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

 General Details

Title:
Neurobehavioral Rating Scale (NRS)
Short Name:
NRS
Description:
The NRS consits of a semistructured interview ans brief cognitive tests during the interview. Each of the 27 items is rated on a 7-level scale(deficit absent,very mild,mild,moderaate, moderately severe, severe, extremely severe) on the basis of indicative behavioral evidence.
Disease:
Traumatic Brain Injury
Organization:
NIH/CIT/DCB
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-05-06
Owner:
Number of Data Elements:
47
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

Neurobehavioral Rating Scale (NRS) (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Neurobehavioral Rating Scale (NRS) - Inattention or reduced alertness scale  Scale for inattention or reduced alertness, as part of the Neurobehavioral Rating Scale (NRS) NRSInattentionReduceAlertScl Recommended CDE
2 Neurobehavioral Rating Scale (NRS) - Somatic concerns scale  Scale for somatic concerns, as part of the Neurobehavioral Rating Scale (NRS) NRSSomaticConcernScl Recommended CDE
3 Neurobehavioral Rating Scale (NRS) - Disorientation scale  Scale for disorientation, as part of the Neurobehavioral Rating Scale (NRS) NRSDisorientationScl Recommended CDE
4 Neurobehavioral Rating Scale (NRS) - Anxiety scale  Scale for anxiety, as part of the Neurobehavioral Rating Scale (NRS) NRSAnxietyScl Recommended CDE
5 Neurobehavioral Rating Scale (NRS) - Expressive deficit scale  Scale for expressive deficit, as part of the Neurobehavioral Rating Scale (NRS) NRSExpressiveDeficitScl Recommended CDE
6 Neurobehavioral Rating Scale (NRS) - Emotional withdrawal scale  Scale for emotional withdrawal, as part of the Neurobehavioral Rating Scale (NRS) NRSEmotionalWithdrawalScl Recommended CDE
7 Neurobehavioral Rating Scale (NRS) - Conceptual disorganization scale  Scale for conceptual disorganization, as part of the Neurobehavioral Rating Scale (NRS) NRSConceptualDisorientatnScl Recommended CDE
8 Neurobehavioral Rating Scale (NRS) - Disinhibition scale  Scale for disinhibition, as part of the Neurobehavioral Rating Scale (NRS) NRSDisinhibitionScl Recommended CDE
9 Neurobehavioral Rating Scale (NRS) - Feelings of guilt scale  Scale for feelings of guilt, as part of the Neurobehavioral Rating Scale (NRS) NRSGuiltFeelingsScl Recommended CDE
10 Neurobehavioral Rating Scale (NRS) - Memory deficit scale  Scale for memory deficit, as part of the Neurobehavioral Rating Scale (NRS) NRSMemoryDeficitScl Recommended CDE
11 Neurobehavioral Rating Scale (NRS) - Agitation scale  Scale for agitation, as part of the Neurobehavioral Rating Scale (NRS) NRSAgitationScl Recommended CDE
12 Neurobehavioral Rating Scale (NRS) - Inaccurate insight and self-appraisal scale  Scale for inaccurate insight and self-appraisal, as part of the Neurobehavioral Rating Scale (NRS) NRSInaccurateInsightScl Recommended CDE
13 Neurobehavioral Rating Scale (NRS) - Depressive mood scale  Scale for depressive mood, as part of the Neurobehavioral Rating Scale (NRS) NRSDepressiveMoodScl Recommended CDE
14 Neurobehavioral Rating Scale (NRS) - Hostility or uncooperativeness scale  Scale for hostility or uncooperativeness, as part of the Neurobehavioral Rating Scale (NRS) NRSHostilityUncooperativScl Recommended CDE
15 Neurobehavioral Rating Scale (NRS) - Decreased initiative or motivation scale  Scale for decreased initiative or motivation, as part of the Neurobehavioral Rating Scale (NRS) NRSDecreasInitiativMotivScl Recommended CDE
16 Neurobehavioral Rating Scale (NRS) - Suspiciousness scale  Scale for suspiciousness, as part of the Neurobehavioral Rating Scale (NRS) NRSSuspiciousnessScl Recommended CDE
17 Neurobehavioral Rating Scale (NRS) - Fatigability scale  Scale for fatigability, as part of the Neurobehavioral Rating Scale (NRS) NRSFatigabilityScl Recommended CDE
18 Neurobehavioral Rating Scale (NRS) - Hallucinatory behavior scale  Scale for hallucinatory behavior, as part of the Neurobehavioral Rating Scale (NRS) NRSHallucinatoryBehaviorScl Recommended CDE
19 Neurobehavioral Rating Scale (NRS) - Motor retardation scale  Scale for motor retardation, as part of the Neurobehavioral Rating Scale (NRS) NRSMotorRetardationScl Recommended CDE
20 Neurobehavioral Rating Scale (NRS) - Unusual thought content scale  Scale for unusual thought content, as part of the Neurobehavioral Rating Scale (NRS) NRSUnusualThoughtContentScl Recommended CDE
21 Neurobehavioral Rating Scale (NRS) - Blunted affect scale  Scale for blunted affect, as part of the Neurobehavioral Rating Scale (NRS) NRSBluntedAffectScl Recommended CDE
22 Neurobehavioral Rating Scale (NRS) - Excitement scale  Scale for excitement, as part of the Neurobehavioral Rating Scale (NRS) NRSExcitementScl Recommended CDE
23 Neurobehavioral Rating Scale (NRS) - Poor planning scale  Scale for poor planning, as part of the Neurobehavioral Rating Scale (NRS) NRSPoorPlanningScl Recommended CDE
24 Neurobehavioral Rating Scale (NRS) - Liability of mood scale  Scale for liability of mood, as part of the Neurobehavioral Rating Scale (NRS) NRSLiabilityMoodScl Recommended CDE
25 Neurobehavioral Rating Scale (NRS) - Tension scale  Scale for tension, as part of the Neurobehavioral Rating Scale (NRS) NRSTensionScl Recommended CDE
26 Neurobehavioral Rating Scale (NRS) - Comprehension deficit scale  Scale for comprehension deficit, as part of the Neurobehavioral Rating Scale (NRS) NRSComprehesionDeficitScl Recommended CDE
27 Neurobehavioral Rating Scale (NRS) - Speech articulation deficit scale  Scale for speech articulation deficit, as part of the Neurobehavioral Rating Scale (NRS) NRSArticulationDeficitScl Recommended CDE

NRS Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Neurobehavioral Rating Scale (NRS) - Cognition/energy factor I score  Score for Factor I Cognition/energy, as part of the Neurobehavioral Rating Scale (NRS) NRSFactorIScore Recommended CDE
2 Neurobehavioral Rating Scale (NRS) - Metacognition factor II score  Score for Factor II Metacognition, as part of the Neurobehavioral Rating Scale (NRS) NRSFactorIIScore Recommended CDE
3 Neurobehavioral Rating Scale (NRS) - Somatic/anxiety factor III score  Score for Factor III Somatic/anxiety, as part of the Neurobehavioral Rating Scale (NRS) NRSFactorIIIScore Recommended CDE
4 Neurobehavioral Rating Scale (NRS) - Language factor IV score  Score for Factor IV Language, as part of the Neurobehavioral Rating Scale (NRS) NRSFactorIVScore Recommended CDE
5 Neurobehavioral Rating Scale (NRS) - Total score  Total score, as a part of the Neurobehavioral Rating Scale (NRS) NRSTotalScore Recommended CDE

 Change History

 Administrative Change History