F2888-C09576
C09576
Brief Pain Inventory (BPI) - pain area indicator
On the diagram, shade in the areas where you feel pain. Put an X on the area that hurts the most, as part of the Brief Pain Inventory (BPI) form
NeuroRehab Supplemental-Highly Recommended
Brief Pain Inventory (Short Form)
True
NeuroRehab
NeuroRehab Comprehensive
F2885-C54389
C54389
Symbol Digit Modalities Test (SDMT) - Number correct score
The score for the number of correct responses in 90 seconds as part of the Symbol Digit Modalities Test (SDMT)
NeuroRehab Supplemental-Highly Recommended
Symbol Digit Modalities Test
True
NeuroRehab
NeuroRehab Comprehensive
F2905-C02014
C02014
Medication prior or concomitant name
Name of the prior/concomitant agent or drug administered
NeuroRehab Sport Related Concussion Core
Immediate Post-Concussion Assessment and Cognitive Testing (imPACT)
True
NeuroRehab
NeuroRehab Persistent/Chronic Sport Related Concussion
F2905-C00005
C00005
Birth country name
Name for country where the participant/subject was born
NeuroRehab Sport Related Concussion Core
Immediate Post-Concussion Assessment and Cognitive Testing (imPACT)
True
NeuroRehab
NeuroRehab Comprehensive
F2865-C14840
C14840
Activities specific Balance Confidence Scale (ABC-Scale) - sweep scale
Using the Activities-specific Balance Confidence (ABC) Scale, the level of confidence that the participant/subject reports for being able to maintain balance and remain steady when sweeping the floor
NeuroRehab Supplemental-Highly Recommended
Activities Specific Balance Confidence Scale (ABC-Scale)
True
NeuroRehab
NeuroRehab General
F2900-C08514
C08514
36-item Short Form Health Survey (SF-36) - Less accomplished physical health indicator
Indicator for surveyee-reported less accomplishment as a result of physical health during past 4 weeks as part of version 1.0 of 36-item Short Form Health Survey (SF-36)
NeuroRehab Supplemental-Highly Recommended
Short Form 36-Item Health Survey (SF-36)
True
NeuroRehab
NeuroRehab General
F2898-C07002
C07002
Alcohol Smoking and Substance Use Involvement Screening Test (ASSIST) - Cannabis use indicator
Indicator for whether the participant/subject has ever used any cannabis products (marijuana, pot, grass, hash, etc.) for non-medical use, as part of the Alcohol Smoking and Substance Use Involvement Screening Test (ASSIST)
NeuroRehab Supplemental-Highly Recommended
Alcohol, Smoking, and Substance Use Involvement Screening Test (ASSIST)
False
NeuroRehab
NeuroRehab General
F2902-C17374
C17374
Parkinson's Disease Quality of Life (PDQUALIF) - affected social life scale
Rating scale for affected social life by Parkinson's symptoms as part of Parkinson's Disease Quality of Life (PDQUALIF) form
NeuroRehab Supplemental-Highly Recommended
Parkinson's Disease Quality of Life Scale (PDQUALIF)
True
NeuroRehab
NeuroRehab Parkinson's Disease
F2889-C07439
C07439
Patient Health Questionnaire (PHQ) - Better dead thought score
Score of how much the subject has been suffering with the thoughts of that he/she would be better off dead to hurt, as part of the Patient Health Questionnaire (PHQ)
NeuroRehab Supplemental-Highly Recommended
Patient Health Questionnaire - 9 (PHQ-9) Depression Scale
True
NeuroRehab
NeuroRehab General
F2900-C08510
C08510
36-item Short Form Health Survey (SF-36) - Health limited walking several blocks score
Score of surveyee-reported limited walking several blocks due to physical health as part of version 1.0 of 36-item Short Form Health Survey (SF-36)
NeuroRehab Supplemental-Highly Recommended
Short Form 36-Item Health Survey (SF-36)
True
NeuroRehab
NeuroRehab Comprehensive
F2886-C10321
C10321
Quality of Life in Swallowing Disorders (SWAL-QOL) - consistency liquid indicator
Category of consistency or texture of the liquids participant has been drinking most often in the last week. As part of Quality of Life in Swallowing Disorders (SWAL-QOL)
NeuroRehab Supplemental-Highly Recommended
Quality of Life in Swallowing Disorders (SWAL-QOL)
True
NeuroRehab
NeuroRehab Comprehensive
F2893-C09350
C09350
Hamilton Anxiety Rating Scale (HAM-A) - tension score
The score of the participant's/subject's tension, as part of the Hamilton Anxiety Rating Scale (HAM-A) form.
NeuroRehab Supplemental-Highly Recommended
Hamilton Anxiety Rating Scale (HAM-A)
False
NeuroRehab
NeuroRehab General
F2898-C07042
C07042
Alcohol Smoking and Substance Use Involvement Screening Test (ASSIST) - Cocaine fail frequency
Frequency for how often the participant/subject has used failed to do what was normally expected because of the use of cocaine (coke, crack, etc.) in the past 3 months, as part of the Alcohol Smoking and Substance Use Involvement Screening Test (ASSIST)
NeuroRehab Supplemental-Highly Recommended
Alcohol, Smoking, and Substance Use Involvement Screening Test (ASSIST)
False
NeuroRehab
NeuroRehab Comprehensive
F2942-C18883
C18883
Orthosis other text
The free-text field related to 'Orthosis type' specifying other text. Type of orthosis (i.e., external orthopedic appliance that prevents or assists the movement of the spine or limbs)
NeuroRehab Supplemental-Highly Recommended
Devices: Mobility and Manipulation
False
NeuroRehab
NeuroRehab Comprehensive
F1807-C00322
C00322
Medical history condition text
Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history
Core
General Core
False
NeuroRehab
NeuroRehab Comprehensive
F2888-C09584
C09584
Brief Pain Inventory (BPI) - pain mood interference scale
Scale assessing how much the pain has interfered with mood, as part of the Brief Pain Inventory (BPI) form
NeuroRehab Supplemental-Highly Recommended
Brief Pain Inventory (Short Form)
True
NeuroRehab
NeuroRehab Comprehensive
F2886-C10281
C10281
Quality of Life in Swallowing Disorders (SWAL-QOL) - eating enjoyment indicator
Scale assessing how true the following statement has been for the participant during the last month: I don't enjoy eating anymore. As part of Quality of Life in Swallowing Disorders (SWAL-QOL)
NeuroRehab Supplemental-Highly Recommended
Quality of Life in Swallowing Disorders (SWAL-QOL)
True
NeuroRehab
NeuroRehab Comprehensive
F2892-C07092
C07092
Center for Epidemiologic Studies-Depression Scale (CES-D) - poor appetite indicator
Indicates how often the subject didn't feel like eating in the past week, as part of the Center for Epidemiologic Studies-Depression Scale (CES-D)
NeuroRehab Supplemental-Highly Recommended
Center for Epidemiologic Studies-Depression Scale (CES-D)
False
NeuroRehab
NeuroRehab General
F2906-C00007
C00007
Birth date
Date (and time, if applicable and known) the participant/subject was born
NeuroRehab Sport Related Concussion Core
Post Concussion Symptom Scale
False
NeuroRehab
NeuroRehab Persistent/Chronic Sport Related Concussion
F2886-C18108
C18108
Quality of Life in Swallowing Disorders (SWAL-QOL) - comment text
Comment from the subject regarding this questionnaire, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL)
NeuroRehab Supplemental-Highly Recommended
Quality of Life in Swallowing Disorders (SWAL-QOL)
True
NeuroRehab
NeuroRehab General
F2865-C14848
C14848
Activities specific Balance Confidence Scale (ABC-Scale) - escalator parcel use scale
Using the Activities-specific Balance Confidence (ABC) Scale, the level of confidence that the participant/subject reports for being able to maintain balance and remain steady when stepping onto or off an escalator while holding onto parcels that deter hold onto the railing
NeuroRehab Supplemental-Highly Recommended
Activities Specific Balance Confidence Scale (ABC-Scale)
True
NeuroRehab
NeuroRehab General
F2900-C08522
C08522
36-item Short Form Health Survey (SF-36) - Pain interfere work score
Score of bodily pain interfering with work (in home and outside) during the past 4 weeks as part of version 1.0 of 36-item Short Form Health Survey (SF-36)
NeuroRehab Supplemental-Highly Recommended
Short Form 36-Item Health Survey (SF-36)
True
NeuroRehab
NeuroRehab General
F2898-C07010
C07010
Alcohol Smoking and Substance Use Involvement Screening Test (ASSIST) - Tobacco product use frequency
Frequency for how often the participant/subject has used tobacco products (cigarettes, chewing tobacco, cigars, etc.) in the past 3 months, as part of the Alcohol Smoking and Substance Use Involvement Screening Test (ASSIST)
NeuroRehab Supplemental-Highly Recommended
Alcohol, Smoking, and Substance Use Involvement Screening Test (ASSIST)
False
NeuroRehab
NeuroRehab General
F2902-C17382
C17382
Parkinson's Disease Quality of Life (PDQUALIF) - away from social scale
Rating scale for staying away from social gatherings due to the Parkinson's symptoms as part of Parkinson's Disease Quality of Life (PDQUALIF) form
NeuroRehab Supplemental-Highly Recommended
Parkinson's Disease Quality of Life Scale (PDQUALIF)
True
NeuroRehab
NeuroRehab Parkinson's Disease
F2900-C08518
C08518
36-item Short Form Health Survey (SF-36) - Less accomplished emotional problems indicator
Indicator for surveyee-reported less accomplishment as a result of emotional problems during past 4 weeks as part of version 1.0 of 36-item Short Form Health Survey (SF-36)
NeuroRehab Supplemental-Highly Recommended
Short Form 36-Item Health Survey (SF-36)
True
NeuroRehab
NeuroRehab Comprehensive