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VA research in action

Assessment tool for military TBI

December 2, 2019


A Stryker armored vehicle lies on its side after surviving a buried IED blast in 2007. (Photo courtesy of U.S. Army Stryker Brigade Combat Team)

VA researchers developed an assessment tool to diagnose and evaluate traumatic brain injury in Veterans from the recent wars in Iraq and Afghanistan. The Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) has become a gold standard for assessing mild TBI specific to Veterans. It is in use at many VA medical centers and War Related Illness and Injury Study Center sites across the country.

Mild TBI is a common injury in post-9/11 Veterans. But its diagnosis is challenging because of the frequent co-occurrence of head injury along with psychological trauma and PTSD. TBI in Veterans is often different from civilian-acquired brain injuries because of exposure to blasts and trauma associated with combat.

The VA Translational Research Center for TBI and Stress Disorders (TRACTS) developed the BAT-L to address these difficulties. It is a semi-structured clinical interview to characterize head injuries and diagnose TBIs throughout a Veteran’s lifespan. Unlike existing TBI assessments, the BAT-L probes the unique experiences of combat-exposed Veterans, such as possible repeated blast exposures. The BAT-L evaluates possible TBIs over the lifetime of a Veteran, rather than just immediately after a traumatic event.

The BAT-L is available to the public for free ( It is being used by clinicians and researchers across the nation. A civilian variation on the interview has also been developed.

Principal investigator: Dr. Catherine Brawn Fortier; VA Boston Healthcare System

Selected publications:

The Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) semistructured interview: Evidence of research utility and validity. Fortier CB, Amick MA, Grande LJ, McGlynn S, Kenna A, Morra L, Clark A, Milberg WP, McGlinchey RE. Journal of Health Trauma Rehabilitation. 2014;29(1):89-98.

Correspondence of the Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) clinical interview and the VA TBI Screen. Fortier CB, Amick MA, Kenna A, Milberg WP, McGlinchey RE. Journal of Head Trauma Rehabilitation. 2015;30(1):E1-7.

Correspondence of the Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) and the VA Comprehensive TBI Evaluation (CTBIE). Radigan L, McGlinchey R, Milberg WP, Fortier CB. Journal of Head Trauma Rehabilitation. 2018 Sep/Oct;33(5):E51-E55.

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