Conclusion
This article showcases 3 of the DoD’s TBI clinical tools (MACE 2, PRA CR, and CMT) that assist HCPs in identifying and treating concussion. Over time, these tools undergo revisions according to the state of the science, and are adapted to meet the needs of clinicians and the SMs they treat. Studies are currently ongoing to better understand the effectiveness of these tools as well as to assist clinicians in making return-to-duty and/or medical separation decisions. These tools assist clinicians throughout the recovery process; from initial assessment and treatment (acute phase), as well as with symptom management (acute and protracted symptoms).
Concussion is not a homogenous condition and the experiences of the SM, including events that may cause emotional distress, other injuries and/or other factors, may further complicate the injury. Accordingly, there is no single clinical tool that can conclusively determine return-to-duty status; rather, these tools can help characterize injury, validate, and treat symptoms, which have been suggested to improve outcomes. More research and data are needed confirm the effectiveness of these tools to improve outcomes.
It is beyond the scope of this article to provide a more in-depth discussion on TBI prevention or longer term effects/care. However, there are additional, personalized tools for specific symptoms, deficits, or dysfunctions following concussion. These tools include the Management of Headache Following mTBI for PCM CR, Management of Sleep Disturbances Following mTBI for PCM CR, Assessment and Management of Visual Dysfunction Associated with mTBI CR, and Assessment and Management of Dizziness Associated mTBI CR. These tools enable endpoint users to evaluate and treat SMs as well as know when to elevate to higher levels of care.
The DoD commitment toward treating TBI influenced the development of the clinical tools highlighted in this article. They are the result of collective efforts among military and civilian TBI subject matter experts, data from medical literature and state-of-the-science research, and feedback from endpoint users to create the most effective, evidence-based tools. These tools undergo continuous review and revision to ensure alignment with the most up-to-date science within the field, to meet the needs of SMs and to continue the commitment to DoD concussion care.
Acknowledgments
This work was prepared under Contract (HT0014-19-C-0004) General Dynamics Information Technology and (W81XWH-16-F-0330) Credence Management Solutions, and is defined as U.S. Government work under Title 17 U.S.C.§101. Per Title 17 U.S.C.§105, copyright protection is not available for any work of the U.S. Government. For more information, please contact dha.DVBICinfo@mail.mil.