Article

OBJECTIVES: To synthesize evidence and report findings from a systematic search
and descriptive analysis of peer-reviewed published evidence of the accuracy of
tests used for diagnosing mild traumatic brain injury (mTBI).
The article also
summarizes points of concurrence and divergence regarding case definitions of
mTBI identified during the review. TYPE: Systematic review and descriptive
analysis of published evidence. LITERATURE SURVEY: A search of PubMed, PsychInfo,
and the Cochrane Library for peer-reviewed publications between 1990 and July 6,
2011, identified 1218 abstracts; 277 articles were identified for full review,
and 13 articles met the criteria for evaluation. METHODOLOGY: Manuscript
inclusion criteria were (1) reported sensitivity (Se) and specificity (Sp), or
reported data were sufficient to compute Se and Sp; (2) >1 participant in the
study; (3) at least 80% of the study cohort was >/=18 years of age; and (4)
written in English. Articles describing clinical practice guidelines, opinions,
theories, or clinical protocols were excluded. Seven investigators independently
evaluated each article according to the Standards for Reporting of Diagnostic
Accuracy (STARD) criteria. SYNTHESIS: Findings indicate that all 13 studies
involved civilian noncombat populations. In 7 studies, authors examined acute
mTBI, and in 4 studies, historical remote mTBI was examined. In the 13 studies,
Se ranged from 13%-92% and Sp ranged from 72%-99%, but confidence in these
findings is problematic because the STARD review indicates opportunities for bias
in each study. CONCLUSIONS: Findings indicate that no well-defined definition or
clinical diagnostic criteria exist for mTBI and that diagnostic accuracy is
currently insufficient for discriminating between mTBI and co-occurring mental
health conditions for acute and historic mTBI. Findings highlight the need for
research examining the diagnostic accuracy for acute and historic mTBI.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS