“In 2007, with roadside bombs exploding across Iraq, Congress moved to improve care for soldiers who had suffered one of the war’s signature wounds, traumatic brain injury.
Lawmakers passed a measure requiring the military to test soldiers’ brain function before they deployed and again when they returned. The test was supposed to ensure that soldiers received proper treatment.
Instead, an investigation by ProPublica and NPR has found, the testing program has failed to deliver on its promise, offering soldiers the appearance of help, but not the reality.
Racing to satisfy Congress’ mandate, the military chose a test that wasn’t actually proven to detect TBI: the Automated Neuropsychological Assessment Metric, or ANAM.”
“Purpose: Provide a detailed review of the Automated Neuropsychological Assessment Metric (ANAM) Neuro-Cognitive Assessment Tool (NCAT) program to Congress.
The ANAM program’s history is more troubled than has been commonly understood. Although the ANAM was a pioneering test, developed in the early days of personal computers, ANAM never achieved popularity or widespread clinical use. Prior to the selection of the ANAM for DoD use, critical head to head studies ranked ANAM toward the bottom of computerized measures available (Tab 2).
The selection of ANAM was nepotistic, and the long delay in examining alternative instruments is baffling. Efforts must immediately begin to compare other computerized neuropsychological tests, in a fair and unbiased manner, and the best instrument selected. The Army is independently seeking to compare ANAM to ImPACT (TAB 21). Barring replacement of the ANAM, serious effort needs to be devoted to repairing known defects in the ANAM, which may be beyond the licensed vendor’s internal abilities. If one had to select a test today, the consensus of the Army’s neuropsychological community is clear that the ImPACT is a superior test, and the Special Forces Command made is proper decision in using it rather than ANAM.”