First web-based TBI screening tool for veterans

A team of researchers at Mount Sinai School of Medicine has developed the first web-based screening tool for Traumatic Brain Injury (TBI). This instrument has recently been used by soldiers returning from the wars in Iraq and Afghanistan who participated in the Sixth Annual Road to Recovery Conference and Tribute in Orlando to determine if they sustained a TBI.

"Traumatic brain injury is underdiagnosed, and left untreated can have long-term cognitive, behavioral and physical effects," said Wayne Gordon, PhD, the Jack Nash Professor of Rehabilitation Medicine and an Associate Director of the Department of Rehabilitation Medicine at Mount Sinai School of Medicine, who led the project. "If we can intervene and diagnose TBI early, then we can prevent further complications."

Dr. Gordon and his team began working on this screening tool 20 years ago. Working in local schools, they found a surprising number of students with TBI but never reported it nor received medical attention, often because the injuries were sustained as a result of abuse or assault. Dr. Gordon wanted to develop an anonymous screening tool to help people assess their risk and avoid long-term complications.

The Brain Injury Screening Questionnaire (BISQ) is a web-based tool that allows users to anonymously answer a series of questions about whether they sustained a blow to the head in which they were unconscious or dazed, confused or disoriented. Their symptoms include sleep disturbances, irritability, memory disturbances, difficulties organizing daily tasks, and difficulty concentrating. At the end of the survey, participants receive a computer-generated report. Those who are found to be at risk are advised to seek further evaluation from a qualified health care professional.

According to Mark Wiederhold, MD, who presented at the conference, TBI was diagnosed in 41 percent of patients being treated in the Walter Reed Army Medical Center in Washington, DC. Dr. Gordon hopes that more veterans' organizations will embrace the tool in this population so that they are treated early.

"I applaud the Coalition to Salute America's Heroes and The American Legion for taking the first step toward bringing this serious issue to the forefront, and encouraging veterans to get screened," said Dr. Gordon. "I hope more organizations around the country will follow suit."

It is estimated that about seven percent of people in the United States have diagnosed or undiagnosed TBI. Dr. Gordon and his team from the Department of Rehabilitation Medicine at Mount Sinai plan to conduct research using the screening tool in other populations as well. The researchers are using BISQ to assess TBI in the prison population in Texas to determine how the condition may contribute to criminality.