Pentagon Brass Plots Mega-Database of Brain Injuries

In the latest of a series of efforts to do right by injured troops, the Pentagon is moving forward with an ambitious database to monitor traumatic brain injuries from war-zone diagnosis to post-deployment treatment. And — in a step that could help scientists unravel the injuries — they want the system to link each TBI to specific incidents on the battlefield.

If, that is, the database even works to begin with.

The Pentagon’s plodding attempts to overhaul their management of troop’s mental health has been marred by a series of recent missteps. In early June, an NPR/Propublica report revealed gaping holes in the military’s ability to diagnose PTSD and traumatic brain injuries. And just last week, the leader of the military’s key mental health centers stepped down amid ongoing criticism of facility’s progress.

But while the military was coping with plenty of bad PR, Deputy Secretary of Defense William Lynn III was issuing an action plan for the new database, in a memo obtained by NextGov.com. Lynn notes in the memo that the Pentagon’s policy will now mandate that officials “identify, track and ensure the appropriate protection of service members exposed to concussive events, including blast events, to the maximum extent possible.”


It’s a step the military’s been planning for months, but the 17-page memo marks the first official policy statement on the database, which will enter development stages within six months. The database would be all-encompassing, following troops from the front-lines to post-deployment care. Those exposed to bomb blasts or other trauma would be inputted into the system immediately, via web-based telemedicine portal, and then monitored for developing symptoms. Because TBIs can take months to show up, the database could be a valuable tool in linking post-deployment ailments to war-zone exposures.

And the system could also be a boon for scientists. Lynn calls for “comprehensive, retrospective analyses of relevant event-triggered data,” which could help determine which kinds of blasts leave troops most susceptible to TBIs, and, hopefully, exactly how the blasts affect the brain.

But the idea could have trouble getting off the ground. Because “forward units operate in areas that have little or no bandwidth, which these communications systems require to work properly,” one unnamed source told NextGov that it’s going to be tough — if not impossible — for the military to catch TBIs right after they happen.

Not to mention that the database will still rely on the same flawed diagnostic tools the military’s been criticized over before. As NPR/Propublica revealed, one screening test missed TBIs in 40 percent of afflicted troops, and another was dubbed “as reliable as a coin flip” by top military medical experts.

Of course, the injuries are notoriously tough to diagnose, largely because scientists still aren’t clear exactly what causes them. That was one catalyst for the Pentagon’s new, 72,000 square foot facility for brain injury research, which opened last week.

No doubt, a computerized database would be better than how the military currently keeps tabs on war-zone injuries — pen and paper forms, of which an estimated 400,000 have yet to be inputted into troop medical files. But while a tool that tracks injuries from war-zone to home would make a valuable addition to the Pentagon’s fledgling health-care system, science (not to mention war-zone Internet connections) needs to catch up before any computer system can make a significant impact.
Wired