Form Structure: NIH Toolbox Motor Domain 9-Hole Pegboard Dexterity Test
This form structure is an organized set of data definitions for a copyrighted form
Title:
NIH Toolbox Motor Domain 9-Hole Pegboard Dexterity Test
Short Name:
NIHTB9HolePegboardDetrTest
Description:
Motor Domain: This simple test of manual dexterity records the time required for the participant to accurately place and remove nine plastic pegs into a plastic pegboard. The protocol includes one practice and one timed trial with each hand. Raw scores are recorded as time in seconds it takes the
participant to complete the task with each hand (separate score for each). The test takes approximately four minutes to administer and is recommended for ages 3-85. Copyright 2012 Northwestern University and the National Institutes of Health. http://www.nihtoolbox.org/Pages/NIH-Toolbox-Terms-and-Conditions.aspx
Disease:
General (For all diseases)
Traumatic Brain Injury
Organization:
NIH/CIT/DCB
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-05-27
Owner:
Number of Data Elements:
39
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 | Language form administration ISO code | Code (ISO 639-2) for the language that was used for CRF/instrument/scale/etc. administration | LangCRFAdministratISOCode | Recommended | CDE |
2 | Language form administration ISO code other text | The free-text field related to 'Language used for CRF/instrument/scale/etc. administration ISO code' specifying other text. | LangCRFAdministratISOCodeOTH | Recommended | CDE |
3 | Context type | The context to which the questions were answered | ContextType | Recommended | CDE |
4 | Context type other text | The free-text related to ContextType specifying other text | ContextTypeOTH | Recommended | CDE |
5 | Data source | Source of the data provided on the case report form | DataSource | Recommended | CDE |
6 | 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 |
NIH Administration (Appears Up To 1 Time)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | NIH Toolbox - Test domain battery type | Type of domain battery for the NIH Toolbox test being administered, as a part of the NIH Toolbox | NIHTBTestDomainBattryTyp | Recommended | CDE |
2 | NIH Toolbox - Test domain battery type other | The free-text related to NIHTBTestDomainBatteryTyp specifying other text, as part of the NIH Toolbox | NIHTBTestDomainBatteryTypOTH | Recommended | CDE |
3 | NIH Toolbox - Test name type | Type of NIH Toolbox test being administered, as part of the NIH Toolbox | NIHTBAdminTestNameTyp | Recommended | CDE |
4 | NIH Toolbox - Test name type other | The free-text related to NIHTBAdminTestNameTyp specifying other text, as part of the NIH Toolbox | NIHTBAdminTestNameTypOTH | Recommended | CDE |
5 | NIH Toolbox - Test administration language type | Type of language for test being administrated, as part of the NIH Toolbox | NIHTBTestAdminLanguageTyp | Recommended | CDE |
6 | NIH Toolbox - Test administration language type other | Free-text related to NIHTBTestAdminLanguageTyp specifying other text, as part of the NIH Toolbox | NIHTBTestAdminLanguageTypOTH | Recommended | CDE |
7 | NIH Toolbox - Form administered type | Type of NIH Toolbox form being administered, as part of the NIH Toolbox | NIHTBFormAdminTyp | Recommended | CDE |
8 | NIH Toolbox - Test administration flag type | Type of flag for the NIH Toolbox test being administered, as part of the NIH Toolbox | NIHTBAdminTestFlagTyp | Recommended | CDE |
9 | NIH Toolbox - Test administration flag indicator | Indicator of a flag for the NIH Toolbox test being administered, as part of the NIH Toolbox | NIHTBAdminTestFlagInd | Recommended | CDE |
NIH Toolbox 9-Hole Pegboard Dexterity Test: Practice (Appears Up To 2 Times)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | Trial number (numeric) | The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. | TrialNumber | Recommended | CDE |
2 | Hand preference type | Hand which the participant/subject uses predominantly, not necessarily the hand he/she writes with exclusively. | HandPrefTyp | Recommended | CDE |
3 | NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test - Non-dominant hand practice test time duration | Duration of non-dominant hand practice test time, as part of the NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test | NIHTB9HPDNonDomPractTestDur | Recommended | CDE |
4 | NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test - Dominant hand practice test time duration | Duration of dominant hand practice test time, as part of the NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test | NIHTB9HPDDomPractTestDur | Recommended | CDE |
NIH Toolbox 9-Hole Pegboard Dexterity Test: Trial Test (Appears Up To 2 Times)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | Trial number (numeric) | The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. | TrialNumber | Recommended | CDE |
2 | Hand preference type | Hand which the participant/subject uses predominantly, not necessarily the hand he/she writes with exclusively. | HandPrefTyp | Recommended | CDE |
3 | NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test - Dominant hand trial test time duration | Duration of dominant hand trial test time, as part of the NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test | NIHTB9HPDDomTrialTestDur | Recommended | CDE |
4 | NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test - Non-dominant hand trial test time duration | Duration of non-dominant hand trial test time, as part of the NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test | NIHTB9HPDNonDomTrialTestDur | Recommended | CDE |
NIH Toolbox 9-Hole Pegboard Dexterity Test Scoring (Appears Up To 1 Time)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test - Dominant hand computed score | Computed score of dominant hand, as part of the NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test | NIHTB9HPDDominantCompScore | Recommended | CDE |
2 | NIH Toolbox Performance Measures (web and CAT) - Age-adjusted scale score | Age-adjusted scale score, as part of the NIH Toolbox Performance Measures (web and CAT) | NIHTBPMAgeAdjSclScore | Recommended | CDE |
3 | NIH Toolbox Performance Measures - Age-adjusted national percentile value | Value of age-adjusted national percentile, as part of the NIH Toolbox Performance Measures | NIHTBPMAgeAdjNationalPctVal | Recommended | CDE |
4 | NIH Toolbox Performance Measures - Fully-adjusted scale score | Fully-adjusted scale score, as part of the NIH Toolbox Performance Measures | NIHTBPMFullyAdjSclScore | Recommended | CDE |
5 | NIH Toolbox Performance Measures (web and CAT) - Unadjusted scale score | Unadjusted scale score, as part of the NIH Toolbox Performance Measures (web and CAT) | NIHTBPMUnadjSclScore | Recommended | CDE |
6 | NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test - Non-dominant hand computed score | Computed score of non-dominant hand, as part of the NIH Toolbox Motor Domain Dexterity Measure 9-Hole Pegboard Dexterity Test | NIHTB9HPDNonDominantCompScore | Recommended | CDE |
7 | NIH Toolbox - Standard error | Standard error (a statistical measure of variance that represents the margin of error for the Tscore), as part of the NIH Toolbox Web, Cat and iPad Cognition measures such as: Picture Vocabulary Test and Oral Reading Recognition Test. | NIHTBStandardError | Optional | CDE |
Keywords