Creation of an Expanded Barel ! Matrix to IdentifyTraumatic Brain Injuries

This paper describes the creation ofa new traumatic brain injury (TSI) dass ification system, the Barell+ system, derived by the Center for Army Medical Department Strategic Stud ies, The Barell+ system is an expa nsion of the standar.d international Sarell body region by nature of injury diagnosis matrix developed by the Intemational Collaborative Effort on Injury Statistics.The expanded version (Barell+) was created as a result of a mapping effort between the originaiSarell matrix and the Department of Defense severity class ification system used for su rvei lIance by the Defen se an d Veteran, Srain Injury Center (DVSIC). Starting with the Barell TSI category definitions, 19 additional TBI-related diagnosis codes from the DVSIC classification were mapped into the resulting Sarell+ matrix. The new Sarell+ system is compared with the original Barel I matrix and the DVSIC dassiflcation system. We recommend using the TBI frequency distributions created by the Sarell+ system as input data in U.s. military medical modeling and simulation efforts because it better reflects the actual di'triburion ofTS I inj u ries.