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CDE Detailed Report
This report contains detailed information about the selected CDEs.
Note: If at least one CDE was selected from a copyright- or trademark-protected instrument/scale then all of the CDEs from that instrument/scale are included in this report.
Disease: Sport Related Concussion
SubDisease: Comprehensive
Sub-Domain: Post-Concussive / Mild TBI-Related Symptoms
CRF: Galveston Orientation and Amnesia Test (GOAT)
Item count: 18 (18 distinct CDEs)
CDE ID
CDE Name
Variable Name
Definition / Description
Question Text
Permissible Value
Description
Data Type
Instructions
References
Population
Classification (e.g., Core)
Version #
Version Date
Aliases for Variable Name
CRF Module / Guideline
© or TM
Sub-Domain
Domain
Previous Title
Size
Input Restrictions
Min Value
Max Value
Measurement Type
LOINC ID
SNOMED
caDSR ID
CDISC ID
C07177
The Galveston Orientation and Amnesia Test (GOAT) - Full name score
GOATNameScore
Scored ability to accurately state first and last name, as part of the Galveston Orientation and Amnesia Test (GOAT).
What is your name?
0;2;
Correct;Incorrect;
Numeric Values
See instructions on form
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q1
 
Single Pre-Defined Value Selected
       
C07178
The Galveston Orientation and Amnesia Test (GOAT) - Born date score
GOATBrnDateScore
Scored ability to accurately state date of birth, as part of the Galveston Orientation and Amnesia Test (GOAT).
When were you born?
0;4;
Correct;Incorrect;
Numeric Values
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, compl
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q2
 
Single Pre-Defined Value Selected
       
C07179
The Galveston Orientation and Amnesia Test (GOAT) - Live location score
GOATLiveLocScore
Scored ability to accurately state place of residence, as part of the Galveston Orientation and Amnesia Test (GOAT).
Where do you live?
0;4;
Correct;Incorrect;
Numeric Values
Town is sufficient.
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q3
 
Single Pre-Defined Value Selected
       
C07180
The Galveston Orientation and Amnesia Test (GOAT) - City location score
GOATCityLocScore
Scored ability to accurately name the city the subject is currently located, as part of the Galveston Orientation and Amnesia Test (GOAT).
Where are you now? City
0;5;
Correct;Incorrect;
Numeric Values
Must give actual town.
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q4a
 
Single Pre-Defined Value Selected
       
C07181
The Galveston Orientation and Amnesia Test (GOAT) - building location score
GOATBuldngLocScore
Scored ability to accurately identify the building they are currently located, as part of the Galveston Orientation and Amnesia Test (GOAT).
Where are you now? Building
0;5;
Correct;Incorrect;
Numeric Values
Usually in hospital or rehab center. Actual name necessary.
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q4b
 
Single Pre-Defined Value Selected
       
C07182
The Galveston Orientation and Amnesia Test (GOAT) - Hospital admittance date score
GOATHospAdmtDateScore
Scored ability to accurately identify hospital admittance date, as part of the Galveston Orientation and Amnesia Test (GOAT).
When were you admitted to this hospital?
0;5;
Correct;Incorrect;
Numeric Values
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, compl
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q5
 
Single Pre-Defined Value Selected
       
C07183
The Galveston Orientation and Amnesia Test (GOAT) - Mode of Transportation score
GOATModeTranspScore
Scored ability to accurately identify the mode of transportation to the hospital, as part of the Galveston Orientation and Amnesia Test (GOAT).
How did you get here?
0;5;
Correct;Incorrect;
Numeric Values
Mode of transport.
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q6
 
Single Pre-Defined Value Selected
       
C07184
The Galveston Orientation and Amnesia Test (GOAT) - Post injury event score
GOATFirstEvntScore
Scored ability to provide specific details about the first event after injury, as part of the Galveston Orientation and Amnesia Test (GOAT).
What is the first event you can remember after the injury?
0;5;
Correct;Incorrect;
Numeric Values
See instructions on form
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q7
 
Single Pre-Defined Value Selected
       
C07185
The Galveston Orientation and Amnesia Test (GOAT) - Post injury event detail score
GOATDetailScore
Scored ability to identify the detail of the first event the subject can remember after the accident, as part of the Galveston Orientation and Amnesia Test (GOAT).
Can you describe in detail (e.g., date, time, companions) the first event you can recall after injury?
0;5;
Correct;Incorrect;
Numeric Values
See instructions on form
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q8
 
Single Pre-Defined Value Selected
       
C07186
The Galveston Orientation and Amnesia Test (GOAT) - Pre injury event score
GOATLastEvntScore
Scored ability to accurately recall the last event before injury, as part of the Galveston Orientation and Amnesia Test (GOAT).
Can you describe the last event you can recall before the accident?
0;5;
Correct;Incorrect;
Numeric Values
See instructions on form
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q9
 
Single Pre-Defined Value Selected
       
C20333
The Galveston Orientation and Amnesia Test (GOAT) - Pre injury event detail score
GOATPreInjuEventDetailScore
Scored ability to provide specific details about the last event before injury, as part of the Galveston Orientation and Amnesia Test (GOAT).
Can you describe in detail (e.g., date, time, companions) the first event you can recall before the injury?
0;5;
Correct;Incorrect;
Numeric Values
See instructions on form
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
1.0
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C07187
The Galveston Orientation and Amnesia Test (GOAT) - Time score
GOATCrntTimeScore
Scored ability to identify the current time, as part of the Galveston Orientation and Amnesia Test (GOAT).
What time is it now?
0;1;2;3;4;5;
Correct;Half an hour off;1 hour off;1.5 hours off;2 hours off;2.5 hours or more off;
Numeric Values
Minus one for every half-hour error.
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q10
 
Single Pre-Defined Value Selected
       
C07188
The Galveston Orientation and Amnesia Test (GOAT) - Day week score
GOATDayScore
Scored ability to identify the current day of the week, as part of the Galveston Orientation and Amnesia Test (GOAT).
What day of the week is it?
0;1;2;3;
Correct;1 day off;2 days off;3 days off;
Numeric Values
Minus one for each day error.
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q11
 
Single Pre-Defined Value Selected
       
C07189
The Galveston Orientation and Amnesia Test (GOAT) - Day month score
GOATDayMnthDateScore
Scored ability to identify the current day of the month, as part of the Galveston Orientation and Amnesia Test (GOAT).
What day of the month is it? (i.e. the date)
0;1;2;3;4;5;
Correct;1 day off;2 days off;3 days off;4 days off;5 days or more off;
Numeric Values
Minus one for each day error.
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q12
 
Single Pre-Defined Value Selected
       
C07190
The Galveston Orientation and Amnesia Test (GOAT) - Month score
GOATMnthScore
Scored ability to identify the current month, as part of the Galveston Orientation and Amnesia Test (GOAT).
What is the month?
0;5;10;15;
Correct;1 month off;2 months off;3 months or more off;
Numeric Values
Minus five for each month error.
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q13
 
Single Pre-Defined Value Selected
       
C07191
The Galveston Orientation and Amnesia Test (GOAT) - Year identification score
GOATYearScore
Scored ability to identify the current year, as part of the Galveston Orientation and Amnesia Test (GOAT).
What is the year?
0;10;20;30;
Correct;1 year off;2 years off;3 years or more off;
Numeric Values
Minus ten for each year error.
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Q14
 
Single Pre-Defined Value Selected
       
C20334
The Galveston Orientation and Amnesia Test (GOAT) - Error sum value
GOATErrorSumVal
Galveston Orientation and Amnesia Test (GOAT) sum of errors score
Total error points
  
Numeric Values
Sum the error points from questions 1–10.
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
1.0
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
  
Free-Form Entry
0
108
     
C07192
The Galveston Orientation and Amnesia Test (GOAT) - Total score
GOATTotalScore
Total score, as part of the Galveston Orientation and Amnesia Test (GOAT).
Total actual score (100 - total error) = 100 -
  
Numeric Values
Subtract total error from 100. Can be negative number. The total score can be interpreted as follows: 76-100 = Normal / 66-75 = Borderline / <66 = Impaired.
Levin, H., O'Donnell, V., and Grossman, R. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis 167(11), 675-684.
Adult;Pediatric
Supplemental
3.1
3/4/2015
Aliases for variable name not defined
Galveston Orientation and Amnesia Test (GOAT)
Post-Concussive / Mild TBI-Related Symptoms
Outcomes and End Points
GOAT Total
 
Free-Form Entry
-8
100
     
12-15-2018
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