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

 General Details

Title:
NIH Toolbox Emotion Domain Self Efficacy Survey CAT 8-12
Short Name:
NIHTBSelfEfficacyCAT8to12
Description:
The NIH Toolbox Self-Efficacy Survey is a self-report measure administered to ages 8-85, as well as a parent-report measure for ages 8-12. Both versions are administered as computer-adaptive tests. It assesses respondents' sense of global self-efficacy. Copyright 2012 Northwestern University and the National Institutes of Health. http://www.nihtoolbox.org/Pages/NIH-Toolbox-Terms-and-Conditions.aspx
Disease:
Traumatic Brain Injury , General (For all diseases)
Organization:
NIH/CIT/DCB
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-07-14
Owner:
Number of Data Elements:
41
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 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

NIH Toolbox Administration (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 NIH Toolbox - Test domain battery type  Type of domain battery for the NIH Toolbox test being administered, as a part of the NIH Toolbox NIHTBTestDomainBatteryTyp Recommended CDE
2 NIH Toolbox - Test domain battery type other  The free-text related to NIHTBTestDomainBatteryTyp specifying other text, as part of the NIH Toolbox NIHTBTestDomainBatteryTypOTH Recommended CDE
3 NIH Toolbox - Test name type  Type of NIH Toolbox test being administered, as part of the NIH Toolbox NIHTBAdminTestNameTyp Recommended CDE
4 NIH Toolbox - Test name type other  The free-text related to NIHTBAdminTestNameTyp specifying other text, as part of the NIH Toolbox NIHTBAdminTestNameTypOTH Recommended CDE
5 NIH Toolbox - Test administration language type  Type of language for test being administrated, as part of the NIH Toolbox NIHTBTestAdminLanguageTyp Recommended CDE
6 NIH Toolbox - Test administration language type other  Free-text related to NIHTBTestAdminLanguageTyp specifying other text, as part of the NIH Toolbox NIHTBTestAdminLanguageTypOTH Recommended CDE
7 NIH Toolbox - Form administered type  Type of NIH Toolbox form being administered, as part of the NIH Toolbox NIHTBFormAdminTyp Recommended CDE
8 NIH Toolbox - Test administration flag indicator  Indicator of a flag for the NIH Toolbox test being administered, as part of the NIH Toolbox NIHTBAdminTestFlagInd Recommended CDE
9 NIH Toolbox - Test administration flag type  Type of flag for the NIH Toolbox test being administered, as part of the NIH Toolbox NIHTBAdminTestFlagTyp Recommended CDE

NIH Toolbox Self Efficacy Survey CAT 8-12 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 NIH Toolbox Emotion Self Efficacy CAT - Difficult problems scale  Scale of participant report of agreement to the statement: I can manage to solve difficult problems if I try hard enough, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECATDffProblemsScl Recommended CDE
2 NIH Toolbox Emotion Self Efficacy CAT - Want scale  Scale of participant report of agreement to the statement: If someone tries to keep me from getting what I want, I can find a way to get what I want, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECATWantScl Recommended CDE
3 NIH Toolbox Emotion Self Efficacy CAT - Goals scale  Scale of participant report of agreement to the statement: It is easy for me to stick to my goals and reacht them, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECATGoalsScl Recommended CDE
4 NIH Toolbox Emotion Self Efficacy CAT - Talents scale  Scale of participant report of agreement to the statement: I am confident that I could do a good job dealing with unexpected events, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECATUnexpectedScl Recommended CDE
5 NIH Toolbox Emotion Self Efficacy CAT - Unexpected situations scale  Scale of participant report of agreement to the statement: Thanks to my talents and skills, I know how to handle unexpected situations, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECATUnxpctdSitnsScl Recommended CDE
6 NIH Toolbox Emotion Self Efficacy CAT - Solve problems scale  Scale of participant report of agreement to the statement: I can solve most problems if I try hard enough, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECATSlvProblemsScl Recommended CDE
7 NIH Toolbox Emotion Self Efficacy CAT - Calm scale  Scale of participant report of agreement to the statement: I stay calm when facing difficulties because I can handle them, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECATCalmScl Recommended CDE
8 NIH Toolbox Emotion Self Efficacy CAT - Several ways scale  Scale of participant report of agreement to the statement: When I have a problem, I can find several ways to solve it, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECATSeveralWaysScl Recommended CDE
9 NIH Toolbox Emotion Self Efficacy CAT - Solution scale  Scale of participant report of agreement to the statement: If I am in trouble, I can think of a solution, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECATSolutionScl Recommended CDE
10 NIH Toolbox Emotion Self Efficacy CAT - Handle scale  Scale of participant report of agreement to the statement: I can handle whatever comes my way, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECATHandleScl Recommended CDE

NIH Toolbox Self Efficacy Survey CAT 8-12 Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 NIH Toolbox Emotion Self Efficacy CAT 8 to 12 - Raw score  Raw score, for ages 8-12, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECAT8to12RawScore Recommended CDE
2 NIH Toolbox Emotion Self Efficacy CAT 8 to 12 - Theta score  Theta score, for ages 8-12, as part of the NIH Toolbox Emotion Battery Self Efficacy Computeized Adaptive Test (CAT) NIHTBSECAT8to12ThetaScore Recommended CDE
3 NIH Toolbox Patient Reported Outcome (PRO) Measures - Age-adjusted scale score  Age-adjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures NIHTBPROAgeAdjSclScore Recommended CDE
4 NIH Toolbox Patient Reported Outcome (PRO) Measures - Age-adjusted national percentile value  Value of age-adjusted national percentile, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures NIHTBPROAgeAdjNationalPctVal Recommended CDE
5 NIH Toolbox Patient Reported Outcome (PRO) Measures - Fully-adjusted scale score  Fully-adjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures NIHTBPROFullyAdjSclScore Recommended CDE
6 NIH Toolbox Patient Reported Outcome (PRO) Measures - Unadjusted scale score  Unadjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures NIHTBPROUnadjSclScore Recommended CDE
7 NIH Toolbox - Standard error  Standard error (a statistical measure of variance that represents the margin of error for the Tscore), as part of the NIH Toolbox NIHTBStandardError Optional CDE

 Change History

 Administrative Change History