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)-Picture Memory and Recognition
Short Name:
WRAML2PMR
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
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:
41
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 Picture Memory Zoo (Appears Up To 9 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) -Picture memory zoo item text  Picture memory zoo item text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryZooItemTxt Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory zoo item response score  Picture memory zoo item response score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryZooItemRspScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory zoo item total score  Picture memory zoo item total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PcMmryZooItemTtlScore Recommended CDE
5 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory zoo item commission error score  Picture memory zoo item commission error score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryZooCommErrScore Recommended CDE

WRAML2 Picture Memory Classroom (Appears Up To 14 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) -Picture memory classroom item text  Picture memory classroom item text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryClssRmItemTxt Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory classroom item response score  Picture memory classroom item response score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryClssRmItmRspScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory classroom item total score  Picture memory classroom item total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryClssRmItmTtlScore Recommended CDE
5 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory classroom item commission error score  Picture memory classroom item commission error score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryClssRmComErrScore Recommended CDE

WRAML2 Picture Memory Garage (Appears Up To 14 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) -Picture memory garage item text  Picture memory garage item text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryGaragItemTxt Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory garage item response score  Picture memory garage item response score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryGaragItmRspScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory garage item total score  Picture memory garage item total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryGaragItemTtlScore Recommended CDE
5 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory garage item commission error score  Picture memory garage item commission error score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryGaragCommErrScore Recommended CDE

WRAML2 Picture Memory Living Room (Appears Up To 14 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) -Picture memory living room item text  Picture memory living room item text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryLvngRmItmTxt Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory living room item response score  Picture memory living room item response score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryLvngRmItmRspScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory living room item total score  Picture memory living room item total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryLvngRmItmTtlScore Recommended CDE
5 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory living room item commission error score  Picture memory living room item commission error score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryLvngRmComErrScore Recommended CDE

WRAML2 Picture Memory Scoring (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory total score  Picture memory total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryTotalScore Recommended CDE
2 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory classroom item commission error score  Picture memory classroom item commission error score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryClssRmComErrScore Recommended CDE

WRAML2 Picture Memory Recognition (Appears Up To 44 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) -Picture memory recognition correct item indicator  Picture memory recognition correct item indicator , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryRcgCorrctItmInd Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory recognition correct item score  Picture memory recognition correct item score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryRcgCorrItemScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Picture memory recognition total score  Picture memory recognition total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2PicMmryRcgTotalScore Recommended CDE

 Change History

 Administrative Change History