Citation

Radigan LJ, McGlinchey RE, Milberg WP, Fortier CB. J. Head Trauma Rehabil. 2018; 33(5): E51-E55.

Affiliation

Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Massachusetts (Ms Radigan and Drs McGlinchey, Milberg, and Fortier); Department of Psychology, Wayne State University, Detroit, Michigan (Ms Radigan); and Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (Drs McGlinchey, Milberg, and Fortier).

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000361

PMID

29194179

Abstract

OBJECTIVE: To compare the diagnosis of positive versus negative for mild traumatic brain injury (mTBI) using the Boston Assessment of TBI-Lifetime (BAT-L), a validated forensic clinical interview used to identify TBI in research, to the diagnosis of mTBI in the clinical polytrauma service using the Comprehensive TBI Evaluation (CTBIE). PARTICIPANTS: Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans who were enrolled in the Translational Research Center for TBI and Stress Disorders longitudinal cohort study and received a CTBIE at a Veterans Health Administration healthcare facility (n = 104). MAIN MEASURES: The BAT-L, CTBIE, and Neurobehavioral Symptom Inventory.

RESULTS: There was poor correspondence between the BAT-L and CTBIE mTBI diagnoses (κ = 0.283). The CTBIE showed moderate sensitivity but poor specificity relative to the BAT-L. The agreement did not improve after removing individuals who had failed symptom validity measures, as assessed by the Validity-10 scale of the Neurobehavioral Symptom Inventory.

CONCLUSIONS: This lack of correspondence highlights the difficulties in diagnosing mTBI in Veterans using retrospective self-report. Future work is needed to establish a reliable and valid method for identifying military mTBI both for the care of our Veterans and for appropriate distribution of benefits.

Language: en