Form Structure: Neurobehavioral Rating Scale (NRS)
This form structure is an organized set of data definitions for a form that has not been copyrighted
Resource:
FITBIR
Title:
Neurobehavioral Rating Scale (NRS)
Short Name:
NRS
Description:
The NRS consits of a semistructured interview ans brief cognitive tests during the interview. Each of the 27 items is rated on a 7-level scale(deficit absent,very mild,mild,moderaate, moderately severe, severe, extremely severe) on the basis of indicative behavioral evidence.
Disease:
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:
2016-05-06
Owner:
Number of Data Elements:
47
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 |
Neurobehavioral Rating Scale (NRS) (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Neurobehavioral Rating Scale (NRS) - Inattention or reduced alertness scale | Scale for inattention or reduced alertness, as part of the Neurobehavioral Rating Scale (NRS) | NRSInattentionReduceAlertScl | Recommended | CDE |
| 2 | Neurobehavioral Rating Scale (NRS) - Somatic concerns scale | Scale for somatic concerns, as part of the Neurobehavioral Rating Scale (NRS) | NRSSomaticConcernScl | Recommended | CDE |
| 3 | Neurobehavioral Rating Scale (NRS) - Disorientation scale | Scale for disorientation, as part of the Neurobehavioral Rating Scale (NRS) | NRSDisorientationScl | Recommended | CDE |
| 4 | Neurobehavioral Rating Scale (NRS) - Anxiety scale | Scale for anxiety, as part of the Neurobehavioral Rating Scale (NRS) | NRSAnxietyScl | Recommended | CDE |
| 5 | Neurobehavioral Rating Scale (NRS) - Expressive deficit scale | Scale for expressive deficit, as part of the Neurobehavioral Rating Scale (NRS) | NRSExpressiveDeficitScl | Recommended | CDE |
| 6 | Neurobehavioral Rating Scale (NRS) - Emotional withdrawal scale | Scale for emotional withdrawal, as part of the Neurobehavioral Rating Scale (NRS) | NRSEmotionalWithdrawalScl | Recommended | CDE |
| 7 | Neurobehavioral Rating Scale (NRS) - Conceptual disorganization scale | Scale for conceptual disorganization, as part of the Neurobehavioral Rating Scale (NRS) | NRSConceptualDisorientatnScl | Recommended | CDE |
| 8 | Neurobehavioral Rating Scale (NRS) - Disinhibition scale | Scale for disinhibition, as part of the Neurobehavioral Rating Scale (NRS) | NRSDisinhibitionScl | Recommended | CDE |
| 9 | Neurobehavioral Rating Scale (NRS) - Feelings of guilt scale | Scale for feelings of guilt, as part of the Neurobehavioral Rating Scale (NRS) | NRSGuiltFeelingsScl | Recommended | CDE |
| 10 | Neurobehavioral Rating Scale (NRS) - Memory deficit scale | Scale for memory deficit, as part of the Neurobehavioral Rating Scale (NRS) | NRSMemoryDeficitScl | Recommended | CDE |
| 11 | Neurobehavioral Rating Scale (NRS) - Agitation scale | Scale for agitation, as part of the Neurobehavioral Rating Scale (NRS) | NRSAgitationScl | Recommended | CDE |
| 12 | Neurobehavioral Rating Scale (NRS) - Inaccurate insight and self-appraisal scale | Scale for inaccurate insight and self-appraisal, as part of the Neurobehavioral Rating Scale (NRS) | NRSInaccurateInsightScl | Recommended | CDE |
| 13 | Neurobehavioral Rating Scale (NRS) - Depressive mood scale | Scale for depressive mood, as part of the Neurobehavioral Rating Scale (NRS) | NRSDepressiveMoodScl | Recommended | CDE |
| 14 | Neurobehavioral Rating Scale (NRS) - Hostility or uncooperativeness scale | Scale for hostility or uncooperativeness, as part of the Neurobehavioral Rating Scale (NRS) | NRSHostilityUncooperativScl | Recommended | CDE |
| 15 | Neurobehavioral Rating Scale (NRS) - Decreased initiative or motivation scale | Scale for decreased initiative or motivation, as part of the Neurobehavioral Rating Scale (NRS) | NRSDecreasInitiativMotivScl | Recommended | CDE |
| 16 | Neurobehavioral Rating Scale (NRS) - Suspiciousness scale | Scale for suspiciousness, as part of the Neurobehavioral Rating Scale (NRS) | NRSSuspiciousnessScl | Recommended | CDE |
| 17 | Neurobehavioral Rating Scale (NRS) - Fatigability scale | Scale for fatigability, as part of the Neurobehavioral Rating Scale (NRS) | NRSFatigabilityScl | Recommended | CDE |
| 18 | Neurobehavioral Rating Scale (NRS) - Hallucinatory behavior scale | Scale for hallucinatory behavior, as part of the Neurobehavioral Rating Scale (NRS) | NRSHallucinatoryBehaviorScl | Recommended | CDE |
| 19 | Neurobehavioral Rating Scale (NRS) - Motor retardation scale | Scale for motor retardation, as part of the Neurobehavioral Rating Scale (NRS) | NRSMotorRetardationScl | Recommended | CDE |
| 20 | Neurobehavioral Rating Scale (NRS) - Unusual thought content scale | Scale for unusual thought content, as part of the Neurobehavioral Rating Scale (NRS) | NRSUnusualThoughtContentScl | Recommended | CDE |
| 21 | Neurobehavioral Rating Scale (NRS) - Blunted affect scale | Scale for blunted affect, as part of the Neurobehavioral Rating Scale (NRS) | NRSBluntedAffectScl | Recommended | CDE |
| 22 | Neurobehavioral Rating Scale (NRS) - Excitement scale | Scale for excitement, as part of the Neurobehavioral Rating Scale (NRS) | NRSExcitementScl | Recommended | CDE |
| 23 | Neurobehavioral Rating Scale (NRS) - Poor planning scale | Scale for poor planning, as part of the Neurobehavioral Rating Scale (NRS) | NRSPoorPlanningScl | Recommended | CDE |
| 24 | Neurobehavioral Rating Scale (NRS) - Liability of mood scale | Scale for liability of mood, as part of the Neurobehavioral Rating Scale (NRS) | NRSLiabilityMoodScl | Recommended | CDE |
| 25 | Neurobehavioral Rating Scale (NRS) - Tension scale | Scale for tension, as part of the Neurobehavioral Rating Scale (NRS) | NRSTensionScl | Recommended | CDE |
| 26 | Neurobehavioral Rating Scale (NRS) - Comprehension deficit scale | Scale for comprehension deficit, as part of the Neurobehavioral Rating Scale (NRS) | NRSComprehesionDeficitScl | Recommended | CDE |
| 27 | Neurobehavioral Rating Scale (NRS) - Speech articulation deficit scale | Scale for speech articulation deficit, as part of the Neurobehavioral Rating Scale (NRS) | NRSArticulationDeficitScl | Recommended | CDE |
NRS Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Neurobehavioral Rating Scale (NRS) - Cognition/energy factor I score | Score for Factor I Cognition/energy, as part of the Neurobehavioral Rating Scale (NRS) | NRSFactorIScore | Recommended | CDE |
| 2 | Neurobehavioral Rating Scale (NRS) - Metacognition factor II score | Score for Factor II Metacognition, as part of the Neurobehavioral Rating Scale (NRS) | NRSFactorIIScore | Recommended | CDE |
| 3 | Neurobehavioral Rating Scale (NRS) - Somatic/anxiety factor III score | Score for Factor III Somatic/anxiety, as part of the Neurobehavioral Rating Scale (NRS) | NRSFactorIIIScore | Recommended | CDE |
| 4 | Neurobehavioral Rating Scale (NRS) - Language factor IV score | Score for Factor IV Language, as part of the Neurobehavioral Rating Scale (NRS) | NRSFactorIVScore | Recommended | CDE |
| 5 | Neurobehavioral Rating Scale (NRS) - Total score | Total score, as a part of the Neurobehavioral Rating Scale (NRS) | NRSTotalScore | Recommended | CDE |
Keywords
