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This form structure is an organized set of data definitions for a copyrighted form
Title:
Delis-Kaplan Executive Functioning Systems (DKEFS) Proverbs Test
Short Name:
DKEFSPT
Description:
Delis-Kaplan Executive Functioning Systems (DKEFS) Proverb Test qualitatively evaluates the nature of an individual's verbal abstraction skills. The D-KEFS Proverb Test includes eight sayings that are presented in two conditions: Free Inquiry and Multiple Choice. The D-KEFS Proverb Test was designed for adolescents and adults (ages 16-89). Copyrighted 2001, NCS Pearson, Inc. All Rights Reserved (http://www.pearsonclinical.com/content/ani/clinicalassessments/us/en.html). References: Shunk AW, Davis AW, Dean RS (2006). TEST REVIEW: Dean C. Delis, Edith Kaplan & Joel H. Kramer, Delis Kaplan Executive Function System (D-KEFS), The Psychological Corporation, San Antonio, TX, 2001. . Applied Neuropsychology. 13 (4): 275–279. doi:10.1207/s15324826an1304_9.
Disease:
Traumatic Brain Injury General (For all diseases)
Organization:
NIH/CIT/BRICS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-08-16
Owner:
Number of Data Elements:
59
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 Vital status   Status of participant/subject as alive or dead VitStatus Optional CDE
5 Visit date   Actual interview or visit date VisitDate Recommended CDE
6 Site name   The name of the site for the study SiteName Recommended CDE
7 Days since baseline   The number of days since baseline DaysSinceBaseline Optional CDE
8 Case control indicator   Indicator of whether subject is in the case or control arm of the study. CaseContrlInd Optional CDE
9 General notes text   General notes GeneralNotesTxt Optional CDE

Additional Element Groups

Listed below are your additional element groups.

Form Administration (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Language form administration ISO code  Code (ISO 639-2) for the language that was used for CRF/instrument/scale/etc. administration LangCRFAdministratISOCode Recommended CDE
2 Language form administration ISO code other text  The free-text field related to 'Language used for CRF/instrument/scale/etc. administration ISO code' specifying other text. LangCRFAdministratISOCodeOTH Recommended CDE
3 Context type  The context to which the questions were answered ContextType Recommended CDE
4 Context type other text  The free-text related to ContextType specifying other text ContextTypeOTH Recommended CDE
5 Data source  Source of the data provided on the case report form DataSource Recommended CDE
6 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

DKEFS Proverbs Test: Condition 1 Free Inquiry (Appears Up To 8 Times)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Common proverbs (Item 1 - 5) text.  The common proverb text for items 1 to 5, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbComPrvTxt Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Uncommon proverbs (Item 6 - 8) text.  The uncommon proverb text for items 6 to 8, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbUncmPrvTxt Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Condition 1: free inquiry accuracy score.  The condition 1 free inquiry accuracy score, as part of the Delis-Kaplan Executive Function System (D-KEFS) . DKEFSPrvrbCnd1FIAccrScore Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Condition 1: free inquiry abstraction score.  The condition 1 free inquiry abstraction score, as part of the Delis-Kaplan Executive Function System (D-KEFS) . DKEFSPrvrbCnd1FIAbsScore Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Condition 1 - free inquiry achievement score.  The condition 1 free inquiry achievement score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbCnd1AchScore Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Condition 1 - free inquiry total accuracy score.  The condition 1 free inquiry total accuracy score, as part of the Delis-Kaplan Executive Function System (D-KEFS) . DKEFSPrvrbFITotAccrScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Condition 1 - free inquiry total abstraction score.  The condition 1 free inquiry total abstraction score, as part of the Delis-Kaplan Executive Function System (D-KEFS) . DKEFSPrvrbFITotAbsScore Recommended CDE
8 Delis-Kaplan Executive Function System (D-KEFS) Condition 1 - free inquiry total achievement score.  The condition 1 free inquiry total achievement score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbFITotAchScore Recommended CDE

DKEFS Proverbs Test: Uncommon Proverbs (Appears Up To 8 Times)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Common proverbs (Item 1 - 5) text.  The common proverb text for items 1 to 5, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbComPrvTxt Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Uncommon proverbs (Item 6 - 8) text.  The uncommon proverb text for items 6 to 8, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbUncmPrvTxt Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Multiple choice condition 2 response type  The multiple choice condition 2 response type, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvbMCCond2ResponseType Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Condition 2 multiple choice letter choice score  The multiple choice condition letter choice score , as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvbMCCond2LetChScore Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test  The multiple choice condition 2 multiple choice responses score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvbMCCond2MCRespScore Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total achievement: multiple choice correct total raw score.  The condition 2 multiple choice total achievement score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbMCTotAchScore Recommended CDE

Summary of Scores: Primary Measures (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Condition 1 - free inquiry total achievement score.  The condition 1 free inquiry total achievement score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbFITotAchScore Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total achievement: free inquiry correct total scaled score.  The total achievement score free inquiry raw scaled score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbTotAchFISclScore Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total achievement: multiple choice correct total raw score.  The condition 2 multiple choice total achievement score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbMCTotAchScore Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total achievement: multiple choice correct cumulative percentile rank.  The total achievement score multiple choice cumulative percentile rank, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSProverbTotAchMCCumPerRank Recommended CDE

Summary of Scores: Optional Measures Free Inquiry (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Common proverb achievement score: free inquiry item 1 - 5 total raw score  The common proverb achievement score free inquiry items 1 to 5 total raw score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbComPrvFIAchRawScore Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Common proverb achievement score: free inquiry item 1 - 5 total scaled score  The common proverb achievement score free inquiry items 1 to 5 scaled score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbComPrvFIAchSclScore Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Uncommon proverb achievement free inquiry item 6 - 8 total raw score  The total uncommon proverb achievement score free inquiry items 6 to 8 total raw score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbUncmPrvFIAchRawScore Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Uncommon proverb achievement free inquiry item 6 - 8 scaled score  The uncommon proverb achievement score free inquiry items 6 to 8 scaled score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbUncmPrvFIAchSclScore Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Condition 1 - free inquiry total accuracy score.  The condition 1 free inquiry total accuracy score, as part of the Delis-Kaplan Executive Function System (D-KEFS) . DKEFSPrvrbFITotAccrScore Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Accuracy only scaled score.  The accuracy only scaled score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrverbAccuOnlyTotSclScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Condition 1 - free inquiry total abstraction score.  The condition 1 free inquiry total abstraction score, as part of the Delis-Kaplan Executive Function System (D-KEFS) . DKEFSPrvrbFITotAbsScore Recommended CDE
8 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Abstraction only scaled score  The abstraction only score scaled score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbAbsOnlyTotSclScore Recommended CDE
9 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - No/don�t know responses total raw score.  The no/don't know responses total raw score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbNDKResTotRawScore Recommended CDE
10 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - No/don�t know responses cumulative percentile rank  The no/don't know responses cumulative percentile rank, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbNDKResTotCumPerRank Recommended CDE
11 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Repeated responses total raw score.  The repeated responses total raw score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbReptRespTotRawScore Recommended CDE
12 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Repeated responses cumulative percentile rank  The repeated responses cumulative percentile rank, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbReptRespCumPerRank Recommended CDE

Summary of Scores: Optional Measures Multiple Choice (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Common proverb achievement multiple choice item 1 - 5 total raw score  The common proverb achievement score multiple choice items 1 to 5 total raw score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbCmPrvMCAchRawScore Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Common proverb achievement multiple choice item 1 - 5 cumulative percentile rank  The common proverb achievement score multiple choice items 1 to 5 cumulative percentile rank, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbCmPrvMCAchCmPerRank Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Uncommon proverb achievement multiple choice item 6 - 8 total raw score  The total uncommon proverb achievement score multiple choice items 6 to 8 total raw score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbUncmPrvMCAchRawScore Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Uncommon proverb achievement multiple choice item 6 - 8 cumulative percentile rank  The total uncommon proverb achievement score multiple choice items 6 to 8 cumulative percentile rank, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbUncmMCAchCumPerRank Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total correct abstract choices raw score  The total correct abstract choices total raw score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbTotCrAbsChRawScore Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total correct abstract choices cumulative percentile rank  The total correct abstract choices cumulative percentile rank, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbTotCrAbsChCumPerRank Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Proverb test - Total correct concrete choices total raw score  The total correct concrete total raw score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbTotCorCnChRawScore Recommended CDE
8 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total correct concrete choices cumulative percentile rank  The total correct concrete cumulative percentile rank, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbTotCorCnChCumPerRank Recommended CDE
9 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total incorrect phonemic choices raw score  The total incorrect phonemic choices total raw score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbTotIncPhChRawScore Recommended CDE
10 Delis-Kaplan Executive Function System (D-KEFS) Proverb test - Total incorrect phonemic choices cumulative percentile rank  The total incorrect phonemic choices cumulative percentile rank, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbTotIncPhChCumPerRank Recommended CDE
11 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total incorrect unrelated choices raw score  The total incorrect unrelated choices total raw score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbTotIncUnrRawScore Recommended CDE
12 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total incorrect unrelated choices cumulative percentile rank  The total incorrect unrelated choices cumulative percentile rank, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbTotIncUnrCumPerRank Recommended CDE
13 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total incorrect phonemic and unrelated choices raw score  The total incorrect phonemic and unrelated choices total raw score, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbTotIncPhUnrRawScore Recommended CDE
14 Delis-Kaplan Executive Function System (D-KEFS) Proverb Test - Total incorrect phonemic and unrelated choices cumulative percentile rank  The total incorrect phonemic and unrelated choices cumulative percentile rank, as part of the Delis-Kaplan Executive Function System (DKEFS) Proverb Test. DKEFSPrvrbTotInPhUnrCumPerRank Recommended CDE
Keywords

Change History