CDE Detailed Report

Disease: Sport Related Concussion
Sub-Domain: Post-Concussive / Mild TBI-Related Symptoms
CRF: Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form)

Displaying 1 - 14 of 14
CDE ID CDE Name Variable Name Definition Short Description Question Text Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C52734 Post-Concussion Symptom Inventory for Children (PCSI-C) - Dizziness scale PCSICDizzinessScl Scale to which the subject appeared or complained of dizziness, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Scale to which the subject appeared or complained of dizziness, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Have you felt dizzy? (like things around you were spinning or moving) 0;1;2 No;A little;A lot Numeric Values

We would like to know if you have had any of these symptoms before your injury. Next, we would like to know if these symptoms have changed after your injury. I am going to ask you to tell me about your symptom at two points in time - Before the Injury and Yesterday / Today. Interviewer: Please circle only one answer.

Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 1.00 2016-12-29 16:00:33.0 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52750 Post-Concussion Symptom Inventory for Children (PCSI-C) - Irritability scale PCSICIrritabilityScl Scale to which the subject expressed irritability, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Scale to which the subject expressed irritability, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Have you felt grumpy? (like you were in a bad mood) 0;1;2 No;A little;A lot Numeric Values

We would like to know if you have had any of these symptoms before your injury. Next, we would like to know if these symptoms have changed after your injury. I am going to ask you to tell me about your symptom at two points in time - Before the Injury and Yesterday / Today. Interviewer: Please circle only one answer.

Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 1.00 2016-12-29 16:14:44.0 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52763 Post-Concussion Symptom Inventory for Children (PCSI-C) - Hard pay attention scale PCSICHardPayAttentionScl Scale to which the subject expressed that it has been hard for them to pay attention to what they are doing, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Scale to which the subject expressed that it has been hard for them to pay attention to what they are doing, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Has it been hard for you to pay attention to what you are doing? (like homework or chores, listening to someone, or playing a game) 0;1;2 No;A little;A lot Numeric Values

We would like to know if you have had any of these symptoms before your injury. Next, we would like to know if these symptoms have changed after your injury. I am going to ask you to tell me about your symptom at two points in time - Before the Injury and Yesterday / Today. Interviewer: Please circle only one answer.

Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 1.00 2016-12-29 15:20:57.0 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C00007 Birth date BirthDate Date (and time, if applicable and known) the participant/subject was born Date (and time, if applicable and known) the participant/subject was born Birthdate: Date or Date & Time Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

793
C52766 Post-Concussion Symptom Inventory for Children (PCSI-C) - Feel different than usual scale PCSICFeelDifferentThanUsualScl Scale to which the subject feels differently than usual, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Scale to which the subject feels differently than usual, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Do you feel "different" than usual? 0;1;2 No;A little;A lot Numeric Values

Please rate the symptom for Current Symptoms/Yesterday and Today time point only. Interviewer: Please circle only one answer.

Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 1.00 2016-12-29 16:54:02.0 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C00008 Age value AgeVal Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject. Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject. Age Numeric Values Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 1800 month
C53688 Post-Concussion Symptom Inventory for Children (PCSI-C) ? Assessment number PCSICAssessmentNum Number of assessments, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Number of assessments, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Post-Concussion Assessment 1;2;3;4;5;6 ;;;;; Numeric Values Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 1.00 2017-02-09 16:24:51.0 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C06005 Data collected date and time DataCollDateTime Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. Today's date: Date or Date & Time Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

C54072 Post-Concussion Symptom Inventory (PCSI) - Change value PCSIChangeVal Value related to change in score, as part of the Post-Concussion Symptom Inventory (PCSI). Value related to change in score, as part of the Post-Concussion Symptom Inventory (PCSI). Change Numeric Values

Change in value is calculated for total score.

Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 1.00 2017-02-13 11:44:59.0 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

C21117 Subject name SubjectName Name of subject/participant. Name of subject/participant. Name: Alphanumeric Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 1.00 2015-06-12 15:16:39.0 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points 255

Free-Form Entry

C51671 Grade status GradeStatus The status of the subject's grade level in school, if applicable. The status of the subject's grade level in school, if applicable. Grade: Alphanumeric Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 1.00 2016-12-12 00:00:00.0 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points 25

Free-Form Entry

C52713 Post-Concussion Symptom Inventory for Children (PCSI-C) - Headache scale PCSICHeadacheScl Scale to which the subject complained of headaches, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Scale to which the subject complained of headaches, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Have you had headaches? Has your head hurt? 0;1;2 No;A little;A lot Numeric Values

We would like to know if you have had any of these symptoms before your injury. Next, we would like to know if these symptoms have changed after your injury. I am going to ask you to tell me about your symptom at two points in time - Before the Injury and Yesterday / Today. Interviewer: Please circle only one answer.

Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 1.00 2016-12-29 15:20:57.0 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C52715 Post-Concussion Symptom Inventory (PCSI) - Total score PCSITotalScore Total score, as a part of the Post-Concussion Symptom Inventory (PCSI). Total score, as a part of the Post-Concussion Symptom Inventory (PCSI). Total PCSI Score Numeric Values

This is the total score of questions 1-5, calculated at two points in time - Before the Injury and Yesterday / Today.

Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 1.00 2017-01-30 10:14:16.0 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 120
C52727 Post-Concussion Symptom Inventory for Children (PCSI-C) - Nausea scale PCSICNauseaScl Scale to which the subject complained of nausea, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Scale to which the subject complained of nausea, as part of the Post-Concussion Symptom Inventory for Children (PCSI-C). Have you felt sick to your stomach or like you were going to throw up? 0;1;2 No;A little;A lot Numeric Values

We would like to know if you have had any of these symptoms before your injury. Next, we would like to know if these symptoms have changed after your injury. I am going to ask you to tell me about your symptom at two points in time - Before the Injury and Yesterday / Today. Interviewer: Please circle only one answer.

Sady MD, Vaughan CG, Gioia GA. Psychometric Characteristics of the Postconcussion Symptom Inventory in Children and Adolescents. Archives of Clinical Neuropsychology. 2014;29(4):348-363. Pediatric Supplemental 1.00 2016-12-29 15:54:39.0 Post-Concussion Symptom Inventory for Children (PCSI-C) Version 5-7 Years Pre and Post-Injury (Interview Form) Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

CSV