Form Structure: Balance Error Scoring System (BESS)
This form structure is an organized set of data definitions for a form that has not been copyrighted
Title:
Balance Error Scoring System (BESS)
Short Name:
BESS
Description:
The Balance Error Scoring System provides a portable, cost-effective, and objective method of assessing static postural stability. In the absence of expensive, sophisticated postural stability assessment tools, the BESS can be used to assess the effects of mild head injury on static postural stability. Information obtained from this clinical balance tool can be used to assist clinicians in making return to play decisions following mild head injury. CDISC (TAUG TBI)
Disease:
Traumatic Brain Injury
Organization:
NIH
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2015-05-13
Version:
1.1
Date Created:
2015-03-20
Owner:
Number of Data Elements:
22
eForms:
N
Logically grouped data elements with defined frequency at which they repeat.
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | GUID | Global Unique ID which uniquely identifies a subject | GUID | Required | CDE |
| 2 | Subject identifier number | An identification number assigned to the participant/subject within a given protocol or a study. | SubjectIDNum | Optional | CDE |
| 3 | Age in years | Value for participant's subject age recorded in years. | AgeYrs | Recommended | CDE |
| 4 | Visit date | Actual interview or visit date | VisitDate | Recommended | CDE |
| 5 | Site name | The name of the site for the study | SiteName | Recommended | CDE |
| 6 | Days since baseline | The number of days since baseline | DaysSinceBaseline | Optional | CDE |
| 7 | Case control indicator | Indicator of whether subject is in the case or control arm of the study. | CaseContrlInd | Optional | CDE |
| 8 | General notes text | General notes | GeneralNotesTxt | Optional | CDE |
Additional Element Groups
Listed below are your additional element groups.
Form Administration (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Context type | The context to which the questions were answered | ContextType | Recommended | CDE |
| 2 | Context type other text | The free-text related to ContextType specifying other text | ContextTypeOTH | Recommended | CDE |
| 3 | Data source | Source of the data provided on the case report form | DataSource | Recommended | CDE |
| 4 | Data source other text | The free-text field related to Data source specifying other text. Source of the data provided on the case report form | DataSourceOTH | Recommended | CDE |
Balance Error Scoring Test (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Balance Error Scoring System (BESS) - Double leg stance firm surface error count | Number of errors during double leg stance with feet together on firm surface, as part of Balance Error Scoring System (BESS). | BESSDblLegFirmErrorCt | Recommended | CDE |
| 2 | Balance Error Scoring System (BESS) - Single leg stance firm surface error count | Number of errors during single leg stance with non-dominant foot tested on firm surface, as part of Balance Error Scoring System (BESS). | BESSSglLegFirmErrorCt | Recommended | CDE |
| 3 | Balance Error Scoring System (BESS) - Tandem stance firm surface error count | Number of errors during tandem stance with non-dominant foot in back on firm surface, as part of Balance Error Scoring System (BESS). | BESSTandemFirmErrorCt | Recommended | CDE |
| 4 | Balance Error Scoring System (BESS) - Firm surface total error count | Total number of errors while on firm surface, as part of Balance Error Scoring System (BESS). | BESSTotalFirmErrorCt | Recommended | CDE |
| 5 | Balance Error Scoring System (BESS) - Double leg stance foam surface error count | Number of errors during double leg stance with feet together on foam surface, as part of Balance Error Scoring System (BESS). | BESSDblLegFoamErrorCt | Recommended | CDE |
| 6 | Balance Error Scoring System (BESS) - Single leg stance foam surface error count | Number of errors during single leg stance with non-dominant foot tested on foam surface, as part of Balance Error Scoring System (BESS). | BESSSglLegFoamErrorCt | Recommended | CDE |
| 7 | Balance Error Scoring System (BESS) - Tandem stance foam surface error count | Number of errors during tandem stance with non-dominant foot in back on foam surface, as part of Balance Error Scoring System (BESS). | BESSTandemStncFoamSrfcErrorCt | Recommended | CDE |
| 8 | Balance Error Scoring System (BESS) - Foam surface total error count | Total number of errors while on foam surface, as part of Balance Error Scoring System (BESS). | BESSTotalFoamErrorCt | Recommended | CDE |
| 9 | Balance Error Scoring System (BESS and mBESS) - Both firm foam surface total error count | Total number of errors for both firm and foam surface, as part of Balance Error Scoring System (BESS) and modified BESS. | BESSTotalErrorCt | Recommended | CDE |
| 10 | Laterality type | Laterality type relative to the anatomic site of the body examined or affected | LatTyp | Recommended | CDE |
Keywords
