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Mardi, 21 Septembre 2010 16:35

Navy SEALs' Instant Brain Injury Test Fizzles

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The Navy SEALs’ much-hyped on-line test to detect traumatic brain injuries churns out a disconcertingly high rate of false positives, according to university researchers

who’ve studied the test in healthy college students.

The finding is bad news for the SEALs, who signed a one-year contract last month with ImPACT Applications to implement the test. It’s an alternative to the Pentagon-mandated Automated Neuropsychological Assessment Metrics (ANAM) tool that the Army surgeon general called “about as effective as a coin flip.”

But it’s also a preview of the results we can expect from a Pentagon-funded study by the Defense and Veterans Brain Injury Center (DVBIC). They’re comparing ImPACT to several other neuroassessment tools, to determine whether any are fit to replace the ANAM as the military’s go-to brain injury test. At least 11,500 troops are suffering from traumatic brain injuries, according to ProPublica.

ImPACT — if effective — would be particularly helpful for the SEALs. The test is taken online, meaning it’d theoretically be available in far-out regions where crews often operate. It’s also entirely computerized, so service members can obtain quick results wherever they are, without a medical specialist on hand.

The SEALS are still using ANAM among active duty crew members, but they’re also touting the benefits of ImPACT, and claim the test is more effective and easier to use than the alternatives.

“We can quickly assess if an operator has suffered a head injury that requires him to be removed from the fight temporarily, or sent to a medical facility for further testing,” Navy Special Warfare Group spokesperson Lt. Catherine Wallace tells NextGov.

But those assessments might not be accurate, according to Professor Steven Broglio at the University of Illinois at Urbana-Champaign. In a 2007 study of ImPACT and two other brain injury tests — both also being reviewed by the DVBIC — Broglio evaluated 118 healthy college students. ImPACT yielded a 38.4 percent false positive rate, meaning it incorrectly diagnosed a vast swath of the students as impaired.

The other two brain injury tests didn’t do much better. They reported 21.9 and 19.2 percent false positive results.

“Reliabilities on some output scores fell within a minimally acceptable range, but no single test had uniformly acceptable reliabilities,” Broglio’s study reads. “No single assessment technique should be used to the exclusion of the others or the physical examination.”

Still, the ANAM tool is in dire need of replacement. Earlier this year, a ProPublica investigation concluded that the military’s brain injury assessments had failed to diagnose thousands of troops, and that diagnoses often weren’t transferred to permanent medical files. Army surgeon general Lt. Gen. Eric Schoomaker told Congress that the ANAM was “fraught with problems,” and “about as effective as a coin flip.”

In other words, the DVBIC review — which includes 2,000 troops and concludes in 2011 — will likely offer a recommendation that’s little more than the lesser of all failures for TBI detection. Meanwhile, the Pentagon’s plodding efforts at overhauling their management of the injuries continue, with plans for a TBI mega-database and long-term research into brain implants that might one day act as “replacement parts” for thousands of ailing vets.

Photo: Department of Defense

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Authors: Katie Drummond

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