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  • Review Clinical Study Methods before You Accept Results, Expert Says

    Read the full story: Review Clinical Study Methods before You Accept Results, Expert Says
    U.S. Navy photo by Douglas Stutz

    As new medical treatment approaches and platforms come along, providers should check whether the evidence offered to support the new approaches actually proves what it claims. This is especially important when it comes to non-inferiority studies, which try to show that a new approach is no worse than the old one, said Derek Smolenski, an epidemiologist and quantitative methodologist for the National Center for Telehealth & Technology.

    A non-inferiority study is conducted to prove, or disprove, that a new form of treatment is no worse than the current standard of treatment, or if it is, that it is not unacceptably worse. Because this type of study is often used to compare new approaches like video conferencing and electronic self-help resources to current methods, a provider’s ability to critically analyze the findings of such studies is paramount, Smolenski said in a webinar hosted last month by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.

  • Clinician’s Corner: Using Psychological Health Data to Inform the Military Health System

    Read the full story: Clinician’s Corner: Using Psychological Health Data to Inform the Military Health System
    Photo courtesy of U.S. Army

    The Defense Department operates one of the largest health systems in the country, with nearly 9.4 million beneficiaries. Much of the care delivered within this system occurs in hospitals and clinics run by the department and the military services. Each visit with a health care provider generates data used to monitor and evaluate care delivery.

    Recent changes in military electronic health records make accessing and using medical data much easier. The changes permit faster analysis and delivery of near real-time information to medical decision-makers while safeguarding individual patient information. Importantly, this increased access to information allows the Military Health System (MHS) to move beyond a review of general health care metrics that are standard across the industry to more nuanced investigations of specific conditions or areas of care.

  • Clinician’s Corner: Top 10 Concussion Research Articles of 2015

    Read the full story: Clinician’s Corner: Top 10 Concussion Research Articles of 2015

    As the Defense Department’s center of excellence for traumatic brain injury (TBI), one of the primary goals of the Defense and Veterans Brain Injury Center (DVBIC) is to stay up-to-date on the latest in brain injury research. A team of DVBIC experts with a variety of clinical backgrounds reviewed approximately 250 abstracts from the TBI clinical research literature published in 2015, choosing the ten articles they felt advanced the field of TBI research the furthest.

    Listed below and categorized by topic are the titles and summaries of these top 10 concussion research articles of 2015. Click on the links provided to access the complete abstract or article on PubMed, a service of the U.S. National Library of Medicine.

  • TBI Experts Debate Causes of Chronic Traumatic Encephalopathy

    With the public taking a close look at whether repeated sports injuries cause chronic traumatic encephalopathy (CTE), the Defense Center of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) hosted a webinar Jan. 14 on the topic.

    CTE is a progressive neurodegenerative disease associated with repeated head injuries. To date, it has mainly been studied by examining the brain tissue after death of a relatively small number of professional athletes who played contact sports.

    Two officials of the Defense and Veterans Brain Injury Center (DVBIC) — senior clinical consultant Dr. Donald Marion and program analyst Anne E. Bunner — staged a mock debate on whether sports injuries cause CTE.

  • Computerized Tests Aren’t Always Best in TBI Assessments

    Computerized tests to measure neurocognitive damage are not always reliable and should not replace traditional assessments, experts at the Defense and Veterans Brain Injury Center (DVBIC) confirmed after comparing various types of assessments in a new study.

    Neurocognitive testing is often standard after a suspected traumatic brain injury (TBI). Current neurocognitive tests, designed to measure various cognitive processes such as attention, memory and executive function, are typically of the paper-and-pencil variety and are administered by a trained psychologist. Traditional testing may also include some computer-based tests.

    The “Head to Head” study examined the reliability and validity of four computerized neurocognitive assessments (NCATs) — ANAM4, CNS Vital Signs, CogState and ImPACT — with service members at Fort Bragg, North Carolina. ANAM is the most widely used, but Army Special Forces prefers to use ImPACT.

    In some ways, comparing NCATs to traditional tests and NCATs to one another is like trying to compare apples to oranges because there are many ways to measure cognitive ability, DVBIC Senior Clinical Research Director Wesley Cole and DVBIC Senior Clinical Research Associate Jacques Arrieux said in a webinar that presented the “Head to Head” study findings. As a result, they were unable to determine whether one NCAT was better than the others.

  • What You Need to Know about Mindfulness Meditation

    Mindfulness meditation swiftly gained popularity as a self-care strategy for improving psychological health symptoms and overall resilience. Clinical evidence shows that this strategy works. DCoE wrote a series of mindfulness blogs to help you understand what mindfulness meditation is, how it can help, what studies and data support it, and how individuals can integrate it into their daily lives. Below is a quick rundown on the entire series, including what you need to know about mindfulness meditation and how to get started.

    What is mindfulness meditation?
    Mindfulness meditation comes from a Buddhist tradition. It increases awareness of the present by focusing on your breathing, body and thoughts. With continual practice, this technique trains the brain to stay in the present moment and can help you accept things for what they are, without judgment.