F2557-C07229
C07229
Health and Behavior Inventory (HBI) - parent retrospective feel faint scale
Scale for how often the parent thinks the patient/subject had felt faint four weeks prior to the injury, as a part of Health Behavior Inventory (HBI)
Supplemental-Highly Recommended
Health and Behavior Inventory (HBI) Parent Retrospective Version
True
Sport-Related Concussion
Acute
F2557-C07230
C07230
Health and Behavior Inventory (HBI) - parent retrospective blur vision scale
Scale for how often the parent thinks the patient/subject had blurred vision four weeks prior to the injury, as a part of Health Behavior Inventory (HBI)
Supplemental-Highly Recommended
Health and Behavior Inventory (HBI) Parent Retrospective Version
True
Sport-Related Concussion
Acute
F2557-C07231
C07231
Health and Behavior Inventory (HBI) - parent retrospective double vision scale
Scale for how often the parent thinks the patient/subject had double vision four weeks prior to the injury, as a part of Health Behavior Inventory (HBI)
Supplemental-Highly Recommended
Health and Behavior Inventory (HBI) Parent Retrospective Version
True
Sport-Related Concussion
Acute
F2557-C07232
C07232
Health and Behavior Inventory (HBI) - parent retrospective nausea scale
Scale for how often the parent thinks the patient/subject experienced nausea four weeks prior to the injury, as a part of Health Behavior Inventory (HBI)
Supplemental-Highly Recommended
Health and Behavior Inventory (HBI) Parent Retrospective Version
True
Sport-Related Concussion
Acute
F2557-C07233
C07233
Health and Behavior Inventory (HBI) - parent retrospective tired frequency scale
Scale for how often the parent thinks the patient/subject had gotten tired a lot four weeks prior to the injury, as a part of Health Behavior Inventory (HBI)
Supplemental-Highly Recommended
Health and Behavior Inventory (HBI) Parent Retrospective Version
True
Sport-Related Concussion
Acute
F2557-C07234
C07234
Health and Behavior Inventory (HBI) - parent retrospective tired easily scale
Scale for how often the parent thinks the patient/subject had gotten tired easily four weeks prior to the injury, as a part of Health Behavior Inventory (HBI)
Supplemental-Highly Recommended
Health and Behavior Inventory (HBI) Parent Retrospective Version
True
Sport-Related Concussion
Acute
F2557-C07237
C07237
Health and Behavior Inventory (HBI) - Parent Retrospective Version cognitive total score
Sum of cognitive items 1-11 (0-33), on parent retrospective version of Health and Behavior Inventory (HBI)
Supplemental-Highly Recommended
Health and Behavior Inventory (HBI) Parent Retrospective Version
True
Sport-Related Concussion
Acute
F2557-C07238
C07238
Health and Behavior Inventory (HBI) - Parent Retrospective Version somatic total score
Sum of somatic items 12-20 (0-27), on parent retrospective version of Health and Behavior Inventory (HBI)
Supplemental-Highly Recommended
Health and Behavior Inventory (HBI) Parent Retrospective Version
True
Sport-Related Concussion
Acute
F2560-C19500
C19500
Assessment performed date
The date of assessment of the examination being performed
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C21117
C21117
Subject name
Name of subject/participant
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52359
C52359
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Double vision scale
Scale that rates the severity of how the subject now suffers from double vision as compared with before the accident, as part of The Rivermead Post-Concussion Symptoms Questionnaire (RPQ)
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52360
C52360
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Forgetfulness scale
Scale that rates the severity of how the subject now suffers from forgetfulness/poor memory as compared with before the accident, as part of The Rivermead Post-Concussion Symptoms Questionnaire (RPQ)
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52361
C52361
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Sum of the ratings for the first 3 items excluding ratings of 1
Sum of the ratings for the first three items of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) excluding ratings of 1
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52362
C52362
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Poor concentration scale
Scale that rates the severity of how the subject now suffers from poor concentration as compared with before the accident, as part of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ)
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52363
C52363
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Nausea scale
Scale that rates the severity of how the subject now suffers from nausea and/or vomiting as compared with before the accident, as part of The Rivermead Post-Concussion Symptoms Questionnaire (RPQ)
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52364
C52364
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Headaches scale
Scale that rates the severity of how the subject now suffers from headaches as compared with before the accident, as part of The Rivermead Post-Concussion Symptoms Questionnaire (RPQ)
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52365
C52365
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Noise sensitivity scale
Scale that rates the severity of how the subject now suffers from noise sensitivity and easily upset by loud noise as compared with before the accident, as part of The Rivermead Post-Concussion Symptoms Questionnaire (RPQ)
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52366
C52366
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Sum of the ratings for items 1-16 excluding ratings of 1
Sum of the ratings for items 1-16 of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) excluding ratings of 1
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52367
C52367
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Second other difficulty scale
Scale that rates the severity of how the subject now suffers from other difficulties as compared with before the accident. Rate the second other difficulty
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52368
C52368
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Second other difficulty text
The free-text field related to 'The Rivermead Post-Concussion Symptoms Questionnaire (RPQ)- Second other difficulty scale' specifying the second other difficulty text
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52369
C52369
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Longer to think scale
Scale that rates the severity of how the subject now suffers from taking longer to think as compared with before the accident, as part of The Rivermead Post-Concussion Symptoms Questionnaire (RPQ)
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52370
C52370
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Dizziness scale
Scale that rates the severity of how the subject now suffers from dizziness as compared with before the accident, as part of The Rivermead Post-Concussion Symptoms Questionnaire (RPQ)
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52371
C52371
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Sum of the ratings for the 13 items (4-16) excluding ratings of 1
Sum of the ratings for the 13 items (4-16) of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) excluding ratings of 1
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52372
C52372
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - Blurred vision scale
Scale that rates the severity of how the subject now suffers from blurred vision as compared with before the accident, as part of The Rivermead Post-Concusion Symptoms Questionnaire (RPQ)
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive
F2560-C52373
C52373
The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) - First other difficulty text
The free-text field related to 'The Rivermead Post-Concussion Symptoms Questionnaire (RPQ)- First other difficulty scale' specifying the first other difficulty text
Supplemental-Highly Recommended
Rivermead Post-Concussive Symptoms Questionnaire (RPQ)
False
Sport-Related Concussion
Comprehensive