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

 General Details

Title:
Delis-Kaplan Executive Function System (D-KEFS) Trail Making Test
Short Name:
DKEFS_TMT
Description:
Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) is one of the Delis-Kaplan Executive Function System (DKEFS) subtests. DKEFS TMT subtest is based on the Trail Making Test originally developed by Partington in 1938, but has been modified to include 5 conditions each purported to assess a different area of functioning (Delis et al., 2001a). Copyright 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. Recommended by CDISC for TBI (TAUG TBI)
Disease:
Traumatic Brain Injury
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-10-03
Version:
1.3
Date Created:
2016-03-31
Owner:
Number of Data Elements:
28
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 Up To 1 Time)

# 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

Primary Measure: Completion Times (Appears Up To 5 Times)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (DKEFS) - Condition type  Type of conditions, as part of Delis-Kaplan Executive Function System (DKEFS) DKEFSConditionTyp Recommended CDE
2 Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Completion time raw score  Complete time as a raw score, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) DKEFSTMTCompltnTimeRawScore Recommended CDE
3 Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Completion time scaled score  Complete time as a scaled score, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) DKEFSTMTCompltnTimeSclScore Recommended CDE
4 Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Notes text  Notes, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS) DKEFSTMTNotesTxt Recommended CDE

Primary Combined Measure: Completion Times (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Sum scaled score  Sum of scaled scores of Number Sequencing and Letter Sequencing, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) DKEFSTMTSumSclScore Recommended CDE
2 Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Composite scaled score  Composite scaled scores of Number Sequencing and Letter Sequencing, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) DKEFSTMTCompstSclScore Recommended CDE

Primary Contrast Measures: Completion Times (Appears Up To 5 Times)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (DKEFS) - Completion time contrast Type  Type of primary contrast measures for completion times, as part of Delis-Kaplan Executive Function System (DKEFS) DKEFSCompletionTimeContrastTyp Recommended CDE
2 Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Difference scaled score  Scaled score difference, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) DKEFSTMTDiffSclScore Recommended CDE
3 Delis-Kaplan Executive Function System (DKEFS) Trail Making Test (TMT) - Contrast scaled score  Contrast scaled score, as part of Delis-Kaplan Executive Function System Trail Making Test (DKEFS-TMT) DKEFSTMTContrastSclScore Recommended CDE

Optional Measures: Error Analysis (Appears Up To 25 Times)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (DKEFS) - Error analysis optional type  Optional measures for error analysis, as part of Delis-Kaplan Executive Function System (DKEFS) DKEFSErrorAnalysisOptionalTyp Recommended CDE
2 Delis-Kaplan Executive Function System (DKEFS) - Condition type  Type of conditions, as part of Delis-Kaplan Executive Function System (DKEFS) DKEFSConditionTyp Recommended CDE
3 Delis-Kaplan Executive Function System (DKEFS) - Error raw score  Errors as a raw score, as part of Delis-Kaplan Executive Function System (DKEFS) DKEFSErrorRawScore Recommended CDE
4 Delis-Kaplan Executive Function System (DKEFS) - Cumulative percentile rank value  Cumulative percentile rank for error analysis, as part of Delis-Kaplan Executive Function System (DKEFS) DKEFSCumulatvPerctRankVal Recommended CDE

Optional Measures: Error Analysis: All Error Types (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Delis-Kaplan Executive Function System (DKEFS) - Error total raw score  Total raw score calculated as the sum of raw scores of Sequencing Errors, Set-Loss Errors and Time-Discontinue Errors in Condition 4 (Number-Letter Switching), as part of Delis-Kaplan Executive Function System (DKEFS) DKEFSErrorTtlRawScore Recommended CDE
2 Delis-Kaplan Executive Function System (DKEFS) - All error types condition 4 scaled score  Scaled score of all error types for condition 4 Number-Letter Switching, as part of Delis-Kaplan Executive Function System (DKEFS) DKEFSAllErTypCond4SclScore Recommended CDE

 Change History

 Administrative Change History