INTRuST Structured Assessment For Evaluation of TBI (SAFE-TBI)

NCT01554891 | Completed Results DMC

• 1 other identifier: INTRuST-SAFE-TBI
• Study Type: observational
• Target: 305
• Locations: 1 country
• Sites: 6

Brief Summary

The current study will evaluate the initial reliability and validity of a new instrument, the INTRuST Structured Assessment for Evaluation of TBI (SAFE-TBI), in three samples of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) veterans. The SAFE-TBI is a relatively brief measure developed by INTRuST consortium investigators and designed to be given by a trained administrator. It allows for a determination of the level of evidence for exposure to a mild traumatic brain injury (TBI) using the following categories: Strong, Moderate, Weak, or No Evidence of mild TBI. The first objective is to determine the reliability (both test-retest and inter-rater) in a sample of 100 veterans recently returned from deployment at Joint Base Lewis-McChord and Fort Bragg (Cohort 1), who have screened positive for TBI on the Post-Deployment Health Assessment. The second objective is to determine the concordance between the SAFE-TBI and the VA TBI Screen in 100 OEF/OIF/OND veterans within the Northern New England VA Research Consortium (Cohort 2). The third objective, to be carried out in a sample of 200 Walter Reed National Military Medical Center (WRNMMC) and Fort Belvoir Community Hospital OEF/OIF/OND patients (Cohort 3), is to determine the sensitivity and specificity of the SAFE-TBI using the INTRuST study "Brain Indices of Risk for Posttraumatic Stress Disorder after Mild Traumatic Brain Injury" initial evaluation as the "gold standard" for TBI assessment.

Conditions

Brain Injuries, Traumatic

Keywords

brain injuries, traumatic; military personnel; classification; diagnosis; instrumentation

Outcome Measures

Primary Outcomes (3)

• Test-retest Reliability SAFE-TBI

  Reliability of SAFE-TBI, as determined by test-retest and inter-rater reliability, in a sample of 100 veterans recently returned from deployment (Cohort 1) Cohort 1: The primary endpoints for this sub-study (cohort) are the degree of agreement for SAFE-TBI outcome (no evidence of TBI vs. at least, weak evidence of TBI) across the two assessment time points (initial vs. 4 to 6 weeks) as well as the two rater types TRC vs. TBIC. (Specific Aim 1).

  Up to 6 weeks

• Concordance Rate of Current VA Screening Instruments and the SAFE-TBI.

  Concordance rate of current VA TBI screening instruments and the SAFE-TBI in 100 OEF/OIF/OND veterans who have screened positive for TBI (Cohort 2) Cohort 2: The primary endpoint for this sub-study is the distribution of SAFE-TBI outcome (percent assigned to each evidence category of the SAFE-TBI) in a group of veterans who have screened positive on the VA TBI screen. (Specific Aim 2).

  baseline

• Sensitivity and Specificity of the SAFE-TBI

  Sensitivity = True Positives/(True Positive + False Negatives) Specificity = True Negatives/(True Negative + False Positives) Cutoff 2 = At least moderate evidence of TBI vs. no or weak evidence of TBI

  6-months after medical evacuation

Study Arms (3)

Cohort 1

100 OEF/OIF/OND veterans returning to Joint Base Lewis-McChord and Fort Bragg who screen positive for TBI on the Post Deployment Health Assessment (PDHA) TBI screen

Cohort 2

100 OEF/OIF/OND veterans seeking care at Northern New England VA Research Consortium (NNEVARC) VA Medical Centers (VAMCs) who screen positive for TBI on VA Level 1 TBI screen

Cohort 3

200 participants in WRNMMC and Fort Belvoir Community Hospital Brain Indices Study (100 with mild TBI; 100 without mild TBI).

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Cohort 1: Active duty OEF/OIF/OND military personnel ages 18-60 who have recently screened positive for TBI following deployment. Cohort 2: OEF/OIF/OND veterans ages 18-60 who have recently screened positive for TBI. Cohort 3: Participants ages 18-60 in the INTRuST Consortium Brain Indices Study at WRNMMC or FBCH.

You may qualify if:

• Cohort 1:
• Military personnel returning to Joint Base Lewis-McChord and Fort Bragg from deployment in support of OEF/OIF/OND between the ages of 18-60.
• Screen positive on the PDHA TBI screen and referred to the Madigan Army Medical Center TBI clinic and Womack Army Medical Center.
• Capable of giving informed consent.
• Cohort 2:
• Veterans of OEF/OIF/OND between the ages of 18-60, receiving care at any of the three VAMCs that comprise the Northern New England VA Research Consortium (White River Junction, VT; Manchester, NH; Togus, ME).
• Screen positive on the VA Level 1 TBI screen.
• Capable of giving informed consent.
• Cohort 3:
• Must be a patient at WRNMMC or FBCH
• Must be Defense Enrollment Eligibility Reporting System (DEERS) eligible.
• Must be diagnosed TBI positive or certified as TBI negative by a licensed medical practitioner using Department of Defense (DoD) criteria
• For mTBI subjects, an initial score of 13-15 on the Glasgow Coma Scale
• Aged 18-60

You may not qualify if:

• Cohort 1:
• Speech/language deficit of sufficient severity to preclude answering interview questions
• Unable or unwilling to provide informed consent and Health Insurance Portability and Accountability Act (HIPAA)authorization ("unable" includes cases in which the potential subject cannot read and understand English well enough to provide informed consent).
• Cohort 2:
• Speech/language deficit of sufficient severity to preclude answering interview questions.
• Unable or unwilling to provide informed consent and HIPAA authorization ("unable" includes cases in which the potential subject cannot read and understand English well enough to provide informed consent).
• Second level in-depth TBI evaluation done prior to SAFE TBI interview
• Cohort 3:
• Unable or unwilling to provide informed consent and HIPAA authorization ("unable" includes cases in which the potential subject cannot read and understand English well enough to provide informed consent).
• Penetrating head injury.
• Record of drug or alcohol abuse or dependence in the past six months as documented in medical chart.
• Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders -IV (SCID) reveals current or lifetime PTSD diagnosis related to life events that occurred prior to most recent deployment.
• Taking intravenous medications for pain; participation will be delayed until such medication has been discontinued.

Sponsors & Collaborators

• INTRuST, Post-Traumatic Stress Disorder - Traumatic Brain Injury Clinical Consortium: lead
• U.S. Army Medical Research and Development Command: collaborator

Study Sites (6)

Walter Reed National Military Medical Center

Washington D.C., District of Columbia, 20307, United States

Location

Togus VA Medical Center

Augusta, Maine, 04330, United States

Location

Manchester VA Medical Center

Manchester, New Hampshire, 03104, United States

Location

White River Junction VA Medical Center

White River Junction, Vermont, 05009-0001, United States

Location

Fort Belvoir Community Hopsital (FBCH)

Fort Belvoir, Virginia, 22060, United States

Location

Madigan Army Medical Center

Fort Lewis, Washington, 98431, United States

Location

MeSH Terms

Conditions

Brain Injuries, Traumatic; Disease

Condition Hierarchy (Ancestors)

Brain Injuries; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Craniocerebral Trauma; Trauma, Nervous System; Wounds and Injuries; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Results Point of Contact

• Title: Laura A. Flashman, Ph.D.
• Organization: Geisel School of Medicine at Dartmouth

flashman@dartmouth.edu

6036505824

Study Officials

• Laura A. Flashman, PhD

  Dartmouth-Hitchcock Medical Center

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 12, 2012
• First Posted: March 15, 2012
• Study Start: February 1, 2012
• Primary Completion: September 1, 2014
• Study Completion: March 1, 2015
• Last Updated: March 3, 2016
• Results First Posted: March 3, 2016

Record last verified: 2016-03

Locations

US (6)