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Citation |
Elliott JE, Balba NM, McBride AA, Callahan ML, Street K, Butler MP, Heinricher MM, Lim MM. J. Neurotrauma 2021; ePub(ePub): ePub. |
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Copyright |
(Copyright © 2021, Mary Ann Liebert Publishers) |
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DOI |
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PMID |
unavailable |
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Abstract |
Common methods for evaluating history of traumatic brain injury (TBI) include self-report, electronic medical record review (EMR), and structured interviews such as the Head Trauma Events Characteristics (HTEC). Each has strengths and weaknesses, but little is known regarding how TBI diagnostic rates or the associated symptom profile differ among them. This study examined 200 Veterans recruited within the VA Portland Health Care System, each evaluated for TBI using self-report, EMR, and HTEC. Participants also completed validated questionnaires assessing chronic symptom severity in broad health-related domains (pain, sleep, quality of life, post-concussive symptoms). The HTEC was more sensitive (80% of participants in our cohort) than either self-report or EMR alone (40%). As expected from the high sensitivity, the HTEC+ group included many people with mild or no post-concussive symptoms. Participants were then grouped according to the degree of concordance across these three diagnostic methods: No-TBI, n=43; or TBI-positive in any one method (TBI-1dx, n=53), any two (TBI-2dx, n=45), or all three (TBI-3dx, n=59). The symptom profile of the TBI-1dx group was indistinguishable from the No TBI group. The TBI-3dx group carried the most severe symptom profile. These data show that understanding the method(s) used to ascertain TBI is essential when interpreting results from other studies, an issue that will be even more salient when interpreting data merged from multiple sources within centralized repositories (e.g., FITBIR). The development of a composite TBI assessment tool including self-report, medical record review, and neuropsychology outcomes is a crucial next step for the field. Language: en |
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Keywords |
MILITARY INJURY; TRAUMATIC BRAIN INJURY; HUMAN STUDIES; REHABILITATION |