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Traumatic Brain Injury (TBI) is considered the signature injury of the Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) conflicts. Penetrating TBI is clearly observable and receives immediate care. Closed TBIs are less apparent and can go undiagnosed--this has been particularly true for mild TBIs. Symptoms of mild TBI can include dizziness, nausea, blurred vision, ringing in ears and depression--all of which can be very debilitating. However, if properly diagnosed, mild TBIs can be effectively treated. Of particular importance, therefore, are screening characteristics and associations of the VA's TBI screening instrument. Considerable research efforts are necessary to evaluate and improve, if necessary, its performance.

While VA HSR&D now has a growing portfolio of TBI studies, we recently solicited concept papers for Service Directed Research projects examining the quality, usefulness, and potential improvement of VA's screening for TBI. Of the 19 concept papers we received and reviewed, 8 were approved for full proposals and many of the others were encouraged to submit Investigator Initiated Research proposals to the VA ORD comprehensive TBI solicitation that included an HSR&D component. HSR&D researchers are encouraged to consider investigations around operational definitions for TBI, TBI screening instruments, and tools that measure the long-term outcomes for veterans with TBI.

I strongly encourage health services researchers, clinical researchers, and epidemiologists to continue to consider this rapidly growing area of investigation. It is a key concern for VA and for our OEF/OIF veterans and their families.

Seth A. Eisen, M.D., M.Sc.
Director, HSR&D