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

 General Details

Title:
TBI-QOL Item Bank v1.0 - Emotional & Behavioral Dyscontrol - Short Form 10a
Short Name:
TBIQOLEmotBehavDyscontrol
Description:
TBI-QOL Item Bank v1.0 - Emotional & Behavioral Dyscontrol - Short Form 10a. Ten items are included. Tulsky, D. S., Kisala, P. A., Victorson, D., Carlozzi, N., Bushnik, T., Sherer, M., & Englander, J. (2016). TBI-QOL: development and calibration of item banks to measure patient reported outcomes following traumatic brain injury.The Journal of head trauma rehabilitation, 31(1), 40. TBI-QOL Items Copyright 2015 David Tulsky and Kessler Foundation. All rights reserved. http://www.assessmentcenter.net/ 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:
2016-12-14
Version:
1.1
Date Created:
2016-05-26
Owner:
Number of Data Elements:
26
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

TBI-QOL Emotional and behavioral dyscontrol (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 TBI Quality of Life (TBI-QOL) - Trouble controlling temper scale  The scale which represents how often the participant felt he/she had trouble controlling his/her temper in the past 7 days, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). TBIQOLTrblCtrlTemprScl Recommended CDE
2 TBI Quality of Life (TBI-QOL) - Control my behavior scale  The scale which represents how often the participant felt it was hard to control his/her behavior in the past 7 days, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). TBIQOLCtrlMyBehavrScl Recommended CDE
3 TBI Quality of Life (TBI-QOL) - Without thinking scale  The scale which represents how often the participant said or did without thinking in the past 7 days, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). TBIQOLWtThinkingScl Recommended CDE
4 TBI Quality of Life (TBI-QOL) - Impatient with other people scale  The scale which represents how often the participant got impatient with other people in the past 7 days, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). TBIQOLImptWOthrPplScl Recommended CDE
5 TBI Quality of Life (TBI-QOL) - Hard time accepting criticism scale  The scale which represents how often the participant had a hard time accepting criticism from other people in the past 7 days, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). TBIQOLHrdTimeAcctCritsmScl Recommended CDE
6 TBI Quality of Life (TBI-QOL) - Easily upset scale  The scale which represents how often the participant became easily upset in the past 7 days, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). TBIQOLEasilyUpsetScl Recommended CDE
7 TBI Quality of Life (TBI-QOL) - In conflict scale  The scale which represents how often the participant was in conflict with others in the past 7 days, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). TBIQOLInConflictScl Recommended CDE
8 TBI Quality of Life (TBI-QOL) - Annoyed Talkative scale  The scale which represents how often other people got annoyed because the participant was so talkative in the past 7 days, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). TBIQOLAnnoydTalktvScl Recommended CDE
9 TBI Quality of Life (TBI-QOL) - Inappropriate things said scale  The scale which represents how often the participant said things that were inappropriate in the past 7 days, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). TBIQOLInapropritThingsSaidScl Recommended CDE
10 TBI Quality of Life (TBI-QOL) - Inappropriate things done scale  The scale which represents how often other people told the participant did things that were inappropriate in the past 7 days, as part of Traumatic Brain Injury-Quality of Life (TBI-QOL). TBIQOLInapropritThingsDoneScl Recommended CDE

TBI-QOL Emotional and behavioral dyscontrol- scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 TBI Quality of Life (TBI-QOL) - Emotional behavioral dyscontrol score  The raw score related to a set of injury and/or treatment related manifestations including disinhibition, emotional liability, irritability, impatience, and impulsiveness, as part of the TBI Quality of Life (TBI-QOL). TBIQOLEBDRawScore Recommended CDE
2 TBI Quality of Life (TBI-QOL) - Emotional behavioral dyscontrol T-score  The T-Score related to a set of injury and/or treatment related manifestations including disinhibition, emotional lability, irritability, impatience, and impulsiveness. TBIQOLEBDTScore Recommended CDE
3 TBI-Quality of Life (TBI-QOL) - Standard error  Standard error, as part of TBI-Quality of Life (TBI-QOL) measures TBIQOLStandardError Recommended CDE

 Change History

 Administrative Change History