Tag Archives: CTE

Brain Trauma Foundation/BTF Learning Portal

Brain Trauma Foundation logo

Brain Trauma Foundation logo

The Brain Trauma Foundation, and its BTF Learning Portal, which provides continuing education for medical professionals, are an excellent  resource for anyone concerned with preventing and treating head injuries.The BTF Learning Portal’s courses are CME-accredited in most, if not all, states. To their credit, BTF courses seem to be priced so as to permit them to continue their work rather than, as is sometimes the case, a revenue stream which can lead a non profit off-course, we we’ve seen in other cases.The BTF research led to treatment guidelines for TBI. According to the CDC, the CDC analysis

found that that if the BTF guidelines were used more routinely, there would be a 50% decrease in deaths, improved quality of life and a savings of $288 million a year in medical and rehabilitation costs.

According to the study, “Using a Cost-Benefit Analysis to Estimate Outcomes of a Clinical Treatment Guideline: Testing the Brain Trauma Foundation Guidelines for the Treatment of Severe Traumatic Brain Injury,” just published in the December issue of the Journal of Trauma: Injury, Infection, and Critical Care, when the BTF guidelines are followed, the proportion of patients with good outcomes increased substantially from 35% to 66%, and the proportion of patients with poor outcomes decreased from 34% to 19%.

Link to BTF press release. (We’ll update this shortly with a direct link to the CDC statement).



Puzzling Veterans Administration regulation limits use of safer, cheaper, effective treatment

For some background, see our earlier post, Mindgrowth – affordable, effective biofeedback devices.

The United States military and veterans hospital systems are making effective and widespread use of biofeedback  ((Biofeedback, as defined by the United States National Institutes of Health.))  in treating PTSD ((Post-Traumatic Stress Disorder; see, inter alia, “Traumatic Stress,” by the Harvard Physician Bess van der Kolk. For other examples see Tackling fears, virtually (Times Colonist, October 8, 2009;Stress management program helps soldiers with PTSD Florida Times-Union, 28 Sep 2009))

That biofeedback (sometimes referred to as “neurofeedback”) can be of medical use seems uncontroversial. The desired end-state, of course, is for the patient to beable to reproduce the same effect (e.g., not panicking when exposed to loud noises) under normal circumstances and without the use of the equipment.It’s a process of learning and unlearning, and like any such process, some repetition is in order.

Why, then, would the government use this equipment widely, but have a rule which prohibits prescribing or dispensing the equipment so that patients can take the devices home and practice with them between  office visits. Link to VA Regulation (excerpted in footnote)  ((http://www.va.gov/hac/forbeneficiaries/champva/policymanual/champva/chapter2/1c2s30-5.htm, or http://tinyurl.com/yfyywhd

VI. EXCLUSIONS

A. Biofeedback for hypertension.

B. Biofeedback for the treatment of migraine headaches.

C. Biofeedback therapy provided for the treatment of ordinary muscle tension or for psychosomatic (i.e., psychophysiological or psychological factors affecting a medical condition) conditions (CPT codes 90901, 90875, and 90876). [38 CFR 17.272(a)(71)]

D. Rental or purchase of biofeedback equipment.  [38 CFR 17.272 (a)(70)]

E. Treatment of psychosomatic conditions (i.e., psychophysiological or psychological factors affecting medical condition) and for CPT codes 90875 and 90876.  This exclusion includes individual psychophysiological therapy incorporating biofeedback training.))

We’d welcome learning that we’ve misread the rule, or that there’s a good reason for it – devices powered by two “AA” batteries don’t generally pose much risk.

But if our reading is correct, who benefits from this rule?

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