Brain Injury Screening Tool: a guide to TBI assessment
The Brain Injury Screening Tool (BIST) was designed by a working group of GPs, trauma clinicians, allied health professionals, academics, Māori advisors, people with lived experience and service providers to help clinicians assess and manage suspected brain injury (or concussion) in people 8 years of age and older.
The BIST takes about 6 minutes to complete.
Download the tool
The BIST-3 can be used in any healthcare setting, including emergency departments, inpatient settings, primary care and allied health services.
What's changed from the original BIST
Download to read an overview of the changes made to the BIST based on research evidence and clinical implementation learnings.
Download summary of changes from BIST-2 to BIST-3
How to use BIST
- Use when someone presents to you as a health professional and you suspect a brain injury (concussion).
- Follow the prompts and enter patient responses.
- The first 10 questions ask about medical history and injury-related risk factors.
- The symptom checklist asks about common post-concussion symptoms.
- The impact of injury item assesses the overall impact of injury on the person’s life.
- Additional questioning and tests are encouraged to add to the clinical picture, eg balance, mood or visual tests.
- The symptom scale and impact question can be repeated at follow-up to monitor recovery over time.
Once completed, the BIST will provide a recommendation as to whether the person is at risk of a prolonged recovery. This recommendation is only a guide, and final decision-making lies with the clinician.
Use of the tool can be halted at any time if an urgent hospital referral is indicated. Some questions do not need to be asked if the injury was less than 24 hours ago.
Publications
- Recognition and detection of concussion in the community
- A supported primary health pathway for mild traumatic brain injury
- Brain Injury Screening Tool (BIST): test–retest reliability in a community adult sample
- Rasch Analysis of the Brain Injury Screening Tool (BIST) in Mild Traumatic Brain Injury - article in Research Square
- The Brain Injury Screening Tool (BIST): Tool development, factor structure and validity - article in Plos One
- Experience of mTBI-like symptoms in a sample without brain injury
Reports
Use of BIST as an outcome measure
We completed a study of how the BIST was working as an outcome measure in a concussion service as part of a project looking at measuring patient outcomes using a digital platform.
Feasibility study in the emergency department
We completed a feasibility study of implementing the BIST in the Middlemore Emergency Department.
Questions?
If you have any questions about the use and effectivity of BIST, contact Alice Theadom.