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Comparing VA Clinician Judgment of Mild Traumatic Brain Injury History with ACRM-Based Criteria

This study examines the concordance of VA clinician judgment of mild traumatic brain injury (mTBI) history with American Congress of Rehabilitation Medicine (ACRM)-based criteria for OIF/OEF Veterans. Findings show clinician judgment aligned with criteria in most cases, identifying factors influencing diagnoses. Adhering to established guidelines is crucial for accurate mTBI history determination and understanding symptom persistence in Veterans.

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Comparing VA Clinician Judgment of Mild Traumatic Brain Injury History with ACRM-Based Criteria

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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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