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

 General Details

Title:
Delis-Kaplan Executive Function System (D-KEFS) Tower Test
Short Name:
DKEFST
Description:
The Delis┬ľKaplan Executive Function System (D-KEFS) Tower Test requires participants to build a series of nine towers that become progressively more difficult. Copyrighted 2001, NCS Pearson, Inc. All Rights Reserved (http://www.pearsonclinical.com/content/ani/clinicalassessments/us/en.html). Delis, D. C., Kaplan, E., & Kramer, J. H. (2001). Delis-Kaplan executive function system (D-KEFS). Psychological Corporation.Copyrighted 2001,San Antonio, Tex. : Psychological Corporation.
Disease:
Traumatic Brain Injury
Organization:
NIH/CIT/BRICS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2017-04-20
Version:
1.0
Date Created:
2016-08-12
Owner:
Number of Data Elements:
91
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 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 Exactly 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

DKEFS Tower Test-Item 1: Two Disks (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-1st move time  The 1st Move time as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTower1stMoveTime Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 1 total number of moves  Item 1 total number of moves, related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem1TotMovesNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Rule violations number  Number of rule violations, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerRuleViolationsNum Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Item completion time  The item completion time, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItemCompletionTime Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Correct tower indicator  Indicates whether the tower was completed correctly or not, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerCorrectTowerInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Item 1 achievement score  The achievement score for item 1, correct within time limit, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem1AchvScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Discontinue indicator  Indicate whether examiner discontinued test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerDiscontinueInd Recommended CDE

DKEFS Tower Test-Item 2: Two Disks (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-1st move time  The 1st Move time as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTower1stMoveTime Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 2 total number of moves  Item 2 total number of moves, related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem2TotMovesNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Rule violations number  Number of rule violations, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerRuleViolationsNum Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Item completion time  The item completion time, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItemCompletionTime Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Correct tower indicator  Indicates whether the tower was completed correctly or not, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerCorrectTowerInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 2 achievement score  The achievement score for item 2, correct within time limit, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem2AchvScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Discontinue indicator  Indicate whether examiner discontinued test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerDiscontinueInd Recommended CDE

DKEFS Tower Test-Item 3: Two Disks (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-1st move time  The 1st Move time as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTower1stMoveTime Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 3 total number of moves  Item 3 total number of moves, related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem3TotMovesNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Rule violations number  Number of rule violations, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerRuleViolationsNum Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Item completion time  The item completion time, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItemCompletionTime Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Correct tower indicator  Indicates whether the tower was completed correctly or not, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerCorrectTowerInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 3 achievement score  The achievement score for item 3, correct within time limit, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem3AchvScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Discontinue indicator  Indicate whether examiner discontinued test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerDiscontinueInd Recommended CDE

DKEFS Tower Test-Item 4: Three Disks (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-1st move time  The 1st Move time as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTower1stMoveTime Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 4 total number of moves  Item 4 total number of moves, related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem4TotMovesNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Rule violations number  Number of rule violations, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerRuleViolationsNum Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Item completion time  The item completion time, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItemCompletionTime Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Correct tower indicator  Indicates whether the tower was completed correctly or not, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerCorrectTowerInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 4 achievement score  The achievement score for item 4, correct within time limit, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem4AchvScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Discontinue indicator  Indicate whether examiner discontinued test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerDiscontinueInd Recommended CDE

DKEFS Tower Test-Item 5: Three Disks (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-1st move time  The 1st Move time as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTower1stMoveTime Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 5 total number of moves  Item 5 total number of moves, related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem5TotMovesNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Rule violations number  Number of rule violations, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerRuleViolationsNum Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Item completion time  The item completion time, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItemCompletionTime Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Correct tower indicator  Indicates whether the tower was completed correctly or not, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerCorrectTowerInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 5 achievement score  The achievement score for item 5, correct within time limit, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem5AchvScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Discontinue indicator  Indicate whether examiner discontinued test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerDiscontinueInd Recommended CDE

DKEFS Tower Test-Item 6: Four Disks (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-1st move time  The 1st Move time as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTower1stMoveTime Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 6 total number of moves  Item 6 total number of moves, related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem6TotMovesNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Rule violations number  Number of rule violations, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerRuleViolationsNum Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Item completion time  The item completion time, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItemCompletionTime Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Correct tower indicator  Indicates whether the tower was completed correctly or not, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerCorrectTowerInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 6 achievement score  The achievement score for item 6, correct within time limit, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem6AchvScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Discontinue indicator  Indicate whether examiner discontinued test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerDiscontinueInd Recommended CDE

DKEFS Tower Test-Item 7: Four Disks (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-1st move time  The 1st Move time as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTower1stMoveTime Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 7 total number of moves  Item 7 total number of moves, related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem7TotMovesNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Rule violations number  Number of rule violations, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerRuleViolationsNum Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Item completion time  The item completion time, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItemCompletionTime Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Correct tower indicator  Indicates whether the tower was completed correctly or not, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerCorrectTowerInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 7 achievement score  The achievement score for item 7, correct within time limit, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem7AchvScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Discontinue indicator  Indicate whether examiner discontinued test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerDiscontinueInd Recommended CDE

DKEFS Tower Test-Item 8: Five Disks (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-1st move time  The 1st Move time as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTower1stMoveTime Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 8 total number of moves  Item 8 total number of moves, related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem8TotMovesNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Rule violations number  Number of rule violations, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerRuleViolationsNum Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Item completion time  The item completion time, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItemCompletionTime Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Correct tower indicator  Indicates whether the tower was completed correctly or not, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerCorrectTowerInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 8 achievement score  The achievement score for item 8, correct within time limit, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem8AchvScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Discontinue indicator  Indicate whether examiner discontinued test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerDiscontinueInd Recommended CDE

DKEFS Tower Test-Item 9: Five Disks (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-1st move time  The 1st Move time as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTower1stMoveTime Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 9 total number of moves  Item 9 total number of moves, related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem9TotMovesNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Rule violations number  Number of rule violations, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerRuleViolationsNum Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Item completion time  The item completion time, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItemCompletionTime Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Correct tower indicator  Indicates whether the tower was completed correctly or not, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerCorrectTowerInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Item 9 achievement score  The achievement score for item 9, correct within time limit, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerItem9AchvScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Discontinue indicator  Indicate whether examiner discontinued test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTowerDiscontinueInd Recommended CDE

DKEFS Tower Test Summary Score: Primary Measure (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Total achievement total raw score  The total achievement total raw score, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerTotAchTotRawScore Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Total achievement total scaled score  The total achievement scaled score as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerTotAchSclScore Recommended CDE

DKEFS Tower Test Summary Score: Optional Measures (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Mean first move time ratio score  The mean first move time ratio score as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerMeanFtMveTmRatScore Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Mean first move time scaled score  The mean first move time scaled score as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerMeanFtMveTmSclScore Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Time per move ratio score  The time per move ratio score as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerTimePerMoveRatScore Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Time per move ratio scaled score  The time per move ratio scaled score as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerTimePerMoveSclScore Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Total minimum moves number.  The total minimum moves possible, as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerTotMinMovesNum Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Move accuracy ratio score  The move accuracy ratio score as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerMoveAccurRatScore Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Move accuracy scaled score  The move accuracy ratio scaled score as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerMoveAccurSclScore Recommended CDE
8 Delis-Kaplan Executive Function System (D-KEFS) Tower Test- Total number rule violation raw score  The total number of rule violations as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerTotRuleViolRawScore Recommended CDE
9 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Total rule violation cumulative percentile rank.  The total rule violates cumulative percentile rank as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerTotRulViolCumPerRank Recommended CDE
10 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Rule-Violation-per-item-ratio raw score.  The rule violations per item ratio score as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerRulViolPrItmRatScore Recommended CDE
11 Delis-Kaplan Executive Function System (D-KEFS) Tower Test-Rule-Violation-per-item-ratio scaled score.  The rule violations per item scaled score as related to Tower Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) Tower Test. DKEFSTowerRulViolPrItmSclScore Recommended CDE

 Change History

 Administrative Change History