MIL12438 365..371

The Defense Automated Neurobehavioral Assessment (DANA) is a new neurocognitive assessment tool that includes a library of standardized cognitive and psychological assessments, with three versions that range from a brief 5-minute screen to a 45-minute complete assessment. DANA is written using the Android open-source operating system and is suitable for multiple mobile platforms. This article presents testing of DANA by 224 active duty U.S. service members in five operationally relevant environments (desert, jungle, mountain, arctic, and shipboard). DANA was found to be a reliable instrument and compared favorably to other computer-based neurocognitive assessments. Implications for using DANA in far-forward military settings are discussed. INTRODUCTION In January 2009, the U.S. Navy Bureau of Medicine and Surgery identified a need to enhance existing battlefield concussion assessment and requested the development of a durable, portable, and field-hardened neurocognitive assessment tool (NCAT) to provide a practical means to conduct neurocognitive and psychological assessment in field deployment settings. The purpose of combining neurocognitive and psychological assessment was to permit more comprehensive evaluation of the broad range of problems that may be encountered during combat deployment. This article describes the resulting NCAT, Defense Automated Neurobehavioral Assessment (DANA); DANA’s psychometric properties based on assessment of 224 active duty U.S. service members under challenging field conditions; and presents comparisons to published NCAT data. DANA consists of three test batteries of different durations and compositions designed for increasingly detailed assessment (Table I). The three batteries include (1) DANA Rapid, a 5-minute battery of three basic reaction-time measures; (2) DANA Brief, a 15-minute test that includes DANA Rapid plus additional neurocognitive tests as well as psychological screening tools for post-traumatic stress disorder (PTSD), depression, and insomnia; and (3) DANA Standard, a 45-minute more comprehensive battery of neurocognitive and psychological tests. This hierarchical set of batteries is designed to facilitate health care providers’ access to standardized, reliable, and valid objective and subjective measures. DANA’s portability, multiple test batteries, and user-friendly interface enable its use by a wide range of health care providers, from frontline medics/corpsmen to licensed health care professionals. Establishing reliability and feasibility of this platform in a military population is necessary before attempting clinical validation and utilization. The eventual goal of DANA is to assist clinicians to (a) make rapid and accurate assessment of cognitive and psychological dysfunction secondary to brain injury and/or the psychological wounds and stressors of war, *AnthroTronix, 8737 Colesville Road, Suite L-203, Silver Spring, MD 20910. †Department of Veterans Affairs, National Center for PTSD, Pacific Islands Health Care System, 3375 Koapaka Street, Honolulu, HI 96819. ‡National Intrepid Center of Excellence, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Building 51, Bethesda, MD 20889. §Wounded, Ill and Injured Directorate, US Navy Bureau of Medicine and Surgery, 7700 Arlington Boulevard, Falls Church, VA 22032. The preliminary data of this article, “Defense Automated Neurobehavioral Assessment (DANA): A Field-Deployable Tool for Assessing Concussion and Deployment Stress,” was presented as an oral presentation by the authors J.L. S. , C.L. , J.B. , and J.W. T. at the Military Health System Research Symposium (MHSRS) Conference, Fort Lauderdale, FL, August 2012. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Veterans Affairs, the Department of the Navy, the Department of Defense, or the U.S. Government. doi: 10.7205/MILMED-D-12-00438 MILITARY MEDICINE, Vol. 178, April 2013 365 D ow naded rom http/academ ic.p.com /m ilm ed/article-ab/178/4/365/4222858 by gest on 15 M arch 2020 (b) facilitate referral to treatment for wounded service members, (c) monitor recovery, and (d) aid in return-to-duty determination. Thus, DANA is intended to enhance military capability and better ensure a healthy fighting force.