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
			
			
		Resource:
							
								
									FITBIR
	    							
							
						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
							
								
									DKEFS_TMT
									,
								
									Executive
									,
								
									Executive_Function
									
								
							
						 
								






