{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:40:38Z","timestamp":1777927238186,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"22","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>\n                    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                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200943; or TBI-positive in any one method (TBI-1dx,\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200953), positive in any two (TBI-2dx,\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200945), or positive in all three (TBI-3dx,\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200959). 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]).\n                  <\/jats:p>","DOI":"10.1089\/neu.2021.0031","type":"journal-article","created":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T05:27:45Z","timestamp":1628746065000},"page":"3126-3136","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Different Methods for Traumatic Brain Injury Diagnosis Influence Presence and Symptoms of Post-Concussive Syndrome in United States Veterans"],"prefix":"10.1177","volume":"38","author":[{"given":"Jonathan E.","family":"Elliott","sequence":"first","affiliation":[{"name":"VA Portland Health Care System, Portland, Oregon, USA."},{"name":"Department of Neurology, Portland, Oregon, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadir M.","family":"Balba","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System, Portland, Oregon, USA."},{"name":"Department of Behavioral Neuroscience, Portland, Oregon, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alisha A.","family":"McBride","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System, Portland, Oregon, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan L.","family":"Callahan","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System, Portland, Oregon, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kendall T.","family":"Street","sequence":"additional","affiliation":[{"name":"Department of School of Nursing, Portland, Oregon, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew P.","family":"Butler","sequence":"additional","affiliation":[{"name":"Department of Behavioral Neuroscience, Portland, Oregon, USA."},{"name":"Department of Oregon Institute of Occupational Health Sciences, and Portland, Oregon, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary M.","family":"Heinricher","sequence":"additional","affiliation":[{"name":"Department of Behavioral Neuroscience, Portland, Oregon, USA."},{"name":"Department of Neurological Surgery, Portland, Oregon, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda M.","family":"Lim","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System, Portland, Oregon, USA."},{"name":"Department of Neurology, Portland, Oregon, USA."},{"name":"Department of Behavioral Neuroscience, Portland, Oregon, USA."},{"name":"Department of Oregon Institute of Occupational Health Sciences, and Portland, Oregon, USA."},{"name":"Department of Department of Medicine; Division of Pulmonary and Critical Care Medicine Oregon Health &amp; Science University, Portland, Oregon, USA."},{"name":"VA Portland Health Care System, National Center for Rehabilitative Auditory Research, Portland, Oregon, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/2017.10.JNS17352"},{"key":"e_1_3_5_3_2","unstructured":"Centers for Disease Control and Prevention (2016). Injury Prevention and Control: Traumatic Brain Injury and Concussion."},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(77)91649-X"},{"key":"e_1_3_5_5_2","author":"Haarbauer-Krupa J.","year":"2021","unstructured":"Haarbauer-Krupa J., , Pugh M.J., , Prager E.M., , Harmon N., , Wolfe J., , and Yaffe K.C. (2021). Epidemiology of chronic effects of traumatic brain injury. J. Neurotrauma [Epub ahead of print].","journal-title":"J. Neurotrauma"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2016.4434"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.06.015"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.6.711"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968304271405"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.26855"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.patbio.2014.05.014"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1023\/B:NERV.0000048181.46159.61"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617708080272"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7482"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7220"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsz237"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2013.08.297"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.yco.0000165601.29047.ae"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2018.03.004"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/02699050410001675906"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001199-200501000-00003"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0b013e3181e50ef1"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.HTR.0000300233.98242.87"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2009.06.0076"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.HTR.0000300227.67748.77"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617709990841"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2011.02.0017"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0b013e318281966e"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22059"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2018.5801"},{"key":"e_1_3_5_31_2","volume-title":"Insomnia. Psychological Assessment and Management","author":"Morin C.M.","year":"1993","unstructured":"Morin C.M. (1993). Insomnia. Psychological Assessment and Management. Guilford Press: New York."},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(00)00065-4"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-006-9047-6"}],"container-title":["Journal of Neurotrauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/neu.2021.0031","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2021.0031","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2021.0031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:38:33Z","timestamp":1777675113000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/neu.2021.0031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":32,"journal-issue":{"issue":"22","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1089\/neu.2021.0031"],"URL":"https:\/\/doi.org\/10.1089\/neu.2021.0031","relation":{},"ISSN":["0897-7151","1557-9042"],"issn-type":[{"value":"0897-7151","type":"print"},{"value":"1557-9042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}