CDE Detailed Report
Disease: NeuroRehab
Subdomain Name: Amnesia/Coma
CRF: Galveston Orientation and Amnesia Test (GOAT)
Displaying 1 - 18 of 18
Subdomain Name: Amnesia/Coma
CRF: Galveston Orientation and Amnesia Test (GOAT)
Displaying 1 - 18 of 18
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07192 | The Galveston Orientation and Amnesia Test (GOAT) - Total score | GOATTotalScore | Total score, as part of the Galveston Orientation and Amnesia Test (GOAT) | 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 / |
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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Free-Form Entry |
-8 | 100 | ||||||||
| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2015-03-04 10:21:26.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C20334 | The Galveston Orientation and Amnesia Test (GOAT) - Error sum value | GOATErrorSumVal | Galveston Orientation and Amnesia Test (GOAT) sum of errors score | 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 | NeuroRehab Supplemental-Highly Recommended | 1.00 | 2015-03-04 10:21:26.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Free-Form Entry |
0 | 108 | ||||||||
| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| 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) | 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 | NeuroRehab Supplemental-Highly Recommended | 3.10 | 2015-03-04 00:00:00.0 | Galveston Orientation and Amnesia Test (GOAT) | Amnesia/Coma | Outcomes and End Points |
Single Pre-Defined Value Selected |
