CDE Detailed Report

Disease: content
Subdomain Name: Military Studies
CRF: welcome

Displaying 1 - 50 of 85
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
C07261 Military Acute Concussion Evaluation (MACE) - Unremembered events after indicator MACEUnremmbrdEvntAftrInd Indicator of whether or not there were events just AFTER the injury that are not remembered, as part of Military Acute Concussion Evaluation (MACE) Indicator of whether or not there were events just AFTER the injury that are not remembered, as part of Military Acute Concussion Evaluation (MACE Amnesia After Are there any events just AFTER the injuries that are not remembered? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Assess time until continuous memory after the injury. Determine whether and length of time that the person wasn't registering continuous memory both prior to injury and after the injury. Approximate the amount of time in seconds, minutes or hours, whichever time increment is most appropriate. For example, if the assessment of the patient yields a possible time of 20 minutes, then 20 minutes should be documented in the "how long?" section.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18450 Military Acute Concussion Evaluation (MACE) - Delayed recall bubble score MACEDlydRcllBubblScore Delayed recall bubble score, as part of Military Acute Concussion Evaluation (MACE) Delayed recall bubble score, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18482 Military Acute Concussion Evaluation (MACE) - Incident description hit head indicator MACEIncdntDescrptHitHeadInd Indicator of whether or not the subject hit his or her head, as part of Military Acute Concussion Evaluation (MACE) Indicator of whether or not the subject hit his or her head, as part of Military Acute Concussion Evaluation (MACE Did you hit your head? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Ask for a description of the incident that resulted in the injury; how the injury occurred, type of force.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07272 Military Acute Concussion Evaluation (MACE) - Delayed recall score MACEDlydRcllScore Delayed recall total score (0-5), as part of Military Acute Concussion Evaluation (MACE) Delayed recall total score (0-5), as part of Military Acute Concussion Evaluation (MACE Delayed Recall Total Score Numeric Values

See instructions on form

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 5
C18461 Military Acute Concussion Evaluation (MACE) - Delayed recall sandwich form B score MACEDlydRcllSandwichFormBScore Delayed recall sandwich from form B, as part of Military Acute Concussion Evaluation (MACE) Delayed recall sandwich from form B, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C20387 Military Acute Concussion Evaluation (MACE) - Unremembered events after time unit of measure MACEUnrememEvntAfterTmUoM Unit of measure for the duration of time of unremembered events from after the trauma, as part of Military Acute Concussion Evaluation (MACE) Unit of measure for the duration of time of unremembered events from after the trauma, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Second;Minute;Hour;Day Second;Minute;Hour;Day Alphanumeric

Assess time until continuous memory after the injury. Determine whether and length of time that the person wasn't registering continuous memory both prior to injury and after the injury. Approximate the amount of time in seconds, minutes or hours, whichev

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18440 Military Acute Concussion Evaluation (MACE) - Concentration 718462 score MACEConc718462Score Subject's concentration score for correctly repeating the number 7-1-8-4-6-2 in reverse order then 5-3-9-1-4-8 also in reverse order , as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly repeating the number 7-1-8-4-6-2 in reverse order then 5-3-9-1-4-8 also in reverse order , as part of Military Acute Concussion Evaluation (MACE Reverse Digits 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18472 Military Acute Concussion Evaluation (MACE) - Immediate memory form C score MACEImmdtMemFormCScore Immediate memory score from form C, as part of Military Acute Concussion Evaluation (MACE) Immediate memory score from form C, as part of Military Acute Concussion Evaluation (MACE Immediate Memory Numeric Values Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

C07262 Military Acute Concussion Evaluation (MACE) - Unremembered events after time duration MACEUnrememEvntAfterTm Duration of time of unremembered events from after the trauma, as part of Military Acute Concussion Evaluation (MACE) Duration of time of unremembered events from after the trauma, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Numeric Values

Assess time until continuous memory after the injury. Determine whether and length of time that the person wasn't registering continuous memory both prior to injury and after the injury. Approximate the amount of time in seconds, minutes or hours, whichev

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points 255

Free-Form Entry

C18451 Military Acute Concussion Evaluation (MACE) - Delayed recall candle form B score MACEDlydRcllCandlFormBScore Delayed recall candle score from form B, as part of Military Acute Concussion Evaluation (MACE) Delayed recall candle score from form B, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18483 Military Acute Concussion Evaluation (MACE) - Orientation date score MACEOrientDateScore Orientation date score, as part of Military Acute Concussion Evaluation (MACE) Orientation date score, as part of Military Acute Concussion Evaluation (MACE Date 0;1 0;1 Numeric Values

Ask: WHAT IS THE DATE OR DAY OF THE MONTH? One point for each correct response for a total of 5 possible points. It should be noted that a correct response on time of day must be within 1 hour of the actual time.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07273 Military Acute Concussion Evaluation (MACE) - Total score MACETotScore The total score for the MACE (0-30), as part of Military Acute Concussion Evaluation (MACE) The total score for the MACE (0-30), as part of Military Acute Concussion Evaluation (MACE TOTAL SCORE Numeric Values

In studies of non-concussed patients, the mean total score was 28. Therefore, a score less than 30 does not imply that a concussion has occurred. Definitive normative data for a "cut-off" score are not available. However, scores below 25 may represent clinically relevant neurocognitive impairment and require further evaluation for the possibility of a more serious brain injury. The scoring system also takes on particular clinical significance during serial assessment where it can be used to document either a decline or an improvement in cognitive functioning.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 30
C18462 Military Acute Concussion Evaluation (MACE) - Delayed recall sugar form B score MACEDlydRcllSugrFormBScore Delayed recall sugar from form B, as part of Military Acute Concussion Evaluation (MACE) Delayed recall sugar from form B, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C20388 Military Acute Concussion Evaluation (MACE) - Individual loss consciousness time unit of measure MACEIndvdlLossConcsnTmUoM Unit of measure associated with the duration of those incidents where the subject reports losing consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE) Unit of measure associated with the duration of those incidents where the subject reports losing consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Second;Minute;Hour;Day Second;Minute;Hour;Day Alphanumeric

Determine whether and length of time of self reported loss of consciousness (LOC) or witnessed/observed LOC. Again, approximate the amount of time in second, minutes or hours, whichever time increment is most appropriate.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18441 Military Acute Concussion Evaluation (MACE) - Concentration form C score MACEDConcFormCScore Concentration score from form C, as part of Military Acute Concussion Evaluation (MACE) Concentration score from form C, as part of Military Acute Concussion Evaluation (MACE Concentration Numeric Values Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 5
C18473 Military Acute Concussion Evaluation (MACE) - Immediate memory iron form C score MACEImmdtMemryIronFormCScore Immediate memory iron score from form C, as part of Military Acute Concussion Evaluation (MACE) Immediate memory iron score from form C, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

1 point for each correct, total over 3 trials. Repeat two more times for a total of three trials. (1 point for each correct, total over 3 trials.) Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M GOING TO TEST YOUR MEMORY, I WILL READ YOU A LIST OF WORDS AND WHEN I AM DONE, REPEAT BACK AS MANY WORDS AS YOU CAN REMEMBER, IN ANY ORDER. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07263 Military Acute Concussion Evaluation (MACE) - Individual loss consciousness indicator MACEIndvdlLossConcsnInd Indicator of whether or not the individual reports loss of consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE) Indicator of whether or not the individual reports loss of consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE Does the individual report loss of consciousness or blacking out? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Determine whether and length of time of self reported loss of consciousness (LOC) or witnessed/observed LOC. Again, approximate the amount of time in second, minutes or hours, whichever time increment is most appropriate.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18452 Military Acute Concussion Evaluation (MACE) - Delayed recall carpet score MACEDlydRcllCarptScore Delayed recall carpet score, as part of Military Acute Concussion Evaluation (MACE) Delayed recall carpet score, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18484 Military Acute Concussion Evaluation (MACE) - Orientation month score MACEOrientMnthScore Orientation month score, as part of Military Acute Concussion Evaluation (MACE) Orientation month score, as part of Military Acute Concussion Evaluation (MACE Month 0;1 0;1 Numeric Values

Ask: WHAT MONTH IS THIS? One point for each correct response for a total of 5 possible points. It should be noted that a correct response on time of day must be within 1 hour of the actual time.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07274 Military Acute Concussion Evaluation (MACE) - Diagnosis name MACEDiagnNam The diagnosis based on the MACE total score, as part of Military Acute Concussion Evaluation (MACE) The diagnosis based on the MACE total score, as part of Military Acute Concussion Evaluation (MACE Diagnosis No concussion;850.0 Concussion without Loss of Consciousness (LOC);850.1 Concussion with Loss of Consciousness (LOC);Other diagnoses No concussion;850.0 Concussion without Loss of Consciousness (LOC);850.1 Concussion with Loss of Consciousness (LOC);Other diagnoses Alphanumeric

Circle the ICD-9 code that corresponds to the evaluation. If loss

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18463 Military Acute Concussion Evaluation (MACE) - Delayed recall sunset form C score MACEDlydRcllSunstFormCScore Delayed recall sunset score from form C, as part of Military Acute Concussion Evaluation (MACE) Delayed recall sunset score from form C, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test DO NOT reread the word list. 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C20389 Military Acute Concussion Evaluation (MACE) - Anyone loss consciousness time unit of measure MACEAnyoneLossConcsnTmUoM Unit of measure associated with the duration of time where anyone observed a period of loss of consciousness or unresponsiveness, as part of Military Acute Concussion Evaluation (MACE) Unit of measure associated with the duration of time where anyone observed a period of loss of consciousness or unresponsiveness, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Second;Minute;Hour;Day Second;Minute;Hour;Day Alphanumeric

Determine whether and length of time of self reported loss of consciousness (LOC) or witnessed/observed LOC. Again, approximate the amount of time in second, minutes or hours, whichever time increment is most appropriate.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18442 Military Acute Concussion Evaluation (MACE) - Concentration months score MACEConcMnthScore Subject's concentration score for correctly reciting the months in reverse order, as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly reciting the months in reverse order, as part of Military Acute Concussion Evaluation (MACE Months in reverse order 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18474 Military Acute Concussion Evaluation (MACE) - Immediate memory monkey form C score MACEImmdtMemryMnkyFormCScore Immediate memory monkey score from form C, as part of Military Acute Concussion Evaluation (MACE) Immediate memory monkey score from form C, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

1 point for each correct, total over 3 trials. Repeat two more times for a total of three trials. (1 point for each correct, total over 3 trials.) Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M GOING TO TEST YOUR MEMORY, I WILL READ YOU A LIST OF WORDS AND WHEN I AM DONE, REPEAT BACK AS MANY WORDS AS YOU CAN REMEMBER, IN ANY ORDER. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07264 Military Acute Concussion Evaluation (MACE) - Individual loss consciousness time duration MACEIndvdlLossConcsnTmDur Duration of incidents where the subject reports losing consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE) Duration of incidents where the subject reports losing consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Numeric Values

Determine whether and length of time of self reported loss of consciousness (LOC) or witnessed/observed LOC. Again, approximate the amount of time in second, minutes or hours, whichever time increment is most appropriate.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points 255

Free-Form Entry

C18453 Military Acute Concussion Evaluation (MACE) - Delayed recall elbow score MACEDlydRcllElbowScore Delayed recall elbow score, as part of Military Acute Concussion Evaluation (MACE) Delayed recall elbow score, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18485 Military Acute Concussion Evaluation (MACE) - Orientation time score MACEOrientTmScore Orientation time score, as part of Military Acute Concussion Evaluation (MACE) Orientation time score, as part of Military Acute Concussion Evaluation (MACE Time 0;1 0;1 Numeric Values

Ask: WHAT TIME DO YOU THINK IT IS? One point for each correct response for a total of 5 possible points. It should be noted that a correct response on time of day must be within 1 hour of the actual time.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18432 Military Acute Concussion Evaluation (MACE) - Incident description subject remember text MACEIncdntDescrptSubjRemmbrTxt Description of incident of what the subject remembers, as part of Military Acute Concussion Evaluation (MACE) Description of incident of what the subject remembers, as part of Military Acute Concussion Evaluation (MACE Tell me what you remember. Alphanumeric

Ask for a description of the incident that resulted in the injury; how the injury occurred, type of force.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points 4000

Free-Form Entry

C18464 Military Acute Concussion Evaluation (MACE) - Delayed recall wagon form B score MACEDlydRcllWagnFormBScore Delayed recall wagon from form B, as part of Military Acute Concussion Evaluation (MACE) Delayed recall wagon from form B, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C20390 Military Acute Concussion Evaluation (MACE) - Concentration form B score MACEConcFormBScore Concentration score from form B, as part of Military Acute Concussion Evaluation (MACE) Concentration score from form B, as part of Military Acute Concussion Evaluation (MACE Concentration Numeric Values

See instructions on form

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 5
C18443 Military Acute Concussion Evaluation (MACE) - Concentration recall 1795 form B score MACEConcRcll1795FormBScore Subject's concentration score for correctly repeating the number 1-7-9-5 in reverse order then 4-9-6-8 also in reverse order , as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly repeating the number 1-7-9-5 in reverse order then 4-9-6-8 also in reverse order , as part of Military Acute Concussion Evaluation (MACE Reverse Digits 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18475 Military Acute Concussion Evaluation (MACE) - Immediate memory perfume form C score MACEImmdtMemryPerfmFormCScore Immediate memory perfume score from form C, as part of Military Acute Concussion Evaluation (MACE) Immediate memory perfume score from form C, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

1 point for each correct, total over 3 trials. Repeat two more times for a total of three trials. (1 point for each correct, total over 3 trials.) Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M GOING TO TEST YOUR MEMORY, I WILL READ YOU A LIST OF WORDS AND WHEN I AM DONE, REPEAT BACK AS MANY WORDS AS YOU CAN REMEMBER, IN ANY ORDER. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07265 Military Acute Concussion Evaluation (MACE) - Anyone loss consciousness indicator MACEAnyoneLossConcsnInd Indicator of whether or not anyone observed a period of loss of consciousness or unresponsiveness, as part of Military Acute Concussion Evaluation (MACE) Indicator of whether or not anyone observed a period of loss of consciousness or unresponsiveness, as part of Military Acute Concussion Evaluation (MACE Did anyone observe a period of loss of consciousness or unresponsiveness? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Determine whether and length of time of self reported loss of consciousness (LOC) or witnessed/observed LOC. Again, approximate the amount of time in second, minutes or hours, whichever time increment is most appropriate.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18454 Military Acute Concussion Evaluation (MACE) - Delayed recall form B score MACEDlydRcllFormBScore Delayed recall total score (0-5) from form B, as part of Military Acute Concussion Evaluation (MACE) Delayed recall total score (0-5) from form B, as part of Military Acute Concussion Evaluation (MACE Delayed Recall Numeric Values Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 5
C18486 Military Acute Concussion Evaluation (MACE) - Orientation weekday score MACEOrientWeekdayScore Orientation weekday score, as part of Military Acute Concussion Evaluation (MACE) Orientation weekday score, as part of Military Acute Concussion Evaluation (MACE Day of Week 0;1 0;1 Numeric Values

Ask: WHAT DAY OF THE WEEK IS IT?One point for each correct response for a total of 5 possible points. It should be noted that a correct response on time of day must be within 1 hour of the actual time.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18433 Military Acute Concussion Evaluation (MACE) - Concentration 142 form C score MACEConc142FormCScore Subject's concentration score for correctly repeating the number 1-4-2 in reverse order then 6-5-8 also in reverse order , as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly repeating the number 1-4-2 in reverse order then 6-5-8 also in reverse order , as part of Military Acute Concussion Evaluation (MACE Reverse Digits 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18465 Military Acute Concussion Evaluation (MACE) - Immediate memory apple score MACEImmdtMemryApplScore Immediate memory apple score, as part of Military Acute Concussion Evaluation (MACE) Immediate memory apple score, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

1 point for each correct, total over 3 trials. Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M GOING TO TEST YOUR MEMORY, I WILL READ YOU A LIST OF WORDS AND WHEN I AM DONE, REPEAT BACK AS MANY WORDS AS YOU CAN REMEMBER, IN ANY ORDER. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18444 Military Acute Concussion Evaluation (MACE) - Concentration recall 48527 form B score MACEConcRcll48527FormBScore Subject's concentration score for correctly repeating the number 4-8-5-2-7 in reverse order then 6-1-8-4-3 also in reverse order , as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly repeating the number 4-8-5-2-7 in reverse order then 6-1-8-4-3 also in reverse order , as part of Military Acute Concussion Evaluation (MACE Reverse Digits 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18476 Military Acute Concussion Evaluation (MACE) - Immediate memory saddle score MACEImmdtMemrySddlScore Immediate memory saddle score, as part of Military Acute Concussion Evaluation (MACE) Immediate memory saddle score, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

1 point for each correct, total over 3 trials. Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M GOING TO TEST YOUR MEMORY, I WILL READ YOU A LIST OF WORDS AND WHEN I AM DONE, REPEAT BACK AS MANY WORDS AS YOU CAN REMEMBER, IN ANY ORDER. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07255 Military Acute Concussion Evaluation (MACE) - Incident description text MACEIncdntDescrptTxt Description of incident of what happened to the subject, as part of Military Acute Concussion Evaluation (MACE) Description of incident of what happened to the subject, as part of Military Acute Concussion Evaluation (MACE Ask: What happened? Alphanumeric

Ask for a description of the incident that resulted in the injury; how the injury occurred, type of force.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points 4000

Free-Form Entry

C07266 Military Acute Concussion Evaluation (MACE) - Anyone loss consciousness time duration MACEAnyoneLossConcsnTmDur Duration of time where anyone observed a period of loss of consciousness or unresponsiveness, as part of Military Acute Concussion Evaluation (MACE) Duration of time where anyone observed a period of loss of consciousness or unresponsiveness, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Numeric Values

Determine whether and length of time of self reported loss of consciousness (LOC) or witnessed/observed LOC. Again, approximate the amount of time in second, minutes or hours, whichever time increment is most appropriate.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points 255

Free-Form Entry

C18455 Military Acute Concussion Evaluation (MACE) - Delayed recall form C score MACEDlydRcllFormCScore Delayed recall score from form C, as part of Military Acute Concussion Evaluation (MACE) Delayed recall score from form C, as part of Military Acute Concussion Evaluation (MACE Delayed Recall Numeric Values Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 5
C18487 Military Acute Concussion Evaluation (MACE) - Orientation year score MACEOrientYrScore Orientation year score, as part of Military Acute Concussion Evaluation (MACE) Orientation year score, as part of Military Acute Concussion Evaluation (MACE Year 0;1 0;1 Numeric Values

Ask: WHAT YEAR IS IT? One point for each correct response for a total of 5 possible points. It should be noted that a correct response on time of day must be within 1 hour of the actual time.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18434 Military Acute Concussion Evaluation (MACE) - Concentration 376519 form C score MACEConc376519FormCScore Subject's concentration score for correctly repeating the number 3-7-6-5-1-9 in reverse order then 9-2-6-5-1-4 also in reverse order , as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly repeating the number 3-7-6-5-1-9 in reverse order then 9-2-6-5-1-4 also in reverse order , as part of Military Acute Concussion Evaluation (MACE Reverse Digits 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18466 Military Acute Concussion Evaluation (MACE) - Immediate memory baby form C score MACEImmdtMemryBabyFormCScore Immediate memory baby score from form C, as part of Military Acute Concussion Evaluation (MACE) Immediate memory baby score from form C, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

1 point for each correct, total over 3 trials. Repeat two more times for a total of three trials. (1 point for each correct, total over 3 trials.) Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M GOING TO TEST YOUR MEMORY, I WILL READ YOU A LIST OF WORDS AND WHEN I AM DONE, REPEAT BACK AS MANY WORDS AS YOU CAN REMEMBER, IN ANY ORDER. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18445 Military Acute Concussion Evaluation (MACE) - Concentration recall 526 form B score MACEConcRcll526FormBScore Subject's concentration score for correctly repeating the number 5-2-6 in reverse order then 4-1-5 also in reverse order , as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly repeating the number 5-2-6 in reverse order then 4-1-5 also in reverse order , as part of Military Acute Concussion Evaluation (MACE Reverse Digits 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18477 Military Acute Concussion Evaluation (MACE) - Immediate memory sandwich form B score MACEImmdtMemSandwchFormBScore Immediate memory sandwich score from form B, as part of Military Acute Concussion Evaluation (MACE) Immediate memory sandwich score from form B, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

Repeat two more times for a total of three trials. (1 point for each correct, total over 3 trials.) Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M GOING TO TEST YOUR MEMORY, I WILL READ YOU A LIST OF WORDS AND WHEN I AM DONE, REPEAT BACK AS MANY WORDS AS YOU CAN REMEMBER, IN ANY ORDER. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07256 Military Acute Concussion Evaluation (MACE) - Injury cause type MACEIncdntCauseTyp Type of injury cause, as part of Military Acute Concussion Evaluation (MACE) Type of injury cause, as part of Military Acute Concussion Evaluation (MACE Cause of injury 1;2;3;4;5;6;7 Explosion/Blast;Blunt object;Motor vehicle crash;Fragment;Fall;Gunshot wound;Other, specify Numeric values

Circle all that apply. Indicate the cause of injury.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Multiple Pre-Defined Values Selected

C07267 Military Acute Concussion Evaluation (MACE) - Symptom type MACESympTyp Type of symptom experienced at the time of the incident as part of Military Acute Concussion Evaluation (MACE) Type of symptom experienced at the time of the incident as part of Military Acute Concussion Evaluation (MACE Symptoms 1;2;3;4;5;6;7;8;9;10 Headache;Dizziness;Memory Problems;Balance Problems;Nausea/Vomiting;Difficulty Concentrating;Irritability;Visual Disturbances;Ringing in the ears;Other, specify Numeric Values

Ask the person to report their experience of each specific symptom since injury.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Multiple Pre-Defined Values Selected

C18456 Military Acute Concussion Evaluation (MACE) - Delayed recall iron form C score MACEDlydRcllIronFormCScore Delayed recall iron score from form C, as part of Military Acute Concussion Evaluation (MACE) Delayed recall iron score from form C, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test DO NOT reread the word list. 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

CSV