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首页> 外文期刊>The Journal of head trauma rehabilitation >Department of Veterans Affairs's traumatic brain injury screening and evaluation program: promoting individualized interdisciplinary care for symptomatic veterans.
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Department of Veterans Affairs's traumatic brain injury screening and evaluation program: promoting individualized interdisciplinary care for symptomatic veterans.

机译：退伍军人事务部的创伤性脑损伤筛查和评估计划：促进有症状退伍军人的个性化跨学科护理。

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WE THANK the editors for the opportunity to provide our viewpoint on traumatic brain injury (TBI) screening by the Department of Veterans Affairs (VA) and Department of Defense (DoD) in response to the article "Screening for a Remote History of Mild TBI: When a Good Idea is Bad" by Drs Vanderploeg and Be-langer in this issue. VA implemented a mandatory screen for possible TBI in April 2007 for all Veterans accessing care in VA that served in the Global War on Terror and separated from active duty service after September 11, 2001. Implementation of the screen was prompted by evidence that exposure to blasts affected brain physiology and function in ways similar to the blunt force to the head experienced in concussion/mild TBI.1 Also, DoD had not yet initiated screening service members postdeployment for possible TBI at the time. When VA implemented the screening, a significant number of ser- vice members had separated from military service, and many were coming to VA for medical care with a constellation of medical complaints. The 4-question screen that was developed identifies Veterans with a history of trauma with immediate as well as current symptoms.2 VA developed the TBI screen realizing that it would not conform to all aspects of medical screening principles but would serve to cast a broad net to identify symptomatic individuals with the goal of connecting them with care. In addition, VA realized that the effects of repeated concussive events secondary to blast in a deployment setting were unknown, thereby increasing VA's obligation to identify affected individuals and offer the best evidence supported interventions available. Those with a positive screen are referred for an evaluation by a TBI specialist for a specific diagnosis and the development of a treatment plan for current complaints (ie, cognitive problems, headaches, irritability, insomnia) regardless of diagnosis.3
机译：我们感谢编辑人员提供机会，对退伍军人事务部（VA）和国防部（DoD）的创伤性脑损伤（TBI）筛查提出看法，以回应文章“筛查轻度TBI的远程病史： “当一个好主意不好时”，Vanderploeg博士和Be-langer撰写。弗吉尼亚州于2007年4月对所有在全球反恐战争中服役并在2001年9月11日之后与现役军人分开的在弗吉尼亚州接受护理的退伍军人实施了可能的TBI强制性检查。影响脑部生理和功能的方式类似于脑震荡/轻度TBI时头部受到的钝力。1此外，DoD当时还没有启动对可能的TBI进行部署后的筛查服务成员。当弗吉尼亚州进行筛查时，许多服务人员已经从兵役中分离出来，许多人带着一些医疗投诉来到弗吉尼亚州接受医疗护理。所开发的四问题筛查可以识别出有外伤史的退伍军人，这些病史既有立即症状也有当前症状。2VA开发了TBI筛查，意识到它不符合医学筛查原则的所有方面，但却可以为人们提供广泛的网络识别有症状的个体，以使他们保持谨慎联系。此外，VA意识到在部署环境中爆炸继发的反复震荡事件的影响尚不清楚，因此增加了VA识别受感染个体并提供最佳证据支持干预措施的义务。筛查结果为阳性的患者将由TBI专家进行评估，以进行具体诊断，并制定针对当前主诉（即认知问题，头痛，烦躁不安，失眠）的治疗计划，而与诊断无关3。

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