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

 General Details

Title:
Military Acute Concussion Evaluation (MACE)
Short Name:
MACE_FITBIR
Description:
The Military Acute Concussion Evaluation (MACE) is a concussion screening tool for the acute assessment of service members involved in a potentially concussive event. References: https://dvbic.dcoe.mil/files/resources/DVBIC_Military-Acute-Concussion-Evaluation_Pocket-Card_Feb2012.pdf McCrea, M. Standardized Mental Status Testing on the Sideline After Sport-Related Concussion. J Athl Train. 2001 Sep;36(3):274-279.
Disease:
Traumatic Brain Injury
Organization:
NIH
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2015-03-26
Version:
1.1
Date Created:
2015-03-24
Owner:
Number of Data Elements:
115
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

Injury Info (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military unit  Military unit, also called Unit, a group having a prescribed size and a specific combat or support role within a larger military organization. MilUnit Recommended UDE
2 Injury date time  Date (and time, if applicable and known) of injury InjDateTime Recommended CDE
3 Injury elapsed time  The elapsed time (in minutes) from the time of injury InjElapsedTime Recommended CDE

History (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military Acute Concussion Evaluation (MACE) - Incident description text  Description of incident of what happened to the subject, as part of Military Acute Concussion Evaluation (MACE). MACEIncdntDescrptTxt Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Incident description subject remember text  Description of incident of what the subject remembers, as part of Military Acute Concussion Evaluation (MACE). MACEIncdntDescrptSubjRemmbrTxt Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Incident description daze indicator  Indicator of whether or not the subject was dazed, confused or "saw stars", as part of Military Acute Concussion Evaluation (MACE). MACEIncdntDescrptDazeInd Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Incident description hit head indicator  Indicator of whether or not the subject hit his or her head, as part of Military Acute Concussion Evaluation (MACE). MACEIncdntDescrptHitHeadInd Recommended CDE
5 Military Acute Concussion Evaluation (MACE) - Incident cause type  Cause of injury, as part of Military Acute Concussion Evaluation (MACE). MACEIncdntCauseTyp Recommended CDE
6 Military Acute Concussion Evaluation (MACE) - Incident cause other text  The free-text field related to Military Acute Concussion Evaluation (MACE) - Incident cause indicator specifying other text, as part of Military Acute Concussion Evaluation (MACE). MACEIncdntCauseOth Recommended CDE
7 Military Acute Concussion Evaluation (MACE) - Helmet worn indicator  Indicator of whether or not a helmet was worn, as part of Military Acute Concussion Evaluation (MACE). MACEHelmWornInd Recommended CDE
8 Military Acute Concussion Evaluation (MACE) - Helmet worn name  Name of helmet, as part of Military Acute Concussion Evaluation (MACE). MACEHelmWornName Recommended CDE
9 Military Acute Concussion Evaluation (MACE) - Unremembered events before indicator  Indicator of whether or not there were events just BEFORE the injury that are not remembered, as part of Military Acute Concussion Evaluation (MACE). MACEUnremmbrdEvntBfrInd Recommended CDE
10 Military Acute Concussion Evaluation (MACE) - Unremembered events before time duration  Duration of time of unremembered events from before the trauma, as part of Military Acute Concussion Evaluation (MACE). MACEUnremmbrdEvntBfrTm Recommended CDE
11 Military Acute Concussion Evaluation (MACE) - Unremembered events before time duration unit of measure  Unit of measure associated with the duration of time of unremembered events from before the trauma, as part of Military Acute Concussion Evaluation (MACE). MACEUnremmbrdEvntBfrTmUoM Recommended CDE
12 Military Acute Concussion Evaluation (MACE) - Unremembered events after indicator  Indicator of whether or not there were events just AFTER the injury that are not remembered, as part of Military Acute Concussion Evaluation (MACE). MACEUnremmbrdEvntAftrInd Recommended CDE
13 Military Acute Concussion Evaluation (MACE) - Unremembered events after time duration  Duration of time of unremembered events from after the trauma, as part of Military Acute Concussion Evaluation (MACE). MACEUnrememEvntAfterTm Recommended CDE
14 Military Acute Concussion Evaluation (MACE) - Unremembered events after time unit of measure  Duration of time of unremembered events from after the trauma, as part of Military Acute Concussion Evaluation (MACE). MACEUnrememEvntAfterTmUoM Recommended CDE
15 Military Acute Concussion Evaluation (MACE) - Individual loss consciousness indicator  Indicator of whether or not the individual reports loss of consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE). MACEIndvdlLossConcsnInd Recommended CDE
16 Military Acute Concussion Evaluation (MACE) - Individual loss consciousness time duration  Duration of incidents where the subject reports losing consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE). MACEIndvdlLossConcsnTmDur Recommended CDE
17 Military Acute Concussion Evaluation (MACE) - Individual loss consciousness time unit of measure  Unit of measure associated with the duration of those incidents where the subject reports losing consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE). MACEIndvdlLossConcsnTmUoM Recommended CDE
18 Military Acute Concussion Evaluation (MACE) - Anyone loss consciousness indicator  Indicator of whether or not anyone observed a period of loss of consciousness or unresponsiveness, as part of Military Acute Concussion Evaluation (MACE). MACEAnyoneLossConcsnInd Recommended CDE
19 Military Acute Concussion Evaluation (MACE) - Anyone loss consciousness time duration  Duration of time where anyone observed a period of loss of consciousness or unresponsiveness, as part of Military Acute Concussion Evaluation (MACE). MACEAnyoneLossConcsnTm Recommended CDE
20 Military Acute Concussion Evaluation (MACE) - Anyone loss consciousness time unit of measure  Unit of measure associated with the duration of time where anyone observed a period of loss of consciousness or unresponsiveness, as part of Military Acute Concussion Evaluation (MACE). MACEAnyoneLossConcsnTmUoM Recommended CDE
21 Military Acute Concussion Evaluation (MACE) - Symptoms type  Type(s) of symptoms experienced at the time of the incident as part of Military Acute Concussion Evaluation (MACE). MACESympTyp Recommended CDE
22 Military Acute Concussion Evaluation (MACE) - Symptoms other text  The free-text field related to Military Acute Concussion Evaluation (MACE) - Symptoms indicator specifying other text, as part of Military Acute Concussion Evaluation (MACE). MACESympOth Recommended CDE

Orientation (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military Acute Concussion Evaluation (MACE) - Orientation month score  Orientation month score, as part of Military Acute Concussion Evaluation (MACE). MACEOrientMnthScore Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Orientation date score  Orientation date score, as part of Military Acute Concussion Evaluation (MACE). MACEOrientDateScore Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Orientation weekday score  Orientation weekday score, as part of Military Acute Concussion Evaluation (MACE). MACEOrientWeekdayScore Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Orientation year score  Orientation year score, as part of Military Acute Concussion Evaluation (MACE). MACEOrientYrScore Recommended CDE
5 Military Acute Concussion Evaluation (MACE) - Orientation time score  Orientation time score, as part of Military Acute Concussion Evaluation (MACE). MACEOrientTmScore Recommended CDE

Immediate Memory Trials (Appears Up To 3 Times)

# Title Short Description Variable Name Required? Type
1 Trial number  The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. TrialNum Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Immediate memory elbow score  Immediate memory elbow score, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemryElbScore Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Immediate memory apple score  Immediate memory apple score, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemryApplScore Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Immediate memory carpet score  Immediate memory carpet score, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemryCrptScore Recommended CDE
5 Military Acute Concussion Evaluation (MACE) - Immediate memory saddle score  Immediate memory saddle score, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemrySddlScore Recommended CDE
6 Military Acute Concussion Evaluation (MACE) - Immediate memory bubble score  Immediate memory bubble score, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemryBubblScore Recommended CDE
7 Military Acute Concussion Evaluation (MACE) - Immediate memory trial score  Concentration total score (0-5) from form B, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemTrialScore Recommended CDE

Concentration (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military Acute Concussion Evaluation (MACE) - Concentration 493 score  Subject's concentration score for correctly repeating the number 4-9-3 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc493Score Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Concentration 629 score  Subject's concentration score for correctly repeating the number 6-2-9 in reverse order , as part of Military Acute Concussion Evaluation (MACE). MACEConc629Score Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Concentration 3814 score  Subject's concentration score for correctly repeating the number 3-8-1-4 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc3814Score Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Concentration 3279 score  Subject's concentration score for correctly repeating the number 3-2-7-9 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc3279Score Recommended CDE
5 Military Acute Concussion Evaluation (MACE) - Concentration 62971 score  Subject's concentration score for correctly repeating the number 6-2-9-7-1 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc62971Score Recommended CDE
6 Military Acute Concussion Evaluation (MACE) - Concentration 15285 score  Subject's concentration score for correctly repeating the number 1-5-2-8-5 in reverse order , as part of Military Acute Concussion Evaluation (MACE). MACEConc15285Score Recommended CDE
7 Military Acute Concussion Evaluation (MACE) - Concentration 718462 score  Subject's concentration score for correctly repeating the number 7-1-8-4-6-2 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc718462Score Recommended CDE
8 Military Acute Concussion Evaluation (MACE) - Concentration 539148 score  Subject's concentration score for correctly repeating the number 5-3-9-1-4-8 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc539148Score Recommended CDE
9 Military Acute Concussion Evaluation (MACE) - Concentration months score  Subject's concentration score for correctly reciting the months in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConcMnthScore Recommended CDE

Delayed Recall (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military Acute Concussion Evaluation (MACE) - Delayed recall elbow score  Delayed recall elbow score, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllElbowScore Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Delayed recall apple score  Delayed recall apple score, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllApplScore Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Delayed recall carpet score  Delayed recall carpet score, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllCarptScore Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Delayed recall saddle score  Delayed recall saddle score, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllSaddlScore Recommended CDE
5 Military Acute Concussion Evaluation (MACE) - Delayed recall bubble score  Delayed recall bubble score, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllBubblScore Recommended CDE

Scores (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military Acute Concussion Evaluation (MACE) - Orientation score  Orientation total score (0-5), as part of Military Acute Concussion Evaluation (MACE). MACEOrientScore Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Immediate memory score  Immediate memory total score (0-15), as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemScore Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Concentration score  Concentration total score (0-5), as part of Military Acute Concussion Evaluation (MACE). MACEConcScore Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Delayed recall score  Delayed recall total score (0-5), as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllScore Recommended CDE
5 Military Acute Concussion Evaluation (MACE) - Total score  The total score for the MACE (0-30), as part of Military Acute Concussion Evaluation (MACE). MACETotScore Recommended CDE
6 General notes text  General notes GeneralNotesTxt Recommended CDE

Diagnosis (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military Acute Concussion Evaluation (MACE) - Neurological screening result  As the clinical condition permits, check: Eyes-pupillary response and tracking; Verbal-speech fluency and word finding; Motor-pronator drift, gait/coordination. Record of any abnormalities, as part of Military Acute Concussion Evaluation (MACE). MACENrlgclScrnngReslt Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Diagnosis name  The diagnosis based on the MACE total score, as part of Military Acute Concussion Evaluation (MACE). MACEDiagnNam Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Diagnosis other specify  The free-text field related to Military Acute Concussion Evaluation (MACE) - Diagnosis name specifying other text, as part of Military Acute Concussion Evaluation (MACE). MACEDiagnOth Recommended CDE

Form B Immediate Memory (Appears Up To 3 Times)

# Title Short Description Variable Name Required? Type
1 Trial number  The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. TrialNum Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Immediate memory candle form B score  Immediate memory candle score from form B, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemCandlFormBScore Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Immediate memory paper form B score  Immediate memory paper score from form B, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemPaprFormBScore Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Immediate memory sugar form B score  Immediate memory sugar score from form B, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemSugrFormBScore Recommended CDE
5 Military Acute Concussion Evaluation (MACE) - Immediate memory sandwich form B score  Immediate memory sandwich score from form B, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemSandwchFormBScore Recommended CDE
6 Military Acute Concussion Evaluation (MACE) - Immediate memory wagon form B score  Immediate memory wagon score from form B, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemWagnFormBScore Recommended CDE
7 Military Acute Concussion Evaluation (MACE) - Immediate memory trial score  Concentration total score (0-5) from form B, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemTrialScore Recommended CDE

Form B Concentration (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military Acute Concussion Evaluation (MACE) - Concentration recall 526 form B score  Subject's concentration score for correctly repeating the number 5-2-6 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConcRcll526FormBScore Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Concentration recall 415 form B score  Subject's concentration score for correctly repeating the number 4-1-5 in reverse order , as part of Military Acute Concussion Evaluation (MACE). MACEConcRcll415FormBScore Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Concentration recall 1795 form B score  Subject's concentration score for correctly repeating the number 1-7-9-5 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConcRcll1795FormBScore Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Concentration recall 4968 form B score  Subject's concentration score for correctly repeating the number 4-9-6-8 in reverse order , as part of Military Acute Concussion Evaluation (MACE). MACEConcRcll4968FormBScore Recommended CDE
5 Military Acute Concussion Evaluation (MACE) - Concentration recall 831964 form B score  Subject's concentration score for correctly repeating the number 8-3-1-9-6-4 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConcRcll831964FormBScore Recommended CDE
6 Military Acute Concussion Evaluation (MACE) - Concentration recall 724856 form B score  Subject's concentration score for correctly repeating the number 7-2-4-8-5-6 in reverse order , as part of Military Acute Concussion Evaluation (MACE). MACEConcRcll724856FormBScore Recommended CDE
7 Military Acute Concussion Evaluation (MACE) - Concentration recall 61843 form B score  Subject's concentration score for correctly repeating the number 6-1-8-4-3 in reverse order , as part of Military Acute Concussion Evaluation (MACE). MACEConcRcll61843FormBScore Recommended CDE
8 Military Acute Concussion Evaluation (MACE) - Concentration recall 48527 form B score  Subject's concentration score for correctly repeating the number 4-8-5-2-7 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConcRcll48527FormBScore Recommended CDE

Form B Scores (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military Acute Concussion Evaluation (MACE) - Immediate memory form B score  Immediate memory score from form B, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemFormBScore Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Concentration recall form B score  Concentration total score (0-5) from form B, as part of Military Acute Concussion Evaluation (MACE). MACEConcRcllFormBScore Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Delayed recall form B score  Delayed recall total score (0-5) from form B, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllFormBScore Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Form B Total score  The total score for the Form B MACE (0-30), as part of Military Acute Concussion Evaluation (MACE). MACEFormBTotScore Recommended CDE

Form C Immediate Memory (Appears Up To 3 Times)

# Title Short Description Variable Name Required? Type
1 Trial number  The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. TrialNum Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Immediate memory baby form C score  Immediate memory baby score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemryBabyFormCScore Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Immediate memory monkey form C score  Immediate memory monkey score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemryMnkyFormCScore Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Immediate memory perfume form C score  Immediate memory perfume score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemryPerfmFormCScore Recommended CDE
5 Military Acute Concussion Evaluation (MACE) - Immediate memory sunset form C score  Immediate memory sunset score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemrySunsetFormCScore Recommended CDE
6 Military Acute Concussion Evaluation (MACE) - Immediate memory iron form C score  Immediate memory iron score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemryIronFormCScore Recommended CDE
7 Military Acute Concussion Evaluation (MACE) - Immediate memory trial score  Concentration total score (0-5) from form B, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemTrialScore Recommended CDE

Form C Concentration (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military Acute Concussion Evaluation (MACE) - Concentration 142 form C score  Subject's concentration score for correctly repeating the number 1-4-2 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc142FormCScore Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Concentration 658 form C score  Subject's concentration score for correctly repeating the number 6-5-8 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc658FormCScore Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Concentration 6831 form C score  Subject's concentration score for correctly repeating the number 6-8-3-1 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc6831FormCScore Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Concentration 3481 form C score  Subject's concentration score for correctly repeating the number 3-4-8-1 in reverse order , as part of Military Acute Concussion Evaluation (MACE). MACEConc3481FormCScore Recommended CDE
5 Military Acute Concussion Evaluation (MACE) - Concentration 49153 form C score  Subject's concentration score for correctly repeating the number 4-9-1-5-3 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc49153FormCScore Recommended CDE
6 Military Acute Concussion Evaluation (MACE) - Concentration 68251 form C score  Subject's concentration score for correctly repeating the number 6-8-2-5-1 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc68251FormCScore Recommended CDE
7 Military Acute Concussion Evaluation (MACE) - Concentration 376519 form C score  Subject's concentration score for correctly repeating the number 3-7-6-5-1-9 in reverse order, as part of Military Acute Concussion Evaluation (MACE). MACEConc376519FormCScore Recommended CDE
8 Military Acute Concussion Evaluation (MACE) - Concentration 926514 form C score  Subject's concentration score for correctly repeating the number 9-2-6-5-1-4 in reverse order , as part of Military Acute Concussion Evaluation (MACE). MACEConc926514FormCScore Recommended CDE

Form C Delayed Recall (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military Acute Concussion Evaluation (MACE) - Delayed recall baby form C score  Delayed recall baby score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllBabyFormCScore Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Delayed recall monkey form C score  Delayed recall monkey score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllMonkyFormCScore Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Delayed recall perfume form C score  Delayed recall perfume score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllPerfmFormCScore Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Delayed recall sunset form C score  Delayed recall sunset score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllSunstFormCScore Recommended CDE
5 Military Acute Concussion Evaluation (MACE) - Delayed recall iron form C score  Delayed recall iron score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllIronFormCScore Recommended CDE

Form C Scores (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Military Acute Concussion Evaluation (MACE) - Immediate memory form C score  Immediate memory score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEImmdtMemFormCScore Recommended CDE
2 Military Acute Concussion Evaluation (MACE) - Concentration form C score  Concentration score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEDConcFormCScore Recommended CDE
3 Military Acute Concussion Evaluation (MACE) - Delayed recall form C score  Delayed recall score from form C, as part of Military Acute Concussion Evaluation (MACE). MACEDlydRcllFormCScore Recommended CDE
4 Military Acute Concussion Evaluation (MACE) - Form C Total score  The total score for the Form C MACE (0-30), as part of Military Acute Concussion Evaluation (MACE). MACEFormCTotScore Recommended CDE

 Change History

 Administrative Change History