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This form structure is an organized set of data definitions for a copyrighted form
Resource:
FITBIR
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