Form Structure: TBI-QOL Item Bank v1.0 - Communication - Short Form 9a
This form structure is an organized set of data definitions for a form that has not been copyrighted
Resource:
FITBIR
Title:
TBI-QOL Item Bank v1.0 - Communication - Short Form 9a
Short Name:
TBIQOLCommunication
Description:
Traumatic Brain Injury - Quality of Life (TBI-QOL) Communication Short Form 9a assesses perceived difficulties related to oral expression, language production, articulation, comprehension, and organization.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
Version:
1.0
Date Created:
2016-06-02
Owner:
Number of Data Elements:
27
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 | 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 |
TBI-QOL Communication (Appears Exactly 1 Time)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | TBI-Quality of Life (TBI-QOL) - Difficulty following what other people are saying scale | The scale representing how much difficulty the participant currently has following what other people are saying | TBIQOLDiffcltyPplSayingScl | Recommended | CDE |
2 | TBI-Quality of Life (TBI-QOL) - Difficulty carrying on a conversation with more than one person scale | The scale representing how much difficulty the participant currently has carrying on a conversation with more than one person | TBIQOLDiffConvPplScl | Recommended | CDE |
3 | TBI-Quality of Life (TBI-QOL) - Difficulty understanding what people say to you scale | The scale representing how much difficulty the participant currently has understanding what people say to him/her | TBIQOLDiffUndrstndPplSayScl | Recommended | CDE |
4 | TBI-Quality of Life (TBI-QOL) - Difficulty speaking scale | The scale representing how much difficulty the participant currently has speaking | TBIQOLDiffcltySpeakingScl | Recommended | CDE |
5 | Quality of Life - Family friend phone understand difficulty scale | The scale which represents the amount of difficulty the participant currently has in understanding family and friends over the phone, as part of Neuro-QOL Communication. | QoLFamFrndPhneUndrstndDiffScl | Recommended | CDE |
6 | TBI-Quality of Life (TBI-QOL)- Forgot what I wanted to say when talking to others scale | The scale representing how much in the past 7 days the subject forgot what he/she want to say when talking to others | TBIQOLForgotScl | 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 saying what I mean in conversations with others scale | The scale representing how often in the past 7 days the participant had trouble saying what he/she means in conversations with others | TBIQOLTrbleSayingCnverstnsScl | Recommended | CDE |
9 | TBI-Quality of Life (TBI-QOL) - Trouble finding the right word(s) to express myself | The scale representing how often in the past 7 days the participant had trouble finding the right word(s) to express him/her self, as part of PROMIS Applied Cog Concerns. | TBIQOLTrbleFindRtWrdsXpressScl | Recommended | CDE |
TBI-QOL Communication Scoring (Appears Exactly 1 Time)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | TBI-Quality of Life (TBI-QOL)- Communication Raw score | Raw score for TBI-QOL Communication | TBIQOLCommRawScore | Recommended | CDE |
2 | TBI Quality of Life (TBI-QOL) - Communication comprehension T-score | The T-Score related to perceived difficulties related to oral expression, language production, articulation, comprehension. | TBIQOLCommCompTScore | 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