Diagnostic accuracy of blast-induced traumatic brain injury: a systematic review and meta-analysis
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By
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Peiqi Zhang
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Lanxin Qin
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Fulin Wang
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Pengfei Wu
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Liang Zhang
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Danna Fang
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Jingmei Zhao
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Yuan Yao
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Hui Zhao
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July 13, 2026
Clinical Scorecard: Evaluating the Diagnostic Precision of Blast-Related Traumatic Brain Injury: A Systematic Review and Meta-Analysis
At a Glance
| Category | Detail |
|---|
| Condition | Primary blast-induced traumatic brain injury (bTBI) |
| Key Mechanisms | Injury caused by overpressure and underpressure shock waves from blasts |
| Target Population | Service members on the battlefield |
| Care Setting | Emergency settings |
Key Highlights
- Pooled sensitivity of diagnostic methods was 0.93, specificity was 0.90, and AUC was 0.96.
- Biomarker-based and neuroimaging approaches showed good diagnostic accuracy but may be inaccessible in acute settings.
- VOMS-based assessment is recommended for front-line and field use.
- BATL-2 instrument was identified as the best structured clinical review tool for bTBI.
Guideline-Based Recommendations
Diagnosis
- Utilize clinical interviews, vestibular/ocular motor screening tools, neuroimaging, and biomarkers.
Management
- Implement rapid, non-invasive diagnostic approaches in emergency settings.
Monitoring & Follow-up
- Assess cognitive dysfunction, memory loss, attention difficulties, and vestibular disorders.
Risks
- Underdiagnosis of bTBI may occur, especially when comorbid with PTSD and depression.
Patient & Prescribing Data
U.S. military personnel diagnosed with bTBI.
Focus on developing accessible diagnostic tools for acute battlefield scenarios.
Clinical Best Practices
- Incorporate VOMS into standard concussion assessments.
- Use BATL-2 for structured clinical reviews of bTBI.
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