CDE Detailed Report
Disease: Epilepsy
Sub-Domain: Assessing Comorbidities
CRF: Adult ADHD Self-Report Scale (ASRS)
Displaying 1 - 7 of 7
Sub-Domain: Assessing Comorbidities
CRF: Adult ADHD Self-Report Scale (ASRS)
Displaying 1 - 7 of 7
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Additional Notes (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 / Guideline) | Sub Domain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C13052 | Adult ADHD Self-Report Scale (ASRS) - problem remembering appointments obligations frequency | ASRSProbRemberApptObligFreq | The frequency assessment for problems remembering appointments or obligations related to question in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | The frequency assessment for problems remembering appointments or obligations related to question in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | How often do you have problems remembering appointments or obligations? | Never;Rarely;Sometimes;Often;Very Often | Never;Rarely;Sometimes;Often;Very Often | Alphanumeric |
Check the box that best describes how you have felt and conducted yourself over the past 6 months. |
Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, Howes MJ, Jin R, Secnik K, Spencer T, Ustun TB, Walters EE. The World Health Organization Adult ADHD Self-Report Scale (ASRS). 2005. Psychological Medicine. 2005; 35(2): 245-56. | Adult | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Adult ADHD Self-Report Scale (ASRS) | Assessing Comorbidities | Outcomes and End Points |
Single Pre-Defined Value Selected |
||||||||
| C13053 | Adult ADHD Self-Report Scale (ASRS) - delay avoid task frequency | ASRSDelayAvoidTaskFreq | The frequency assessment for delaying or avoiding a task related to question in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | The frequency assessment for delaying or avoiding a task related to question in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | When you have a task that requires a lot of thought, how often do you avoid or delay getting started? | Never;Rarely;Sometimes;Often;Very Often | Never;Rarely;Sometimes;Often;Very Often | Alphanumeric |
Check the box that best describes how you have felt and conducted yourself over the past 6 months. |
Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, Howes MJ, Jin R, Secnik K, Spencer T, Ustun TB, Walters EE. The World Health Organization Adult ADHD Self-Report Scale (ASRS). 2005. Psychological Medicine. 2005; 35(2): 245-56. | Adult | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Adult ADHD Self-Report Scale (ASRS) | Assessing Comorbidities | Outcomes and End Points |
Single Pre-Defined Value Selected |
||||||||
| C13054 | Adult ADHD Self-Report Scale (ASRS) - fidget squirm frequency | ASRSFidgetSquirmFreq | The frequency assessment for fidgeting or squirming with hands or feet when sitting down for a long time related to question in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | The frequency assessment for fidgeting or squirming with hands or feet when sitting down for a long time related to question in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist. | How often do you fidget or squirm with your hands or feet when you have to sit down for a long time? | Never;Rarely;Sometimes;Often;Very Often | Never;Rarely;Sometimes;Often;Very Often | Alphanumeric |
Check the box that best describes how you have felt and conducted yourself over the past 6 months. |
Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, Howes MJ, Jin R, Secnik K, Spencer T, Ustun TB, Walters EE. The World Health Organization Adult ADHD Self-Report Scale (ASRS). 2005. Psychological Medicine. 2005; 35(2): 245-56. | Adult | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Adult ADHD Self-Report Scale (ASRS) | Assessing Comorbidities | Outcomes and End Points |
Single Pre-Defined Value Selected |
||||||||
| C13055 | Adult ADHD Self-Report Scale (ASRS) - overly active frequency | ASRSOverActiveFreq | The frequency assessment for feeing overly active and compelled to do things related question in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | The frequency assessment for feeing overly active and compelled to do things related question in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | How often do you feel overly active and compelled to do things, like you were driven by a motor? | Never;Rarely;Sometimes;Often;Very Often | Never;Rarely;Sometimes;Often;Very Often | Alphanumeric |
Check the box that best describes how you have felt and conducted yourself over the past 6 months. |
Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, Howes MJ, Jin R, Secnik K, Spencer T, Ustun TB, Walters EE. The World Health Organization Adult ADHD Self-Report Scale (ASRS). 2005. Psychological Medicine. 2005; 35(2): 245-56. | Adult | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Adult ADHD Self-Report Scale (ASRS) | Assessing Comorbidities | Outcomes and End Points |
Single Pre-Defined Value Selected |
||||||||
| C13056 | Adult ADHD Self-Report Scale (ASRS) - total score | ASRSTotalScore | The total score related to the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | The total score related to the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | Add the number of checkmarks that appear in the darkly shaded area. | 0;1;2;3;4;5;6 | 0;1;2;3;4;5;6 | Numeric Values |
Add the number of checkmarks that appear in the darkly shaded area. Four (4) or more checkmarks indicate that your symptoms may be consistent with adult ADHD. It may be beneficial for you to talk with your healthcare provider about an evaluation. |
Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, Howes MJ, Jin R, Secnik K, Spencer T, Ustun TB, Walters EE. The World Health Organization Adult ADHD Self-Report Scale (ASRS). 2005. Psychological Medicine. 2005; 35(2): 245-56. | Adult | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Adult ADHD Self-Report Scale (ASRS) | Assessing Comorbidities | Outcomes and End Points |
Single Pre-Defined Value Selected |
||||||||
| C13050 | Adult ADHD Self-Report Scale (ASRS) - wrapping up frequency | ASRSWrapUpFreq | The frequency assessment for trouble wrapping up final details in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | The frequency assessment for trouble wrapping up final details in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done? | Never;Rarely;Sometimes;Often;Very Often | Never;Rarely;Sometimes;Often;Very Often | Alphanumeric |
Check the box that best describes how you have felt and conducted yourself over the past 6 months. |
Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, Howes MJ, Jin R, Secnik K, Spencer T, Ustun TB, Walters EE. The World Health Organization Adult ADHD Self-Report Scale (ASRS). 2005. Psychological Medicine. 2005; 35(2): 245-56. | Adult | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Adult ADHD Self-Report Scale (ASRS) | Assessing Comorbidities | Outcomes and End Points |
Single Pre-Defined Value Selected |
||||||||
| C13051 | Adult ADHD Self-Report Scale (ASRS) - difficulty organizing frequency | ASRSDiffOrgFreq | The frequency assessment for diffculty getting things in order when you have to do a task that requires organization related to question in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist, a self-reported questionnaire used to assist in the diagnosis of adult ADHD. | The frequency assessment for difficulty getting things in order when you have to do a task that requires organization related to question in the Adult ADHD Self-Report Scale (ASRS) Symptom Checklist. | How often do you have difficulty getting things in order when you have to do a task that requires organization? | Never;Rarely;Sometimes;Often;Very Often | Never;Rarely;Sometimes;Often;Very Often | Alphanumeric |
Check the box that best describes how you have felt and conducted yourself over the past 6 months. |
Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, Howes MJ, Jin R, Secnik K, Spencer T, Ustun TB, Walters EE. The World Health Organization Adult ADHD Self-Report Scale (ASRS). 2005. Psychological Medicine. 2005; 35(2): 245-56. | Adult | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Adult ADHD Self-Report Scale (ASRS) | Assessing Comorbidities | Outcomes and End Points |
Single Pre-Defined Value Selected |
