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

 General Details

Title:
Wechsler Intelligence Scale for Children -Fourth edition (WISC-IV) Cancellation section
Short Name:
WISCIVCA
Description:
WISC-IV measures a child's intellectual ability. Cancellation subtest measures processing speed using random and structured animal target forms. Wechsler, D. (2003). Wechsler Intelligence Scale for Children–Fourth Edition: Technical and interpretive manual. San Antonio, TX: Psychological Corporation. Copyright 2003 by The Psychological Corporation, a Harcourt Assessment Company http://www.pearsonclinical.com/
Disease:
Traumatic Brain Injury
Organization:
FITBIR
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-07-25
Owner:
Number of Data Elements:
25
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

WISC-IV Cancellation (Appears Up To 2 Times)

# Title Short Description Variable Name Required? Type
1 Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation Section - Item type  Item type, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest WISCIVCAItemTyp Recommended CDE
2 Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation Section - Completion time  Cancellation completion time, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest WISCIVCACompltnTime Recommended CDE
3 Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Number incorrect  Count of number correct, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest WISCIVCANumCorrectCt Recommended CDE
4 Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Number correct  Count of number incorrect, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest WISCIVCANumIncorrectCt Recommended CDE
5 Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Difference score  Score of difference, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest WISCIVCADiffScore Recommended CDE
6 Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Bonus points score  Bonus points, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest WISCIVCABonusPtsScore Recommended CDE
7 Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Item total raw score  Item total raw score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest WISCIVCAItemTtlRawScore Recommended CDE

WISC-IV Cancellation-Search pattern (Appears Up To 2 Times)

# Title Short Description Variable Name Required? Type
1 Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation Section - Item type  Item type, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest WISCIVCAItemTyp Recommended CDE
2 Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation Section - Search pattern category  Search pattern, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest WISCIVCASearchPatCat Recommended CDE

WISC-IV Cancellation-Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Intelligence Scale For Children - Fourth Edition (WISC-IV) Cancellation - Total raw score  Total raw score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Cancellation subtest WISCIVCATtlRawScore Recommended CDE

 Change History

 Administrative Change History