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

 General Details

Title:
Neurological Assessment: Glasgow Coma Scale (GCS) and Pupils
Short Name:
GCS
Description:
Contains data elements that are collected to assess severity of the injury using the Glasgow Coma Scale, Pediatric Glasgow Coma Scale, and an examination of the participant's/subject's pupils. Recommended by CDISC for TBI Reference: http://www.glasgowcomascale.org/ Teasdale G, Jennett B, Assessment of coma and impaired consciousness. A practical scale, Lancet. 1974 Jul 13;2(7872):81-4. http://www.ncbi.nlm.nih.gov/pubmed/4136544 . .
Disease:
Traumatic Brain Injury
Organization:
NINDS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-01-20
Version:
1.2
Date Created:
2016-01-14
Owner:
Number of Data Elements:
35
eForms:
Y

 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 (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

Glasgow Coma Scale (Repeat Infinitely)

# Title Short Description Variable Name Required? Type
1 Glasgow Coma Scale (GCS) - Confounders type  Type of confounders influencing participant's/subject's Glasgow Coma Scale (GCS) score GCSConfounderTyp Recommended CDE
2 Glasgow Coma Scale (GCS) - Eye response scale  Glasgow Coma Scale (GCS) - Best eye response (E). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. GCSEyeRespnsScale Recommended CDE
3 Glasgow Coma Scale (GCS) - Motor response scale  Glasgow Coma Scale (GCS) - Best motor response (M). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. GCSMotorRespnsScale Recommended CDE
4 Glasgow Coma Scale (GCS) - Verbal response scale  Score that describes the participant's verbal response according to the Glasgow Coma Scale (GCS) GCSVerbalRspnsScale Recommended CDE
5 Glasgow Coma Scale (GCS) - Total score  Glasgow Coma Scale (GCS) - Total Score. The GCS is a standardized instrument for assessing the level of consciousness. GCSTotalScore Recommended CDE
6 Pupil reactivity light left eye result  Result of testing of the contraction of the participant's/subject's left pupil when a bright light is shone on it from an angle PupilReactivityLghtLftEyeReslt Recommended CDE
7 Pupil reactivity light right eye result  Result of testing of the contraction of the participant's/subject's right pupil when a bright light is shone on it from an angle PupilReactivityLghtRtEyeReslt Recommended CDE
8 Pupil left eye measurement  Measurement of the left pupil of the eye in mm PupilLftEyeMeasr Recommended CDE
9 Pupil right eye measurement  Measurement of the right pupil in millimeters PupilRtEyeMeasr Recommended CDE
10 Pupil shape left eye type  Type of shape of the pupil of the left eye PupilShapeLftEyeTyp Recommended CDE
11 Pupil shape right eye type  Type of shape of the pupil of the right eye PupilShapeRtEyeTyp Recommended CDE

Pediatric Glasgow Coma Scale (Repeat Infinitely)

# Title Short Description Variable Name Required? Type
1 Glasgow Coma Scale (GCS) - Confounders type  Type of confounders influencing participant's/subject's Glasgow Coma Scale (GCS) score GCSConfounderTyp Recommended CDE
2 Pediatric Glasgow Coma Scale (PGCS) - Eye response score  Score for the participant's eye response according to the Pediatric Glasgow Coma Scale (PGCS) if the participant is under the age of 18. PGCSEyeRespnsScore Recommended CDE
3 Pediatric Glasgow Coma Scale (PGCS) - Motor response score  Score for the participant's motor response according to the Pediatric Glasgow Coma Scale (PGCS) if the participant is under the age of 18. PGCSMotorRespnsScore Recommended CDE
4 Pediatric Glasgow Coma Scale (PGCS) - Verbal response score  Score for the participant's verbal response according to the Pediatric Glasgow Coma Scale (PGCS) if the participant is under the age of 18. PGCSVerbalRespnsScore Recommended CDE
5 Pediatric Glasgow Coma Scale (PGCS) - Total score  The participant's total Pediatric Glasgow Coma Scale (PGCS) score of 3 tests, eye, motor, and verbal responses. A score of less than 9 would indicate that that participant is in a severe coma; a score of greater than 9 is a mild or no coma at all. PGCSTotalScore Recommended CDE
6 Pupil reactivity light left eye result  Result of testing of the contraction of the participant's/subject's left pupil when a bright light is shone on it from an angle PupilReactivityLghtLftEyeReslt Recommended CDE
7 Pupil reactivity light right eye result  Result of testing of the contraction of the participant's/subject's right pupil when a bright light is shone on it from an angle PupilReactivityLghtRtEyeReslt Recommended CDE
8 Pupil left eye measurement  Measurement of the left pupil of the eye in mm PupilLftEyeMeasr Recommended CDE
9 Pupil right eye measurement  Measurement of the right pupil in millimeters PupilRtEyeMeasr Recommended CDE
10 Pupil shape left eye type  Type of shape of the pupil of the left eye PupilShapeLftEyeTyp Recommended CDE
11 Pupil shape right eye type  Type of shape of the pupil of the right eye PupilShapeRtEyeTyp Recommended CDE

 Change History

 Administrative Change History