VA Health Care: Mild Traumatic Brain Injury Screening and Evaluation Implemented for OEF/OIF Veterans, but Challenges Remain
Highlights
Traumatic brain injury (TBI) has emerged as a leading injury among servicemembers serving in the Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) combat theaters. The widespread use of improvised explosive devices, such as roadside bombs, in these combat theaters increases the likelihood that servicemembers will be exposed to incidents that can cause a TBI. TBIs can vary from mild to severe, and in general, mild TBI can be difficult to identify. Because mild TBI can have lasting effects if not identified and treated, concerns have been raised about how the Department of Veterans Affairs (VA) identifies and treats OEF/OIF veterans with a mild TBI. In this report GAO describes VA's (1) efforts to screen OEF/OIF veterans for mild TBI, (2) steps taken so that those OEF/OIF veterans at risk for mild TBI are evaluated and treated, and (3) challenges in screening and evaluating OEF/OIF veterans for mild TBI. GAO reviewed VA's policies, interviewed VA officials and TBI experts, and reviewed nine VA medical facilities' efforts to implement TBI screening and evaluation processes.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Veterans Affairs | To establish whether the use of VA's TBI screening tool is effective in identifying OEF/OIF veterans at risk for mild TBI, the Secretary of Veterans Affairs should direct the Under Secretary for Health to expeditiously evaluate the clinical validity and reliability of VA's TBI screening tool. |
Closed – Implemented
VA has evaluated the clinical validity and reliability of VA's TBI screening tool through conducting seven investigations related to evaluating Traumatic Brain Injury (TBI) screening instruments. Four of these studies had been completed as of May 2012, with the remaining three studies expected to be completed by the end of 2012. Studies included (1) Validation of Brief Objective Neurobehavioral Detectors of Mild TBI, (2) Characteristics of the TBI Clinical Reminder Screening Process, (3) Evaluation of VA's TBI Clinical Reminder and Secondary Level Evaluation, (4) Evaluation of TBI Screening Processes and Healthcare Utilization, (5) TBI Evaluation Instruments and Processes for Clinical Follow-up, (6) TBI Screening Instruments and Processes for Clinical Follow-Up, and (7) Existing Practice Patterns for Screening Mild TBI in Operation Enduring Freedom and Operation Iraqi Freedom Veterans.
|