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

 General Details

Title:
Word Memory Test (WMT)
Short Name:
WMT
Description:
The Word Memory Test is a computerized assessment that tests for verbal learning and memory. It is designed to evaluate an individual's effort to do well to determine whether or not the person's test scores are valid estimates of ability;Green, P. (2003). Green's Word Memory Test for Windows User's Manual. Edmonton, Alberta, Canada:Green's Publishing;http://wordmemorytest.com/;Note on copyright: As the inventor, first author and main researcher of the WMT, MSVT, NV-MSVT & MCI, Dr. Green is the legally registered owner of copyright of the WMT, MSVT, NV-MSVT & MCI internationally. Legitimate copies of the CDs and test manuals and the licenses to use the WMT, MSVT, NV-MSVT or MCI in any format are sold only by Green's Publishing. Copyright by Green's Publishing: http://wordmemorytest.com/
Disease:
General (For all diseases) , Traumatic Brain Injury
Organization:
NIH/CIT/BRICS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-08-18
Owner:
Number of Data Elements:
28
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

Word Memory Test Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Word Memory Test (WMT) - Diagnosis text  The diagnosis text, as part of the Word Memory Test (WMT). WMTDiagnosisTxt Recommended CDE
2 Word Memory Test (WMT) - Diagnosis comment text  The diagnosis comment text, as part of the Word Memory Test (WMT). WMTDiagnosisCommentTxt Recommended CDE
3 Word Memory Test (WMT) - Diagnosis subcategory text  The subcategory of diagnosis text, as part of the Word Memory Test (WMT). WMTDiagnosisSubcategoryTxt Recommended CDE
4 Word Memory Test (WMT) - Immediate recognition percent value  The immediate recognition percent value, as part of the Word Memory Test (WMT). WMTImmedRecogPerVal Recommended CDE
5 Word Memory Test (WMT) - Delay recognition percent value  The delayed recognition percent value, as part of the Word Memory Test (WMT). WMTDelayRecogPerVal Recommended CDE
6 Word Memory Test (WMT) - Consistency percent value  The consistency value, as part of the Word Memory Test (WMT). WMTConsisPerVal Recommended CDE
7 Word Memory Test (WMT) - Multiple choice percent value  The multiple choice value, as part of the Word Memory Test (WMT). WMTMultChoicePerVal Recommended CDE
8 Word Memory Test (WMT) -Paired associates percent value  The paired associates percent value , as part of the Word Memory Test (WMT). WMTPairAssocPerVal Recommended CDE
9 Word Memory Test (WMT) -Free recall percent value  The free recall percent value, as part of the Word Memory Test (WMT). WMTFreeRecalPerVal Recommended CDE
10 Word Memory Test (WMT) -Delay free recall percent value  The delay free recall percent value, as part of the Word Memory Test (WMT). WMTLonDelayFreeRecalPerVal Recommended CDE
11 Word Memory Test (WMT) - Immediate recognition average response time  The immediate recognition average response time, as part of the Word Memory Test (WMT). WMTImmedRecogAvRespTime Recommended CDE
12 Word Memory Test (WMT) -Delay recognition average response time  The delay recognition average response time,, as part of the Word Memory Test (WMT). WMTDelayRecogAvRespTime Recommended CDE
13 Word Memory Test (WMT) - Multiple choice average response time  The multiple choice average response time, as part of the Word Memory Test (WMT) . WMTMultChoiceAvRespTime Recommended CDE

 Change History

 Administrative Change History