OBJECTIVE Traumatic brain injury (TBI) is a significant public health concern and has implications for people directly impacted by the criminal legal system during arrest, conviction, incarceration, and community supervision. This meta-analysis estimated the lifetime prevalence of TBI among people supervised by the criminal legal system across settings. HYPOTHESES Building on previous research, we hypothesized that prevalence estimates would be impacted by methodological, clinical, and demographic factors. METHOD Eligible studies included those with adult participants supervised by the criminal legal system (i.e., prison, jail, probation, parole, inpatient/forensic hospital) and that provided sample TBI prevalence and method of ascertaining TBI history. We employed subgroup analyses and metaregression to investigate the effects of setting, TBI definition and method of detection, lifetime history of mental illness and substance use disorders, and gender. RESULTS The sample ultimately included 64 studies totaling 52,540 participants. Using a random-effects model and logit transformation, we found that the overall estimate of TBI prevalence was 45.8% (95% confidence interval, CI [37.8, 54.1], 95% prediction interval, PI [5.5, 92.5]) across all studies and 32.0% (95% CI [25.0, 39.8], 95% PI [11.2, 63.6]) for moderate-to-severe TBI. Significant effects were found for TBI definition and method of detection on the pooled estimate. CONCLUSIONS The prevalence of TBI among people impacted by the criminal legal system may be larger than in the general population. However, despite recent and ongoing progress in this area of study, the reliability of prevalence estimates remains limited by methodological factors related to TBI definitions and detection methods. Implications for TBI research and clinical service provision are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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受刑事法律制度影响的人群中创伤性脑损伤（TBI）的患病率：更新的荟萃分析和亚组分析。

目的 创伤性脑损伤 (TBI) 是一个重大的公共卫生问题，对在逮捕、定罪、监禁和社区监督期间直接受到刑事法律制度影响的人们具有影响。这项荟萃分析估计了不同环境下受刑事法律系统监管的人群中 TBI 的终生患病率。假设 基于之前的研究，我们假设患病率估计值将受到方法学、临床和人口因素的影响。方法 符合条件的研究包括由刑事法律系统（即监狱、看守所、缓刑、假释、住院/法医医院）监督的成年参与者的研究，并提供 TBI 患病率样本和确定 TBI 病史的方法。我们采用亚组分析和元回归来研究环境、TBI 定义和检测方法、精神疾病和物质使用障碍的终生史以及性别的影响。结果样本最终包含 64 项研究，总计 52,540 名参与者。使用随机效应模型和 Logit 变换，我们发现所有研究中 TBI 患病率的总体估计值为 45.8%（95% 置信区间，CI [37.8, 54.1]，95% 预测区间，PI [5.5, 92.5]）中度至重度 TBI 为 32.0%（95% CI [25.0, 39.8]，95% PI [11.2, 63.6]）。发现 TBI 定义和检测方法对汇总估计值有显着影响。结论 受刑事法律制度影响的人群中 TBI 的患病率可能高于一般人群。然而，尽管这一研究领域最近不断取得进展，但患病率估计的可靠性仍然受到与 TBI 定义和检测方法相关的方法学因素的限制。讨论了 TBI 研究和临床服务提供的影响。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。