Traumatic Brain Injury-2Accuracy of Self-Reported Questions for Assessment of TBI History

Abstract

Objective: Often times a history of traumatic brain injury (TBI) is assessed via self-report using questionnaires. In these assessments, individuals are asked to simply report whether or not they have had a TBI in their lifetime. This relies on a lay person's understanding of what denes a medical diagnosis for a TBI. In contrast, structured clinical interviews such as the Ohio State University TBI Identication Method (OSU TBI-ID) provide clinician guided questions to determine TBI history. The objective of this study was to determine the validity of TBI questionnaires. Method: 115 active duty service members with a mean age of 26.83 (SD = 3.47) completed a self-report TBI questionnaire asking them to report if they have had a concussion or traumatic brain injury. Participants also completed the OSU TBI-ID. Results: On self-report TBI questions, 52 (45.2%) participants reported a previous TBI compared to 81 (70.4%) who had a positive TBI on the OSU-TBI ID. The TBI questionnaire had good specicity (94.12%) but poor sensitivity (61.73%). Negative predictive power was 50.79% while positive predictive power was 96.15%. Only 31.7% of participants reported an accurate number of lifetime TBI's. The majority (51.2%) with a positive TBI history under-reported their total lifetime TBI's. Conclusion: In healthy military personnel, self-reported TBI history based on questionnaires lacks sensitivity in comparison to a clinician directed structured interview. Participants fail to report having had a TBI in their lifetime, and when they do report a positive history, they tend to underestimate the total number of injuries.