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BACKGROUND/RATIONALE:
The Veterans Health Administration (VHA) has stated the need for a brief screening instrument that can assist with the triage of the large number of returning OEF/OIF veterans with mild traumatic brain injury (mTBI). The current investigators have combined selected neurological measures and brief cognitive tests to develop an instrument called, "Brief Objective Neurobehavioral Detectors" (BOND). BOND takes 15-20 minutes to administer and results are immediately available.
In a recent study, a (slight) variation of BOND demonstrated 91% sensitivity to and 76% specificity for subtle brain change in older adults with periventricular white matter abnormalities on magnetic resonance imaging (MRI)1. In clinical practice, we have observed considerable differences in performance on BOND between veterans with and without mTBI. We propose a validation study of BOND for use as a screening tool for OEF/OIF veterans with mTBI.
OBJECTIVE(S):
Short-term Objective 1: To determine the criterion-related validity of BOND for predicting an individual's group membership (mTBI or normal).
Short-term Objective 2: To provide evidence for the construct validity of BOND through convergent validity.
METHODS:
One hundred OEF/OIF veterans will be recruited (mtbi=70; non-tbi=30). Each veteran will be administered the BOND and selected traditional cognitive tests. Additionally, a subset of the sample will undergo diffusion tensor imaging.
Objective 1:
-Level One Analysis: The association between the total score from BOND and group membership will be calculated.
-Level Two Analysis: Sensitivity and specificity will be calculated.
-Level Three Analysis: A two-group discriminant analysis will be used to find the BOND total score (cut point) that best classifies subjects into the correct groups.
Objective 2:
-Level One Analysis: The correlation coefficient between the total score of BOND and performance measures from three cognitive tests shown to be sensitive to brain injury will be calculated. The association between performance measures from the cognitive tests and group membership will also be examined.
-Level Two Analysis: The correlation coefficient between the total score of BOND and the measure of fractional anisotropy (FA) from diffusion tensor imaging will be determined.
FINDINGS/RESULTS:
Results are not yet available.
IMPACT:
Although this project has recently been initiated, several impacts have been noted. First, the study evaluation visit provides OEF/OIF veterans with an additional opportunity to ask questions and receive answers about brain injury. Second, the coordination of multidisciplinary staff required for this study has resulted in the collaborative development of several concepts with the potential for positive influences on veteran health. For example, the Principal Investigator and colleagues in Neurology, Research, Radiology, and Occupational Health have designed a clinical neuroimaging algorithm for mtbi.
PUBLICATIONS:
None at this time.
DRA:
none
DRE:
none
Keywords:
none
MeSH Terms:
none
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