To minimize risks associated with use of this novel capability, we recommend a highly controlled rollout of the TBI biomarker. Each theater should restrict interpretation of test results and evacuation decisions to a select number of designated TBI biomarker consultants typically co-located at the Role 3. The ADVISOR teleconsultation system may be utilized (Neurosurgery) if a Role 3 consultant is not available. These individuals possess experience in evaluation, triage, and management of TBI in the acute setting and are knowledgeable in the clinical application of TBI biomarker values. The Theater Trauma Medical Director (TMD) is responsible for directing this overall effort but will normally yield clinical decision-making capacity to the neurosurgeon or other neurospecialist if available. The consultant is responsible for supporting the forward provider in execution of the TBI Biomarker Algorithm (Appendix A), use of TBI biomarker results, and disposition of the patient. When a negative TBI biomarker test guides a decision to keep the patient at the forward location, the consultant or TMD should remain engaged with that provider until no longer necessary.