title: Evaluation of the Military Acute Concussion Evaluation for use in combat operations more than 12 hours after injury.
abstract: The diagnosis and management of concussion can be difficult in a combat environment, especially in the absence of loss of consciousness or post-traumatic amnesia. As no validated test exists to diagnose or grade neurocognitive impairment from a concussion, the military currently employs the Military Acute Concussion Evaluation (MACE) in Iraq. This is a two-part test, which incorporates the standardized assessment of concussion (SAC) as its objective score, although it has not been shown to be valid unless administered shortly after injury. A research team deployed to Iraq between January and April 2009 to examine the validity of several tests of neurocognitive function following a concussion, including the MACE. When administered more than 12 hours after the concussive injury, the MACE lacked sufficient sensitivity and specificity to be clinically useful.
authors.affiliation: Uniformed Services University of the Health Sciences, Department of Preventive Medicine and Biometrics, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
authors.forename: Rodney L
authors.initials: RL
authors.lastname: Coldren
authors.forename: Mark P
authors.initials: MP
authors.lastname: Kelly
authors.forename: Robert V
authors.initials: RV
authors.lastname: Parish
authors.forename: Michael
authors.initials: M
authors.lastname: Dretsch
authors.forename: Michael L
authors.initials: ML
authors.lastname: Russell
mesh_terms: D000328:Adult; D001924:Brain Concussion / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel; D008890:Military Psychiatry / Q000379:methods*; D009483:Neuropsychological Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013997:Time Factors; D015599:Trauma Severity Indices