CDE Detailed Report

Disease: Traumatic Brain Injury
Sub-Domain: Post-concussive/TBI-Related Symptoms
CRF: Immediate Post-Concussion Assessment and Cognitive Testing (imPACT)

Displaying 1 - 50 of 109
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 / 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
C21414 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Falling asleep trouble score ImPACTPCSSTroubFallAsleepScore The subject's current trouble falling asleep rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current trouble falling asleep rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Trouble falling asleep 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21446 Immediate Post-Concussion Assessment Testing (ImPACT) - X and O interference total correct count ImPACTXOInterTotCorrCt The interference total correct on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The interference total correct on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Total correct (interference) Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0
C21382 Immediate Post-Concussion Assessment Testing (ImPACT) - Substance alcohol abuse treatment administered indicator ImPACTTreatSubAlcoholAbusInd Indicator of whether the subject has received treatment for substance or alcohol abuse, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Indicator of whether the subject has received treatment for substance or alcohol abuse, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Treatment for substance/alcohol abuse No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21425 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Slowed down assessment score ImPACTPCSSFeelSlowDownScore The subject's current feeling slowed down rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current feeling slowed down rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Feeling slowed down 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C00025 Language primary text LangPrimryTxt Text for the language the participant/subject speaks most often Text for the language the participant/subject speaks most often Native language eng;spa;sgn;chi;fre;ger;Other, specify English;Spanish;Sign Languages;Chinese languages;French;German;Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21457 Immediate Post-Concussion Assessment Testing (ImPACT) - Color match average commissions reaction time duration ImPACTColorMatchAvgCommRTDur The average commissions reaction time duration on the color match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The average commissions reaction time duration on the color match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Avg. commissions RT Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0
C21393 Immediate Post-Concussion Assessment Testing (ImPACT) - Visual memory composite score ImPACTVisMemoryCompScore Visual memory composite score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Visual memory composite score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Memory composite (visual) Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 100
C21436 Immediate Post-Concussion Assessment Testing (ImPACT) - Word memory delayed percent correct percentage value ImPACTWordMemDelayCorrPercVal The delayed memory percent correct number on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The delayed memory percent correct number on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Delayed memory pct. Correct Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 100
C21372 Immediate Post-Concussion Assessment Testing (ImPACT) - Loss of consciousness concussion result count ImPACTConcussResultLOCCt Number of concussions that resulted in loss of consciousness (LOC), as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Number of concussions that resulted in loss of consciousness (LOC), as part of the Immediate Post-Concussion Assessment Testing (ImPACT Concussions that resulted in loss of consciousness Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0
C21404 Immediate Post-Concussion Assessment Testing (ImPACT) - Impulse control Reliable Change Index (RCI) exceeded indicator ImPACTImplseCntrlRCIExceedInd Indicator of whether the subject's composite score in impulse control exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Indicator of whether the subject's composite score in impulse control exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21415 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Sleep greater than normal duration score ImPACTPCSSSlpMoreThnUsualScore The subject's current sleep more than usual rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current sleep more than usual rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Sleeping more than usual 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21447 Immediate Post-Concussion Assessment Testing (ImPACT) - X and O interference average correct reaction time duration ImPACTXOInterAvgCorrRTDur The interference average correct reaction time duration on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The interference average correct reaction time duration on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Avg. correct RT (interference) Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0
C21383 Immediate Post-Concussion Assessment Testing (ImPACT) - Psychiatric condition treatment administered indicator ImPACTTreatPsychiatricCondInd Indicator of whether the subject has received treatment for a psychiatric condition such as depression or anxiety, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Indicator of whether the subject has received treatment for a psychiatric condition such as depression or anxiety, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Treatment for psychiatric condition (depression, anxiety) No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21426 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Mental fog assessment score ImPACTPCSSFeelMentFogScore The subject's current feeling mentally foggy rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current feeling mentally foggy rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Feeling mentally foggy 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C02014 Medication prior or concomitant name MedctnPriorConcomName Name of the prior/concomitant agent or drug administered Name of the prior/concomitant agent or drug administere Prior or concomitant medication name Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points 4000

Free-Form Entry

3162728
C21458 Immediate Post-Concussion Assessment Testing (ImPACT) - Three letters total sequence correct count ImPACTThreeLetTotSeqCorrCt The number of total sequence items correct on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The number of total sequence items correct on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Total sequence correct Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 5
C21394 Immediate Post-Concussion Assessment Testing (ImPACT) - Visual memory composite percentage value ImPACTVisMemCompPercVal The percentile of the subject's visual memory composite score (if available), as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The percentile of the subject's visual memory composite score (if available), as part of the Immediate Post-Concussion Assessment Testing (ImPACT Memory composite (visual) Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 100
C21405 Immediate Post-Concussion Assessment Testing (ImPACT) - Total symptom Reliable Change Index (RCI) exceeded indicator ImPACTTotalSymptomRCIExceedInd Indicator of whether the subject's total symptom score exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Indicator of whether the subject's total symptom score exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21437 Immediate Post-Concussion Assessment Testing (ImPACT) - Word memory total percent correct percentage value ImPACTWordMemTotCorrPercVal The total percent correct on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The total percent correct on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Total percent correct Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 100
C21373 Immediate Post-Concussion Assessment Testing (ImPACT) - Confusion concussion result count ImPACTConcussResultConfCt Number of concussions that resulted in confusion, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Number of concussions that resulted in confusion, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Concussions that resulted in confusion Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0
C21416 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Sleep less than normal duration score ImPACTPCSSSlpLessThnUsualScore The subject's current sleep less than usual rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current sleep less than usual rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Sleeping less than usual 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21448 Immediate Post-Concussion Assessment Testing (ImPACT) - X and O interference total incorrect count ImPACTXOInterTotIncorrCt The interference total incorrect number on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The interference total incorrect number on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Total incorrect (interference) Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0
C21384 Immediate Post-Concussion Assessment Testing (ImPACT) - Dyslexia diagnosis indicator ImPACTDxDyslexiaInd Indicator of whether the subject has been diagnosed with dyslexia, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Indicator of whether the subject has been diagnosed with dyslexia, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Diagnosed with Dyslexia No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21427 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Concentration difficultly assessment score ImPACTPCSSDiffConcentrateScore The subject's current difficulty concentrating rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current difficulty concentrating rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Difficulty concentrating 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21363 Immediate Post-Concussion Assessment Testing (ImPACT) - Second language spoken year duration ImPACTSecondLanguageYrDur The count of years the subject spoke a language, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The count of years the subject spoke a language, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Years speaking Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0
C21459 Immediate Post-Concussion Assessment Testing (ImPACT) - Three letters total letters correct count ImPACTThreeLetTotLetCorrCt The number of total correct letters on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The number of total correct letters on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Total letters correct Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 15
C21395 Immediate Post-Concussion Assessment Testing (ImPACT) - Visual memory Reliable Change Index (RCI) exceeded indicator ImPACTVisMemRCIExceedInd Indicator of whether the subject's composite score in visual memory exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Indicator of whether the subject's composite score in visual memory exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21406 Immediate Post-Concussion Assessment Testing (ImPACT) - Cognitive efficiency index score ImPACTCogEfficiencyIndexScore Cognitive efficiency index score (CEI) is the subject's cognitive efficiency index score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Cognitive efficiency index score (CEI) is the subject's cognitive efficiency index score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Cognitive Efficiency Index: Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

-1 1
C21438 Immediate Post-Concussion Assessment Testing (ImPACT) - Design memory immediate hit count ImPACTDesignMemImmedHitCt The number of immediate hits on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The number of immediate hits on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Hits (Immediate) Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 12
C21374 Immediate Post-Concussion Assessment Testing (ImPACT) - Memory loss post injury concussion result count ImPACTConcussResMemLossAftCt Number of concussions that resulted in loss of memory of events immediately after injury, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Number of concussions that resulted in loss of memory of events immediately after injury, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Concussions that resulted in difficulty remembering events that occurred immediately after injury Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0
C21417 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Drowsiness score ImPACTPCSSDrowsinessScore The subject's current drowsiness rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current drowsiness rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Drowsiness 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21449 Immediate Post-Concussion Assessment Testing (ImPACT) - X and O interference average incorrect reaction time duration ImPACTXOInterAvgIncorrRTDur The interference average incorrect reaction time duration on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The interference average incorrect reaction time duration on the X's and O's module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Avg. incorrect RT (interfer.) Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0
C21385 Immediate Post-Concussion Assessment Testing (ImPACT) - Autism diagnosis indicator ImPACTDxAutismInd Indicator of whether the subject has been diagnosed with autism, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Indicator of whether the subject has been diagnosed with autism, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Diagnosed with Autism No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21428 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Memory difficulty assessment score ImPACTPCSSDiffRemeberScore The subject's current difficulty remembering rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current difficulty remembering rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Difficulty remembering 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21364 Immediate Post-Concussion Assessment Testing (ImPACT) - Speech therapy receive indicator ImPACTReceivedSpeechTherInd Indicator of whether the subject received speech therapy Indicator of whether the subject received speech therap Received speech therapy No;Yes No;Yes Alphanumeric

N/A

Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21460 Immediate Post-Concussion Assessment Testing (ImPACT) - Three letters percent of total letters correct percentage value ImPACTThreLetPctTotLetCorPVal The numeric percentage of total letters correct on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The numeric percentage of total letters correct on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Pct. of total letters correct Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 100
C21396 Immediate Post-Concussion Assessment Testing (ImPACT) - Visual motor speed composite score ImPACTVisMotSpeedCompScore Visual motor speed composite score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Visual motor speed composite score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Visual motor speed composite Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 100
C21407 Immediate Post-Concussion Assessment Testing (ImPACT) - Sleep last night hour duration ImPACTHoursSleptLstNghtDur Duration (in hours) the subject slept last night, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Duration (in hours) the subject slept last night, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Hours slept last night Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 24
C21439 Immediate Post-Concussion Assessment Testing (ImPACT) - Design memory immediate correct distractor count ImPACTDesignMemImmedCorrDisCt The number of immediate correct distractors identified on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The number of immediate correct distractors identified on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Correct distractors (immed.) Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 12
C21375 Immediate Post-Concussion Assessment Testing (ImPACT) - Memory loss prior injury concussion result count ImPACTConcussResMemLossBefCt Number of concussions that resulted in a loss of memory of the events that occurred before injury, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Number of concussions that resulted in a loss of memory of the events that occurred before injury, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Concussions that resulted in difficulty remembering events that occurred Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0
C21418 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Light sensitivity score ImPACTPCSSSensitiveLightScore The subject's current sensitivity to light rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current sensitivity to light rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Sensitivity to light 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21450 Immediate Post-Concussion Assessment Testing (ImPACT) - Symbol match visible total correct count ImPACTSymbMatchVisTotCorrCt The number of visible total correct responses on the symbol match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The number of visible total correct responses on the symbol match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Total correct (visible) Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 27
C21386 Immediate Post-Concussion Assessment Testing (ImPACT) - Strenuous exercise 3 hour duration indicator ImPACTStrenExerLst3HrInd Indicator of whether the subject did strenuous exercise in the last 3 hours, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Indicator of whether the subject did strenuous exercise in the last 3 hours, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Strenuous exercise in the last 3 hours No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21429 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Visual problem score ImPACTPCSSVisualProbScore The subject's current visual problems rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current visual problems rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Visual problems 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21365 Immediate Post-Concussion Assessment Testing (ImPACT) - School year repeat indicator ImPACTRepeatYrsSchoolInd Indicator of whether the subject has to repeat one or more years of school, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Indicator of whether the subject has to repeat one or more years of school, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Repeated one or more years of school No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21461 Immediate Post-Concussion Assessment Testing (ImPACT) - Three letters average time to first click duration ImPACTThreeLetAvgTmFstClickDur The duration of average time to first click on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The duration of average time to first click on the three letters module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Avg. time to first click Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

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0
C21397 Immediate Post-Concussion Assessment Testing (ImPACT) - Visual motor speed composite percentage value ImPACTVisMotSpeedCompPercVal The percentile of the subject's visual motor speed composite score (if available), as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The percentile of the subject's visual motor speed composite score (if available), as part of the Immediate Post-Concussion Assessment Testing (ImPACT Visual motor speed composite Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 100
C21408 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Headache score ImPACTPCSSHeadacheScore The subject's current headache rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current headache rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Headache 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21440 Immediate Post-Concussion Assessment Testing (ImPACT) - Design memory learning correct percentage value ImPACTDesignMemLrnCorrPercVal The learning percent correct number on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The learning percent correct number on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Learning percent correct Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 100
C21376 Immediate Post-Concussion Assessment Testing (ImPACT) - Game miss count ImPACTGamesMissedCt Total number of games missed as a result of concussions, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Total number of games missed as a result of concussions, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Total games missed as a result of all concussions combined Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-concussive/TBI-Related Symptoms Outcomes and End Points

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0
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