Form Structure: Glasgow Outcome Score (GOS)
This form structure is an organized set of data definitions for a form that has not been copyrighted
Title:
Glasgow Outcome Score (GOS)
Short Name:
GOS_V2
Description:
Glasgow Outcome Score is a one item scale with 5 possible ratings - Dead, Vegetative State, Severe Disability, Moderate Disability, and Good Recovery. References: Jennett, B; Bond, M (Mar 1, 1975). \\"Assessment of outcome after severe brain damage.\\". Lancet. 1 (7905): 480484. doi:10.1016/s0140-6736(75)92830-5. PMID 46957.
Disease:
Traumatic Brain Injury
Organization:
NINDS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-09-12
Version:
1.0
Date Created:
2014-05-28
Owner:
Number of Data Elements:
15
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 Administation (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 |
GOS (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Glasgow Outcome Scale (GOS) - score | Glasgow Outcome Scale (1-5) | GlasgowOutcomeScalScore | Optional | CDE |
| 2 | Glasgow Outcome date and time | Date and Time of Glasgow Outcome Scale | GasgwDateTime | Optional | CDE |
Keywords
