Form Structure: TBI-QOL Item Bank v1.0 - Cognition: General Concerns - Short Form 10a - deprecated
This form structure is an organized set of data definitions for a copyrighted form
Resource:
FITBIR
Title:
TBI-QOL Item Bank v1.0 - Cognition: General Concerns - Short Form 10a - deprecated
Short Name:
TBIQOLCognitionGeneralConc
Description:
Deprecated as per new developments in TBI-QOL instruments. Use TBIQOLCognGenConcSF10a FS instead. Some updates in permissible values description instead. Refer to TBIQOLCognGenConcSF10a FS for the latest FS for upload.
References: Tulsky, D. S., Kisala, P. A., Victorson, D., Carlozzi, N., Bushnik, T., Sherer, M., & Englander, J. (2016). TBI-QOL: development and calibration of item banks to measure patient reported outcomes following traumatic brain injury.The Journal of head trauma rehabilitation, 31(1), 40. TBI-QOL Items Copyright 2015 David Tulsky and Kessler Foundation. All rights reserved. http://www.assessmentcenter.net/ Recommended by CDISC for TBI
Disease:
Traumatic Brain Injury
Organization:
NIH/CIT/BRICS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-09-30
Version:
1.2
Date Created:
2016-05-31
Owner:
Number of Data Elements:
26
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 | 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 |
TBI-QOL Cognition (Appears Up To 1 Time)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | TBI Quality of Life (TBI-QOL) - Trouble remembering things scale | The scale which represents how often the participant had trouble remembering things, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL) Cognition: General Concerns � Short Form 10a | TBIQOLTrblRembringThingsScl | Recommended | CDE |
2 | Quality of Life - Trouble keep track interrupt scale | The scale representing how often the participant had trouble keeping track of what they were doing if they were interrupted, as part of Neuro-QOL Cognitive Function and TBI-QOL Cognition: General Concerns � Short Form 10a | QoLTrbleKeepTrackInteruptScl | Recommended | CDE |
3 | TBI Quality of Life (TBI - QOL) and Quality of Life - Maintain task thought trouble scale | The scale representing how often the participant had trouble keeping their mind on what they were doing, as part of Neuro-QOL Depression. And as part of Traumatic Brain Injury-Quality of Life (TBI-QOL) Cognition: General Concerns � Short Form 10a | QoLMntainTaskThoughtTroublScl | Recommended | CDE |
4 | TBI Quality of Life (TBI-QOL) - Hard to pay attention scale | The scale which represents how often the participant had to work really hard to pay attention or he/she would make a mistake, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL) Cognition: General Concerns � Short Form 10a | TBIQOLTrblHardToPayAttenScl | Recommended | CDE |
5 | Quality of Life - Trouble concentrate scale | The scale representing how often the participant had trouble concentrating, as part of Neuro-QOL Cognitive Function. And as part of Traumatic Brain Injury-Quality of Life (TBI-QOL) Cognition: General Concerns � Short Form 10a | QoLTroubleConcentrateScl | Recommended | CDE |
6 | TBI Quality of Life (TBI - QOL) - Felt confused scale | The scale representing how often the participant felt confused, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL) Cognition: General Concerns � Short Form 10a | TBIQOLIFeltConfusedScl | Recommended | CDE |
7 | TBI Quality of Life (TBI - QOL) - Difficulty following the topic of conversation scale | The scale representing how often the subject had difficulty following the topic of conversation, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL) Cognition: General Concerns � Short Form 10a | TBIQOLDiffcltyTopicConvrstnScl | Recommended | CDE |
8 | TBI Quality of Life (TBI-QOL) - Trouble thinking clearly scale | The scale which represents how often the participant had trouble thinking clearly, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL) Cognition: General Concerns � Short Form 10a | TBIQOLTrblThinkingClearlyScl | Recommended | CDE |
9 | TBI Quality of Life (TBI-QOL) - Slow thinking scale | The scale which represents how often the participant had slow thinking, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL) Cognition: General Concerns � Short Form 10a | TBIQOLSlowThinkingScl | Recommended | CDE |
10 | TBI Quality of Life (TBI-QOL) - Reacted slowly scale | The scale which represents how often the participant reacted slowly to things that were said or done, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL) Cognition: General Concerns � Short Form 10a | TBIQOLReactedSlowlyScl | Recommended | CDE |
TBI-QOL Cognition- scoring (Appears Up To 1 Time)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | TBI Quality of Life (TBI-QOL) - Cognition general concerns raw score | The raw score related to perceived difficulties in everyday cognitive abilities such as learning, memory, attention, and concentration, as part of the TBI Quality of Life (TBI-QOL). | TBIQOLCogGenRawScore | Recommended | CDE |
2 | TBI Quality of Life (TBI-QOL) - Cognition general concerns T-score | The T-Score related to perceived difficulties in everyday cognitive abilities such as learning, memory, attention, and concentration, as part of the TBI Quality of Life (TBI-QOL). | TBIQOLCogGenTScore | Recommended | CDE |
3 | TBI Quality of Life (TBI - QOL) - Standard error | Standard error (a statistical measure of variance that represents the margin of error for the T-score), as part of TBI-Quality of Life (TBI-QOL) measures | TBIQOLStandardError | Recommended | CDE |
Keywords