Form Structure: Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV) Letter-Number Sequencing
This form structure is an organized set of data definitions for a copyrighted form
Title:
Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV) Letter-Number Sequencing
Short Name:
WAISIV_LN_Seq
Description:
In WAIS-IV Letter-Number Sequencing test, the examinee is read a sequence of numbers and letters and recalls the numbers in ascending order and the letters in alphabetical order. This subtest measures sequential processing, mental manipulation, attention, concentration, memory span, and short-term auditory memory. Recommended by CDISC for TBI (TAUG TBI)
Disease:
Traumatic Brain Injury
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-05-13
Version:
1.2
Date Created:
2016-02-09
Owner:
Number of Data Elements:
24
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 |
WAIS_IV_LNS-Demonstration and Sample Questions (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | WAIS-IV Letter-Number Sequencing -Demonstration item A response text | Response for demonstration item A, as part of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Letter-Number Sequencing subtest | WAISIVLNDARespnsTxt | Recommended | CDE |
| 2 | WAIS-IV Letter-Number Sequencing -Sample item A response text | Response for sample item A, as part of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Letter-Number Sequencing subtest | WAISIVLNSARespnsTxt | Recommended | CDE |
| 3 | WAIS-IV Letter-Number Sequencing -Demonstration item B response text | Response for demonstration item A, as part of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Letter-Number Sequencing subtest | WAISIVLNDBRespnsTxt | Recommended | CDE |
| 4 | WAIS-IV Letter-Number Sequencing -Sample item B response text | Response for sample item B, as part of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Letter-Number Sequencing subtest | WAISIVLNSBRespnsTxt | Recommended | CDE |
WAIS_IV_LNS (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | WAIS-IV Letter-Number Sequencing - Item number | Number of item as part of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Letter-Number Sequencing subtest | WAISIVLNSItemNum | Recommended | CDE |
| 2 | Trial number | The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. | TrialNum | Recommended | CDE |
| 3 | WAIS-IV Letter-Number Sequencing - Item, Trial response text | Response for a given item of a given trial as part of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Letter-Number Sequencing subtest | WAISIVLNSItemTrialRespnsTxt | Recommended | CDE |
| 4 | WAIS-IV Letter-Number Sequencing - Trial score | Score for a given trial as part of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Letter-Number Sequencing subtest | WAISIVLNSTrialScore | Recommended | CDE |
| 5 | WAIS-IV Letter-Number Sequencing - Item score | Score for a given item as part of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Letter-Number Sequencing subtest | WAISIVLNSItemScore | Recommended | CDE |
WAIS_IV_LNS- Scoring (Repeat Infinitely)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | WAIS-IV Letter-Number Sequencing - Letters and digits recalled Number | Number of letter and digits recalled on last trial scored 1 point, as part of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Letter-Number Sequencing subtest | WAISIVLNLLNSNum | Recommended | CDE |
| 2 | WAIS-IV Letter-Number Sequencing - Total raw score | Total score as part of Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Letter-Number Sequencing subtest | WAISIVLNSTtlScore | Recommended | CDE |
Keywords
