Reliable Change Estimates for Assessing Recovery From Concussion Using the ANAM4 TBI-MIL.
To establish the reliable change parameters for the Automated Neuropsychological Assessment Metrics (ANAM) using a healthy normative sample of active duty service members (SMs) and apply the parameters to sample of recently deployed SMs.



Postdeployment neurocognitive performance was compared in 1893 US Marines with high rates of combat exposure during deployment. Of the sample, 289 SMs had data for 2 predeployment assessments and were used as a normative subsample and 502 SMs had data for predeployment and postdeployment assessments and were used as a deployed subsample. On the basis of self-report, the deployed subsample were further classified as concussed (n = 238) or as nonconcussed controls (n = 264). Reliable change parameters were estimated from the normative sample and applied data for both deployed groups. Postdeployment performance was quantified using a general linear model (2 group × 2 time) multivariate analysis of variance with repeated measures.



Both deployed groups demonstrated a pattern of meaningful decreases in performance over time.



Information from this effort, specifically the reliable change parameters and the base rates of reliable decline, can be used to assist with the identification of postdeployment cognitive issues.
Biomedical Research & Operations Department, Navy Experimental Diving Unit, Panama City Beach, Florida (LT Haran, MSC, USN); Yale Medical School, New Haven, Connecticut (Ms Alphonso); Pricewaterhouse Coopers (Dr Creason); Naval Space and Warfare Systems Center Pacific, San Diego, California (LCDR Campbell, MSC, USN); Eyak Development Corporation, Arlington, Virginia (Mss Johnson and Young); Traumatic Brain Injury Programs, Wounded, Illinois, and Injured Directorate, US Navy Bureau of Medicine and Surgery, Arlington, Virginia (CAPT Tsao, MC, USN).
F J
FJ
Haran
Aimee L
AL
Alphonso
Alia
A
Creason
Justin S
JS
Campbell
Dagny
D
Johnson
Emily
E
Young
Jack W
JW
Tsao
D000328:Adult; D001924:Brain Concussion / Q000175:diagnosis*; D016022:Case-Control Studies; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008889:Military Personnel; D009483:Neuropsychological Tests; D057566:Self Report; D055815:Young Adult