Form Structure: Wechsler Intelligence Scale for Children -Fourth edition (WISC-IV) Cancellation section
This form structure is an organized set of data definitions for a copyrighted form
Title:
Wechsler Intelligence Scale for Children -Fourth edition (WISC-IV) Cancellation section
Short Name:
WISCIVCA
Description:
WISC-IV measures a child's intellectual ability. Cancellation subtest measures processing speed using random and structured animal target forms. Wechsler, D. (2003). Wechsler Intelligence Scale for Children–Fourth Edition: Technical and interpretive manual. San Antonio, TX: Psychological Corporation. Copyright 2003 by The Psychological Corporation, a Harcourt Assessment Company http://www.pearsonclinical.com/
Disease:
Traumatic Brain Injury
Organization:
FITBIR
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-07-25
Owner:
Number of Data Elements:
25
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 | 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 |
WISC-IV Cancellation (Appears Up To 2 Times)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation Section - Item type | Item type, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest | WISCIVCAItemTyp | Recommended | CDE |
| 2 | Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation Section - Completion time | Cancellation completion time, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest | WISCIVCACompltnTime | Recommended | CDE |
| 3 | Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Number incorrect | Count of number correct, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest | WISCIVCANumCorrectCt | Recommended | CDE |
| 4 | Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Number correct | Count of number incorrect, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest | WISCIVCANumIncorrectCt | Recommended | CDE |
| 5 | Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Difference score | Score of difference, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest | WISCIVCADiffScore | Recommended | CDE |
| 6 | Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Bonus points score | Bonus points, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest | WISCIVCABonusPtsScore | Recommended | CDE |
| 7 | Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Item total raw score | Item total raw score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest | WISCIVCAItemTtlRawScore | Recommended | CDE |
WISC-IV Cancellation-Search pattern (Appears Up To 2 Times)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation Section - Item type | Item type, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest | WISCIVCAItemTyp | Recommended | CDE |
| 2 | Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation Section - Search pattern category | Search pattern, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest | WISCIVCASearchPatCat | Recommended | CDE |
WISC-IV Cancellation-Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Total raw score | Total raw score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest | WISCIVCATtlRawScore | Recommended | CDE |
Keywords
