Observational studyThe Journal of head trauma rehabilitation
Traumatic Brain Injury Classification Variability During the Afghanistan/Iraq Conflicts: Surveillance, Clinical, Research, and Policy Implications.
Observational study in The Journal of head trauma rehabilitation. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 19 citations in OpenAlex.
- Challenges with Tracking Post Concussive Symptoms Using the Neurobehavioral Symptom Inventory in Active Duty Service Members with Mild Traumatic Brain Injury.Military medicine · 2026Article
- Suicide-related outcomes in veterans with post-traumatic headache: a retrospective cohort study.Lancet regional health. Americas · 2026Article
- Access to Outpatient Occupational Therapy Services After Inpatient Psychiatric Hospitalization in the Veterans Health Administration.The American journal of occupational therapy : official publication of the American Occupational Therapy Association · 2025Article
- Article
- An evaluation and comparison of traumatic brain injury data sources within the VA Million Veteran Program: A descriptive epidemiological study.Journal of psychiatric research · 2025Article
- Profiles of Nonpharmacologic Treatment Receipt in the First 10 Weeks Following a New Back Pain Diagnosis Among Active Duty Soldiers: A Latent Class Analysis.Military medicine · 2025Article
- Associations of Military-Related Traumatic Brain Injury With New-Onset Mental Health Conditions and Suicide Risk.JAMA network open · 2023Article
- Quality of Opioid Use Disorder Treatment for Persons With and Without Disabling Conditions.JAMA network open · 2023Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectiveChallenges associated with case ascertainment of traumatic brain injuries (TBIs) sustained during the Afghanistan/Iraq military operations have been widespread. This study was designed to examine how the prevalence and severity of TBI among military members who served during the conflicts were impacted when a more precise classification of TBI diagnosis codes was compared with the Department of Defense Standard Surveillance Case-Definition (DoD-Case-Definition).
settingIdentification of TBI diagnoses in the Department of Defense's Military Health System from October 7, 2001, until December 31, 2019.
participantsMilitary members with a TBI diagnosis on an encounter record during the study window.
designDescriptive observational study to evaluate the prevalence and severity of TBI with regard to each code set (ie, the DoD-Case-Definition and the more precise set of TBI diagnosis codes). The frequencies of index TBI severity were compared over time and further evaluated against policy changes. MAIN MEASURES: The more precise TBI diagnosis code set excludes the following: (1) DoD-only extender codes, which are not used in other healthcare settings; and (2) nonprecise TBI codes, which include injuries that do not necessarily meet TBI diagnostic criteria.
resultsWhen comparing the 2 TBI classifications, the DoD-Case-Definition captured a higher prevalence of TBIs; 38.5% were classified by the DoD-Case-Definition only (>164 000 military members). 73% of those identified by the DoD-Case-Definition only were diagnosed with nonprecise TBI codes only, with questionable specificity as to whether a TBI occurred.
conclusionWe encourage the field to reflect on decisions made pertaining to TBI case ascertainment during the height of the conflicts. Efforts focused on achieving consensus regarding TBI case ascertainment are recommended. Doing so will allow the field to be better prepared for future conflicts, and improve surveillance, screening, and diagnosis in noncombat settings, as well as our ability to understand the long-term effects of TBI.
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