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

 General Details

Title:
Wide Range Assessment of Memory and Learning, Second Edition( WRAML-2)-Number letter
Short Name:
WRAML2NL
Description:
"The WRAML2 is a carefully standardized psychometric instrument which allows the user to evaluate an individual's memory functioning. The WRAML2 affords evaluation of both immediate and delayed memory ability, as well as the acquisition of new learning. Copyright 2003 by Wide Range. Sheslow, D., Adams, W. 2003. Wide Range Assessment of Memory and Learning. NCS Pearson, Bloomington, MN."
Disease:
Traumatic Brain Injury , General (For all diseases)
Organization:
FITBIR
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-11-18
Owner:
Number of Data Elements:
19
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

WRAML2 Number Letter (Appears Up To 25 Times)

# Title Short Description Variable Name Required? Type
1 Test item number (numeric)  The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked TestItemNum Recommended CDE
2 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Number letter sequence item response text  Number letter sequence item response text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2NumberLetterSeqItmRspTxt Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Number letter sequence item response score  Number letter sequence item response score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2NumberLttrSeqItmRspScore Recommended CDE

WRAML2 Number letter scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Number letter sequence total score  Number letter sequence total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2NumberLetterTotalScore Recommended CDE

 Change History

 Administrative Change History