Development of a measure to inform return-to-duty decision making after mild traumatic brain injury

Mary Vining Radomski, Margaret M. Weightman, Leslie Freeman Davidson, Marsha Finkelstein, Sarah Goldman, Karen McCulloch, Tanja C. Roy, Matthew Scherer, Erica B. Stern

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Mild traumatic brain injury (mTBI), a principal injury of the wars in Iraq and Afghanistan, can result in significant morbidity. To make accurate return-to-duty decisions for soldiers with mTBI, military medical personnel require sensitive, objective, and duty-relevant data to characterize subtle cognitive and sensorimotor injury sequelae. A military-civilian research team reviewed existing literature and obtained input from stakeholders, end users, and experts to specify the concept and develop a preliminary assessment protocol to address this need. Results of the literature review suggested the potential utility of a test based on dual-task and multitask assessment methods. Thirty-three individuals representing a variety of military and civilian stakeholders/experts participated in interviews. Interview data suggested that reliability/validity, clinical feasibility, usability across treatment facilities, military face validity, and capacity to challenge mission-critical mTBI vulnerabilities were important to ultimate adoption. The research team developed the Assessment of Military Multitasking Performance, a tool composed of eight dual and multitasking testtasks. A concept test session with 10 subjects indicated preliminary face validity and informed modifications to scoring and design. Further validation is needed. The Assessment of Military Multitasking Performance may fill a gap identified by stakeholders for complex cognitive/motor testing to assist return-to-duty decisions for service members with mTBI.

Original languageEnglish (US)
Pages (from-to)246-253
Number of pages8
JournalMilitary medicine
Issue number3
StatePublished - Mar 2013


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