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

 General Details

Title:
PROMIS Ability to Participate in Social Roles and Activities Short Form 8a
Short Name:
PROMISAbilPartSocRolSF8a
Description:
The PROMIS Ability of Participate in Social Roles and Activities is a carefully standardized psychometric instrument which allows the user to evaluate an individual'sability to function in a social setting. Copyright 2008-2012 PROMIS Health Organization and PROMIS Cooperative Group
Disease:
General (For all diseases) , Traumatic Brain Injury
Organization:
FITBIR
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-12-08
Owner:
Number of Data Elements:
29
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

Ability to Participate in Social Roles and Activities (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a - Trouble leisure activity scale  Scale relating to how often the person has trouble doing of his or her regular leisure activities, as part of the Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a. PROMISPSRATrblLeisureActScl Recommended CDE
2 Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a - Trouble family activity scale  Scale relating to how often the person has trouble doing all of the family activities he or she wants, as part of the Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a. PROMISPSRATrblFamilyActScl Recommended CDE
3 Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a - Trouble usual work scale  Scale relating to how often the person has trouble doing all of his or her usual work, as part of the Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a. PROMISPSRATrblUsualWorkScl Recommended CDE
4 Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a - Trouble friend activity scale  Scale relating to how often the person has trouble doing all of the activities with friends, as part of the Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a. PROMISPSRATrblFriendActScl Recommended CDE
5 Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a - Limit fun thing scale  Scale relating to how often the person has to limit the things he or she does for fun with others, as part of the Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a. PROMISPSRALimitFunThingScl Recommended CDE
6 Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a - Limit regular friend activity scale  Scale relating to how often the person has to limit his or her regular activities with friends, as part of the Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a. PROMISPSRALmtRglrFriendActScl Recommended CDE
7 Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a - Limit regular family activity scale  Scale relating to how often the person has to limit his or her regular family activities, as part of the Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a. PROMISPSRALmtRglrFamilyActScl Recommended CDE
8 Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a - Trouble doing work scale  Scale relating to how often the person has trouble doing all of the work that is important to him/her, as part of the Patient Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Short Form 8a. PROMISPSRATrblDoingWorkScl Recommended CDE

Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Patient-Reported Outcome Measure Information System (PROMIS) - form administered type  The specific PROMIS form type administered, as part of the Patient-Reported Outcome Measurement Information System (PROMIS). PROMISFormType Recommended CDE
2 Patient-Reported Outcome Measure Information System (PROMIS) - raw score  The participant's raw score on the PROMIS form, as part of the Patient-Reported Outcome Measurement Information System (PROMIS). PROMISRawScore Recommended CDE
3 Patient-Reported Outcome Measure Information System (PROMIS) - items completed count  The count of items on the PROMIS form completed by the participant, as part of the Patient-Reported Outcome Measurement Information System (PROMIS). PROMISItemCompletedCount Recommended CDE
4 Patient-Reported Outcome Measure Information System (PROMIS) - T-score value  The T-score value, a standardized score with a mean of 50 and standard deviation of 10 representing the rescaled raw score, as part of the Patient-Reported Outcome Measurement Information System. PROMISTScore Recommended CDE
5 Patient-Reported Outcome Measure Information System (PROMIS) - Standard error  Standard error, as part of the Patient-Reported Outcome Measurement Information System (PROMIS) PROMISStandardError Recommended CDE
6 Patient-Reported Outcome Measure Information System (PROMIS) - theta value  The value of theta reported from the CAT PROMIS results, as part of the Patient-Reported Outcome Measurement Information System (PROMIS). PROMISTheta Recommended CDE

 Change History

 Administrative Change History