The Veterans Health Administration’s traumatic brain injury clinical reminder screen and evaluation: Practice patterns

Belanger, Heather G.; Powell‐Cope, Gail; Spehar, Andrea M.; McCranie, Mark; Klanchar, S Angelina; Yoash-Gantz, Ruth E.; Kosasih, Judith B.; Scholten, Joel

doi:10.1682/jrrd.2015.09.0187

Cited by 8 publications

(5 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings may be a result of differential utilization, as previous research suggests that Hispanic veterans were less likely to utilize TBI services, including specialty clinics, neurology, and rehabilitation services in the VA health care system. 12 , 14 Low service utilization could lead to condition exacerbation or failure to identify preventable medical conditions early and before becoming chronic.…”

Section: Discussionmentioning

confidence: 99%

Geographic Disparities in Mortality Risk Within a Racially Diverse Sample of U.S. Veterans with Traumatic Brain Injury

et al. 2018

View full text Add to dashboard Cite

Purpose: Traumatic brain injury (TBI) is a signature injury among the U.S. veterans. Hispanic U.S. veterans diagnosed with TBI have been found to have higher risk-adjusted mortality. This study examined the adjusted association of geographic location with all-cause mortality in 114,593 veterans diagnosed with TBI between January 1, 2000 and December 31, 2010, and followed through December 31, 2014.Methods: National Veterans Health Administration (VHA) databases containing administrative data including International Classification of Diseases, 9th Revision (ICD-9) codes, sociodemographic characteristics, and survival were linked. TBI was identified based on ICD-9 codes. Cox proportional hazards regression methods were used to examine the association of time from first TBI ICD-9 code to death with geographic location, after adjustment for TBI severity, race/ethnicity, other sociodemographic characteristics, military factors, and Elixhauser comorbidities.Results: Relative to urban mainland veterans with a median survival of 76.4 months, veterans living in the U.S. territories had a median survival of 69.1 months, whereas rural mainland veterans had a median survival of 77.1 months, and highly rural mainland veterans had a mean survival of 77.6 months. The final model adjusted for race/ethnicity, TBI severity, sociodemographic, military, and comorbidity covariates showed that residing in the U.S. territories was associated with a higher risk of death (hazard ratios=1.24; 95% confidence interval 1.15–1.34) relative to residing on the U.S. mainland. The race/ethnicity disparity previously found for the U.S. veterans diagnosed with TBI seems to be accounted for by living in the U.S. territories.Conclusion: The study shows that among veterans with TBI, mortality rates were higher in those who reside in the U.S. territories, even after adjustment. Previous documented higher mortality among Hispanic veterans seems to be explained by residing in the U.S. territories. The VA has a mission of ensuring equitable treatment of all veterans, and should investigate targeted policies and interventions to improve the survival of the U.S. territory veterans diagnosed with TBI.

show abstract

Section: Discussionmentioning

confidence: 99%

Geographic Disparities in Mortality Risk Within a Racially Diverse Sample of U.S. Veterans with Traumatic Brain Injury

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Subsequent studies have confirmed these findings, with alphas ranging from .91 to .94 (Menatti et al, 2020; Silva et al, 2013; Soble et al, 2014; Vos et al, 2019). The test–retest reliability of the NSI is also excellent, showing a strong correlation after both a 7-day ( r = .94) and 30-day ( r = .78) period (Belanger et al, 2016; Silva et al, 2013).…”

mentioning

confidence: 89%

“…Previous studies have evaluated the NSI with respect to its reliability, validity, and other psychometric properties (Belanger et al, 2016; King et al, 2012; Menatti et al, 2020; Silva et al, 2013; Soble et al, 2014; Vos et al, 2019). This research has generally shown that the NSI has excellent internal consistency, test–retest reliability, and concurrent and construct validity.…”

mentioning

confidence: 99%

Measurement Invariance of the Neurobehavioral Symptom Inventory in Male and Female Million Veteran Program Enrollees Completing the Comprehensive Traumatic Brain Injury Evaluation

Ozturk,

Zhang,

Lai

et al. 2023

Assessment

View full text Add to dashboard Cite

This study evaluated measurement invariance across males and females on the Neurobehavioral Symptom Inventory (NSI) in U.S. military veterans enrolled in the VA Million Veteran Program. Participants ( N = 17,059; males: n = 15,450; females: n = 1,609) included Veterans who took part in the VA Traumatic Brain Injury (TBI) Screening and Evaluation Program and completed the NSI. Multiple-group confirmatory factor analyses investigated measurement invariance of the NSI 4-factor model. The configural (comparative fit index [CFI] = 0.948, root mean square error of approximation [RMSEA] = 0.060) and metric (CFI = 0.948, RMSEA = 0.058) invariance models showed acceptable fit. There was a minor violation of scalar invariance (Δχ2 = 232.50, p < .001); however, the degree of noninvariance was mild (ΔCFI = −0.002, [Formula: see text]). Our results demonstrate measurement invariance across sex, suggesting that the NSI 4-factor model can be used to accurately assess symptoms in males and females following TBI. Findings highlight the importance of considering validity of measurement across study groups to increase confidence that a measure is interpreted similarly by respondents from different subgroups.

show abstract

“…With regard to data collection, the VATBIST, which was used to identify subjects that were referred to the TBI clinic, was found to provide good data sensitivity by Donnelly et al, 34 by Vanderploeg et al, 35 and by Belanger et al 36 However, in a subsequent report, the latter group noted poor test-retest reliability and validity compared to a semistructured interview developed at their institution. 53,54 The CTBIE used for evaluation in the TBI clinic was found to provide reliable data, 35,36 however, the depth of the data is not adequate to answer some highly specific questions. This is a cross-sectional study of previously collected data with one data point per participant and not a true longitudinal study with multiple data points spaced over time.…”

Section: Prior Tbimentioning

confidence: 99%

“…In the TBI clinic, the veteran was seen by a physician or physician's assistant with special training in TBI. A second questionnaire, the Comprehensive TBI Evaluation (CTBIE) 35,36 form was administered by the medical professional. This form queried detailed information about the possible DTBI, including whether the mode of injury was related to:…”

Section: Definition Of Tbimentioning

confidence: 99%

Persistence of headache and its relation to other major sequelae following traumatic brain injury at 2–8 years after deployment‐related traumatic brain injury in veterans of Afghanistan and Iraq wars

Couch

Stewart

2022

Headache

View full text Add to dashboard Cite

Objective: This study deals with headache in relation to other major sequelae of traumatic brain injury (TBI) in veterans of Iraq and Afghanistan wars over 8 years after experiencing a deployment-related TBI (DTBI).Background: TBI occurred in 14%-23% of veterans deployed to the Iraq or Afghanistan campaigns. This study evaluates sequelae of TBI (STBI) over 1-8 years after a DTBI.Methods: This is a secondary, cross-sectional analysis of previously collected data, which was taken from review of medical records of the first 500 veterans with a DTBI seen in the TBI clinic of the Oklahoma City Veterans Health Center. This report deals with five of the most common STBIs and represents the presence and severity of, or absence of, the particular symptom at the time of a patient's initial visit to the clinic.All subjects were evaluated between June 1, 2008, and April 30, 2011. The STBI used here include: headache, dizziness, balance, coordination difficulties, and difficulty with decisions. In the TBI clinic, the burden of these symptoms was evaluated with a Likert Scale of none, mild, moderate, severe, or very severe. For this report, the scale was compressed into three categories: none, mild/moderate, and severe/very severe. Data were complete for age at TBI and mechanism of TBI in 500 subjects, for symptom severity in 497 subjects, for TBI severity in 491 subjects, and for presence of prior TBI in 496 subjects.Results: For the 497 subjects with complete symptom severity data, headache was seen in 476 (95.8%) and absent in 21 (4.2%). Regarding headache severity, 236 (47.5%) reported mild/moderate and 240 (48.3%) reported severe/very severe headache burden. For other sequelae, including severity of dizziness, balance, and coordination problems, these symptoms were absent in 85 (17.1%), 85 (17.1%), and 106 (21.3%) patients, respectively; of mild/moderate severity in 356 (71.6%), 355 (71.4%), and 321 (64.6%) patients; and of severe/very severe intensity in 56 (11.3%), 57 (11.5%), and 70 (14.1%) patients. Difficulty with decisions, which was used as an indication of

show abstract

The Veterans Health Administration’s traumatic brain injury clinical reminder screen and evaluation: Practice patterns

Cited by 8 publications

References 29 publications

Geographic Disparities in Mortality Risk Within a Racially Diverse Sample of U.S. Veterans with Traumatic Brain Injury

Geographic Disparities in Mortality Risk Within a Racially Diverse Sample of U.S. Veterans with Traumatic Brain Injury

Measurement Invariance of the Neurobehavioral Symptom Inventory in Male and Female Million Veteran Program Enrollees Completing the Comprehensive Traumatic Brain Injury Evaluation

Persistence of headache and its relation to other major sequelae following traumatic brain injury at 2–8 years after deployment‐related traumatic brain injury in veterans of Afghanistan and Iraq wars

Contact Info

Product

Resources

About