DOD aims for flexibility with brain injury Web tool

The Defense Department is working to enhance its tools and procedures for assessing troops who may have suffered traumatic brain injury while deployed, and improvements in assessment capabilities are critical to troop health, a DOD official testified March 25.

Clifford Stanley, undersecretary of defense for personnel and readiness, told the armed services committees of each house of Congress  that DOD is in the final stages of developing a neurocognitive assessment test tool that would be automated and Web accessible, but would not require Web access, NexGov reported.

DOD reportedly passed on a Web-based version of the Automated Neuropsychological Assessment Metrics tool in favor of a Web-enabled form that could be more flexible in use. In battlefield conditions, Web access isn't always available.

“Intermittent Web connectivity would severely degrade test results for a Web-based tool,” Stanley said in a report submitted to Congress. “Any tool that is completely Web-based will not provide functionality in a disconnected fashion and will present challenges in military operation. This product must operate independent of Internet connectivity to maximize its use and improve test accuracy and performance.”

ANAM is “a proven Army computer-based tool that is being deployed DOD-wide that is designed to detect a service member’s speed and accuracy of attention, memory and thinking ability,” according to a Navy document regarding ANAM’s medical privacy implications. Service members take a baseline test before deployment, and if injured take a second test to be compared to the baseline.

Using the tool in the field, as close to the time of injury as possible, is critical for properly identifying potential damage. It’s a point of contention in the effort to help troops who have may have suffered brain injury from explosions, which is a frequent injury in the wars in Iraq and Afghanistan, according to DOD reports.

Last month, Army Surgeon General Lt. Gen. Eric Schoomaker testified before the House Armed Services Committee that ANAM fails to correctly measure traumatic brain injury between 25 and 33 percent of the time, calling the tool “insensitive and nonspecific.”

Now the Army is testing other assessment tools, Schoomaker said, including Immediate Post-Concussion Assessment and Cognitive Testing, or ImPACT, which the National Football League uses to check for brain injuries, NexGov reported as part of its Broken Warrior series.

Neurocognitive assessments for all service members were mandated in a 2008 memo from the assistant secretary of defense, health affairs, the Navy document noted.