@article{ref1,
title="Algorithm for symptom attribution and classification following possible mild traumatic brain injury",
journal="Journal of head trauma rehabilitation",
year="2016",
author="Pape, Theresa Louise-Bender and Herrold, Amy A. and Smith, Bridget and Babcock-Parziale, Judith and Harp, Jordan and Shandera-Ochsner, Anne and Jenkins, Shonna and Evans, Charlesnika T. and Schleenbaker, Randal and High, Walter M.",
volume="31",
number="6",
pages="E10-E22",
abstract="OBJECTIVE: To present a heuristic model of a symptom attribution and classification algorithm (SACA) for mild traumatic brain injury (mTBI). SETTING: VA Polytrauma sites. PARTICIPANTS: 422 Veterans. <br><br>DESIGN: Cross-sectional. MAIN MEASURES: SACA, Comprehensive TBI Evaluation (CTBIE), Structured TBI Diagnostic Interview, Minnesota Multiphasic Personality Inventory (MMPI-2-RF), Letter Memory Test, Validity-10. <br><br>RESULTS: SACA and CTBIE diagnoses differ significantly (P <.01). The CTBIE, compared with SACA, attributes 16% to 500% more symptoms to mTBI, behavioral health (BH), mTBI + BH and symptom resolution. Altering SACA criteria indicate that (1) CTBIE determination of cognitive impairment yields 27% to 110% more mTBI, mTBI + BH and symptom resolution diagnoses, (2) ignoring timing of symptom onset yields 32% to 76% more mTBI, mTBI + BH and Other Condition diagnoses, (3) Proportion of sample having questionably valid profiles using structured TBI diagnostic interview and MMPI-2-RF and Letter Memory Test is 26% whereas with CTBIE item number 23 and Validity-10 is 6% to 26%, (4) MMPI-2-RF F-scale is the only measure identifying Veterans with posttraumatic amnesia for more than 24 hours as having questionably valid profiles. <br><br>CONCLUSIONS: Symptom attribution-based diagnoses differ when using status quo versus the SACA. The MMPI-2-RF F-scale, compared with the Validity-10 and Letter Memory Test, may be more precise in identifying questionably valid profiles for mTBI + BH. The SACA provides a framework to inform clinical practice, resource allocation, and future research.<p /> <p>Language: en</p>",
language="en",
issn="0885-9701",
doi="10.1097/HTR.0000000000000220",
url="http://dx.doi.org/10.1097/HTR.0000000000000220"
}