Form Structure: Immediate Post-Concussion Assessment Testing (ImPACT)
This form structure is an organized set of data definitions for a copyrighted form
Title:
Immediate Post-Concussion Assessment Testing (ImPACT)
Short Name:
ImPACT
Description:
ImPACT test establishes a baseline for athletes prior to concussion. After concussion, the ImPACT test is re administered to assess the level of cognitive damage to the subject. Copyright https://impactconcussion.com/. Concussion Assessment, Knowledge graph, See also
Disease:
Traumatic Brain Injury
Organization:
ImPACT
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-03-23
Version:
1.2
Date Created:
2015-07-17
Owner:
Number of Data Elements:
137
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 | Case control indicator | Indicator of whether subject is in the case or control arm of the study. | CaseContrlInd | Optional | CDE |
| 7 | Site name | The name of the site for the study | SiteName | Recommended | CDE |
| 8 | Days since baseline | The number of days since baseline | DaysSinceBaseline | Optional | CDE |
| 9 | General notes text | General notes | GeneralNotesTxt | Optional | CDE |
Additional Element Groups
Listed below are your additional element groups.
Form Administration Group (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 |
ImPACT Test Administration (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Immediate Post-Concussion Assessment Testing (ImPACT) - Exam type | Type of exam conducted, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTExamType | Recommended | CDE |
| 2 | Immediate Post-Concussion Assessment Testing (ImPACT) - Exam language type | Type of language the exam was conducted in, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTExamLanguageType | Recommended | CDE |
| 3 | Immediate Post-Concussion Assessment Testing (ImPACT) - Test version type | Type of test version used for the exam, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTTestVersionType | Recommended | CDE |
ImPACT Demographics (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Birth date | Date (and time, if applicable and known) the participant/subject was born | BirthDate | Recommended | CDE |
| 2 | Gender Type | Self-reported gender of the participant/subject. Gender is the socially constructed identity of sex. | GenderTyp | Recommended | CDE |
| 3 | Hand preference type | Hand which the participant/subject uses predominantly, not necessarily the hand he/she writes with exclusively. | HandPrefTyp | Recommended | CDE |
| 4 | Age value | Value for participant's subject age, calculated as elapsed time since the birth of the participant/subject. By default in months | AgeVal | Recommended | CDE |
| 5 | Height measurement | Measurement of participant's/subject's height. | HgtMeasr | Recommended | CDE |
| 6 | Height unit of measure | Unit of measure for the height numerical value for subject/participant | HgtUOM | Recommended | CDE |
| 7 | Weight measurement | Measurement of participant's/subject's weight | WgtMeasr | Recommended | CDE |
| 8 | Weight unit of measure | Unit of measure for the weight numerical value | WgtUoM | Recommended | CDE |
| 9 | Immediate Post-Concussion Assessment Testing (ImPACT) - Native country region name | The subject's native country or region, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTNativeCountRegionName | Recommended | CDE |
| 10 | Immediate Post-Concussion Assessment Testing (ImPACT) - Native language type | The subject's native language, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTNativeLanguageTyp | Recommended | CDE |
| 11 | Immediate Post-Concussion Assessment Testing (ImPACT) - Second language type | The subject's second language, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTSecondLanguageTyp | Recommended | CDE |
| 12 | Immediate Post-Concussion Assessment Testing (ImPACT) - Second language spoken year duration | The count of years the subject spoke second language, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTSecondLanguageYrDur | Recommended | CDE |
| 13 | Race USA category | The subject self declared racial origination, independent of ethnic origination, using OMB approved categories. | RaceUSACat | Recommended | CDE |
| 14 | Ethnicity USA category | Category of ethnicity the participant/subject most closely identifies with | EthnUSACat | Recommended | CDE |
| 15 | Education year count | Number of years of education completed (age 5 and beyond) | EduYrCt | Recommended | CDE |
ImPACT Learning History (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Immediate Post-Concussion Assessment Testing (ImPACT) - Speech therapy receive indicator | Indicator of whether the subject received speech therapy. | ImPACTReceivedSpeechTherInd | Recommended | CDE |
| 2 | Special education indicator | Indicator as to whether the participant/subject has or had special education | SpecialEduInd | Recommended | CDE |
| 3 | Special education services describe text | The free-test related to "SpecialEduInd", specifying describe text. | SpecialEduIndOTH | Recommended | UDE |
| 4 | Immediate Post-Concussion Assessment Testing (ImPACT) - School year repeat indicator | Indicator of whether the subject has to repeat one or more years of school, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTRepeatYrsSchoolInd | Recommended | CDE |
| 5 | Learning disability indicator | Indicator of whether there is a history of diagnosed learning disability. | LearningDisabilityInd | Recommended | UDE |
| 6 | Immediate Post-Concussion Assessment Testing (ImPACT) - Attention deficit disorder hyperactivity problem indicator | Indicator of whether the subject has problems with ADD/hyperactivity, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTProbADDHyperInd | Recommended | CDE |
| 7 | Immediate Post-Concussion Assessment Testing (ImPACT) - Student performance type | Type of student performance at school, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTStudentPerfType | Recommended | CDE |
ImPACT Sport Concussion and Health History (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Immediate Post-Concussion Assessment Testing (ImPACT) - Current sport type | Type of sport the subject participates currently, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTCurrentSportType | Recommended | CDE |
| 2 | Immediate Post-Concussion Assessment Testing (ImPACT) - Primary position event class text | Primary type of position/event/class, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTPrimPosEventClassText | Recommended | CDE |
| 3 | Immediate Post-Concussion Assessment Testing (ImPACT) - Current participation level type | Current type of level of participation in sports, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTCurrentPartLvlTyp | Recommended | CDE |
| 4 | Immediate Post-Concussion Assessment Testing (ImPACT) - Current participation level year count | Number of years experience at current participation level, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTYrsExpLevelCt | Recommended | CDE |
| 5 | Concussion diagnosed by medical provider number | Number of times subject has been diagnosed with a concussion by a medical provider (i.e. MD, ATC, EMT, PA, Nurse, etc.,) in the past (not including current concussion). | ConcussionDxNumber | Recommended | UDE |
| 6 | Immediate Post-Concussion Assessment Testing (ImPACT) - Loss of consciousness concussion result count | Number of concussions that resulted in loss of consciousness (LOC), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTConcussResultLOCCt | Recommended | CDE |
| 7 | Immediate Post-Concussion Assessment Testing (ImPACT) - Confusion concussion result count | Number of concussions that resulted in confusion, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTConcussResultConfCt | Recommended | CDE |
| 8 | Immediate Post-Concussion Assessment Testing (ImPACT) - Memory loss post injury concussion result count | Number of concussions that resulted in loss of memory of events immediately after injury, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTConcussResMemLossAftCt | Recommended | CDE |
| 9 | Immediate Post-Concussion Assessment Testing (ImPACT) - Memory loss prior injury concussion result count | Number of concussions that resulted in a loss of memory of the events that occurred before injury, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTConcussResMemLossBefCt | Recommended | CDE |
| 10 | Immediate Post-Concussion Assessment Testing (ImPACT) - Game miss count | Total number of games missed as a result of concussions, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTGamesMissedCt | Recommended | CDE |
| 11 | Immediate Post-Concussion Assessment Testing (ImPACT) - Concussion five most recent month year text | The month/year text of the 5 most recent concussions, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACT5MostRecentConcussTxt | Recommended | CDE |
| 12 | Immediate Post-Concussion Assessment Testing (ImPACT) - Headache treatment physician administered indicator | Indicator of whether the subject was treated for headaches by a physician, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTTreatHeadPhysicianInd | Recommended | CDE |
| 13 | Immediate Post-Concussion Assessment Testing (ImPACT) - Migraine treatment physician administered indicator | Indicator of whether the subject was treated for headaches by a physician, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTTreatMigPhysicianInd | Recommended | CDE |
| 14 | Immediate Post-Concussion Assessment Testing (ImPACT) - Epilepsy seizure treatment administered indicator | Indicator of whether the subject was treated for epilepsy/seizures, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTTreatEpilepSeizInd | Recommended | CDE |
| 15 | Immediate Post-Concussion Assessment Testing (ImPACT) - Brain surgery patient medical history indicator | Indicator of whether the subject has a history of brain surgery, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTHxBrainSurgInd | Recommended | CDE |
| 16 | Meningities indicator | Complications Neuro: Meningities Indicator | MeningitisInd | Recommended | UDE |
| 17 | Immediate Post-Concussion Assessment Testing (ImPACT) - Substance alcohol abuse treatment administered indicator | Indicator of whether the subject has received treatment for substance or alcohol abuse, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTTreatSubAlcoholAbusInd | Recommended | CDE |
| 18 | Immediate Post-Concussion Assessment Testing (ImPACT) - Psychiatric condition treatment administered indicator | Indicator of whether the subject has received treatment for a psychiatric condition such as depression or anxiety, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTTreatPsychiatricCondInd | Recommended | CDE |
| 19 | Attention deficit disorder attention deficit hyperactivity disorder indicator | Indicator as to whether the participant/subject has or had attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) | AttentionDeficitADHDInd | Recommended | CDE |
| 20 | Immediate Post-Concussion Assessment Testing (ImPACT) - Dyslexia diagnosis indicator | Indicator of whether the subject has been diagnosed with dyslexia, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTDxDyslexiaInd | Recommended | CDE |
| 21 | Immediate Post-Concussion Assessment Testing (ImPACT) - Autism diagnosis indicator | Indicator of whether the subject has been diagnosed with autism, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTDxAutismInd | Recommended | CDE |
| 22 | Immediate Post-Concussion Assessment Testing (ImPACT) - Strenuous exercise 3 hour duration indicator | Indicator of whether the subject did strenuous exercise in the last 3 hours, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTStrenExerLst3HrInd | Recommended | CDE |
| 23 | Concussion diagnosed sustained date | Date concussion sustained by subject (month and year) | ConcussionDxDate | Recommended | UDE |
Post-Concussion Symptom Scale (PCSS) (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Headache score | The subject's current headache rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSHeadacheScore | Recommended | CDE |
| 2 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Nausea score | The subject's current nausea rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSNauseaScore | Recommended | CDE |
| 3 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Vomiting score | The subject's current vomiting rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSVomitingScore | Recommended | CDE |
| 4 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Balance problem score | The subject's current balance problems rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSBalanceProblemScore | Recommended | CDE |
| 5 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Dizziness score | The subject's current dizziness rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSDizzinessScore | Recommended | CDE |
| 6 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Fatigue score | The subject's current fatigue rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSFatigueScore | Recommended | CDE |
| 7 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Falling asleep trouble score | The subject's current trouble falling asleep rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSTroubFallAsleepScore | Recommended | CDE |
| 8 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Sleep greater than normal duration score | The subject's current sleep more than usual rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSSlpMoreThnUsualScore | Recommended | CDE |
| 9 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Sleep less than normal duration score | The subject's current sleep less than usual rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSSlpLessThnUsualScore | Recommended | CDE |
| 10 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Drowsiness score | The subject's current drowsiness rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSDrowsinessScore | Recommended | CDE |
| 11 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Light sensitivity score | The subject's current sensitivity to light rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSSensitiveLightScore | Recommended | CDE |
| 12 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Noise sensitivity score | The subject's current sensitivity to noise rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSSensitiveNoiseScore | Recommended | CDE |
| 13 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Irritability score | The subject's current irritability rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSIrritabilityScore | Recommended | CDE |
| 14 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Sadness score | The subject's current sadness rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSSadnessScore | Recommended | CDE |
| 15 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Nervousness score | The subject's current nervousness rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSNervousnessScore | Recommended | CDE |
| 16 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Emotional greater than normal score | The subject's current feeling more emotional rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSFeelEmotionalScore | Recommended | CDE |
| 17 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Numbness tingling assessment score | The subject's current numbness or tingling rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSNumbTingleScore | Recommended | CDE |
| 18 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Slowed down assessment score | The subject's current feeling slowed down rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSFeelSlowDownScore | Recommended | CDE |
| 19 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Mental fog assessment score | The subject's current feeling mentally foggy rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSFeelMentFogScore | Recommended | CDE |
| 20 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Concentration difficultly assessment score | The subject's current difficulty concentrating rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSDiffConcentrateScore | Recommended | CDE |
| 21 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Memory difficulty assessment score | The subject's current difficulty remembering rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSDiffRemeberScore | Recommended | CDE |
| 22 | Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Visual problem score | The subject's current visual problems rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS). | ImPACTPCSSVisualProbScore | Recommended | CDE |
| 23 | Immediate Post-Concussion Assessment Testing (ImPACT) - Total symptom score | The subject's total symptom score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTTotalSymptomScore | Recommended | CDE |
ImPACT Test (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Immediate Post-Concussion Assessment Testing (ImPACT) - Verbal memory composite score | Verbal memory composite score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTVerbMemoryCompScore | Recommended | CDE |
| 2 | Immediate Post-Concussion Assessment Testing (ImPACT) - Verbal memory composite percentile value | The percentile of the subject's verbal memory composite score (if available), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTVerbMemCompPercVal | Recommended | CDE |
| 3 | Immediate Post-Concussion Assessment Testing (ImPACT) - Verbal memory Reliable Change Index (RCI) exceed indicator | Indicator of whether the subject's composite score in verbal memory exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTVerbMemRCIExceedInd | Recommended | CDE |
| 4 | Immediate Post-Concussion Assessment Testing (ImPACT) - Visual memory composite score | Visual memory composite score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTVisMemoryCompScore | Recommended | CDE |
| 5 | Immediate Post-Concussion Assessment Testing (ImPACT) - Visual memory composite percentile value | The percentile of the subject's visual memory composite score (if available), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTVisMemCompPercVal | Recommended | CDE |
| 6 | Immediate Post-Concussion Assessment Testing (ImPACT) - Visual memory Reliable Change Index (RCI) exceeded indicator | Indicator of whether the subject's composite score in visual memory exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTVisMemRCIExceedInd | Recommended | CDE |
| 7 | Immediate Post-Concussion Assessment Testing (ImPACT) - Visual motor speed composite score | Visual motor speed composite score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTVisMotSpeedCompScore | Recommended | CDE |
| 8 | Immediate Post-Concussion Assessment Testing (ImPACT) - Visual motor speed composite percentile value | The percentile of the subject's visual motor speed composite score (if available), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTVisMotSpeedCompPercVal | Recommended | CDE |
| 9 | Immediate Post-Concussion Assessment Testing (ImPACT) - Visual motor speed Reliable Change Index (RCI) exceed indicator | Indicator of whether the subject's composite score in visual motor speed exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTVisMotSpeedRCIExceedInd | Recommended | CDE |
| 10 | Immediate Post-Concussion Assessment Testing (ImPACT) - Reaction time composite score | Reaction time composite score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTReactTimeCompScore | Recommended | CDE |
| 11 | Immediate Post-Concussion Assessment Testing (ImPACT) - Reaction time composite percentile value | The percentile of the subject's reaction time composite score (if available), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTReactTimeCompPercVal | Recommended | CDE |
| 12 | Immediate Post-Concussion Assessment Testing (ImPACT) - Reaction time Reliable Change Index (RCI) exceeded indicator | Indicator of whether the subject's composite score in reaction time exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTReactTimeRCIExceedInd | Recommended | CDE |
| 13 | Immediate Post-Concussion Assessment Testing (ImPACT) - Impulse control composite score | Impulse control composite score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTImplseCntrlCompScore | Recommended | CDE |
| 14 | Immediate Post-Concussion Assessment Testing (ImPACT) - Impulse control composite percentile value | The percentile of the subject's impulse control composite score (if available), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTImplseCntrlCompPercVal | Recommended | CDE |
| 15 | Immediate Post-Concussion Assessment Testing (ImPACT) - Impulse control Reliable Change Index (RCI) exceeded indicator | Indicator of whether the subject's composite score in impulse control exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTImplseCntrlRCIExceedInd | Recommended | CDE |
| 16 | Immediate Post-Concussion Assessment Testing (ImPACT) - Total symptom Reliable Change Index (RCI) exceeded indicator | Indicator of whether the subject's total symptom score exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTTotalSymptomRCIExceedInd | Recommended | CDE |
| 17 | Immediate Post-Concussion Assessment Testing (ImPACT) - Cognitive efficiency index score | The subject's cognitive efficiency index score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTCogEfficiencyIndexScore | Recommended | CDE |
| 18 | Immediate Post-Concussion Assessment Testing (ImPACT) - Sleep last night hour duration | Duration (in hours) the subject slept last night, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTHoursSleptLstNghtDur | Recommended | CDE |
| 19 | Medication prior or concomitant name | Name of the prior/concomitant agent or drug administered. | MedctnPriorConcomName | Recommended | CDE |
| 20 | Immediate Post-Concussion Assessment Testing (ImPACT) - Word memory immediate hit count | The number of immediate hits on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTWordMemImmedHitCt | Recommended | CDE |
| 21 | Immediate Post-Concussion Assessment Testing (ImPACT) - Word memory immediate correct distractor count | The number of immediate correct distractors identified on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTWordMemImmedCorrDisCt | Recommended | CDE |
| 22 | Immediate Post-Concussion Assessment Testing (ImPACT) - Word memory learning correct percentile value | The learning percent correct number on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTWordMemLearnCorrPercVal | Recommended | CDE |
| 23 | Immediate Post-Concussion Assessment Testing (ImPACT) - Word memory delay hit count | The number of delayed hits on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTWordMemDelayHitCt | Recommended | CDE |
| 24 | Immediate Post-Concussion Assessment Testing (ImPACT) - Word memory delay correct distractor count | The number of delay correct distractors identified on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTWordMemDelayCorrDisCt | Recommended | CDE |
| 25 | Immediate Post-Concussion Assessment Testing (ImPACT) - Word memory delayed percent correct percentile value | The delayed memory percent correct number on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTWordMemDelayCorrPercVal | Recommended | CDE |
| 26 | Immediate Post-Concussion Assessment Testing (ImPACT) - Word memory total percent correct percentile value | The total percent correct on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTWordMemTotCorrPercVal | Recommended | CDE |
| 27 | Immediate Post-Concussion Assessment Testing (ImPACT) - Design memory immediate hit count | The number of immediate hits on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTDesignMemImmedHitCt | Recommended | CDE |
| 28 | Immediate Post-Concussion Assessment Testing (ImPACT) - Design memory immediate correct distractor count | The number of immediate correct distractors identified on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTDesignMemImmedCorrDisCt | Recommended | CDE |
| 29 | Immediate Post-Concussion Assessment Testing (ImPACT) - Design memory learning correct percentile value | The learning percent correct number on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTDesignMemLrnCorrPercVal | Recommended | CDE |
| 30 | Immediate Post-Concussion Assessment Testing (ImPACT) - Design memory delay hit count | The number of delayed hits on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTDesignMemDelayHitCt | Recommended | CDE |
| 31 | Immediate Post-Concussion Assessment Testing (ImPACT) - Design memory delay correct distractor count | The number of delayed correct distractors on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTDesignMemDelayCorrDisCt | Recommended | CDE |
| 32 | Immediate Post-Concussion Assessment Testing (ImPACT) - Design memory delay percent correct percentile value | The delayed memory percent correct number on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTDesignMemDelCorrPercVal | Recommended | CDE |
| 33 | Immediate Post-Concussion Assessment Testing (ImPACT) - Design memory total correct percentile value | The total percent correct on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTDesignMemTotCorrPercVal | Recommended | CDE |
| 34 | Immediate Post-Concussion Assessment Testing (ImPACT) - X and O memory total correct count | The memory total correct on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTXOMemTotCorrectCt | Recommended | CDE |
| 35 | Immediate Post-Concussion Assessment Testing (ImPACT) - X and O interference total correct count | The interference total correct on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTXOInterTotCorrCt | Recommended | CDE |
| 36 | Immediate Post-Concussion Assessment Testing (ImPACT) - X and O interference average correct reaction time duration | The interference average correct reaction time duration on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTXOInterAvgCorrRTDur | Recommended | CDE |
| 37 | Immediate Post-Concussion Assessment Testing (ImPACT) - X and O interference total incorrect count | The interference total incorrect number on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTXOInterTotIncorrCt | Recommended | CDE |
| 38 | Immediate Post-Concussion Assessment Testing (ImPACT) - X and O interference average incorrect reaction time duration | The interference average incorrect reaction time duration on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTXOInterAvgIncorrRTDur | Recommended | CDE |
| 39 | Immediate Post-Concussion Assessment Testing (ImPACT) - Symbol match visible total correct count | The number of visible total correct responses on the symbol match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTSymbMatchVisTotCorrCt | Recommended | CDE |
| 40 | Immediate Post-Concussion Assessment Testing (ImPACT) - Symbol match visible average correct reaction time duration | The visible average reaction time total correct duration, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTSymbMatchVisAvgCorrRTDur | Recommended | CDE |
| 41 | Immediate Post-Concussion Assessment Testing (ImPACT) - Symbol match hidden total correct count | The number of hidden total correct responses on the symbol match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTSymbMatchHidTotCorrCt | Recommended | CDE |
| 42 | Immediate Post-Concussion Assessment Testing (ImPACT) - Symbol match hidden average correct reaction time duration | The hidden average reaction time total correct duration, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTSymbMatchHidAvgCorrRTDur | Recommended | CDE |
| 43 | Immediate Post-Concussion Assessment Testing (ImPACT) - Color match total correct count | The number of total correct on the color match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTColorMatchTotCorrCt | Recommended | CDE |
| 44 | Immediate Post-Concussion Assessment Testing (ImPACT) - Color match average correct reaction time duration | The average correct reaction time duration on the color match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTColorMatchAvgCorrRTDur | Recommended | CDE |
| 45 | Immediate Post-Concussion Assessment Testing (ImPACT) - Color match total commission count | The number of total commissions on the color match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTColorMatchTotCommCt | Recommended | CDE |
| 46 | Immediate Post-Concussion Assessment Testing (ImPACT) - Color match average commissions reaction time duration | The average commissions reaction time duration on the color match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTColorMatchAvgCommRTDur | Recommended | CDE |
| 47 | Immediate Post-Concussion Assessment Testing (ImPACT) - Three letters total sequence correct count | The number of total sequence items correct on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTThreeLetTotSeqCorrCt | Recommended | CDE |
| 48 | Immediate Post-Concussion Assessment Testing (ImPACT) - Three letters total letters correct count | The number of total correct letters on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTThreeLetTotLetCorrCt | Recommended | CDE |
| 49 | Immediate Post-Concussion Assessment Testing (ImPACT) - Three letters percent of total letters correct percentile value | The numeric percentage of total letters correct on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTThreLetPctTotLetCorPVal | Recommended | CDE |
| 50 | Immediate Post-Concussion Assessment Testing (ImPACT) - Three letters average time to first click duration | The duration of average time to first click on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTThreeLetAvgTmFstClickDur | Recommended | CDE |
| 51 | Immediate Post-Concussion Assessment Testing (ImPACT) - Three letter average count | The average number of counted items on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTThreeLetAvgCt | Recommended | CDE |
| 52 | Immediate Post-Concussion Assessment Testing (ImPACT) - Three letter average correct count | The average number of correctly counted items on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTThreeLetAvCorrCt | Recommended | CDE |
| 53 | Immediate Post-Concussion Assessment Testing (ImPACT) - Invalid assessment indicator | Indicator of whether the data is considered to be invalid, as part of the Immediate Post-Concussion Assessment Testing (ImPACT). | ImPACTInvalidAssInd | Recommended | CDE |
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