Common methods for evaluating history of traumatic brain injury (TBI) include self-report, electronic medical record review (EMR), and structured interviews such as the Head Trauma Events Characteristics (HTEC). Each has strengths and weaknesses, but little is known regarding how TBI diagnostic rates or the associated symptom profile differ among them. This study examined 200 Veterans recruited within the VA Portland Health Care System, each evaluated for TBI using self-report, EMR, and HTEC. Participants also completed validated questionnaires assessing chronic symptom severity in broad health-related domains (pain, sleep, quality of life, post-concussive symptoms). The HTEC was more sensitive (80% of participants in our cohort) than either self-report or EMR alone (40%). As expected from the high sensitivity, participants screening positive for TBI through the HTEC included many people with mild or no post-concussive symptoms. Participants were grouped according to degree of concordance across these diagnostic methods: no TBI, n = 43; or TBI-positive in any one method (TBI-1dx, n = 53), positive in any two (TBI-2dx, n = 45), or positive in all three (TBI-3dx, n = 59). The symptom profile of the TBI-1dx group was indistinguishable from the no TBI group. The TBI-3dx group had the most severe symptom profile. Our results show that understanding the exact methods used to ascertain TBI is essential when interpreting results from other studies, given that results and conclusions may differ dramatically depending on the method. This issue will become even more critical when interpreting data merged from multiple sources within newer, centralized repositories (e.g., Federal Interagency Traumatic Brain Injury Research [FITBIR]).

中文翻译：

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创伤性脑损伤诊断的不同方法影响美国退伍军人脑震荡后综合症的存在和症状

评估创伤性脑损伤 (TBI) 病史的常用方法包括自我报告、电子病历审查 (EMR) 和结构化访谈，例如头部外伤事件特征 (HTEC)。每个都有优点和缺点，但关于 TBI 诊断率或相关症状特征在它们之间有何不同，知之甚少。这项研究检查了在 VA 波特兰医疗保健系统内招募的 200 名退伍军人，每个人都使用自我报告、EMR 和 HTEC 评估了 TBI。参与者还完成了经过验证的问卷，以评估广泛的健康相关领域（疼痛、睡眠、生活质量、脑震荡后症状）中慢性症状的严重程度。HTEC 比自我报告或单独的 EMR (40%) 更敏感（我们队列中 80% 的参与者）。正如预期的高灵敏度，通过 HTEC 筛查 TBI 阳性的参与者包括许多有轻微或没有脑震荡后症状的人。参与者根据这些诊断方法的一致性程度进行分组：无 TBI，n  = 43；或 TBI 在任何一种方法中呈阳性（TBI-1dx，n  = 53），在任何两种方法中呈阳性（TBI-2dx，n  = 45），或在所有三种方法中呈阳性（TBI-3dx，n  = 59）。TBI-1dx 组的症状特征与无 TBI 组没有区别。TBI-3dx 组的症状最严重。我们的结果表明，在解释其他研究的结果时，理解用于确定 TBI 的确切方法是必不可少的，因为结果和结论可能因方法的不同而有很大差异。当解释从更新的集中存储库（例如，联邦机构间创伤性脑损伤研究 [FITBIR]）中的多个来源合并的数据时，这个问题将变得更加重要。