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This form structure is an organized set of data definitions for a copyrighted form
Resource:
FITBIR
Title:
Wechsler Preschool and Primary Scale of Intelligence Third Edition- Information subtest
Short Name:
WPPSI3IN
Description:
WPPSI-III is a measure of intelligence in young children that is more age-appropriate and user-friendly. Information subtest measures general cultural knowledge, long-term memory, and acquired facts. Wechsler, D. (2002). Wechsler Preschool and Primary Scale of Intelligence?third edition technical and interpretive manual. San Antonio, TX: Psychological Corporation. Copyright 2002 by NCS Pearson, Inc. 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:
2016-07-29
Owner:
Number of Data Elements:
22
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

WPPSI-III Information Picture Items (Appears Up To 6 Times)

# Title Short Description Variable Name Required? Type
1 Test item number (numeric)  The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked TestItemNum Recommended CDE
2 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Information Section - Picture item response text  Response numbers of picture items, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) WPPSI3INPicRespnsNum Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Information Section - Item score  Item score, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Information subtest WPPSI3INItemScore Recommended CDE

WPPSI-III Information Verbal Items (Appears Up To 28 Times)

# Title Short Description Variable Name Required? Type
1 Test item number (numeric)  The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked TestItemNum Recommended CDE
2 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Information Section - Verbal response text  Information verbal response text, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) WPPSI3INVerbRespnsTxt Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Information Section - Item score  Item score, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Information subtest WPPSI3INItemScore Recommended CDE

WPPSI-III Information-Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Information Section - Total raw score  Information total raw score, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) WPPSI3INTtlRawScore Recommended CDE
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