Abstract
Despite the high prevalence of traumatic brain injuries (TBI), there are few rapid and straightforward tests to improve its assessment. To this end, we developed a tablet-based software battery ("BrainCheck") for concussion detection that is well suited to sports, emergency department, and clinical settings. This article is a study of the diagnostic accuracy of BrainCheck. We administered BrainCheck to 30 TBI patients and 30 pain-matched controls at a hospital Emergency Department (ED), and 538 healthy individuals at 10 control test sites. We compared the results of the tablet-based assessment against physician diagnoses derived from brain scans, clinical examination, and the SCAT3 test, a traditional measure of TBI. We found consistent distributions of normative data and high test-retest reliability. Based on these assessments, we defined a composite score that distinguishes TBI from non-TBI individuals with high sensitivity (83%) and specificity (87%). We conclude that our testing application provides a rapid, portable testing method for TBI.
Highlights
Between 1.6 and 3.8 million cases of traumatic brain injuries (TBI) are reported every year in America [1], of which 75% are classified as mild [2]
Eligible subjects were patients admitted to the Emergency Department (ED) at Ben Taub Hospital with a chief complaint of head trauma, and were determined by a physician evaluation to have suffered a mTBI in accordance with the diagnostic criteria [11]
We examined the performance of the individual tests as diagnostic of mTBI, presented as specificity and sensitivity as a function of the threshold for distinguishing TBI and healthy individuals (Fig 7)
Summary
BackgroundBetween 1.6 and 3.8 million cases of traumatic brain injuries (TBI) are reported every year in America [1], of which 75% are classified as mild (mTBI) [2]. It is a growing belief that the number of TBI cases are underestimated due to the lack of a central reporting system and the fact that many people with less severe injuries do not seek medical treatment [1, 4, 5]. Such statistics and the downstream neurodevelopmental consequences [6] have created a call to action to provide more objective measures of cognitive functioning— both before an injury occurs, as well as post-injury to measure recovery [7].
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