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Abstract Details

The Rehabilitation Institute of Chicago Military Traumatic Brain Injury Screening Instrument: Determination of Sensitivity, Specificity and Predictive Value
Neural Repair/Rehabilitation
P04 - (-)
023
BACKGROUND: TBI is the "signature injury" of the wars in Iraq and Afghanistan. 15-23% of service members deployed to these locations have experienced a TBI. There is a need for validated instruments tailored to accurately screen for TBI in this population.
DESIGN/METHODS: 300 service members or veterans underwent a novel screen and comprehensive diagnostic assessment to identify the occurrence of TBI, the presence of cognitive impairment, and/or the presence of posttraumatic stress disorder (PTSD). Negative predictive value (NPV), positive predictive value (PPV), sensitivity and specificity were calculated.
RESULTS: Our screening instrument classified 191 subjects (64%) as having potentially experienced a TBI during their military service, and 104 as having PTSD (35%). Comprehensive diagnostic assessment: 212 (71%) were identified as having experienced a TBI at some point in their lifetime; 46% (n = 137) during military service specifically. 109 subjects (36%) were diagnosed as having PTSD. 57 subjects (19%) met criteria for cognitive impairment. Of these 57 cognitively impaired individuals, 42 (74%) had experienced a TBI. This screening tool for TBI yielded: sensitivity of 96%, specificity of 64%, PPV of 70%, and NPV of 95%; i.e., there is a 95% likelihood that a negative screen result would be upheld by a comprehensive assessment.
CONCLUSIONS: The Rehabilitation Institute of Chicago Military Traumatic Brain Injury Screening Instrument has a high NPV and high sensitivity for TBI. This tool identifies individuals likely to have sustained a TBI. Moreover, it detects those who are likely not to have sustained a TBI and can be reassured in this regard. Because such distinction can be made with accuracy, in rapid and cost-effective fashion, the tool represents an important contribution to the armamentarium of TBI screening tools.
Authors/Disclosures
Felise S. Zollman, MD, FÂ鶹´«Ã½Ó³»­ (United HealthCare)
PRESENTER 		No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
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Pietro Annovazzi No disclosure on file