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 Subacute Sport Related Concussion
F2901-C09931
C09931
World Health Organization Quality of Life (WHOQOL-BREF) - health satisfaction scale
Scale used to assess health satisfaction, as part of the World Health Organization Quality of Life (WHQOL-BREF) questionnaire
NeuroRehab Supplemental-Highly Recommended
World Health Organization Quality of Life Assessment (WHOQOL-BREF)
True
NeuroRehab
NeuroRehab Comprehensive
F2898-C07026
C07026
Alcohol Smoking and Substance Use Involvement Screening Test (ASSIST) - Desire sedative sleep pill frequency
Frequency for how often the particpant/subject had a strong desire to use sedative or sleeping pills (Valium, Serepax, Rohypnol, 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
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 Comprehensive
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 Acute Sport Related Concussion
F2939-C18153
C18153
Data unknown text
The free-text field to Mark an "X" in to record if data are unknown or not available
NeuroRehab Core
Assessments and Examinations Demographic and Clinical Conditions
False
NeuroRehab
NeuroRehab General
F2900-C08534
C08534
36-item Short Form Health Survey (SF-36) - Healthy as anybody score
Score of how true or false surveyee perceived the statement: I am as healthy as anybody I know, 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
F2894-C09374
C09374
Hamilton Depression Rating Scale (HDRS) - retardation indicator
Score for any retardation in the participant/subject's mental or physical behavior, as part of the Hamilton Depression Rating Scale (HDRS)
NeuroRehab Supplemental-Highly Recommended
Hamilton Depression Rating Scale (HDRS)
False
NeuroRehab
NeuroRehab Comprehensive
F2898-C07066
C07066
Alcohol Smoking and Substance Use Involvement Screening Test (ASSIST) - Hallucinogen fail control indicator
Indicator for whether the participant/subject has ever tried, but failed to control, cut down or stop using hallucinogens (LSD, acid, mushrooms, PCP, Special K, etc), 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
F2889-C07433
C07433
Patient Health Questionnaire (PHQ) - Tired little energy score
Score of how much the subject has been feeling tired in the past two weeks, as part of the Patient Health Questionnaire (PHQ)
NeuroRehab Supplemental-Highly Recommended
Patient Health Questionnaire - 9 (PHQ-9) Depression Scale
True
NeuroRehab
NeuroRehab Comprehensive
F2939-C06060
C06060
Pain location indicator
Indicates if the participant experienced pain in the particular location described jointly by the laterality and anatomic site
NeuroRehab Supplemental-Highly Recommended
Assessments and Examinations Demographic and Clinical Conditions
False
NeuroRehab
NeuroRehab Comprehensive
F2942-C21640
C21640
Fall details assistive device specify text
The free-text field to specify the other type of assistive device used when the fall recorded in the Falls Diary occurred
NeuroRehab Supplemental-Highly Recommended
Devices: Mobility and Manipulation
False
NeuroRehab
NeuroRehab General
F2886-C10305
C10305
Quality of Life in Swallowing Disorders (SWAL-QOL) - careful diet annoy problem indicator
Scale assessing how true the following statement has been for the participant during the last month: Having to be so careful when I eat or drink annoys me. 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-C09348
C09348
Hamilton Anxiety Rating Scale (HAM-A) - depressed mood score
The score of the participant's/subject's depressed mood, as part of the Hamilton Anxiety Rating Scale (HAM-A) form.
NeuroRehab Supplemental-Highly Recommended
Hamilton Anxiety Rating Scale (HAM-A)
False
NeuroRehab
NeuroRehab Comprehensive
F2887-C17234
C17234
Swallowing Disturbance Questionnaire (SwDQ) - lump food stuck throat meal score
Score for how frequent the participant/subject feels as if a lump of food is stuck in the throat while eating, as a part of Swallowing Disturbance Questionnaire (SDQ)
NeuroRehab Supplemental-Highly Recommended
Swallowing Disturbance Questionnaire (SDQ)
True
NeuroRehab
NeuroRehab Parkinson's Disease
F2906-C05400
C05400
Injury date time
Date (and time, if applicable and known) of injury
NeuroRehab Sport Related Concussion Core
Post Concussion Symptom Scale
False
NeuroRehab
NeuroRehab Acute Sport Related Concussion
F2886-C10286
C10286
Quality of Life in Swallowing Disorders (SWAL-QOL) - gagging problem indicator
Scale assessing how true the following statement has been for the participant during the last month: Gagging. 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 General
F2907-C13246
C13246
National Institutes of Health Stroke Scale (NIHSS) Supplemental - intervention present type
Were any of the following present during the NIHSS assessment?
NeuroRehab Stroke Core
NIH Stroke Scale (NIHSS)
True
NeuroRehab
NeuroRehab Comprehensive
F2902-C17361
C17361
Parkinson's Disease Quality of Life (PDQUALIF) - lightheaded scale
Rating scale for lightheaded symptom caused by changing positions (lying to standing, or sitting to standing) 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 Comprehensive
F2899-C09300
C09300
Apathy Scale (AS) - Comment text
Comments about the subjects apathetic rating, as part of the Apathy Scale (AS) form
NeuroRehab Supplemental-Highly Recommended
Apathy Scale (AS)
True
NeuroRehab
NeuroRehab Comprehensive
F2942-C14292
C14292
Durable medical equipment indicator
Indicates if the participant/ subject was provided with any durable medical equipment
NeuroRehab Supplemental-Highly Recommended
Devices: Mobility and Manipulation
False
NeuroRehab
NeuroRehab General
F2866-C17394
C17394
Berg Balance Scale (BBS) - stand one leg scale
The scale for assessment of standing on one leg based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities
NeuroRehab Supplemental-Highly Recommended
Berg Balance Scale (BBS)
False
NeuroRehab
NeuroRehab General
F2892-C07107
C07107
Center for Epidemiologic Studies-Depression Scale (CES-D) - crying spell indicator
Indicates how often the subject had crying spells 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 Comprehensive
F2897-C07087
C07087
Alcohol Use Disorders Identification Test (AUDIT) - Cannot remember night before frequency score
Score for the frequency within the last year with which the subject was unable to remember what happened the previous night due to drinking, as part of the Alcohol Use Disorders Identification Test (AUDIT)
NeuroRehab Supplemental-Highly Recommended
Alcohol Use Disorders Identification Test: Self-Report Version (AUDIT)
False
NeuroRehab
NeuroRehab General
F2942-C10702
C10702
Walking own unable reason
Reason why the participant/subject is unable to walk on his/her own
NeuroRehab Supplemental-Highly Recommended
Devices: Mobility and Manipulation
False
NeuroRehab
NeuroRehab Comprehensive