B – 139 Evaluating the Clinical Utility of ANAM 4 in the VA: A Critical Review

Abstract Objective This review evaluates the clinical utility of the Automated Neuropsychological Assessment Metrics (ANAM4) for assessing mild traumatic brain injury (mTBI) in military and Veteran populations. ANAM’s effectiveness in detecting short- and long-term cognitive sequelae of mTBI, sensitivity to cumulative head injuries, and ability to identify domain-specific deficits are examined. This review critiques the translational value of ANAM4 data to Department of Veterans Affairs (VA) clinical settings as a tool for baseline cognitive data and longitudinal tracking of brain health. Method We used scholarly research identified through searches in peer-reviewed research publication databases. Included studies involved military cohorts assessed with ANAM4, and prioritized evaluations of sensitivity, specificity, test-retest reliability, demographic influences, and comparisons to neuropsychological assessments. We used case examples to illustrate clinical strengths and limitations. Results Evidence supports ANAM4’s moderate sensitivity to acute mTBI-related deficits—particularly within 72 hours post-injury and in tasks measuring reaction time, processing speed, and learning. Limitations in long-term sensitivity, inconsistent test-retest reliability, lack of convergent validity, and overreliance on reaction time reduce its clinical interpretability. Inconsistencies in computerized administration platform, baseline testing, and medical record documentation further reduce translational value. Conclusion While ANAM4 provides a large-scale standardized screening option with baseline comparison potential, its clinical translation remains limited as a longitudinal tracking tool for brain health. Optimizing its utility will require improved data accessibility, task-specific scoring, integration with comprehensive neuropsychological assessments, and enhanced sensitivity to chronic and cumulative mTBI effects. Future efforts should prioritize standardization and multimodal validation to support ANAM4 and ANAM4E (ANAM4-Expanded) use in Veteran care.