To systematically evaluate the existing diagnostic approaches of primary blast-induced brain injury through meta-analysis.
Approach:
Systematic Review and Meta-Analysis: Conducted in PubMed, Web of Science, Cochrane Library, and Defense Technical Information Center databases, focusing on clinical interviews, vestibular/ocular motor screening tools, neuroimaging, and non-specific biomarkers.
Statistical Analysis: Utilized univariate meta-regression and subgroup analyses to identify sources of heterogeneity.
Key Findings:
Pooled sensitivity: 0.93 [95%CI: 0.81–0.97]
Pooled specificity: 0.90 [95%CI: 0.80–0.95]
Area Under Curve (AUC): 0.96 [95%CI: 0.94–0.98]
Biomarker-based and neuroimaging approaches showed good diagnostic accuracy but were less accessible in acute battlefield scenarios.
VOMS-based assessment may be more suitable for front-line use.
BATL-2 instrument performed best among structured clinical review tools.
Interpretation:
High diagnostic accuracy exists for primary blast-related TBI, but applicability varies across clinical scenarios.
Limitations:
Diagnostic tools may not be accessible in acute, resource-constrained environments.
Existing studies may have variability in their methodologies.
Conclusion:
Efforts should focus on developing rapid, non-invasive, and precise diagnostic approaches for primary blast-related TBI in emergency settings.
