This form structure is an organized set of data definitions for a form that has not been copyrighted

 General Details

Title:
Balance Error Scoring System (BESS)
Short Name:
BESS
Description:
The Balance Error Scoring System provides a portable, cost-effective, and objective method of assessing static postural stability. In the absence of expensive, sophisticated postural stability assessment tools, the BESS can be used to assess the effects of mild head injury on static postural stability. Information obtained from this clinical balance tool can be used to assist clinicians in making return to play decisions following mild head injury. CDISC (TAUG TBI)
Disease:
Traumatic Brain Injury
Organization:
NIH
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2015-05-13
Version:
1.1
Date Created:
2015-03-20
Owner:
Number of Data Elements:
22
eForms:
N

 Documentation


 Groups & Attached Data Elements

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 Visit date   Actual interview or visit date VisitDate Recommended CDE
5 Site name   The name of the site for the study SiteName Recommended CDE
6 Days since baseline   The number of days since baseline DaysSinceBaseline Optional CDE
7 Case control indicator   Indicator of whether subject is in the case or control arm of the study CaseContrlInd Optional CDE
8 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

Balance Error Scoring Test (Repeat Infinitely)

# Title Short Description Variable Name Required? Type
1 Balance Error Scoring System (BESS) - Double leg stance firm surface error count  Number of errors during double leg stance with feet together on firm surface, as part of Balance Error Scoring System (BESS). BESSDblLegFirmErrorCt Recommended CDE
2 Balance Error Scoring System (BESS) - Single leg stance firm surface error count  Number of errors during single leg stance with non-dominant foot tested on firm surface, as part of Balance Error Scoring System (BESS). BESSSglLegFirmErrorCt Recommended CDE
3 Balance Error Scoring System (BESS) - Tandem stance firm surface error count  Number of errors during tandem stance with non-dominant foot in back on firm surface, as part of Balance Error Scoring System (BESS). BESSTandemFirmErrorCt Recommended CDE
4 Balance Error Scoring System (BESS) - Firm surface total error count  Total number of errors while on firm surface, as part of Balance Error Scoring System (BESS). BESSTotalFirmErrorCt Recommended CDE
5 Balance Error Scoring System (BESS) - Double leg stance foam surface error count  Number of errors during double leg stance with feet together on foam surface, as part of Balance Error Scoring System (BESS). BESSDblLegFoamErrorCt Recommended CDE
6 Balance Error Scoring System (BESS) - Single leg stance foam surface error count  Number of errors during single leg stance with non-dominant foot tested on foam surface, as part of Balance Error Scoring System (BESS). BESSSglLegFoamErrorCt Recommended CDE
7 Balance Error Scoring System (BESS) - Tandem stance foam surface error count  Number of errors during tandem stance with non-dominant foot in back on foam surface, as part of Balance Error Scoring System (BESS). BESSTandemStncFoamSrfcErrorCt Recommended CDE
8 Balance Error Scoring System (BESS) - Foam surface total error count  Total number of errors while on foam surface, as part of Balance Error Scoring System (BESS). BESSTotalFoamErrorCt Recommended CDE
9 Balance Error Scoring System (BESS) - Both firm foam surface total error count  Total number of errors for both firm and foam surface, as part of Balance Error Scoring System (BESS). BESSTotalErrorCt Recommended CDE
10 Laterality type  Laterality type relative to the anatomic site of the body examined or affected LatTyp Recommended CDE

 Change History

 Administrative Change History