Form Structure: TBI-QOL Item Bank v1.0 - Resilience - Short Form 10a
This form structure is an organized set of data definitions for a copyrighted form
Title:
TBI-QOL Item Bank v1.0 - Resilience - Short Form 10a
Short Name:
TBIQOLResil
Description:
TBI-QOL Item Bank v1.0 Resilience Short Form 10a. 10 items are included. 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:
2016-12-08
Version:
1.1
Date Created:
2016-06-02
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 Resilience (Appears Up To 1 Time)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | TBI Quality of Life (TBI-QOL) - Recognize overcome challenges scale | The scale representing how often the participant was able to recognize and overcome challenges lately, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). | TBIQOLRecogOvrcmChallengesScl | Recommended | CDE |
2 | TBI Quality of Life (TBI-QOL) - Positive side scale | The scale representing how often the participant tried to see the positive side of things lately, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). | TBIQOLPostvSideScl | Recommended | CDE |
3 | TBI Quality of Life (TBI-QOL) - Adapt to new situations scale | The scale which represents how easily the participant could adapt easily to new situations lately, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). | TBIQOLAdtToNewSituScl | Recommended | CDE |
4 | TBI Quality of Life (TBI-QOL) - Confident overcome limitations scale | The scale which represents how much the participant was confident that he/she could overcome his/her limitations lately, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). | TBIQOLCofidntOvrcomeLimtnScl | Recommended | CDE |
5 | TBI Quality of Life (TBI-QOL) - New Things To Enjoy scale | The scale which represents how often the participant found new things to enjoy lately, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). | TBIQOLNewThingsToEnjoyScl | Recommended | CDE |
6 | TBI Quality of Life (TBI-QOL) - Get through difficult times scale | The scale which represents how often the participant felt he/she can get through difficult times lately, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). | TBIQOLGtThrouDiffcltTimesScl | Recommended | CDE |
7 | TBI Quality of Life (TBI-QOL) - Positive ways cope with injury scale | The scale which represents how often the participant used positive ways to cope with my injury lately, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). | TBIQOLPostvWaysCopeWInjScl | Recommended | CDE |
8 | TBI Quality of Life (TBI-QOL) - Strong person scale | The scale which represents how often the participant felt the things he/she went through made him/her a stronger person lately, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). | TBIQOLStrongPersonScl | Recommended | CDE |
9 | TBI Quality of Life (TBI-QOL) - Achieve emotional balance scale | The scale which represents how often the participant felt the things he/she went through made him/her a stronger person lately, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). | TBIQOLAchivEmotnBalnceScl | Recommended | CDE |
10 | TBI Quality of Life (TBI-QOL) - Good about coping with injury scale | The scale which represents how often the participant felt good about how I have coped with my injury lately, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). | TBIQOLGodAbtCopWInjeScl | Recommended | CDE |
TBI-QOL Resilience- scoring (Appears Up To 1 Time)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | TBIQOLResilRawScore | The raw score related to subjective experience of the process and outcome of successfully adapting to difficult or challenging life experiences, especially highly stressful or traumatic events, as part of the TBI Quality of Life (TBI-QOL). | TBIQOLResilRawScore | Recommended | CDE |
2 | TBI Quality of Life (TBI-QOL) - Resilience T-score | The T-Score related to subjective experience of the process and outcome of successfully adapting to difficult or challenging life experiences, especially highly stressful or traumatic events. | TBIQOLResilTScore | 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 |
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