F Jay Haran1, Michael N Dretsch2, Jill C Slaboda3, Dagny E Johnson4, Octavian R Adam5, Jack W Tsao6. 1. a Naval Submarine Medical Research Laboratory , Groton , CT , USA. 2. b National Intrepid Center of Excellence , Walter Reed National Military Medical Center , Bethesda , MD USA. 3. c Geneva Foundation , Tacoma , WA , USA. 4. d Eyak Development Corporation , Arlington , VA , USA. 5. e Naval Medical Center Portsmouth , Portsmouth , VA , USA. 6. f US Navy Bureau of Medicine and Surgery , Arlington , VA USA.
Abstract
PRIMARY OBJECTIVE: To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). RESEARCH DESIGN: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. METHODS AND PROCEDURES: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. MAIN OUTCOMES AND RESULTS: There were no statistical differences, p < 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either the norm-referenced (0.65) or baseline-referenced (0.66) approaches, p > 0.05. CONCLUSIONS: Overall, the findings suggest there is no clear advantage of using the baseline-referenced approach over norm-referenced approach.
PRIMARY OBJECTIVE: To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). RESEARCH DESIGN: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. METHODS AND PROCEDURES: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. MAIN OUTCOMES AND RESULTS: There were no statistical differences, p < 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either the norm-referenced (0.65) or baseline-referenced (0.66) approaches, p > 0.05. CONCLUSIONS: Overall, the findings suggest there is no clear advantage of using the baseline-referenced approach over norm-referenced approach.
Authors: Henry W Mahncke; Joseph DeGutis; Harvey Levin; Mary R Newsome; Morris D Bell; Chad Grills; Louis M French; Katherine W Sullivan; Sarah-Jane Kim; Annika Rose; Catherine Stasio; Michael M Merzenich Journal: Brain Date: 2021-08-17 Impact factor: 15.255