Form Structure: Neurological Assessment: Glasgow Coma Scale (GCS) and Pupils
This form structure is an organized set of data definitions for a form that has not been copyrighted
Title:
Neurological Assessment: Glasgow Coma Scale (GCS) and Pupils
Short Name:
GCS
Description:
Contains data elements that are collected to assess severity of the injury using the Glasgow Coma Scale, Pediatric Glasgow Coma Scale, and an examination of the participant's/subject's pupils. Recommended by CDISC for TBI
Reference:
http://www.glasgowcomascale.org/
Teasdale G, Jennett B, Assessment of coma and impaired consciousness. A practical scale, Lancet. 1974 Jul 13;2(7872):81-4.
http://www.ncbi.nlm.nih.gov/pubmed/4136544
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Disease:
Traumatic Brain Injury
Organization:
NINDS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-01-20
Version:
1.2
Date Created:
2016-01-14
Owner:
Number of Data Elements:
35
eForms:
Y
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 (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 |
Glasgow Coma Scale (Repeat Infinitely)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | Glasgow Coma Scale (GCS) - Confounders type | Type of confounders influencing participant's/subject's Glasgow Coma Scale (GCS) score | GCSConfounderTyp | Recommended | CDE |
2 | Glasgow Coma Scale (GCS) - eye response scale | Glasgow Coma Scale (GCS) - Best eye response (E). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. | GCSEyeRespnsScale | Recommended | CDE |
3 | Glasgow Coma Scale (GCS) - motor response scale | Glasgow Coma Scale (GCS) - Best motor response (M). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. | GCSMotorRespnsScale | Recommended | CDE |
4 | Glasgow Coma Scale (GCS) - verbal response scale | Score that describes the participant's verbal response according to the Glasgow Coma Scale (GCS) | GCSVerbalRspnsScale | Recommended | CDE |
5 | Glasgow Coma Scale (GCS) - total score | Glasgow Coma Scale (GCS) - Total Score. The GCS is a standardized instrument for assessing the level of consciousness. | GCSTotalScore | Recommended | CDE |
6 | Pupil reactivity light left eye result | Result of testing of the contraction of the participant's/subject's left pupil when a bright light is shone on it from an angle | PupilReactivityLghtLftEyeReslt | Recommended | CDE |
7 | Pupil reactivity light right eye result | Result of testing of the contraction of the participant's/subject's right pupil when a bright light is shone on it from an angle | PupilReactivityLghtRtEyeReslt | Recommended | CDE |
8 | Pupil left eye measurement | Measurement of the left pupil of the eye in mm | PupilLftEyeMeasr | Recommended | CDE |
9 | Pupil right eye measurement | Measurement of the right pupil in millimeters | PupilRtEyeMeasr | Recommended | CDE |
10 | Pupil shape left eye type | Type of shape of the pupil of the left eye | PupilShapeLftEyeTyp | Recommended | CDE |
11 | Pupil shape right eye type | Type of shape of the pupil of the right eye | PupilShapeRtEyeTyp | Recommended | CDE |
Pediatric Glasgow Coma Scale (Repeat Infinitely)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | Glasgow Coma Scale (GCS) - Confounders type | Type of confounders influencing participant's/subject's Glasgow Coma Scale (GCS) score | GCSConfounderTyp | Recommended | CDE |
2 | Pediatric Glasgow Coma Scale (PGCS) - eye response score | Score for the participant's eye response according to the Pediatric Glasgow Coma Scale (PGCS) if the participant is under the age of 18. | PGCSEyeRespnsScore | Recommended | CDE |
3 | Pediatric Glasgow Coma Scale (PGCS) - motor response score | Score for the participant's motor response according to the Pediatric Glasgow Coma Scale (PGCS) if the participant is under the age of 18. | PGCSMotorRespnsScore | Recommended | CDE |
4 | Pediatric Glasgow Coma Scale (PGCS) - verbal response score | Score for the participant's verbal response according to the Pediatric Glasgow Coma Scale (PGCS) if the participant is under the age of 18. | PGCSVerbalRespnsScore | Recommended | CDE |
5 | Pediatric Glasgow Coma Scale (PGCS) - total score | The participant's total Pediatric Glasgow Coma Scale (PGCS) score of 3 tests, eye, motor, and verbal responses. A score of less than 9 would indicate that that participant is in a severe coma; a score of greater than 9 is a mild or no coma at all. | PGCSTotalScore | Recommended | CDE |
6 | Pupil reactivity light left eye result | Result of testing of the contraction of the participant's/subject's left pupil when a bright light is shone on it from an angle | PupilReactivityLghtLftEyeReslt | Recommended | CDE |
7 | Pupil reactivity light right eye result | Result of testing of the contraction of the participant's/subject's right pupil when a bright light is shone on it from an angle | PupilReactivityLghtRtEyeReslt | Recommended | CDE |
8 | Pupil left eye measurement | Measurement of the left pupil of the eye in mm | PupilLftEyeMeasr | Recommended | CDE |
9 | Pupil right eye measurement | Measurement of the right pupil in millimeters | PupilRtEyeMeasr | Recommended | CDE |
10 | Pupil shape left eye type | Type of shape of the pupil of the left eye | PupilShapeLftEyeTyp | Recommended | CDE |
11 | Pupil shape right eye type | Type of shape of the pupil of the right eye | PupilShapeRtEyeTyp | Recommended | CDE |
Keywords