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Concordance of clinician judgment of mild traumatic brain injury history with a diagnostic standard.
J Rehabil Res Dev. 2014; 51(3):363-75.JR

Abstract

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.

Authors+Show Affiliations

VA Boston Healthcare System, 150 S Huntington Ave (152M), Boston, MA 02130. terri.pogoda@va.gov.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25019660

Citation

Pogoda, Terri K., et al. "Concordance of Clinician Judgment of Mild Traumatic Brain Injury History With a Diagnostic Standard." Journal of Rehabilitation Research and Development, vol. 51, no. 3, 2014, pp. 363-75.
Pogoda TK, Iverson KM, Meterko M, et al. Concordance of clinician judgment of mild traumatic brain injury history with a diagnostic standard. J Rehabil Res Dev. 2014;51(3):363-75.
Pogoda, T. K., Iverson, K. M., Meterko, M., Baker, E., Hendricks, A. M., Stolzmann, K. L., Krengel, M., Charns, M. P., Amara, J., Kimerling, R., & Lew, H. L. (2014). Concordance of clinician judgment of mild traumatic brain injury history with a diagnostic standard. Journal of Rehabilitation Research and Development, 51(3), 363-75. https://doi.org/10.1682/JRRD.2013.05.0115
Pogoda TK, et al. Concordance of Clinician Judgment of Mild Traumatic Brain Injury History With a Diagnostic Standard. J Rehabil Res Dev. 2014;51(3):363-75. PubMed PMID: 25019660.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Concordance of clinician judgment of mild traumatic brain injury history with a diagnostic standard. AU - Pogoda,Terri K, AU - Iverson,Katherine M, AU - Meterko,Mark, AU - Baker,Errol, AU - Hendricks,Ann M, AU - Stolzmann,Kelly L, AU - Krengel,Maxine, AU - Charns,Martin P, AU - Amara,Jomana, AU - Kimerling,Rachel, AU - Lew,Henry L, PY - 2013/05/10/received PY - 2013/10/02/revised PY - 2014/7/15/entrez PY - 2014/7/16/pubmed PY - 2015/4/8/medline KW - American Congress of Rehabilitation Medicine guidelines KW - Veterans KW - blast injuries KW - comprehensive traumatic brain injury evaluation KW - diagnosis KW - mild traumatic brain injury KW - neurobehavioral manifestations KW - non-blast injuries KW - posttraumatic stress disorder KW - psychological factors SP - 363 EP - 75 JF - Journal of rehabilitation research and development JO - J Rehabil Res Dev VL - 51 IS - 3 N2 - 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. SN - 1938-1352 UR - https://www.unboundmedicine.com/medline/citation/25019660/Concordance_of_clinician_judgment_of_mild_traumatic_brain_injury_history_with_a_diagnostic_standard_ L2 - https://www.rehab.research.va.gov/jour/2014/513/pdf/page363.pdf DB - PRIME DP - Unbound Medicine ER -