Form Structure: Delis-Kaplan Executive Function System (D-KEFS) Trail Making Test
This form structure is an organized set of data definitions for a copyrighted form
Title:
Delis-Kaplan Executive Function System (D-KEFS) Trail Making Test
Short Name:
DKEFS_TMT
Description:
Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) is one of the Delis-Kaplan Executive Function System (DKEFS) subtests. DKEFS TMT subtest is based on the Trail Making Test originally developed by Partington in 1938, but has been modified to include 5 conditions each purported to assess a different area of functioning (Delis et al., 2001a).
Copyright 2001, NCS Pearson, Inc. All Rights Reserved (http://www.pearsonclinical.com/content/ani/clinicalassessments/us/en.html). Delis, D. C., Kaplan, E., & Kramer, J. H. (2001). Delis-Kaplan executive function system (D-KEFS). Psychological Corporation.Copyrighted 2001,San Antonio, Tex. : Psychological Corporation. Recommended by CDISC for TBI (TAUG TBI), Neuropsychological impairment, Knowledge graph, See also
Disease:
Traumatic Brain Injury
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-10-03
Version:
1.4
Date Created:
2016-03-31
Owner:
Number of Data Elements:
28
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 | 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 |
Primary Measure: Completion Times (Appears Up To 5 Times)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Delis - Kaplan Executive Function System (DKEFS) - Condition type | Type of conditions, as part of Delis-Kaplan Executive Function System (DKEFS) | DKEFSConditionTyp | Recommended | CDE |
| 2 | Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Completion time raw score | Complete time as a raw score, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) | DKEFSTMTCompltnTimeRawScore | Recommended | CDE |
| 3 | Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Completion time scaled score | Complete time as a scaled score, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) | DKEFSTMTCompltnTimeSclScore | Recommended | CDE |
| 4 | Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Notes text | Notes, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS) | DKEFSTMTNotesTxt | Recommended | CDE |
Primary Combined Measure: Completion Times (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Sum scaled score | Sum of scaled scores of Number Sequencing and Letter Sequencing, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) | DKEFSTMTSumSclScore | Recommended | CDE |
| 2 | Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Composite scaled score | Composite scaled scores of Number Sequencing and Letter Sequencing, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) | DKEFSTMTCompstSclScore | Recommended | CDE |
Primary Contrast Measures: Completion Times (Appears Up To 5 Times)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Delis - Kaplan Executive Function System (DKEFS) - Completion time contrast Type | Type of primary contrast measures for completion times, as part of Delis-Kaplan Executive Function System (DKEFS) | DKEFSCompletionTimeContrastTyp | Recommended | CDE |
| 2 | Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Difference scaled score | Scaled score difference, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) | DKEFSTMTDiffSclScore | Recommended | CDE |
| 3 | Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Contrast scaled score | Contrast scaled score, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) | DKEFSTMTContrastSclScore | Recommended | CDE |
Optional Measures: Error Analysis (Appears Up To 25 Times)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Delis - Kaplan Executive Function System (DKEFS) - Color Word Inference Test (CWIT) - Error analysis optional type | Optional measures for error analysis, as part of Delis-Kaplan Executive Function System (DKEFS) | DKEFSErrorAnalysisOptionalTyp | Recommended | CDE |
| 2 | Delis - Kaplan Executive Function System (DKEFS) - Condition type | Type of conditions, as part of Delis-Kaplan Executive Function System (DKEFS) | DKEFSConditionTyp | Recommended | CDE |
| 3 | Delis - Kaplan Executive Function System (DKEFS) - Color Word Inference Test (CWIT) - Error raw score | Errors as a raw score, as part of Delis-Kaplan Executive Function System (DKEFS) | DKEFSErrorRawScore | Recommended | CDE |
| 4 | Delis - Kaplan Executive Function System (DKEFS) - Cumulative percentile rank value | Cumulative percentile rank for error analysis, as part of Delis-Kaplan Executive Function System (DKEFS) | DKEFSCumulatvPerctRankVal | Recommended | CDE |
Optional Measures: Error Analysis: All Error Types (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Delis - Kaplan Executive Function System (DKEFS) - Color Word Inference Test (CWIT) - Error total raw score | Total raw score calculated as the sum of raw scores of Sequencing Errors, Set-Loss Errors and Time-Discontinue Errors in Condition 4 (Number-Letter Switching), as part of Delis-Kaplan Executive Function System (DKEFS) | DKEFSErrorTtlRawScore | Recommended | CDE |
| 2 | Delis - Kaplan Executive Function System (DKEFS) - All error types condition 4 scaled score | Scaled score of all error types for condition 4 Number-Letter Switching, as part of Delis-Kaplan Executive Function System (DKEFS) | DKEFSAllErTypCond4SclScore | Recommended | CDE |
Keywords
