CDE Detailed Report

Disease: Sport-Related Concussion
Subdomain Name: Post-Concussive / Mild TBI-Related Symptoms
CRF: Sport Concussion Assessment Tool - 3rd Edition (SCAT3)

Displaying 1 - 50 of 114
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
C52499 Standardized Assessment of Concussion (SAC) - Immediate memory Trial 3 Item 3 score SACImmMemT3Item3Score The score the subject received on Item 3 (default carpet) of Trial 3 of the Immediate section of the Standardized Assessment of Concussion (SAC) The score the subject received on Item 3 (default carpet) of Trial 3 of the Immediate section of the Standardized Assessment of Concussion (SAC carpet Trial 3 0;1 0;1 Numeric Values

I am going to repeat the same list again. Repeat back as many words as you can remember in any order, even if you said the word before.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52430 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Blank vacant look indicator SCAT3BlankVacLookInd The indicator relating to whether or not the subject has a blank or vacant look on his or her face, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The indicator relating to whether or not the subject has a blank or vacant look on his or her face, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Blank or vacant look: Y;N Yes;No Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-18 14:23:09.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52467 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation fatigue low energy score SCAT3SymptmEvalFatLowEngScore The score pertaining to how much the subject feels fatigued or like he/she has low energy, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The score pertaining to how much the subject feels fatigued or like he/she has low energy, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Fatigue or low energy 0;1;2;3;4;5;6 None;Mild;mild;Moderate;Moderate;Severe;Severe Numeric Values

You should score yourself on the following symptoms, based on how you feel now

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Exploratory 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C01001 Glasgow Coma Scale (GCS) - motor response scale GCSMotorRespnsScale Glasgow Coma Scale (GCS) - Best motor response (M). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response Glasgow Coma Scale (GCS) - Best motor response (M). The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal respons Best motor response (M) 1;2;3;4;5;6 No motor response;Abnormal extension/Extensor response;Abnormal flexion;Flexion withdrawal/withdraws from pain;Localizes pain;Obeys command Numeric Values 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C124725
C52510 Standardized Assessment of Concussion (SAC) - Concentration digit backward total score SACConcDBTotalScore The total score the subject received on the Concentration: Digits Backward section of the Standardized Assessment of Concussion (SAC) The total score the subject received on the Concentration: Digits Backward section of the Standardized Assessment of Concussion (SAC Total of 4 Numeric Values 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

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C52446 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Headache migraine diagnosis indicator SCAT3HeadMigrDiagnsInd Indicator of whether the subject has ever been diagnosed with a headache or migraine, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Indicator of whether the subject has ever been diagnosed with a headache or migraine, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Have you ever been diagnosed with headaches or migraines? Y;N Yes;No Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52478 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation worse with mental activity indicator SCAT3SymptmEvalWorMenActInd The indicator relating to whether or not the subject's symptoms get worse with mental activity, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The indicator relating to whether or not the subject's symptoms get worse with mental activity, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Do the symptoms get worse with mental activity? Y;N Yes;No Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52489 Standardized Assessment of Concussion (SAC) - Immediate memory Trial 1 Item 3 score SACImmMemT1Item3Score The score the subject received on Item 3 (default carpet) of Trial 1 of the Immediate section of the Standardized Assessment of Concussion (SAC) The score the subject received on Item 3 (default carpet) of Trial 1 of the Immediate section of the Standardized Assessment of Concussion (SAC carpet Trial 1 0;1 0;1 Numeric Values

I am 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.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21566 Footwear use type FootwearUseTyp The type related to footwear used The type related to footwear use Footwear (shoes, barefoot, braces, tape, etc.) Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2015-07-28 11:30:40.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points 255

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C52527 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Scoring summary date SCAT3ScorSummDate The date on which the subject's scoring summary is recorded, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The date on which the subject's scoring summary is recorded, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Date Date or Date & Time 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

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C52457 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation dizziness score SCAT3SymptmEvalDizzScore The score pertaining to how much the subject experiences dizziness, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The score pertaining to how much the subject experiences dizziness, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Dizziness 0;1;2;3;4;5;6 None;Mild;mild;Moderate;Moderate;Severe;Severe Numeric Values

You should score yourself on the following symptoms, based on how you feel now

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52500 Standardized Assessment of Concussion (SAC) - Immediate memory Trial 3 Item 4 score SACImmMemT3Item4Score The score the subject received on Item 4 (default saddle) of Trial 3 of the Immediate section of the Standardized Assessment of Concussion (SAC) The score the subject received on Item 4 (default saddle) of Trial 3 of the Immediate section of the Standardized Assessment of Concussion (SAC saddle Trial 3 0;1 0;1 Numeric Values

I am going to repeat the same list again. Repeat back as many words as you can remember in any order, even if you said the word before.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52431 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Visible facial injury combination indicator SCAT3VisiFacInjComboInd The indicator relating to whether or not the subject has a visible facial injury in combination with any of the signs previously mentioned, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The indicator relating to whether or not the subject has a visible facial injury in combination with any of the signs previously mentioned, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Visible facial injury in combination with any of the above: Y;N Yes;No Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-18 14:23:09.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52468 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation confusion score SCAT3SymptmEvalConfScore The score pertaining to how much the subject feels confused, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The score pertaining to how much the subject feels confused, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Confusion 0;1;2;3;4;5;6 None;Mild;mild;Moderate;Moderate;Severe;Severe Numeric Values

To be completed by the athlete. in situations where the symptom scale is being completed after exercise, it should still be done in a resting state, at least 10 minutes post exercise.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C01002 Glasgow Coma Scale (GCS) - verbal response scale GCSVerbalRspnsScale Score that describes the participant's verbal response according to the Glasgow Coma Scale (GCS) Score that describes the participant's verbal response according to the Glasgow Coma Scale (GCS) Best verbal response (V) 1;2;3;4;5 No verbal response/sounds;Incomprehensible sound;Inappropriate words;Confused;Oriented Numeric Values

GCS should be recoded for all athletes in case of subsequent deterioration

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C124726
C52511 Standardized Assessment of Concussion (SAC) - Concentration month reverse order score SACConcMoRevOrderScore The score the subject received on the Concentration: Month in Reverse Order section of the Standardized Assessment of Concussion (SAC) The score the subject received on the Concentration: Month in Reverse Order section of the Standardized Assessment of Concussion (SAC Dec-Nov-Oct-Sept-Aug-Jul-Jun-May-Apr-Mar-Feb-Jan 0;1 0;1 Numeric Values

Now tell me the months of the year in reverse order. Start with the last month and go
backward. So you'll say December, November … Go ahead

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52447 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Hospitalized medical imaging head injury indicator SCAT3HosMedImgngHeadInjInd The indicator relating to whether or not the subject has ever been hospitalized or had medical imaging done for a head injury, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The indicator relating to whether or not the subject has ever been hospitalized or had medical imaging done for a head injury, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Have you ever been hospitalized or hd medical imaging done for a head injury? Y;N Yes;No Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-18 15:13:32.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52479 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation rating type SCAT3SymptmEvalRatTyp Type representing how the Symptom Evaluation was rated and who rated it, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Type representing how the Symptom Evaluation was rated and who rated it, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Rater self rated;self rated and clinician monitored;self rated with parent input;clinician interview self rated;self rated and clinician monitored;self rated with parent input;clinician interview Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52490 Standardized Assessment of Concussion (SAC) - Immediate memory Trial 1 Item 4 score SACImmMemT1Item4Score The score the subject received on Item 4 (default saddle) of Trial 1 of the Immediate section of the Standardized Assessment of Concussion (SAC) The score the subject received on Item 4 (default saddle) of Trial 1 of the Immediate section of the Standardized Assessment of Concussion (SAC saddle Trial 1 0;1 0;1 Numeric Values

I am 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.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C50680 Examiner name ExaminerName The name of the person performing the exam The name of the person performing the exa Examiner Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2016-12-12 00:00:00.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points 255

Free-Form Entry

C52528 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Mechanism of injury text SCAT3MechInjTxt Text describing the mechanism of the subject's injury (i.e., what happened), as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Text describing the mechanism of the subject's injury (i.e., what happened), as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Notes: Mechanism of Injury ("tell me what happened"?) Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points 4000

Free-Form Entry

C52458 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation blurred vision score SCAT3SymptmEvalBlurVisScore The score pertaining to how much the subject has blurred vision, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The score pertaining to how much the subject has blurred vision, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Blurred vision 0;1;2;3;4;5;6 None;Mild;mild;Moderate;Moderate;Severe;Severe Numeric Values

You should score yourself on the following symptoms, based on how you feel now.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52501 Standardized Assessment of Concussion (SAC) - Immediate memory Trial 3 Item 5 score SACImmMemT3Item5Score The score the subject received on Item 5 (default bubble) of Trial 3 of the Immediate section of the Standardized Assessment of Concussion (SAC) The score the subject received on Item 5 (default bubble) of Trial 3 of the Immediate section of the Standardized Assessment of Concussion (SAC bubble Trial 3 0;1 0;1 Numeric Values

I am going to repeat the same list again. Repeat back as many words as you can remember in any order, even if you said the word before.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52437 Maddocks Score - Venue today score MaddocksVenueTodayScore The score the subject received on first question (venue today question) of the Maddocks Score The score the subject received on first question (venue today question) of the Maddocks Scor What venue are we at today? 0;1 0;1 Numeric Values

I am going to ask you a few questions, please listen carefully and give your best effort.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-18 14:31:26.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

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C52469 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation drowsiness score SCAT3SymptmEvalDrowScore The score pertaining to how much the subject feels drowsiness, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The score pertaining to how much the subject feels drowsiness, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Drowsiness 0;1;2;3;4;5;6 None;Mild;mild;Moderate;Moderate;Severe;Severe Numeric Values

You should score yourself on the following symptoms, based on how you feel now

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C01016 Glasgow Coma Scale (GCS) - total score GCSTotalScore Glasgow Coma Scale (GCS) - Total Score. The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. The total score is the sum of the scores for the three response types. (3-15) Glasgow Coma Scale (GCS) - Total Score. The GCS is a standardized instrument for assessing the level of consciousness. It evaluates three aspects of responsiveness: eye opening, motor response, verbal response. The total score is the sum of the scores for the three response types. (3-15 Galsgow Coma score (E + V + M) 3;4;5;6;7;8;9;10;11;12;13;14;15;Untestable;Unknown 3;4;5;6;7;8;9;10;11;12;13;14;15;Untestable;Unknown Numeric Values

GCS should be recoded for all athletes in case of subsequent deterioration

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C124727
C52512 Standardized Assessment of Concussion (SAC) - Concentration total score SACConcTotalScore The total score the subject received on the Concentration section of the Standardized Assessment of Concussion (SAC) The total score the subject received on the Concentration section of the Standardized Assessment of Concussion (SAC Concentration score Numeric Values 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

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C52448 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Learning disability dyslexia ADD ADHD indicator SCAT3LearnDisDysADDADHDInd The indicator relating to whether or not the subject has a learning disability, dyslexia, or ADD/ADHD, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The indicator relating to whether or not the subject has a learning disability, dyslexia, or ADD/ADHD, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Do you have a learning disability, dyslexia, or ADD/ADHD? Y;N Yes;No Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-18 15:13:32.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52480 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation overall rating status SCAT3SymptmEvalOverRatStat The status of the subject, compared before and after the injury in the eyes of the rater, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The status of the subject, compared before and after the injury in the eyes of the rater, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Overall rating: If you know the athlete well prior to the injury, how different is the athlete acting compared to his/her usual self? No different;Very different;Unsure;N/A No different;Very different;Unsure;N/A Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52491 Standardized Assessment of Concussion (SAC) - Immediate memory Trial 1 Item 5 score SACImmMemT1Item5Score The score the subject received on Item 5 (default bubble) of Trial 1 of the Immediate section of the Standardized Assessment of Concussion (SAC) The score the subject received on Item 5 (default bubble) of Trial 1 of the Immediate section of the Standardized Assessment of Concussion (SAC bubble Trial 1 0;1 0;1 Numeric Values

I am 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.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C51670 School name SchoolName The name of the school that the subject currently attends, if applicable The name of the school that the subject currently attends, if applicabl Sport/team/school Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2016-12-12 00:00:00.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points 255

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C52459 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation balance problem score SCAT3SymptmEvalBalProbScore The score pertaining to how much the subject has balance problems, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The score pertaining to how much the subject has balance problems, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Balance problems 0;1;2;3;4;5;6 None;Mild;mild;Moderate;Moderate;Severe;Severe Numeric Values

You should score yourself on the following symptoms, based on how you feel now

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52502 Standardized Assessment of Concussion (SAC) - Immediate memory Trial 1 total score SACImmMemT1TotalScore The total score the subject received on Trial 1 of the Immediate section of the Standardized Assessment of Concussion (SAC) The total score the subject received on Trial 1 of the Immediate section of the Standardized Assessment of Concussion (SAC Trial 1 Total Numeric Values 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

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C52438 Maddocks Score - Half game score MaddocksHalfGameScore The score the subject received on second question (half of game question) of the Maddocks Score The score the subject received on second question (half of game question) of the Maddocks Scor Which half is it now? 0;1 0;1 Numeric Values

I am going to ask you a few questions, please listen carefully and give your best effort.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-18 14:31:26.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52470 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation trouble falling asleep score SCAT3SymptmEvalTroFallAslScore The score pertaining to how much the subject has trouble falling asleep, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The score pertaining to how much the subject has trouble falling asleep, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Trouble falling asleep 0;1;2;3;4;5;6 None;Mild;mild;Moderate;Moderate;Severe;Severe Numeric Values

You should score yourself on the following symptoms, based on how you feel now

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C05400 Injury date time InjDateTime Date (and time, if applicable and known) of injury Date (and time, if applicable and known) of injury Date/Time of Injury Date or Date & Time 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

C52513 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Neck Examination type SCAT3NeckExamTyp The type of neck examination the subject received, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The type of neck examination the subject received, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Neck Examination Range of motion;Tenderness;Upper and lower limb sensation & strength Range of motion;Tenderness;Upper and lower limb sensation & strength Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52449 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Psychiatric disorder diagnosis indicator SCAT3PsychDisDiagnosInd The indicator relating to whether or not the subject has ever been diagnosed with depression, anxiety, or another psychiatric disorder, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The indicator relating to whether or not the subject has ever been diagnosed with depression, anxiety, or another psychiatric disorder, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Have you ever been diagnosed with depression, anxiety, or other psychiatric disorder? Y;N Yes;No Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-18 15:13:32.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52481 Standardized Assessment of Concussion (SAC) - Orientation month score SACOrientMnthScore The score of the first question (month question) of the Orientation section of the Standardized Assessment of Concussion (SAC) The score of the first question (month question) of the Orientation section of the Standardized Assessment of Concussion (SAC What month is it? 0;1 0;1 Numeric Values 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52492 Standardized Assessment of Concussion (SAC) - Immediate memory Trial 2 Item 1 score SACImmMemT2Item1Score The score the subject received on Item 1 (default elbow) of Trial 2 of the Immediate section of the Standardized Assessment of Concussion (SAC) The score the subject received on Item 1 (default elbow) of Trial 2 of the Immediate section of the Standardized Assessment of Concussion (SAC elbow Trial 2 0;1 0;1 Numeric Values

I am going to repeat the same list again. Repeat back as many words as you can remember in any order, even if you said the word before.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52423 Sport Concussion Assessment Tool (SCAT) - Loss consciousness indicator SCATLossConcsnInd Indicator of whether or not the individual reports loss of consciousness , as part of the Sport Concussion Assessment Tool (SCAT) Indicator of whether or not the individual reports loss of consciousness , as part of the Sport Concussion Assessment Tool (SCAT) Any loss of consciousness? No;Yes No;Yes Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52460 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation sensitivity to light score SCAT3SymptmEvalSensLightScore The score pertaining to how sensitive the subject is to light, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The score pertaining to how sensitive the subject is to light, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Sensitivity to light 0;1;2;3;4;5;6 None;Mild;mild;Moderate;Moderate;Severe;Severe Numeric Values

You should score yourself on the following symptoms, based on how you feel now

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52503 Standardized Assessment of Concussion (SAC) - Immediate memory Trial 2 total score SACImmMemT2TotalScore The total score the subject received on Trial 2 of the Immediate section of the Standardized Assessment of Concussion (SAC) The total score the subject received on Trial 2 of the Immediate section of the Standardized Assessment of Concussion (SAC Trial 2 Total Numeric Values 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

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0 5
C52439 Maddocks Score - Last match score MaddocksMatchScore The score the subject received on third question (last match question) of the Maddocks Score The score the subject received on third question (last match question) of the Maddocks Scor Who scored last in this match? 0;1 0;1 Numeric Values

I am going to ask you a few questions, please listen carefully and give your best effort.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-18 14:31:26.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52471 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Symptom Evaluation more emotional score SCAT3SymptmEvalMoreEmoScore The score pertaining to how much the subject feels like he/she has been more emotional, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The score pertaining to how much the subject feels like he/she has been more emotional, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 More emotional 0;1;2;3;4;5;6 None;Mild;mild;Moderate;Moderate;Severe;Severe Numeric Values

You should score yourself on the following symptoms, based on how you feel now

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C19500 Assessment performed date AssessmentPerformedDate The date of assessment of the examination being performed The date of assessment of the examination being performed Date of Assessment Date or Date & Time 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2014-06-18 08:10:12.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

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C52514 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Neck Examination finding text SCAT3NeckExamFindTxt Text describing the findings from the subject's neck examination, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Text describing the findings from the subject's neck examination, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Findings: Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points 2000

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C52450 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) - Family diagnosis indicator SCAT3FmlyDiagnosInd The indicator relating to whether or not the subject's family has ever been diagnosed with any of the aforementioned problems, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3) The indicator relating to whether or not the subject's family has ever been diagnosed with any of the aforementioned problems, as part of the Sport Concussion Assessment Tool - 3rd Edition (SCAT3 Has anyone in your family ever been diagnosed wiith any of these problems? Y;N Yes;No Alphanumeric 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-18 15:13:32.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52482 Standardized Assessment of Concussion (SAC) - Orientation date score SACOrientDateScore The score of the second question (date question) of the Orientation section of the Standardized Assessment of Concussion (SAC) The score of the second question (date question) of the Orientation section of the Standardized Assessment of Concussion (SAC What is the date today? 0;1 0;1 Numeric Values 1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52493 Standardized Assessment of Concussion (SAC) - Immediate memory Trial 2 Item 2 score SACImmMemT2Item2Score The score the subject received on Item 2 (default apple) of Trial 2 of the Immediate section of the Standardized Assessment of Concussion (SAC) The score the subject received on Item 2 (default apple) of Trial 2 of the Immediate section of the Standardized Assessment of Concussion (SAC apple Trial 2 0;1 0;1 Numeric Values

I am going to repeat the same list again. Repeat back as many words as you can remember in any order, even if you said the word before.

1. This tool has been developed by a group of international experts at the 4th international Consensus meeting on Concussion in Sport held in Zurich, Switzerland in November 2012. The full details of the conference outcomes and the authors of the tool are published in the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012: McCrory et al., Br J Sports Med 2013;47(5). The outcome paper will also be simultaneously co-published in other leading biomedical journals with the copyright held by the Concussion in Sport<br />Group, to allow unrestricted distribution, providing no alterations are made.<br />2. McCrory et al., Consensus Statement on Concussion in Sport - the 3rd international Conference on Concussion in Sport held in Zurich, november 2008. British Journal of Sports medicine 2009; 43: i76-89.<br />3. Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-35. <br />4. McCrea M. Standardized mental status assessment of sports concussion. Clin J<br />Sport Med. 2001 Jul;11(3):176-81.<br />5. Guskiewicz KM. Assessment of postural stability following sport-related concussion. Curr Sports Med Rep. 2003;2(1):24-30.<br />6. Schneiders AG, Sullivan SJ, Gray AR, Hammond-Tooke GD, McCrory PR. Normative values for three clinical measures of motor performance used in the neurological assessment of sports concussion. J Sci Med Sport. 2010;13(2):196-201.<br />7. Schneiders AG, Sullivan SJ, Kvarnstr&Ouml;m J, Olsson M, Yd&Eacute;n T, Marshall S. The effect of footwear and sports-surface on dynamic neurological screening for sport-related concussion. J Sci Med Sport. 2010 Jul;13(4):382-386. Adult;Pediatric Supplemental 1.00 2017-01-19 08:45:04.0 Sport Concussion Assessment Tool - 3rd Edition (SCAT3) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

CSV