Reliable Change Estimates for Assessing Recovery From Concussion Using the ANAM4 TBI-MIL
F J Haran1, Aimee L Alphonso, Alia Creason
1Biomedical 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).
Objective:
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.
Methods:
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.
Results:
Both deployed groups demonstrated a pattern of meaningful decreases in performance over time.
Conclusions:
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.
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