Concordance of clinician judgment of mild traumatic brain injury history with a diagnostic standard
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Authors
Pogoda, Terri K.
Iverson, Katherine M.
Meterko, Mark
Baker, Errol
Hendricks, Ann M.
Stolzmann, Kelly L.
Krengel, Maxine
Charns, Martin P.
Amara, Jomana
Kimerling, Rachel
Subjects
American Congress of Rehabilitation Medicine guidelines
blast injuries
comprehensive traumatic brain injury evaluation
diagnosis
mild traumatic brain injury
neurobehavioral manifestations
non-blast injuries
posttraumatic stress disorder
psychological factors
Veterans
blast injuries
comprehensive traumatic brain injury evaluation
diagnosis
mild traumatic brain injury
neurobehavioral manifestations
non-blast injuries
posttraumatic stress disorder
psychological factors
Veterans
Advisors
Date of Issue
2014
Date
Publisher
Language
Abstract
The concordance of Department of Veterans Affairs
(VA) clinician judgment of mild traumatic brain injury (mTBI)
history with American Congress of Rehabilitation Medicine
(ACRM)-based criteria was examined for Operation Iraqi Freedom
(OIF) and Operation Enduring Freedom (OEF) Veterans. In
order to understand inconsistencies in agreement, we also examined
the associations between evaluation outcomes and conceptually
relevant patient characteristics, deployment-related events,
current self-reported health symptoms, and suspected psychiatric
conditions. The Veteran sample comprised 14,026 OIF/OEF VA
patients with deployment-related mTBI history (n = 9,858) or no
history of mTBI (n = 4,168) as defined by ACRM-based criteria.
In the majority of cases (76.0%), clinician judgment was in agreement
with the ACRM-based criteria. The most common inconsistency
was between clinician judgment (no) and ACRM-based
criteria (yes) for 21.3% of the patients. Injury etiology, current
self-reported health symptoms, and suspected psychiatric conditions
were additional factors associated with clinician diagnosis
and ACRM-based criteria disagreement. Adherence to established
diagnostic guidelines is essential for accurate determination
of mTBI history and for understanding the extent to which mTBI
symptoms resolve or persist over time in OIF/OEF Veterans.
Type
Article
Description
The article of record as published may be located at http://dx.doi.org/10.1682/JRRD.2013.05.0115
Series/Report No
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Organization
Defense Resources Management Institute (DRMI)
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Citation
Pogoda, Terri K., et al. "Concordance of clinician judgment of mild traumatic brain injury history with a diagnostic standard." Journal of rehabilitation research and development 51.3 (2014): 363-376.
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This publication is a work of the U.S. Government as defined in Title 17, United States Code, Section 101. Copyright protection is not available for this work in the United States.