen. Results Based on BAT-L diagnosis of military TBI, the VA TBI screen demonstrated similar sensitivity (0.85) and specificity (0.82) when administered by research staff. When BAT-L diagnosis was compared with historical clinician-administered VA TBI screen in a subset of participants, sensitivity was reduced. Conclusions The specificity of the research-administered VA TBI screen was more than adequate. The sensitivity of the VA TBI screen, although relatively high, suggests that it does not oversample or “catch all” possible military TBIs. Traumatic brain injuries identified by the BAT-L, but not identified by the VA TBI screen, were predominantly noncombat military injuries. There is potential concern regarding the validity and reliability of the clinician administered VA TBI screen, as we found poor correspondence between it and the BAT-L, as well as low interrater reliability between the clinician-administered and research-administered screen.

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Section: Discussionsupporting

confidence: 60%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Correspondence of the Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) Clinical Interview and the VA TBI Screen

Fortier

Amick

Kenna

et al. 2015

Journal of Head Trauma Rehabilitation

View full text Add to dashboard Cite

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“…[5] have been calling for better ways to assess PTSD rather than self-report, such as that captured in the military with the Warrior Administered Retrospective Causality Assessment Tool, or WARCAT [6]. A review of the PTSD literature by [7] noted several gaps, including: (1) differences in diagnoses among self-report instruments, (2) silos between military and civilian aspects of PTSD, (3) silos between government agencies, and (4) differences in manifestations of PTSD connected with head trauma (e.g.…”

Section: Introductionmentioning

confidence: 99%

Diagnosing Post Traumatic Stress Disorder: Using a Physiological Computing Method and Apparatus

Workman¹

2016

Int J Comput Softw Eng

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Background: Post traumatic stress disorder (PTSD) is typically diagnosed using self-reports and physician interviews and observations. For example, the US military has used the Warrior Administered Retrospective Causality Assessment Tool (WARCAT), which is a self-report method for diagnostics. Methods: To help correct for associated deficiencies in self-reports, we utilized a computerized dual-task method and central nervous system (CNS) monitoring of reactions by participants who viewed troubling scenes. Results: We found evidence to support unreported PTSD reactions to these incidents. Furthermore, we used a computerized technique to induce cognitive load to distract participants from the purpose of the assessment to gain more accurate assessments. Conclusion:We conclude that using a computer apparatus is more effective in diagnosing PTSD than psychological instrumentation.

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“…Veterans are at risk for PTSD and other mood disorders, substance use, TBI, and chronic pain [22][23][24][25]. These risks appear to be present for the subgroup of Veterans who return to school as well.…”

Section: Introductionmentioning

confidence: 99%

Student Veteran perceptions of facilitators and barriers to achieving academic goals

et al. 2015

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Abstract-According to recent estimates, over 1 million Operation Iraqi Freedom/Operation Enduring Freedom Veterans are utilizing the post-9/11 GI Bill to pursue higher education. Data collected by the Department of Defense suggests that greater than 17% of returning Veterans may experience mental and physical health disorders, which can negatively affect school performance. The current study explored student Veterans' perceived facilitators and barriers to achieving academic goals. Thirty-one student Veterans completed self-report measures and interviews. Results suggested that Veterans who were reporting problems or symptoms in one mental or physical health domain were likely to be reporting symptoms or problems in others as well. The interview data were coded, and three overarching themes related to barriers and facilitators emerged: person features (e.g., discipline and determination, symptoms and stressors), institutional structure (i.e., what schools and the Department of Veterans Affairs do that was perceived to help or hinder student Veteran success), and policy concerns (i.e., how the structure of the GI Bill affects student Veteran school experience). Results from this research indicate the need for larger studies and program development efforts aimed at enhancing academic outcomes for Veterans.

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Postdeployment traumatic brain injury screening questions: Sensitivity, specificity, and predictive values in returning soldiers.

Cited by 47 publications

References 21 publications

Correspondence of the Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) Clinical Interview and the VA TBI Screen

Correspondence of the Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) Clinical Interview and the VA TBI Screen

Diagnosing Post Traumatic Stress Disorder: Using a Physiological Computing Method and Apparatus

Student Veteran perceptions of facilitators and barriers to achieving academic goals

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