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)-Story Memory and Delay Recall
Short Name:
WRAML2SMDR
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:
2016-11-17
Owner:
Number of Data Elements:
67
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 Story A (Appears Up To 26 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) -Story item response text  Story item response text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemResponseTxt Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item response core score  Story item response core score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemRespCoreScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item verbatim score  Story item verbatim score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryVrbtmScore Recommended CDE
5 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item gist score  Story item gist score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryGistScore Recommended CDE
6 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item delay recall score  Story item delay recall score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryDelayRecallScore Recommended CDE
7 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story A total score  Story A total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryATotalScore Recommended CDE
8 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story A verbatim total score  Story A verbatim total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryAVrbtmTotalScore Recommended CDE
9 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story A gist total score  Story A gist total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryAGistTotalScore Recommended CDE
10 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story A delay recall score  Story A delay recall score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryADelyReclTotalScore Recommended CDE

WRAML2 Story B (Appears Up To 38 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) -Story item response text  Story item response text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemResponseTxt Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item response core score  Story item response core score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemRespCoreScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item verbatim score  Story item verbatim score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryVrbtmScore Recommended CDE
5 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item gist score  Story item gist score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryGistScore Recommended CDE
6 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item delay recall score  Story item delay recall score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryDelayRecallScore Recommended CDE
7 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story B total score  Story B total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryBTotalScore Recommended CDE
8 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story B verbatim total score  Story B verbatim total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryBVrbtmTotalScore Recommended CDE
9 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story B gist total score  Story B gist total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryBGistTotalScore Recommended CDE
10 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story B delay recall score  Story B delay recall score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryBDelyReclTotalScore Recommended CDE

WRAML2 Story C (Appears Up To 40 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) -Story item response text  Story item response text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemResponseTxt Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item response core score  Story item response core score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemRespCoreScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item verbatim score  Story item verbatim score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryVrbtmScore Recommended CDE
5 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item gist score  Story item gist score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryGistScore Recommended CDE
6 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item delay recall score  Story item delay recall score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryDelayRecallScore Recommended CDE
7 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story C total score  Story C total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryCTotalScore Recommended CDE
8 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story C verbatim total score  Story C verbatim total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryCVrbtmTotalScore Recommended CDE
9 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story C gist total score  Story C gist total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryCGistTotalScore Recommended CDE
10 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story C delay recall score  Story C delay recall score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryCDelyReclTotalScore Recommended CDE

WRAML2 Story 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) -Story Memory Story A and Story B 8 and younger total score  Story Memory Story A and Story B 8 and younger total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StryMmryAB8YngrTtlScore Recommended CDE
2 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story Memory Story A and Story B 8 and younger verbatim total score  Story Memory Story A and Story B 8 and younger verbatim total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StryMmryAB8YngrVrbScore Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story Memory Story A and Story B 8 and younger gist total score  Story Memory Story A and Story B 8 and younger gist total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StryMmryAB8YngrGstScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story Memory Story A and Story B 8 and younger delay recall total score  Story Memory Story A and Story B 8 and younger delay recall total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StryMmryAB8YngrDyRcScore Recommended CDE
5 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story Memory Story B and Story C 9 to adult total score  Story Memory Story B and Story C 9 to adult total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryMmryBC9AdltTtlScore Recommended CDE
6 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story Memory Story B and Story C 9 to adult verbatim total score  Story Memory Story B and Story C 9 to adult verbatim total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryMmryBC9AdtVrbScore Recommended CDE
7 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story Memory Story B and Story C 9 to adult gist total score  Story Memory Story B and Story C 9 to adult gist total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryMmryBC9AdtGstScore Recommended CDE
8 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story Memory Story B and Story C 9 to adult delay recall total score  Story Memory Story B and Story C 9 to adult delay recall total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryMmryBC9AdtDyRcScore Recommended CDE

WRAML2 Story Memory Recognition Story A (Appears Up To 15 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) -Story item response text  Story item response text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemResponseTxt Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item response core score  Story item response core score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemRespCoreScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story A memory recognition total score  Story A memory recognition total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StryAMmryRcgnTtlScore Recommended CDE

WRAML2 Story Memory Recognition Story B (Appears Up To 18 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) -Story item response text  Story item response text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemResponseTxt Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item response core score  Story item response core score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemRespCoreScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story B memory recognition total score  Story B memory recognition total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StryBMmryRcgnTtlScore Recommended CDE

WRAML2 Story Memory Recognition Story C (Appears Up To 22 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) -Story item response text  Story item response text , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemResponseTxt Recommended CDE
3 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story item response core score  Story item response core score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StoryItemRespCoreScore Recommended CDE
4 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story B memory recognition total score  Story B memory recognition total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StryBMmryRcgnTtlScore Recommended CDE

WRAML2 Story Memory Recognition Score (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story A and story B memory recognition 8 yrs and younger total score  Story A and story B memory recognition 8 yrs and younger total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StryMmryRcgnAB8TtlScore Recommended CDE
2 Wide Range Assessment of Memory and Learning Second Edition (WRAML2) -Story B and story C memory recognition 9 yrs to adult total score  Story B and story C memory recognition 9 yrs to adult total score , as part of Wide Range Assessment of Memory and Learning Second Edition (WRAML2) WRAML2StryMmryRcgnBC9TtlScore Recommended CDE

 Change History

 Administrative Change History