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

 General Details

Title:
Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Matrix Reasoning
Short Name:
WASIIIMatrixReason_FITBIR
Description:
The Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Matrix reasoning subtest is used to assess problem solving, spatial reasoning, and fluid intelligence.
Disease:
General (For all diseases) , Traumatic Brain Injury
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2015-03-27
Version:
1.0
Date Created:
2015-03-27
Owner:
Number of Data Elements:
45
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.

Form Administration Group (Repeat Infinitely)

# 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

Matrix Reasoning Subtest (Repeat Infinitely)

# Title Short Description Variable Name Required? Type
1 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning sample item A score  Score for Matrix Reasoning sample item A, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrResSAScore Recommended CDE
2 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning sample item B score  Score for Matrix Reasoning sample item B, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrResSBScore Recommended CDE
3 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 1 score  Score for Matrix Reasoning item 1, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes1Score Recommended CDE
4 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 2 score  Score for Matrix Reasoning item 2, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes2Score Recommended CDE
5 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 3 score  Score for Matrix Reasoning item 3, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes3Score Recommended CDE
6 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 4 score  Score for Matrix Reasoning item 4, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes4Score Recommended CDE
7 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 5 score  Score for Matrix Reasoning item 5, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes5Score Recommended CDE
8 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 6 score  Score for Matrix Reasoning item 6, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes6Score Recommended CDE
9 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 7 score  Score for Matrix Reasoning item 7, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes7Score Recommended CDE
10 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 8 score  Score for Matrix Reasoning item 8, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes8Score Recommended CDE
11 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 9 score  Score for Matrix Reasoning item 9, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes9Score Recommended CDE
12 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 10 score  Score for Matrix Reasoning item 10, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes10Score Recommended CDE
13 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 11 score  Score for Matrix Reasoning item 11, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes11Score Recommended CDE
14 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 12 score  Score for Matrix Reasoning item 12, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes12Score Recommended CDE
15 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 13 score  Score for Matrix Reasoning item 13, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes13Score Recommended CDE
16 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 14 score  Score for Matrix Reasoning item 14, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes14Score Recommended CDE
17 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 15 score  Score for Matrix Reasoning item 15, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes15Score Recommended CDE
18 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 16 score  Score for Matrix Reasoning item 16, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes16Score Recommended CDE
19 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 17 score  Score for Matrix Reasoning item 17, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes17Score Recommended CDE
20 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 18 score  Score for Matrix Reasoning item 18, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes18Score Recommended CDE
21 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 19 score  Score for Matrix Reasoning item 19, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes19Score Recommended CDE
22 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 20 score  Score for Matrix Reasoning item 20, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes20Score Recommended CDE
23 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 21 score  Score for Matrix Reasoning item 21, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes21Score Recommended CDE
24 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 22 score  Score for Matrix Reasoning item 22, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes22Score Recommended CDE
25 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 23 score  Score for Matrix Reasoning item 23, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes23Score Recommended CDE
26 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 24 score  Score for Matrix Reasoning item 24, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes24Score Recommended CDE
27 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 25 score  Score for Matrix Reasoning item 25, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes25Score Recommended CDE
28 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 26 score  Score for Matrix Reasoning item 26, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes26Score Recommended CDE
29 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 27 score  Score for Matrix Reasoning item 27, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes27Score Recommended CDE
30 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 28 score  Score for Matrix Reasoning item 28, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes28Score Recommended CDE
31 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 29 score  Score for Matrix Reasoning item 29, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes29Score Recommended CDE
32 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning item 30 score  Score for Matrix Reasoning item 30, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrRes30Score Recommended CDE
33 Wechsler Abbreviated Scale of Intelligence II (WASI II) - Matrix Reasoning total score  Total score for Matrix Reasoning questions, as part of the Wechsler Abbreviated Scale of Intelligence (WASI II). WASI_IIMatrResTotalScore Recommended CDE

 Change History

 Administrative Change History