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New study highlights the differences in assessment and management of mild traumatic brain injury
A new study highlights the differences in assessment and management of mild traumatic brain injury (mTBI) presented at hospital emergency departments, when compared with mTBIs specifically obtained through sports injuries.
The study, published in the Journal of the International Neuropsychological Society (JINS), aimed to evaluate the reliability and validity of three computerized neurocognitive tests (CNT) in assessing mTBI in patients recruited through a level one trauma center emergency department.
Most mTBIs occur in civilian, patient-based populations. Despite this, there has been limited scientific progress made to understand the effects of these injuries and to improve its assessment and management, in comparison to the progress made in the understanding of sports related mTBIs. For example, there are now a range of CNT batteries developed which are widely used in assessment of sports related mTBIs.
This study aimed to determine whether the CNTs regularly used in sports related mTBIs also hold clinical utility for the broader mTBI population presented at hospital emergency departments.
The three CNTs evaluated in this study were Automated Neuropsychological Assessment Metrics (ANAM), Defense Automated Neurobehavioral Assessment (DANA), and the most commonly used, Immediate Post-Concussion and Cognitive Testing (ImPACT).
When used on mTBI patients recruited from an emergency department, none of the three CNTs tested provided more than minimal discrimination between mTBI and trauma control groups within 72 hours of injury, or at later points in time. These findings contrast those previously published in assessments of CNTs on sports-related mTBIs, which found stronger between-group differences in performance within 24 hours of injury.
The researchers believe the limited discrimination observed in neurocognitive measures between the patients with non-sports related mTBIs is likely due to the nonspecific neurocognitive sequelae of recent traumatic injury. Thus, the CNTs which are commonly used for assessment in sports-related mTBI appear less valuable for patients who have presented at emergency departments with mTBIs caused by other means.
Neurocognitive assessment may provide supporting data on patients' presenting concerns then, but it does not seem to be useful for diagnosis.
The article, Prospective, Head-to-Head Study of Three Computerized Neurocognitive Assessment Tools Part 2: Utility for Assessment of Mild Traumatic Brain Injury in Emergency Department Patients, has been made freely available to all for a limited time until April 30 2017.
About the Journal of the International Neuropsychological Society (JINS)
JINS is the official journal of the International Neuropsychological Society, an organization of over 4,700 international members from a variety of disciplines. Our editorial board is comprised of internationally known experts with a broad range of interests. JINS publishes empirically-based articles covering all areas of neuropsychology and the interface of neuropsychology with other areas, such as cognitive neuroscience. Theoretically driven work that has clinical implications is of particular interest.
For further information, go to www.cambridge.org/INS.
About Cambridge University Press
Cambridge University Press is part of the University of Cambridge. It furthers the University's mission by disseminating knowledge in the pursuit of education, learning and research at the highest international levels of excellence. Its extensive peer-reviewed publishing lists comprise 50,000 titles covering academic research and professional development, as well as school-level education and English language teaching. Playing a leading role in today's international marketplace, Cambridge University Press has more than 50 offices around the globe, and it distributes its products to nearly every country in the world.
For further information, go to www.cambridge.org