CDE Detailed Report

Disease: NeuroRehab
Subdomain Name: Other Clinical Data
CRF: Brief Symptom Inventory-18 (BSI-18)

Displaying 1 - 26 of 26
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
C18642 Brief Symptom Inventory-18 (BSI18)- Depression raw score BSI18DeprScoreRaw Raw score for depression symptom scale Raw score for depression symptom scal Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

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C18632 Brief Symptom Inventory-18 (BSI18)- Feeling worthless scale BSI18FeelWorthlessScale The scale for the participant's distress from feelings of worthlessness The scale for the participant's distress from feelings of worthlessnes How much were you distressed by: Feelings of worthlessness 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18643 Brief Symptom Inventory-18 (BSI18)- Depression normalized T score BSI18DeprScoreT Normalized T score for depression symptom scale Normalized T score for depression symptom scal Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

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C18622 Brief Symptom Inventory-18 (BSI18)- Faintness scale BSI18FaintScale A scale to indicate how much the participant is distressed by faintness or dizziness A scale to indicate how much the participant is distressed by faintness or dizzines How much were you distressed by: Faintness or dizziness 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18633 Brief Symptom Inventory-18 (BSI18)- terror or panic scale BSI18TerrorOrPanicScale The scale for the participant's distress from spells of terror or panic The scale for the participant's distress from spells of terror or panic How much were you distressed by: Spells of terror or panic 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18644 Brief Symptom Inventory-18 (BSI18)- Anxiety raw score BSI18AnxScoreRaw Raw score for anxiety symptom scale Raw score for anxiety symptom scal Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

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C18623 Brief Symptom Inventory-18 (BSI18)- No interest scale BSI18NoInterestScale A scale to indicate how much a participant is distressed by feeling no interest in things A scale to indicate how much a participant is distressed by feeling no interest in thing How much were you distressed by: Feeling no interest in things 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18634 Brief Symptom Inventory-18 (BSI18)- Numbness or tingling scale BSI18NumbScale The scale for the participant's distress from numbness or tingling in parts of their body The scale for the participant's distress from numbness or tingling in parts of their bod How much were you distressed by: Numbness or tingling in parts of your body 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18645 Brief Symptom Inventory-18 (BSI18)- Anxiety normalized T score BSI18AnxScoreT Normalized T score for anxiety symptom scale Normalized T score for anxiety symptom scal Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

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C18624 Brief Symptom Inventory-18 (BSI18)- Nervousness scale BSINervousScale A scale for participant's distress by nervousness or shakiness inside A scale for participant's distress by nervousness or shakiness insid How much were you distressed by: Nervousness or shakiness inside 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18635 Brief Symptom Inventory-18 (BSI18)- Hopeless scale BSI18FeelHopelessScale The scale for the participant's distress from feeling hopeless about the future The scale for the participant's distress from feeling hopeless about the futur How much were you distressed by: Feeling hopeless about the future 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18646 Brief Symptom Inventory-18 (BSI18)- Global Severity Index raw score BSI18GSIScoreRaw Raw score for Global Severity Index symptom scale Raw score for Global Severity Index symptom scal Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

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C18625 Brief Symptom Inventory-18 (BSI18)- Chest pains scale BSI18ChestPainScale The scale for the participant's distress by pains in heart or chest The scale for the participant's distress by pains in heart or ches How much were you distressed by: Pains in heart or chest 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18636 Brief Symptom Inventory-18 (BSI18)- Restless scale BSI18FeelRestlessScale The scale for the participant's distress from feeling so restless they couldn't sit still The scale for the participant's distress from feeling so restless they couldn't sit still. How much were you distressed by: Feeling so restless you couldn't sit still 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18647 Brief Symptom Inventory-18 (BSI18)- Global Severity Index normalized T score BSI18GSIScoreT Normalized T score for Global Severity Index symptom scale Normalized T score for Global Severity Index symptom scal Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

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C18626 Brief Symptom Inventory-18 (BSI18)- Feeling lonely scale BSI18FeelLonelyScale The scale for the participant's distress in feeling lonely The scale for the participant's distress in feeling lonel How much were you distressed by:Feeling lonely 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18637 Brief Symptom Inventory-18 (BSI18)- Weak scale BSI18FeelWeakScale The scale for the participant's distress from feeling weak in parts of their body The scale for the participant's distress from feeling weak in parts of their bod How much were you distressed by: Feeling weak in parts of your body 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18627 Brief Symptom Inventory-18 (BSI18)- Feeling tense scale BSI18FeelTenseScale The scale for the participant's distress in feeling tense or keyed up The scale for the participant's distress in feeling tense or keyed u How much were you distressed by: Feeling tense or keyed up 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18638 Brief Symptom Inventory-18 (BSI18)- Thoughts of ending life scale BSI18ThoughtsEndingLifeScale The scale for the participant's distress from thoughts of ending their life The scale for the participant's distress from thoughts of ending their lif How much were you distressed by: Thoughts of ending your life 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18628 Brief Symptom Inventory-18 (BSI18)- Nausea scale BSI18NauseaScale The scale for the participant's distress from nausea or upset stomach The scale for the participant's distress from nausea or upset stomac How much were you distressed by: Nausea or upset stomach 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18639 Brief Symptom Inventory-18 (BSI18)- Fearful scale BSI18FeelFearfulScale The scale for the participant's distress from feeling fearful The scale for the participant's distress from feeling fearfu How much were you distressed by: Feeling fearful 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18629 Brief Symptom Inventory-18 (BSI18)- Feeling blue scale BSI18FeelBlueScale The scale for the participant's distress from feeling blue The scale for the participant's distress from feeling blu How much were you distressed by: Feeling blue 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18640 Brief Symptom Inventory-18 (BSI18)- Somatization raw score BSI18SomScoreRaw Raw score for somatization symptom scale Raw score for somatization symptom scal Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

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C18630 Brief Symptom Inventory-18 (BSI18)- Suddenly scared scale BSI18ScaredScale The scale for the participant's distress from suddenly scared for no reason The scale for the participant's distress from suddenly scared for no reaso How much were you distressed by: Suddenly scared for no reason 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

C18641 Brief Symptom Inventory-18 (BSI18)- Somatization normalized T score BSI18SomScoreT Normalized T score for somatization symptom scale Normalized T score for somatization symptom scal Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

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C18631 Brief Symptom Inventory-18 (BSI18)- Trouble getting breath scale BSI18TrblBreathScale The scale for the participant's distress from trouble getting their breath The scale for the participant's distress from trouble getting their breat How much were you distressed by: Trouble getting your breath 1;2;3;4;0 A little bit;Moderately;Quite a bit;Extremely;not at all Numeric Values Copyright 2001 Leonard R. Derogatis, PHD. All rights reserved. "BSI" is a registered trademark of Leonard R. Derogatis, PhD. Adult NeuroRehab Supplemental-Highly Recommended 1.00 2014-01-02 00:00:00.0 Brief Symptom Inventory-18 (BSI-18) Other Clinical Data Assessments and Examinations

Single Pre-Defined Value Selected

CSV