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

 General Details

Title:
Sport Concussion Assessment Tool 2nd edition (SCAT-2)
Short Name:
SCAT2
Description:
Sport Concussion Assessment Tool 2nd edition (SCAT-2) represents a standardized method of evaluating injured athletes for concussion and can be used in athletes aged from 10 years and older. It supersedes the original SCAT published in 2005. This tool also enables the calculation of the Standardized Assessment of Concussion (SAC) score and the Maddocks questions for sideline concussion assessment. Reference: http://bjsm.bmj.com/content/43/Suppl_1/i85.full.pdf Consensus Statement on Concussion in Sports, 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Clinical Journal of Sports Medicine, Volume 19, No. 3 May 2009, pp.185-200. Copyright: BMJ - http://www.bmj.com/company/the-story-of-bmj/ Recommended by CDISC for TBI.
Disease:
Traumatic Brain Injury
Organization:
NIH/CIT/BRICS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-09-09
Version:
1.1
Date Created:
2016-04-15
Owner:
Number of Data Elements:
104
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 Context type  The context to which the questions were answered ContextType Recommended CDE
2 Context type other text  The free-text related to ContextType specifying other text ContextTypeOTH Recommended CDE
3 Data source  Source of the data provided on the case report form DataSource Recommended CDE
4 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

Symptom Evaluation (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Headache scale  Headache scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3Headache Recommended CDE
2 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Pressure in head scale  Pressure in head scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3Pressureinhead Recommended CDE
3 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Neck pain scale  Neck pain scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3Neckpain Recommended CDE
4 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Nausea, vomiting scale  Nausea vomiting scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3Nauseavomiting Recommended CDE
5 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Dizziness scale  Dizziness scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3Dizziness Recommended CDE
6 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Blurred vision scale  Blurred vision scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3BlurryVision Recommended CDE
7 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Balance problems scale  Balance problems scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3BalanceProblem Recommended CDE
8 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Sensitivity to light scale  Sensitivity to light scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3SenssivityLight Recommended CDE
9 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Sensitivity to noise scale  Sensitivity to noise scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3SensitivityNoise Recommended CDE
10 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Feeling slowed down scale  Feeling slowed down scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3FeelSlowDown Recommended CDE
11 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Feeling in a fog scale  Feeling in a fog scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3FeelFog Recommended CDE
12 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Don't feel right scale  Don't feel right scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3DontFeelRight Recommended CDE
13 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Difficult concentrating scale  Difficult concentrating scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3DifficultyConcent Recommended CDE
14 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Difficulty remembering scale  Difficulty remembering scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3DifficultyRemembering Recommended CDE
15 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Fatigue or low energy scale  Fatigue or low energy scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3FatgLowEnergy Recommended CDE
16 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Confusion scale  Confusion scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3Confusion Recommended CDE
17 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Drowsiness scale  Drowsiness scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3Drowsiness Recommended CDE
18 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Trouble falling asleep  SCAT-3 Trouble falling asleep indicator Scat3TroublFallAsleep Recommended CDE
19 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - More emotional scale  More emotional scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3MoreEmotional Recommended CDE
20 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Irritability scale  Irritability scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3Irritable Recommended CDE
21 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Sadness scale  Sadness scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3Sadness Recommended CDE
22 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Nervous or anxious scale  Nervous or anxious scale, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3NervousAnxious Recommended CDE
23 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Total symptoms  Value for total number of symptoms reported, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3TotalSymptoms Recommended CDE
24 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Total symptom score  Value for total symptom score, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3TotSympScore Recommended CDE
25 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Symptoms worsen with physical activity indicator  Symptoms get worse with physical activity indicator, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3SympPhysActvty Recommended CDE
26 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Symptoms worsen with mental activity indicator  Symptoms get worse with mental activity indicator, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3SympMentActvty Recommended CDE
27 Sport Concussion Assessment Tool (SCAT-3) - Difference in athlete acting scale  Scale showing how different is the athlete acting compared to his / her usual (before injury) self, as part of Sport Concussion Assessment Tool (SCAT-3) SCAT3DifferAthleteActScore Recommended CDE

Symptom Score (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Sport Concussion Assessment Tool (SCAT) 2 - Symptom score  Value of the maximum number of symptoms (22) minus the value for total number of symptoms reported, as part of Sport Concussion Assessment Tool (SCAT-2). Scat2SymptomScore Recommended UDE
2 Injury elapsed time  The elapsed time (in minutes) from the time of injury InjElapsedTime Recommended CDE

Physical signs score (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Sport Concussion Assessment Tool (SCAT) 2 - Loss of consciousness indicator  Indication of whether the subject had loss of consciousness or was unresponsive, as a part of the Sport Concussion Assessment Tool (SCAT) 2. SCAT2LOCInd Recommended UDE
2 Loss of consciousness duration of time value  Duration of loss of consciousness (in seconds) the participant/subject experienced. LOCDurationVal Recommended CDE
3 Sport Concussion Assessment Tool (SCAT) 2 - Balance problem indicator  Indication of whether the subject had a balance problem or was unsteady, as a part of the Sport Concussion Assessment Tool (SCAT) 2. SCAT2BalProblemInd Recommended UDE
4 Sport Concussion Assessment Tool (SCAT) 2 - Physical signs score  Subject's total physical signs score (1 point for each negative response, as a part of the a part of the Sport Concussion Assessment Tool (SCAT) 2. SCAT2PhysSignScore Recommended UDE
5 Injury elapsed time  The elapsed time (in minutes) from the time of injury InjElapsedTime Recommended CDE

Glasgow Coma Scale (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Glasgow Coma Scale (GCS) - Eye response scale  Glasgow Coma Scale (GCS) - Best eye response (E). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. GCSEyeRespnsScale Recommended CDE
2 Glasgow Coma Scale (GCS) - Verbal response scale  Score that describes the participant's verbal response according to the Glasgow Coma Scale (GCS) GCSVerbalRspnsScale Recommended CDE
3 Glasgow Coma Scale (GCS) - Motor response scale  Glasgow Coma Scale (GCS) - Best motor response (M). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. GCSMotorRespnsScale Recommended CDE
4 Glasgow Coma Scale (GCS) - Total score  Glasgow Coma Scale (GCS) - Total Score. The GCS is a standardized instrument for assessing the level of consciousness. GCSTotalScore Recommended CDE
5 Injury elapsed time  The elapsed time (in minutes) from the time of injury InjElapsedTime Recommended CDE

Sideline Assessment - Maddocks Score (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Maddocks Score - Correct venue indicator  Indicator that the subject remembered the location of the game correctly, as part of the Maddocks Score - Recent Memory Questions MaddocksScoreCorrVenueInd Recommended CDE
2 Maddocks Score - Correct game quarter indicator  Indicator that the subject remembered the quarter correctly, as part of the Maddocks Score - Recent Memory Questions MaddocksScoreCorrQuarterInd Recommended CDE
3 Maddocks Score - Correct name of team to score last indicator  Indicator that the subject remembered the name of the team that kicked the last goal correctly, as part of the Maddocks Score - Recent Memory Questions MaddocksScoreCorrTeamScoreInd Recommended CDE
4 Maddocks Score - Correct name of team played last week indicator  Indicator that the subject remembered the name of the team they played last week correctly, as part of the Maddocks Score - Recent Memory Questions MaddocksScoreCorrTeamPlayInd Recommended CDE
5 Maddocks Score - Correct winning team indicator  Indicator that the subject remembered correctly whether their team won last week, as part of the Maddocks Score - Recent Memory Questions MaddocksScoreCorrTeamWonInd Recommended CDE
6 Maddocks Score - Total score  Total score, as part of the Maddocks Score MaddocksScoreTotalScore Recommended CDE

SAC Cognitive Assessment- Orientation (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Standardized Assessment of Concussion (SAC) - Orientation current month score  Scored ability to identify the current month, as part of the Standardized Assessment of Concussion (SAC) Orientation subtest SACOrientationCurrMonthScore Recommended CDE
2 Standardized Assessment of Concussion (SAC) - current date score  Scored ability to identify the current date as part of the Standardized Assessment of Concussion (SAC) Orientation subtest SACOrientationCurrDateScore Recommended CDE
3 Standardized Assessment of Concussion (SAC) - current day of the week score  Scored ability to identify the current day of the week as part of the Standardized Assessment of Concussion (SAC) Orientation subtest SACOrientationCurrDayWeekScore Recommended CDE
4 Standardized Assessment of Concussion (SAC) - current year score  Scored ability to identify the current year as part of the Standardized Assessment of Concussion (SAC) Orientation subtest SACOrientationCurrYearScore Recommended CDE
5 Standardized Assessment of Concussion (SAC) - current time score  Scored ability to identify the current time (within 1 hour) as part of the Standardized Assessment of Concussion (SAC) Orientation subtest SACOrientationCurrTimeScore Recommended CDE
6 Injury elapsed time  The elapsed time (in minutes) from the time of injury InjElapsedTime Recommended CDE

SAC Cognitive Assessment - Immediate Memory (Appears Up To 3 Times)

# Title Short Description Variable Name Required? Type
1 Trial number (numeric)  The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. TrialNumber Recommended CDE
2 Standardized Assessment of Concussion (SAC) - immediate memory list type  Type of list, as part of the Standardized Assessment of Concussion (SAC) SACListTyp Recommended CDE
3 Standardized Assessment of Concussion (SAC) - Immediate memory subtest recalls word 1 score  Scored ability of the participant to remember word 1 as part of the Standardized Assessment of Concussion (SAC) immediate memory subtest SACImmediateMemoryWord1Score Recommended CDE
4 Standardized Assessment of Concussion (SAC) - Immediate memory subtest recalls word 2  Scored ability of the participant remembering word 2 as part of the Standardized Assessment of Concussion (SAC) immediate memory subtest SACImmediateMemoryWord2Score Recommended CDE
5 Standardized Assessment of Concussion (SAC) - Immediate memory subtest recalls word 3  Scored ability of the participant remembering word 3 as part of the Standardized Assessment of Concussion (SAC) immediate memory subtest SACImmediateMemoryWord3Score Recommended CDE
6 Standardized Assessment of Concussion (SAC) - Immediate memory subtest recalls word 4  Scored ability of the participant remembering word 4 as part of the Standardized Assessment of Concussion (SAC) immediate memory subtest SACImmediateMemoryWord4Score Recommended CDE
7 Standardized Assessment of Concussion (SAC) - Immediate memory subtest recalls word 5  Scored ability of the participant remembering word 5 as part of the Standardized Assessment of Concussion (SAC) immediate memory subtest SACImmediateMemoryWord5Score Recommended CDE
8 Standardized Assessment of Concussion (SAC) - Immediate memory 5 words subset trial total score  Trial score as part of the Standardized Assessment of Concussion (SAC) immediate memory subtest 5 words list SACImmdMemoryTrialScore Recommended CDE
9 Injury elapsed time  The elapsed time (in minutes) from the time of injury InjElapsedTime Recommended CDE

SAC Cognitive Assessment - Concentration (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Trial number (numeric)  The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. TrialNumber Recommended CDE
2 Standardized Assessment of Concussion (SAC) - immediate memory list type  Type of list, as part of the Standardized Assessment of Concussion (SAC) SACListTyp Recommended CDE
3 Standardized Assessment of Concussion (SAC) - Concentration subtest digits backward set 1 score  Scored ability of the participant to recite the first set of digits backwards, as part of the Standardized Assessment of Concussion (SAC) concentration subtest digits backward SACConcDigitBackwrdsSet1Score Recommended CDE
4 Standardized Assessment of Concussion (SAC) - Concentration subtest digits backward set 2 score  Scored ability of the participant to recite the second set of digits backwards, as part of the Standardized Assessment of Concussion (SAC) concentration subtest digits backward SACConcDigitBackwrdsSet2Score Recommended CDE
5 Standardized Assessment of Concussion (SAC) - Concentration subtest digits backward set 3 score  Scored ability of the participant to recite the third set of digits backwards, as part of the Standardized Assessment of Concussion (SAC) concentration subtest digits backward SACConcDigitBackwrdsSet3Score Recommended CDE
6 Standardized Assessment of Concussion (SAC) - Concentration subtest digits backward set 4 score  Scored ability of the participant to recite the fourth set of digits backwards, as part of the Standardized Assessment of Concussion (SAC) concentration subtest digits backward SACConcDigitBackwrdsSet4Score Recommended CDE
7 Standardized Assessment of Concussion (SAC) - Concentration subtest months in reverse order score  Scored ability of the participant to recite months of the year backward as part of the Standardized Assessment of Concussion (SAC) concentration subtest month in reverse order SACConcMonthReverseScore Recommended CDE
8 Injury elapsed time  The elapsed time (in minutes) from the time of injury InjElapsedTime Recommended CDE

Balance examination (BESS) (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Balance Error Scoring System Modified (BESS Modified) - Foot tested anatomic site  Anatomic site of non-dominant foot tested, as part of Balance Error Scoring System Modified (BESS Modified). BESSFootTestAnatSite Recommended CDE
2 Balance examination double leg stance score  Subject's double leg stance score as a part of the balance examination. BalanceExamDblLegStanceScore Recommended UDE
3 Balance examination single leg stance score  Subject's single leg stance score as a part of the balance examination. BalanceExamSnglLegStanceScore Recommended UDE
4 Balance examination tandem stance score  Subject's tandem stance score as a part of the balance examination. BalanceExamTndmStanceScore Recommended UDE
5 Injury elapsed time  The elapsed time (in minutes) from the time of injury InjElapsedTime Recommended CDE

Coordination examination (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Laterality type  Laterality type relative to the anatomic site of the body examined or affected LatTyp Recommended CDE
2 Sport Concussion Assessment Tool (SCAT-3) - Upper limb coordination score  Score for the upper limb coordination, as part of Sport Concussion Assessment Tool (SCAT-3) SCAT3UpperLimbCoordinatScore Recommended UDE
3 Injury elapsed time  The elapsed time (in minutes) from the time of injury InjElapsedTime Recommended CDE

SAC Delayed Recall (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Standardized Assessment of Concussion (SAC) - Delayed recall 5 words list subset score  Total score as part of the Standardized Assessment of Concussion (SAC) delayed recall 5 words list subtest SACDelayedRecallSubsetScore Recommended CDE
2 Injury elapsed time  The elapsed time (in minutes) from the time of injury InjElapsedTime Recommended CDE

Overall Score (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Sport Concussion Assessment Tool (SCAT-3, SCAT-5) - Total symptoms  Value for total number of symptoms reported, as part of Sport Concussion Assessment Tool (SCAT-3) Scat3TotalSymptoms Recommended CDE
2 Sport Concussion Assessment Tool (SCAT) 2 - Physical signs score  Subject's total physical signs score (1 point for each negative response, as a part of the a part of the Sport Concussion Assessment Tool (SCAT) 2. SCAT2PhysSignScore Recommended UDE
3 Glasgow Coma Scale (GCS) - Total score  Glasgow Coma Scale (GCS) - Total Score. The GCS is a standardized instrument for assessing the level of consciousness. GCSTotalScore Recommended CDE
4 Balance examination total score  Subject's total score as a part of the balance examination. BalanceExamTotalScore Recommended UDE
5 Sport Concussion Assessment Tool (SCAT-3) - Upper limb coordination score  Score for the upper limb coordination, as part of Sport Concussion Assessment Tool (SCAT-3) SCAT3UpperLimbCoordinatScore Recommended UDE
6 Standardized Assessment of Concussion (SAC) - Orientation subset score  Total score as part of the Standardized Assessment of Concussion (SAC) orientation subtest SACOrientationSubsetScore Recommended CDE
7 Standardized Assessment of Concussion (SAC) - Immediate memory 5 words subset score  Total score as part of the Standardized Assessment of Concussion (SAC) immediate memory subtest 5 words list SACImmdMemorySubsetScore Recommended CDE
8 Standardized Assessment of Concussion (SAC) - Concentration subset score  Total score as part of the Standardized Assessment of Concussion (SAC) concentration subtest SACConcentationSubsetScore Recommended CDE
9 Standardized Assessment of Concussion (SAC) - Delayed recall 5 words list subset score  Total score as part of the Standardized Assessment of Concussion (SAC) delayed recall 5 words list subtest SACDelayedRecallSubsetScore Recommended CDE
10 Standardized Assessment of Concussion (SAC) - Total score  Total Score as sum of the Orientation, Immediate Memory, Concentration, and Delayed Recall subset scores SACTotalScore Recommended CDE
11 Sport Concussion Assessment Tool (SCAT) 2 - Total score  Subject's total score for the Sport Concussion Assessment Tool (SCAT) 2. SCAT2TotalScore Recommended UDE
12 Maddocks Score - Total score  Total score, as part of the Maddocks Score MaddocksScoreTotalScore Recommended CDE
13 Sport Concussion Assessment Tool (SCAT) 2 - Return to play indicator  Indication whether the subject was able to return to play, as a part of the Sport Concussion Assessment Tool (SCAT) 2. SCAT2ReturnToPlayInd Recommended UDE

 Change History

 Administrative Change History