Abstract Details

Title The Rehabilitation Institute of Chicago Military Traumatic Brain Injury Screening Instrument: Determination of Sensitivity, Specificity and Predictive Value

Topic Neural Repair/Rehabilitation

Presentation(s) P04 - (-)

Poster/Presentation
Number 023

Objective

Background 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 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 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 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, FAAN (United HealthCare) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Pietro Annovazzi	No disclosure on file

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