For the registry to have the greatest benefit, predeployment information on all groups mentioned above should be made available to the injury-research community. Complete medical information on outcomes of each person (stripped of personal identifiers) in the registry should be available whether or not care is sought at or covered by the VA system.
In considering the question of long-term outcomes of TBI, questions arise that are very seldom addressable in current studies: What was the predeployment cognitive ability of the person? How did the TBI affect the baseline functioning? The answers to those questions are important in isolating and understanding the effects of TBI itself on long-term outcome. Most information about TBI effects comes from studies of World War I, World War II, and Vietnam veterans, but those studies are based on penetrating or severe closed head injuries. In the current conflict, many injuries are related to blast, and outcomes are unknown.
In an effort to understand the long-term outcomes of traumatic brain injury, including consequences that might be related to blast, the committee recommends that all deployed military personnel undergo predeployment neurocognitive testing. The committee also recommends postdeployment neurocognitive testing of representative samples of military personnel (including those with traumatic brain injury, those with other non-TBI injuries, and uninjured service members without blast exposure).
Among service members with predeployment and postdeployment testing, it should be possible to link the results for each person with DoD and VA records, and those should be made available for research and treatment.