Report: Cognitive Testing Program Fails Soldiers, Leaving Brain Injuries Undetected

Test­ing Pro­gram Fails Sol­diers, Leav­ing Brain Injuries Unde­tect­ed (ProP­ub­li­ca):

“In 2007, with road­side bombs explod­ing across Iraq, Con­gress moved to improve care for sol­diers who had suf­fered one of the war’s sig­na­ture wounds, trau­mat­ic brain injury.

Law­mak­ers passed a mea­sure requir­ing the mil­i­tary to test sol­diers’ brain func­tion before they deployed and again when they returned. The test was sup­posed to ensure that sol­diers received prop­er treatment.

Instead, an inves­ti­ga­tion by ProP­ub­li­ca and NPR has found, the test­ing pro­gram has failed to deliv­er on its promise, offer­ing sol­diers the appear­ance of help, but not the reality.
Rac­ing to sat­is­fy Con­gress’ man­date, the mil­i­tary chose a test that was­n’t actu­al­ly proven to detect TBI: the Auto­mat­ed Neu­ropsy­cho­log­i­cal Assess­ment Met­ric, or ANAM.”

Link to Study:  The DoD ANAM Pro­gram: A Crit­i­cal Review of Sup­port­ing Doc­u­men­ta­tion (Depart­ment of the Army Office of the Sur­geon General).

• “Pur­pose:  Pro­vide a detailed review of the Auto­mat­ed Neu­ropsy­cho­log­i­cal Assess­ment Met­ric (ANAM) Neu­ro-Cog­ni­tive Assess­ment Tool (NCAT) pro­gram to Congress.

• Facts:

• The ANAM pro­gram’s his­to­ry is more trou­bled than has been com­mon­ly under­stood. Although the ANAM was a pio­neer­ing test, devel­oped in the ear­ly days of per­son­al com­put­ers, ANAM nev­er achieved pop­u­lar­i­ty or wide­spread clin­i­cal use.  Pri­or to the selec­tion of the ANAM for DoD use, crit­i­cal head to head stud­ies ranked ANAM toward the bot­tom of com­put­er­ized mea­sures avail­able (Tab 2).
• …

• The selec­tion of ANAM was nepo­tis­tic, and the long delay in exam­in­ing alter­na­tive instru­ments is baf­fling.  Efforts must imme­di­ate­ly begin to com­pare oth­er com­put­er­ized neu­ropsy­cho­log­i­cal tests, in a fair and unbi­ased man­ner, and the best instru­ment select­ed.  The Army is inde­pen­dent­ly seek­ing to com­pare ANAM to ImPACT (TAB 21). Bar­ring replace­ment of the ANAM, seri­ous effort needs to be devot­ed to repair­ing known defects in the ANAM, which may be beyond the licensed ven­dor’s inter­nal abil­i­ties.  If one had to select a test today, the con­sen­sus of the Army’s neu­ropsy­cho­log­i­cal com­mu­ni­ty is clear that the ImPACT is a supe­ri­or test, and the Spe­cial Forces Com­mand made is prop­er deci­sion in using it rather than ANAM.”

To learn more, you can read relat­ed arti­cles on Neu­ropsy­chol­o­gy: Tests, Con­cus­sions, TBI, and more.