Background: Mild traumatic brain injury (mTBI) occurs at a higher frequency among military personnel than among civilians. A common symptom of mTBIs is cognitive dysfunction. Health care professionals use neuropsychological assessments as part of a multidisciplinary and best practice approach for mTBI management. Such assessments support clinical diagnosis, symptom management, rehabilitation, and return-to-duty planning. Military health care organizations currently use computerized neurocognitive assessment tools (NCATs). NCATs and more traditional neuropsychological assessments present unique challenges in both clinical and military settings. Many research gaps remain regarding psychometric properties, usability, acceptance, feasibility, effectiveness, sensitivity, and utility of both types of assessments in military environments. Objective: The aims of this study were to explore evidence regarding the use of NCATs among military personnel who have sustained mTBIs; evaluate the psychometric properties of the most commonly tested NCATs for this population; and synthesize the data to explore the range and extent of NCATs among this population, clinical recommendations for use, and knowledge gaps requiring future research. Methods: Studies were identified using MEDLINE, Embase, American Psychological Association PsycINFO, CINAHL Plus with Full Text, Psych Article, Scopus, and Military & Government Collection. Data were analyzed using descriptive analysis, thematic analysis, and the Randolph Criteria. Narrative synthesis and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews) guided the reporting of findings. The psychometric properties of NCATs were evaluated with specific criteria and summarized. Results: Of the 104 papers, 33 met the inclusion criteria for this scoping review. Thematic analysis and NCAT psychometrics were reported and summarized. Conclusions: When considering the psychometric properties of the most commonly used NCATs in military populations, these assessments have yet to demonstrate adequate validity, reliability, sensitivity, and clinical utility among military personnel with mTBIs. Additional research is needed to further validate NCATs within military populations, especially for those living outside of the United States and individuals experiencing other conditions known to adversely affect cognitive processing. Knowledge gaps remain, warranting further study of psychometric properties and the utility of baseline and normative testing for NCATs.

中文翻译：

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轻度颅脑外伤军事人员的神经认知评估工具：范围研究综述

背景：军事人员中轻度颅脑损伤的发生频率高于平民中。mTBI的常见症状是认知功能障碍。卫生保健专业人员使用神经心理学评估作为mTBI管理的多学科和最佳实践方法的一部分。这些评估支持临床诊断，症状管理，康复和重返工作计划。军事卫生保健组织当前使用计算机化的神经认知评估工具（NCAT）。NCAT和更传统的神经心理学评估在临床和军事环境中都提出了独特的挑战。在军事环境中两种评估类型的心理测量特性，可用性，接受性，可行性，有效性，敏感性和实用性方面，仍存在许多研究空白。目的：本研究的目的是探索在患有持续性mTBIs的军事人员中使用NCAT的证据；评估该人群中最常测试的NCAT的心理测量特性；并综合数据以探讨该人群中NCAT的范围和程度，临床使用建议以及需要进一步研究的知识缺口。方法：使用MEDLINE，Embase，美国心理学会PsycINFO，带有全文的CINAHL Plus，心理文章，Scopus以及军事和政府收藏来鉴定研究。使用描述性分析，主题分析和兰道夫准则对数据进行了分析。叙事综合和PRISMA-ScR（系统评价的首选报告项目和范围界定评价的元分析扩展）指导了调查结果的报告。NCAT的心理计量学特性通过特定标准进行评估并进行总结。结果：在104篇论文中，有33篇符合本研究范围的纳入标准。报告并总结了主题分析和NCAT心理计量学。结论：考虑军事人群中最常用的NCAT的心理计量学特性时，这些评估尚未证明具有mTBI的军事人员具有足够的有效性，可靠性，敏感性和临床实用性。需要进一步的研究来进一步验证军事人群中的NCAT，尤其是对于居住在美国以外的人群以及正在经历已知会对认知加工产生不利影响的其他条件的个人。知识方面的差距仍然存在，有必要进一步研究心理计量学特性以及对NCAT进行基准测试和规范测试的实用性。