Tens of thousands of soldiers serving in Iraq and Afghanistan suffer concussions and other difficult-to-detect traumatic brain injuries, often the result of bombings by insurgents. To identify troops needing care for these injuries, Congress in 2007 passed a measure requiring the military to test soldiers’ brain function before they deploy and when they return.

But an investigation by the news organizations ProPublica and NPR has found that the computerized cognitive test being used by the military, and the way it is being administered, are badly flawed. What’s more, the test — known as Automated Neuropsychological Assessment Metric, or ANAM — was chosen hurriedly, without proof that it is effective.

As a result, ProPublica and NPR found, more than one million troops have taken the test at a cost of more than $42 million to taxpayers, yet the military still has no reliable way to diagnose brain injuries.

Among the problems identified in the investigation, part of a series by the two news organizations on the epidemic of brain injuries suffered by soldiers:

  • Researchers who developed ANAM for the military and who stood to make money from the test were involved in the decision to use it, raising questions about the impartiality of the selection process.
  • The Pentagon ignored years of warnings that there was insufficient evidence that the test can diagnose traumatic brain injury.
  • Top Pentagon officials misrepresented the cost of the test, indicating that because the Army invented the ANAM, the military could use it for free. In fact, because the military licensed its invention to outside contractors, it has paid millions of dollars to use it.
  • The military has delayed for years a long-promised study to make sure the ANAM is the best available test.

Although studies have shown that ANAM has promise for purposes such as helping doctors determine if soldiers can return to duty after suffering an injury, experts say that neither it or any other computerized test can, on its own, enable doctors to diagnose traumatic brain injury.

“We have failed soldiers,” said retired Col. Mary Lopez, who used to manage the Army’s ANAM program. “It is incredibly frustrating because I can see first-hand the soldiers that we’ve missed, the soldiers that have not been treated, not been identified, [or] misdiagnosed. And then they struggle.”


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