Military Testing for Traumatic Brain Injuries Questioned

Dr. Alex Dromerick co-directs the Brain Research Center at the National Rehabilitation Hospital. Here he observes Stephen Jones, a policeman who was involved in a motorcycle accident. Photo by Becky Lettenberger/NPR

A joint investigation by ProPublica and National Public Radio has revealed problems with mandated military testing for traumatic brain injury – one of the signature wounds of the wars in Iraq and Afghanistan.

From Propublica:

In 2007, with roadside bombs exploding across Iraq, Congress moved to improve care for soldiers who had suffered one of the war’s signature wounds, traumatic brain injury.

Lawmakers passed a measure requiring the military to test soldiers’ brain function before they deployed and again when they returned. The test was supposed to ensure that soldiers received proper treatment.

Instead, an investigation by ProPublica and NPR has found, the testing program has failed to deliver on its promise, offering soldiers the appearance of help, but not the reality.

Racing to satisfy Congress’ mandate, the military chose a test that wasn’t actually proven to detect TBI: the Automated Neuropsychological Assessment Metric, or ANAM.

Four years later, more than a million troops have taken the test at a cost of more than $42 million to taxpayers, yet the military still has no reliable way to catch brain injuries. When such injuries are left undetected, it can delay healing and put soldiers at risk for further mental damage.

You can read the full ProPublica report HERE.

NPR reports that the National Hockey League may have a better solution when testing for brain injuries.

Another problem with the program is that top military officials did not choose a very good test, according to the Pentagon’s own medical advisers. They say the National Hockey League, whose players are constantly hitting the glass — and each other — has a better test to help spot brain injuries than does the U.S. military.

“We find that the testing program is very useful for our athletes,” says Ruben Echemendia, a chief neurologist for the NHL.

There are various computer brain tests on the market, just like there are different kits to test blood pressure, so to pick the best one, Echemendia assembled a Concussion Working Group with doctors, players’ representatives and others.

“All of the research in their tests, all of the peer-reviewed publications that they had, including the reliability and validity data with the tests, and it was fairly clear to us which program we wanted to use in our testing program,” he says.

ANAM was not that test. Instead, the NHL chose one called ImPact.

According to Echemendia, the test can pinpoint problems in thinking, concentrating or reacting in about 30 percent of the players who say, “No problem, I feel fine,” after slamming their heads.

You can read or listen to the entire NPR story HERE.