Detecting Combat Brain Injuries: A Comparison of Methods

Identifying mild traumatic brain injuries (TBIs) in veterans can be tricky. Two different systems, the Veterans Health Administration (VHA) and the LIMBIC-CENC research project, were compared to see how well they found these injuries. The LIMBIC-CENC study uses detailed interviews to find all possible concussive events (PCEs) and diagnose mild TBI. The VHA, on the other hand, screens all post-9/11 combat veterans for historical TBI and offers a full evaluation if they screen positive. The LIMBIC-CNC study found many more PCEs than the VHA (86% vs. 41%), but they didn't agree much overall. Veterans who were older, female, had more service time, or certain disability ratings were more likely to be missed by the VHA. The LIMBIC-CNC study also found more mild TBI cases (81% vs. 72%). Veterans who were never married or in the Air Force were more likely to be missed by the VHA. The LIMBIC-CNC study's structured interviews found more TBIs than the VHA's system. But there were big differences in who they found. Veterans who were older, had more service time, or certain disability ratings were more likely to be missed by the VHA. This shows that the VHA might need to change how they screen for TBI. Doctors should know that some veterans might have undiagnosed TBIs even if they've been screened.