Article

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.

Langue : ANGLAIS