Form Structure: NIH ToolBox Cognition Domain List Sorting Working Memory Test
This form structure is an organized set of data definitions for a form that has not been copyrighted
Resource:
FITBIR
Title:
NIH ToolBox Cognition Domain List Sorting Working Memory Test
Short Name:
NIHTBListSortWorkMemTest
Description:
Cognition Domain: The NIH Toolbox List Sorting Working Memory Test (List Sorting) requires immediate recall and sequencing of different visually and orally presented stimuli. Pictures of different foods and animals are displayed with accompanying audio recording and written text (e.g., elephant), and the participant is asked to say the items back in size order from smallest to largest, first within a single dimension (either animals or foods, called 1-List) and then on two dimensions 15 (foods, then animals, called 2-List). The test takes approximately seven minutes to administer and is recommended for ages 7-85, though it is available for use as young as age 3.
Disease:
Traumatic Brain Injury
Organization:
NIH/CIT/DCB
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-07-01
Version:
1.0
Date Created:
2016-05-19
Owner:
Number of Data Elements:
35
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 (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 |
NIH Toolbox Administration (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 |
NIH Toolbox - Test domain battery type
(Retired) |
Type of domain battery for the NIH Toolbox test being administered, as a part of the NIH Toolbox | NIHTBTestDomainBatteryTyp | 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 other | The free-text related to NIHTBAdminTestNameTyp specifying other text, as part of the NIH Toolbox | NIHTBAdminTestNameTypOTH | Recommended | CDE |
| 4 | NIH Toolbox - Test name type | Type of NIH Toolbox test being administered, as part of the NIH Toolbox | NIHTBAdminTestNameTyp | Recommended | CDE |
| 5 | NIH Toolbox - Form administered type | Type of NIH Toolbox form being administered, as part of the NIH Toolbox | NIHTBFormAdminTyp | Recommended | CDE |
| 6 | NIH Toolbox - Test administration language type | Type of language for test being administrated, as part of the NIH Toolbox | NIHTBTestAdminLanguageTyp | Recommended | CDE |
| 7 | NIH Toolbox - Test administration language type other | Free-text related to NIHTBTestAdminLanguageTyp specifying other text, as part of the NIH Toolbox | NIHTBTestAdminLanguageTypOTH | 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 |
List Sorting Working Memory Test 1 - List (Repeat Infinitely)
| # | 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 | NIH Toolbox Cognition Domain List Sorting Working Memory Test - Trial result type | Trial result type (correct or incorrect) as part of the NIH Toolbox Cognition Domain List Sorting Working Memory Test | NIHTBLSTrialResultTyp | Recommended | CDE |
List Sorting Working Memory Test 2 - List (Repeat Infinitely)
| # | 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 | NIH Toolbox Cognition Domain List Sorting Working Memory Test - Trial result type | Trial result type (correct or incorrect) as part of the NIH Toolbox Cognition Domain List Sorting Working Memory Test | NIHTBLSTrialResultTyp | Recommended | CDE |
List Sorting Working Memory Test Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | NIH Toolbox Cognition Domain List Sorting Working Memory Test - Sum score | The sum score of the total number of items correctly recalled and sequenced on 1-List and 2-List, as part of the NIH Toolbox Cognition Domain List Sorting Working Memory Test | NIHTBLSSumScore | 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 (web and CAT) - Unadjusted scale score | Unadjusted scale score, as part of the NIH Toolbox Performance Measures (web and CAT) | NIHTBPMUnadjSclScore | Recommended | CDE |
| 5 | NIH Toolbox Performance Measures - Fully-adjusted scale score | Fully-adjusted scale score, as part of the NIH Toolbox Performance Measures | NIHTBPMFullyAdjSclScore | Recommended | CDE |
| 6 | 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 |
NIH Toolbox Cognition Composite Scores (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | NIH Toolbox Cognition Domain - Fluid Cognition Composite Score | NIH Toolbox Fluid Cognition Composite Score, as a part of the cognition domain of NIH Toolbox | NIHTBFluidCognitionCompScore | Recommended | CDE |
| 2 | NIH Toolbox Cognition Domain - Cognitive Function Composite Score (DCCS) | NIH Toolbox Cognitive Function Composite Score, as a part of cognition domain of the NIH Toolbox | NIHTBCognitFunctCompositeScore | Recommended | CDE |
| 3 | NIH Toolbox Cognition Domain - Early Childhood Composite Score | NIH Toolbox Early Childhood Composite Score, as a part of cognition domain of the NIH Toolbox | NIHTBEarlyChildhdCompsiteScore | Recommended | CDE |
Keywords
