Defense Automated Neurobehavioral Assessment (DANA)—Psychometric Properties of a New Field-Deployable Neurocognitive Assessment Tool

Lathan, Corinna; Spira, James; Bleiberg, Joseph; Vice, Jack; Tsao, Jack W.

doi:10.7205/milmed-d-12-00438

Cited by 40 publications

(39 citation statements)

References 17 publications

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“…This finding was corroborated by additional analysis of a previously collected dataset 11, in which a similar, ∼15-min version of DANA was administered to groups of healthy volunteers in a variety of extreme climates (desert, jungle, aboard a ship, and at high altitude postacclimatization). Paired t -tests comparing throughput in SRT1 versus SRT2 failed to reach significance in any of these climates (all P ’s>0.05), supporting the conclusion that the intervening tests in the DANA battery do not adversely impact SRT performance in healthy humans under these conditions.…”

Section: Resultsmentioning

confidence: 58%

“…Cognitive performance was assessed in this study using the Defense Automated Neurobehavioral Assessment (DANA), a software package of public domain cognitive tests that runs on the Android platform. DANA was originally developed as a means of rapidly assessing cognitive changes following mild traumatic brain injury/concussion in deployed service members exposed to blasts, and its reliability has been previously validated in a number of extreme environments 11. The DANA test battery includes two administrations of a simple reaction time (SRT) task: one at the beginning and one at the end of the ∼20-min test session.…”

Section: Introductionmentioning

confidence: 99%

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AltitudeOmics

et al. 2014

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Humans experiencing hypoxic conditions exhibit multiple signs of cognitive impairment, and high altitude expeditions may be undermined by abrupt degradation in mental performance. Therefore, the development of psychometric tools to quickly and accurately assess cognitive impairment is of great importance in aiding medical decision-making in the field, particularly in situations where symptoms may not be readily recognized. The present study used the Defense Automated Neurobehavioral Assessment (DANA), a ruggedized and portable neurocognitive assessment tool, to examine cognitive function in healthy human volunteers at sea level, immediately after ascending to an elevation over 5000 m, and following 16 days of acclimatization to this high altitude. The DANA battery begins with a simple reaction time test (SRT1) which is followed by a 20-min series of complex cognitive tests and ends with a second test of simple reaction time (SRT2). Tabulating the performance scores from these two tests allows the calculation of an SRT change score (dSRT=SRT1–SRT2) that reflects the potential effect of mental effort spent during the 20-min testing session. We found that dSRT, but not direct SRT in comparison to sea-level baseline performance, is highly sensitive to acute altitude-related performance deficits and the remission of impairment following successful acclimatization. Our results suggest that dSRT is a potentially useful analytical method to enhance the sensitivity of neurocognitive assessment.

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Section: Resultsmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

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et al. 2014

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“…Only the first test administrations are discussed here, because reliability of this instrument has been reported elsewhere. 41 …”

Section: Methodsmentioning

confidence: 99%

“…Although DANA uses standard assessments tools that have been well researched and widely utilized, because of its unique delivery system, DANA was tested under extreme field conditions as well as classroom settings, and found to have adequate test-retest ( > 0.70) and split-half ( > 0.80) reliability 41 …”

Section: Methodsmentioning

confidence: 99%

“…Power was also calculated based on stability of measures and expected standard errors determined in the Phase 1 pilot study. 41 Descriptive reporting includes mean correct responses (Mean), SD, percent correct (%Correct), and TP for all neurocognitive scores; mean and SD for self-report psychological scores, and mean or number of cases and SD for age, sex, and number and recency of concussions. TP was used for analyses of interest for all cognitive tests, except for GNG and CDD where %Correct is the metric of relevance.…”

Section: Planned Analysesmentioning

confidence: 99%

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The Impact of Multiple Concussions on Emotional Distress, Post-Concussive Symptoms, and Neurocognitive Functioning in Active Duty United States Marines Independent of Combat Exposure or Emotional Distress

Spira¹,

Lathan

Bleiberg

et al. 2014

Journal of Neurotrauma

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Controversy exists as to whether the lingering effects of concussion on emotional, physical, and cognitive symptoms is because of the effects of brain trauma or purely to emotional factors such as post-traumatic stress disorder or depression. This study examines the independent effects of concussion on persistent symptoms. The Defense Automated Neurobehavioral Assessment, a clinical decision support tool, was used to assess neurobehavioral functioning in 646 United States Marines, all of whom were fit for duty. Marines were assessed for concussion history, post-concussive symptoms, emotional distress, neurocognitive functioning, and deployment history. Results showed that a recent concussion or ever having experienced a concussion was associated with an increase in emotional distress, but not with persistent postconcussive symptoms (PPCS) or neurocognitive functioning. Having had multiple lifetime concussions, however, was associated with greater emotional distress, PPCS, and reduced neurocognitive functioning that needs attention and rapid discrimination, but not for memory-based tasks. These results are independent of deployment history, combat exposure, and symptoms of post-traumatic stress disorder and depression. Results supported earlier findings that a previous concussion is not generally associated with post-concussive symptoms independent of covariates. In contrast with other studies that failed to find a unique contribution for concussion to PPCS, however, evidence of recent and multiple concussion was seen across a range of emotional distress, post-concussive symptoms, and neurocognitive functioning in this study population. Results are discussed in terms of implications for assessing concussion on return from combat.

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A review of methods for assessment of cognitive function in high‐altitude hypoxic environments

Fan,

Meng,

Zhu

et al. 2024

Brain and Behavior

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Hypoxic environments like those present at high altitudes may negatively affect brain function. Varying levels of hypoxia, whether acute or chronic, are previously shown to impair cognitive function in humans. Assessment and prevention of such cognitive impairment require detection of cognitive changes and impairment using specific cognitive function assessment tools. This paper summarizes the findings of previous research, outlines the methods for cognitive function assessment used at a high altitude, elaborates the need to develop standardized and systematic cognitive function assessment tools for high‐altitude hypoxia environments.

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Defense Automated Neurobehavioral Assessment (DANA)—Psychometric Properties of a New Field-Deployable Neurocognitive Assessment Tool

Cited by 40 publications

References 17 publications

AltitudeOmics

AltitudeOmics

The Impact of Multiple Concussions on Emotional Distress, Post-Concussive Symptoms, and Neurocognitive Functioning in Active Duty United States Marines Independent of Combat Exposure or Emotional Distress

A review of methods for assessment of cognitive function in high‐altitude hypoxic environments

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