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Aim

Concordance of clinician judgment of mild traumatic brain injury history with a diagnostic standard.

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Aim

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  1. Concordance of clinician judgment of mild traumatic brain injury history with a diagnostic standard Terri K. Pogoda, PhD; Katherine M. Iverson, PhD; Mark Meterko, PhD; Errol Baker, PhD; Ann M. Hendricks, PhD; Kelly L. Stolzmann, MS; Maxine Krengel, PhD; Martin P. Charns, DBA; Jomana Amara, PhD; Rachel Kimerling, PhD; Henry L. Lew, MD, PhD

  2. Aim • Examine concordance of VA clinician judgment of mild traumatic brain injury (mTBI) history with American Congress of Rehabilitation Medicine (ACRM)-based criteria for Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans. • Relevance • Examining associations between evaluation outcomes and patient characteristics, deployment-related events, self-reported health symptoms, and psychiatric conditions can clarify inconsistencies in mTBI diagnoses.

  3. Method • Examined Veteran sample as defined by ACRM-based criteria: • 14,026 OIF/OEF VA patients. • With deployment-related mTBI: 9,858. • With no history of mTBI: 4,168.

  4. Results • Clinician judgment agreed with ACRM-based criteria in majority of cases (76.0%). • Most common inconsistency was between clinician judgment (no) and ACRM-based criteria (yes) for 21.3% of patients. • Additional factors associated with clinician diagnosis and ACRM-based criteria disagreement: • Injury etiology. • Current self-reported health symptoms. • Suspected psychiatric conditions.

  5. Conclusion • Adherence to established diagnostic guidelines is essential for: • Accurate determination of mTBI history. • Understanding extent to which mTBI symptoms resolve or persist over time in OIF/OEF Veterans

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