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subjectkey |
GUID |
|
Required |
The NDAR Global Unique Identifier (GUID) for research subject |
NDAR*
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src_subject_id |
String |
20
|
Required |
Subject ID how it's defined in lab/project |
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interview_date |
Date |
|
Required |
Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY |
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interview_age |
Integer |
|
Required |
Age in months at the time of the interview/test/sampling/imaging. |
0 :: 1260
|
Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month.
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sex |
String |
20
|
Required |
Sex of subject at birth |
M;F; O; NR
|
M = Male; F = Female; O=Other; NR = Not reported
|
gender |
Query
|
mtbi_screen_1 |
Integer |
|
Recommended |
Initial GCS (1st available Glasgow Coma Scale Score) |
0::15
|
for an mTBI, GCS must be between 13 and 15
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Query
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mtbi_screen_2 |
Integer |
|
Recommended |
Brain Imaging upon admission (Head CT or Brain MRI) |
1::3
|
1=Negative (no acute intracranial findings); 2=Positive (acute intracranial findings); 3=Not performed/Unknown
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Query
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mtbi_screen_3 |
Integer |
|
Recommended |
Retrograde Amnesia (RGA) "Tell me what happened right before [the accident, your fall, the injury]" If unclear: "Was there anything or any period of time right before you were hurt that you don't remember?" *RGA must be present RIGHT before injury and can extend backward in time for any duration |
1::4
|
1= No; 2= Yes (witnessed); 3= Suspected (not witnessed); 4= Unknown
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Query
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mtbi_screen_6 |
Integer |
|
Recommended |
RGA, hours? |
0::24
|
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Query
|
mtbi_screen_7 |
Float |
|
Recommended |
RGA, minutes? |
0::60
|
|
|
Query
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mtbi_screen_8 |
Float |
|
Recommended |
RGA Total Minutes |
0::9999
|
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Query
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mtbi_screen_9 |
Integer |
|
Recommended |
Loss of consciousness (LOC) "Were you knocked out? Did you lose consciousness?" If witnessed per EPIC OR subject report, select Witnessed, if subject believes LOC was present but was alone/unwitnessed, select Suspected. |
1::4
|
1= No; 2= Yes (witnessed); 3= Suspected (not witnessed); 4= Unknown
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|
Query
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mtbi_screen_10 |
Integer |
|
Recommended |
LOC, minutes? |
0::60
|
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Query
|
mtbi_screen_11 |
Integer |
|
Recommended |
LOC, seconds? |
0::60
|
|
|
Query
|
mtbi_screen_12 |
Integer |
|
Recommended |
LOC Total Seconds |
0::9999
|
|
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Query
|
mtbi_screen_13 |
Integer |
|
Recommended |
Post-traumatic amnesia (PTA) "Is there anything you don't remember after [the accident, your fall, you were injured]?" [If memory is fuzzy/came in and out:] "When did your memory become continuous?" For +LOC: full memory afer waking - no PTA; if some PTA after waking, record duration as time from injury to clearing of PTA -If unwitnessed period of time with no memory - record as unwitnessed LOC or unwitnessed PTA but not both, based on subject belief of their state |
1::4
|
1= No; 2= Yes (witnessed); 3= Suspected (not witnessed); 4= Unknown
|
|
Query
|
mtbi_screen_14 |
Integer |
|
Recommended |
PTA, hours? |
0::24
|
|
|
Query
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mtbi_screen_15 |
Integer |
|
Recommended |
PTA, minutes? |
0::60
|
|
|
Query
|
mtbi_screen_16 |
Integer |
|
Recommended |
PTA Total Minutes |
0::9999
|
|
|
Query
|
mtbi_screen_17 |
Integer |
|
Recommended |
Head trauma or acceleration / deceleration event "Did our head or face hit anything / Were you hit in the head or face?" If no head trauma and MVC or similar mechanism: "Was your head suddenly jolted?" *If ANY contact with head/face, select Struck by/Against instead of other options. |
0::2
|
0= None; 1= Struck by/against (contact with head /face); 2= Whiplash (forceful jolt to head without contact)
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Query
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mtbi_screen_18 |
Integer |
|
Recommended |
Altered Mental Status (AMS) self-report READ VERBATIM: "Right after you [were injured/woke up], did you feel confused, dazed, stunned, see stars or like you got your bell rung? |
0::1; 88
|
0= No; 1= Yes; 88=Other
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mtbi_screen_19 |
String |
15
|
Recommended |
If yes, check what was endorssed by subject: |
|
1=Confused; 2=Dazed; 3=Stunned; 4=Saw stars; 5=Felt like "bell rung"; 6=other
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mtbi_screen_21 |
String |
30
|
Recommended |
Symptoms "Right after the accident or soon after, tell me if you had any of these symptoms. |
|
1= Headache; 2=Nausea; 3= Vomiting; 4=Dizziness; 5= Fatigue; 6= Difficulty Sleeping; 7= Drowsiness; 8= Sensitivity to Light; 9= Sensitivity to Noise; 10= Blurred Vision; 11= Memory Difficulties; 12= Difficulty Concentrating; 13= Balance Problems
|
|
Query
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mtbi_screen_22 |
Integer |
|
Recommended |
Altered Mental Status - Other Was any information gathered elsewhere in the interview that could suggest acute mental status changes/AMS? |
0::1
|
0= No; 1= Yes
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mtbi_screen_23 |
String |
500
|
Recommended |
Symptoms. If Other, list: |
|
|
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Query
|
mtbi_screen_25 |
Integer |
|
Recommended |
Participant Group: Subject meets criteria for all mTBI if ALL of the following are present: (1) Struck by/against or whiplash event (2) Altered mental status (reported OR LOC < 30 minutes OR PTA < 24 hours) (3) One or more subjective symptoms (4) Initial Glasgow Coma Scale (GCS) = 13-15 Participant is eligible for which group? |
1::3
|
1= mTBI Group; 1= Control Group; 3= Other
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comments_misc |
String |
4,000
|
Recommended |
Miscellaneous comments on study, interview, methodology relevant to this form data |
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mtbi_screen_24 |