Form Structure: Wide Range Assessment of Memory and Learning, Second Edition( WRAML-2)-Number letter
This form structure is an organized set of data definitions for a copyrighted form
Resource:
FITBIR
Title:
Wide Range Assessment of Memory and Learning, Second Edition( WRAML-2)-Number letter
Short Name:
WRAML2NL
Description:
"The WRAML2 is a carefully standardized psychometric instrument which allows the user to evaluate an individual's memory functioning. The WRAML2 affords evaluation of both immediate and delayed memory ability, as well as the acquisition of new learning. Copyright 2003 by Wide Range. Sheslow, D., Adams, W. 2003. Wide Range Assessment of Memory and Learning. NCS Pearson, Bloomington, MN."
Disease:
General (For all diseases)
Traumatic Brain Injury
Organization:
FITBIR
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-11-18
Owner:
Number of Data Elements:
19
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 |
WRAML2 Number Letter (Appears Up To 25 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 | Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Number letter sequence item response text | Number letter sequence item response text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) | WRAML2NumberLetterSeqItmRspTxt | Recommended | CDE |
| 3 | Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Number letter sequence item response score | Number letter sequence item response score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) | WRAML2NumberLttrSeqItmRspScore | Recommended | CDE |
WRAML2 Number letter scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Number letter sequence total score | Number letter sequence total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) | WRAML2NumberLetterTotalScore | Recommended | CDE |
Keywords
