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

 General Details

Title:
Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test
Short Name:
DKEFSTQ
Description:
The D-KEFS 20 Questions Test is an instrument to used to assess abstract reasoning and concept formation skills. Participants ask the fewest number of yes and no questions to identify an unknown target object. 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
Version:
1.0
Date Created:
2016-08-17
Owner:
Number of Data Elements:
71
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 Twenty Questions Item 1 (Appears Up To 21 Times)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - Item type  Type of items, as related to Twenty Questions test as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueItemTyp Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) -Total questions asked number  The total questions asked, as related to twenty questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueResponseNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) -Question type  The spatial or repeated indicator for the examinee's questions, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueQuestionType Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - Total questions asked count  Total questions asked count, as part of the Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test DKEFSTwentyQueTotQuAskedCt Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS)- Examiner's answer indicator  Indicator of examiner's answer, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueExaminersAnsInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - 21 failed to guess indicator  Question 21, failed to guess in 20 questions indicator, as part of the Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test DKEFSTwentyQue21FailedGuessInd Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS)- Weighted achievement score  Weighted achievement score, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueWeightedAchScore Recommended CDE
8 Delis-Kaplan Executive Function System (D-KEFS)- Initial abstraction raw score  Raw score of initial abstraction, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueIniAbsRawScore Recommended CDE
9 Delis-Kaplan Executive Function System (D-KEFS)- Spatial question raw score  Raw score of spatial questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueSpatQuRawScore Recommended CDE
10 Delis-Kaplan Executive Function System (D-KEFS)- Repeated questions raw score  Raw score of repeated questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueRepQuRawScore Recommended CDE
11 Delis-Kaplan Executive Function System (D-KEFS)- Set-loss questions raw score  Raw score of set-loss questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueSetLsRawScore Recommended CDE

DKEFS Twenty Questions Item 2 (Appears Up To 21 Times)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - Item type  Type of items, as related to Twenty Questions test as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueItemTyp Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) -Total questions asked number  The total questions asked, as related to twenty questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueResponseNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) -Question type  The spatial or repeated indicator for the examinee's questions, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueQuestionType Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - Total questions asked count  Total questions asked count, as part of the Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test DKEFSTwentyQueTotQuAskedCt Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS)- Examiner's answer indicator  Indicator of examiner's answer, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueExaminersAnsInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - 21 failed to guess indicator  Question 21, failed to guess in 20 questions indicator, as part of the Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test DKEFSTwentyQue21FailedGuessInd Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS)- Weighted achievement score  Weighted achievement score, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueWeightedAchScore Recommended CDE
8 Delis-Kaplan Executive Function System (D-KEFS)- Initial abstraction raw score  Raw score of initial abstraction, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueIniAbsRawScore Recommended CDE
9 Delis-Kaplan Executive Function System (D-KEFS)- Spatial question raw score  Raw score of spatial questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueSpatQuRawScore Recommended CDE
10 Delis-Kaplan Executive Function System (D-KEFS)- Repeated questions raw score  Raw score of repeated questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueRepQuRawScore Recommended CDE
11 Delis-Kaplan Executive Function System (D-KEFS)- Set-loss questions raw score  Raw score of set-loss questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueSetLsRawScore Recommended CDE

DKEFS Twenty Questions Item 3 (Appears Up To 21 Times)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - Item type  Type of items, as related to Twenty Questions test as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueItemTyp Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) -Total questions asked number  The total questions asked, as related to twenty questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueResponseNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) -Question type  The spatial or repeated indicator for the examinee's questions, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueQuestionType Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - Total questions asked count  Total questions asked count, as part of the Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test DKEFSTwentyQueTotQuAskedCt Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS)- Examiner's answer indicator  Indicator of examiner's answer, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueExaminersAnsInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - 21 failed to guess indicator  Question 21, failed to guess in 20 questions indicator, as part of the Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test DKEFSTwentyQue21FailedGuessInd Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS)- Weighted achievement score  Weighted achievement score, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueWeightedAchScore Recommended CDE
8 Delis-Kaplan Executive Function System (D-KEFS)- Initial abstraction raw score  Raw score of initial abstraction, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueIniAbsRawScore Recommended CDE
9 Delis-Kaplan Executive Function System (D-KEFS)- Spatial question raw score  Raw score of spatial questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueSpatQuRawScore Recommended CDE
10 Delis-Kaplan Executive Function System (D-KEFS)- Repeated questions raw score  Raw score of repeated questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueRepQuRawScore Recommended CDE
11 Delis-Kaplan Executive Function System (D-KEFS)- Set-loss questions raw score  Raw score of set-loss questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueSetLsRawScore Recommended CDE

DKEFS Twenty Questions Item 4 (Appears Up To 21 Times)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - Item type  Type of items, as related to Twenty Questions test as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueItemTyp Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) -Total questions asked number  The total questions asked, as related to twenty questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueResponseNum Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) -Question type  The spatial or repeated indicator for the examinee's questions, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueQuestionType Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - Total questions asked count  Total questions asked count, as part of the Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test DKEFSTwentyQueTotQuAskedCt Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS)- Examiner's answer indicator  Indicator of examiner's answer, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueExaminersAnsInd Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test - 21 failed to guess indicator  Question 21, failed to guess in 20 questions indicator, as part of the Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test DKEFSTwentyQue21FailedGuessInd Recommended CDE
7 Delis-Kaplan Executive Function System (D-KEFS)- Weighted achievement score  Weighted achievement score, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueWeightedAchScore Recommended CDE
8 Delis-Kaplan Executive Function System (D-KEFS)- Initial abstraction raw score  Raw score of initial abstraction, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueIniAbsRawScore Recommended CDE
9 Delis-Kaplan Executive Function System (D-KEFS)- Spatial question raw score  Raw score of spatial questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueSpatQuRawScore Recommended CDE
10 Delis-Kaplan Executive Function System (D-KEFS)- Repeated questions raw score  Raw score of repeated questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueRepQuRawScore Recommended CDE
11 Delis-Kaplan Executive Function System (D-KEFS)- Set-loss questions raw score  Raw score of set-loss questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueSetLsRawScore Recommended CDE

Summary Scores Primary Measures (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) - Initial abstraction total raw score  Total raw score for initial abstraction, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS) DKEFSTwentyQueIniAbTotRawScore Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) - Initial abstraction scaled score  Scaled score of initial abstraction, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueIniAbsSclScore Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) - Total questions asked total raw score  Total questions asked total raw score, as related to the Twenty Questions Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) DKEFSTwentyQueTotAskRawScore Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) - Total questions asked scaled score  Scaled score of total questions asked, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueTotAskSclScore Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) - Total weighted achievement total raw score  Total weighted achievement score total raw score, as related to Twenty Questions Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) DKEFSTwentyQueTotWhAchRawScore Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) - Total weighted achievement scaled score  Total scaled score of weighted achievement, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueTotWhAchSclScore Recommended CDE

Summary Score Optional Measures (Appears Up To 5 Times)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions - Spatial questions total raw score  Spatial questions total raw score, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueSpaQuTotRawScore Recommended CDE
2 Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions - Spatial questions cumulative percentile rank  Spatial questions cumulative percentile rank, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueSpaQuCumPerRank Recommended CDE
3 Delis-Kaplan Executive Function System (D-KEFS) - Repeated questions total raw score  Repeated questions total raw score, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueRepQuTotRawScore Recommended CDE
4 Delis-Kaplan Executive Function System (D-KEFS) - Repeated questions cumulative percentile rank  Cumulative percentile rank of repeated questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueRepQuCumPerRank Recommended CDE
5 Delis-Kaplan Executive Function System (D-KEFS) - Set-loss questions total raw score  Set loss questions total raw score, as related to Twenty Questions Test, as part of the Delis-Kaplan Executive Function System (D-KEFS) DKEFSTwentyQueSetLsTotRawScore Recommended CDE
6 Delis-Kaplan Executive Function System (D-KEFS) - Set-loss questions cumulative percentile rank  Cumulative percentile rank of set-loss questions, as related to Twenty Questions test, as part of the Delis-Kaplan Executive Function System (D-KEFS). DKEFSTwentyQueSetLsCumPerRank Recommended CDE

 Change History

 Administrative Change History