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

 General Details

Title:
Rancho Los Amigos Scale
Short Name:
RanchoLosAmigos
Description:
This scale measures the level of awareness, cognition, behavior, and interaction with the environment.
Disease:
Traumatic Brain Injury
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2015-03-06
Version:
1.0
Date Created:
2015-02-06
Owner:
Number of Data Elements:
9
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.

Los Ranchos Amigos Score (Appears Exactly 1 Time)

# Title Short Description Variable Name Required? Type
1 Rancho Los Amigos Level of Cognitive Functioning Scale (LCFS) version 1 - Score  Participant's score on the Rancho Los Amigos Level of Cognitive Functioning Scale (LCFS) version 1. RanchoLosAmigosLCFS1Score Recommended UDE

 Change History

 Administrative Change History