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

 General Details

Title:
Neuro-QoL Positive Affect and Well Being Long Form
Short Name:
NeuroQoLPstvAffctWellBngLF
Description:
NeuroQoL Positive Affect and Well Being Long Form. Copyright 2008-2013 David Cella and the PROMIS Health Organization on behalf of the National Institute for Neurological Disorders and Stroke (NINDS)
Disease:
Traumatic Brain Injury , General (For all diseases)
Organization:
FITBIR
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-12-28
Owner:
Number of Data Elements:
44
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

NeuroQoL Form Administration (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Quality of Life in Neurological Disorders (Neuro-Qol) - Form administered status  The specific Neuro-Qol form administered status, as part of the Quality of Life in Neurological Disorders (Neuro-Qol). QoLFormStatus Recommended CDE

Positive Affect and Well Being LF (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Quality of Life - Satisfaction well being recent asssement scale  The scale representing how often the participant had a sense of well-being lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLSatisfWellBngRcntAssmntScl Recommended CDE
2 Quality of Life - Satisfaction hopeful recent assessment scale  The scale representing how often the participant felt hopeful lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLSatisfHopfulRcntAssmntScl Recommended CDE
3 Quality of Life - Satisfication general life recent assessment scale  The scale representing how often the participant felt their life was satisfying lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLSatisfGenLifRcntAssmntScl Recommended CDE
4 Quality of Life - Satisfaction life purpose recent assessment scale  The scale representing how often the participant felt their life had purpose lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnLfePurpsRcntAssmtScl Recommended CDE
5 Quality of Life - Satisfaction life significance recent assessment scale  The scale representing how often the participant felt their life had meaning lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnLfeSgnfRcntAssmntScl Recommended CDE
6 Quality of Life - Satisfaction cheerful recent assessment scale  The scale representing how often the participant felt cheerful lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnCheerflRcntAssmntScl Recommended CDE
7 Quality of Life - Satisfaction life functional recent assessment scale  The scale representing how often the participant felt their life was worth living lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfcnLfeFunctRcntAssmntScl Recommended CDE
8 Quality of Life - Satisfaction life balance sense recent assessment scale  The scale representing how often the participant had a sense of balance in their life lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnLfeBlncRcntAssmntScl Recommended CDE
9 Quality of Life - Satisfaction life many area interest recent assessment scale  The scale representing how often the participant was interested in many areas of their life lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnLfeAreaRcntAssmntScl Recommended CDE
10 Quality of Life - Satisfaction life enjoyment ability recent assessment scale  The scale representing how often the participant was able to enjoy life lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnLfeEnjyRcntAssmntScl Recommended CDE
11 Quality of Life - Satisfaction life purpose recent assesment scale  The scale representing how often the participant felt a sense of purpose in their life lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnLfePurpRcntAssmntScl Recommended CDE
12 Quality of Life - Satisfaction laugh humor recent assessment scale  The scale representing how often the participant could laugh and see the humor in situations lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnLghHmrRcntAssmntScl Recommended CDE
13 Quality of Life - Satisfaction relax recent assessment scale  The scale representing how often the participant was able to be at ease and feel relaxed lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnRelaxRecntAssmntScl Recommended CDE
14 Quality of Life - Satisfaction future event interest recent assessment scale  The scale representing how often the participant looked forward with enjoyment to upcoming events lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfcnFutrEvntRcntAssmntScl Recommended CDE
15 Quality of Life - Satisfaction emotion stable recent assessment scale  The scale representing how often the participant felt emotionally stable lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnEmtnStblRcntAssmtScl Recommended CDE
16 Quality of Life - Satisfaction lovable recent assessment scale  The scale representing how often the participant felt lovable lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnLovbleRecntAssmntScl Recommended CDE
17 Quality of Life - Satisfaction confident recent assessment scale  The scale representing how often the participant felt confident lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLSatisfConfdntRecntAssmntScl Recommended CDE
18 Quality of Life - Satisfaction good life recent assessment scale  The scale representing how often the participant had a good life, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnGoodLfeRcntAssmntScl Recommended CDE
19 Quality of Life - Satisfaction peaceful life recent assessment scale  The scale representing how often the participant felt their life was peaceful lately, as par of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnPeacLfeRcntAssmntScl Recommended CDE
20 Quality of Life - Satisfaction live life fully recent assessment scale  The scale representing how often the participant felt they were living life to the fullest lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnLivFullRcntAssmntScl Recommended CDE
21 Quality of Life - Satisfaction close ideal life recent assessment scale  The scale representing how often the participant felt in most ways their life was close to their ideal lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnIdlLfeRcntAssmntScl Recommended CDE
22 Quality of Life - Satisfaction good thought control recent assessment scale  The scale representing how often the participant had good control of their thoughts lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnGoodThouRcntAssmtScl Recommended CDE
23 Quality of Life - Satisfaction hope during bad episode recent assessment scale  The scale representing how often the participant still had hope even when things were going badly lately, as part of Neuro-QOL Positive Affect and Well-Being. QoLStsfctnBadEpsdRcntAssmntScl Recommended CDE

NeuroQol Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Quality of Life in Neurological Disorders (Neuro-Qol) - Items completed count  The count of items on the Neuro-Qol form completed by the participant, as part of the Quality of Life in Neurological Disorders (Neuro-Qol). QoLItemCompletedCount Recommended CDE
2 Quality of Life in Neurological Disorders (Neuro-Qol) - Raw score  The participant's raw score on the Neuro-Qol form, as part of the Quality of Life in Neurological Disorders (Neuro-Qol). QoLRawScore Recommended CDE
3 Quality of Life in Neurological Disorders (Neuro-Qol) - Standard error  Standard error, as part of the Quality of Life in Neurological Disorders (Neuro-Qol) QoLStandardError Recommended CDE
4 Quality of Life in Neurological Disorders (Neuro-Qol) - T-score value  The value of the T-score, a standardized score with a mean of 50 and a standard deviation (SD) of 10 representing the rescaled raw score, as part of the Quality of Life in Neurological Disorders (Neuro-Qol).(PROMIS). QoLTScore Recommended CDE
5 Quality of Life in Neurological Disorders (Neuro-Qol) - Theta value  Theta metric value reported from the CAT Neuro-Qol results, as part of the Quality of Life in Neurological Disorders (Neuro-Qol). QoLThetaVal Recommended CDE

 Change History

 Administrative Change History