CDE Detailed Report

Disease: Traumatic Brain Injury
Subdomain Name: Military Studies
CRF: Military Acute Concussion Evaluation (MACE)

Displaying 1 - 50 of 85
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
C18436 Military Acute Concussion Evaluation (MACE) - Concentration 49153 form C score MACEConc49153FormCScore Subject's concentration score for correctly repeating the number 4-9-1-5-3 in reverse order then 6-8-2-5-1 also in reverse order , as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly repeating the number 4-9-1-5-3 in reverse order then 6-8-2-5-1 also in reverse order , as part of Military Acute Concussion Evaluation (MACE Reverse Digits 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18468 Military Acute Concussion Evaluation (MACE) - Immediate memory candle form B score MACEImmdtMemCandlFormBScore Immediate memory candle score from form B, as part of Military Acute Concussion Evaluation (MACE) Immediate memory candle score from form B, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

Repeat two more times for a total of three trials. (1 point for each correct, total over 3 trials.) Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M 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. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18447 Military Acute Concussion Evaluation (MACE) - Concentration recall form B score MACEConcRcllFormBScore Concentration total score (0-5) from form B, as part of Military Acute Concussion Evaluation (MACE) Concentration total score (0-5) from form B, as part of Military Acute Concussion Evaluation (MACE Concentration Numeric Values Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 5
C18479 Military Acute Concussion Evaluation (MACE) - Immediate memory sunset form C score MACEImmdtMemrySunsetFormCScore Immediate memory sunset score from form C, as part of Military Acute Concussion Evaluation (MACE) Immediate memory sunset score from form C, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

1 point for each correct, total over 3 trials. Repeat two more times for a total of three trials. (1 point for each correct, total over 3 trials.) Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M 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. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07258 Military Acute Concussion Evaluation (MACE) - Helmet worn name MACEHelmWornName Name of helmet, as part of Military Acute Concussion Evaluation (MACE) Name of helmet, as part of Military Acute Concussion Evaluation (MACE Type Alphanumeric

Assess for helmet use. Military: Kevlar or ACH (Advanced Combat Helmet). Sports helmet, motorcycle helmet, etc.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points 255

Free-Form Entry

C18458 Military Acute Concussion Evaluation (MACE) - Delayed recall paper form B score MACEDlydRcllPaprFormBScore Delayed recall paper score from form B, as part of Military Acute Concussion Evaluation (MACE) Delayed recall paper score from form B, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C19527 Military Acute Concussion Evaluation (MACE) - Symptoms other text MACESympOth The free-text field related to Military Acute Concussion Evaluation (MACE) - Symptoms indicator specifying other text, as part of Military Acute Concussion Evaluation (MACE) The free-text field related to Military Acute Concussion Evaluation (MACE) - Symptoms indicator specifying other text, as part of Military Acute Concussion Evaluation (MACE Other, specify Alphanumeric

Ask the person to report their experience of each specific symptom since injury.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points 4000

Free-Form Entry

C07269 Military Acute Concussion Evaluation (MACE) - Immediate memory score MACEImmdtMemScore Immediate memory total score (0-15), as part of Military Acute Concussion Evaluation (MACE) Immediate memory total score (0-15), as part of Military Acute Concussion Evaluation (MACE Immediate Memory Total Score Numeric Values

See instructions on form

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 15
C18437 Military Acute Concussion Evaluation (MACE) - Concentration 493 score MACEConc493Score Subject's concentration score for correctly repeating the number 4-9-3 in reverse order then 6-2-9 also in reverse order , as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly repeating the number 4-9-3 in reverse order then 6-2-9 also in reverse order , as part of Military Acute Concussion Evaluation (MACE Reverse Digits 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18469 Military Acute Concussion Evaluation (MACE) - Immediate memory carpet score MACEImmdtMemryCrptScore Immediate memory carpet score, as part of Military Acute Concussion Evaluation (MACE) Immediate memory carpet score, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

1 point for each correct, total over 3 trials. Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M 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. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18448 Military Acute Concussion Evaluation (MACE) - Delayed recall apple score MACEDlydRcllApplScore Delayed recall apple score, as part of Military Acute Concussion Evaluation (MACE) Delayed recall apple score, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18480 Military Acute Concussion Evaluation (MACE) - Immediate memory wagon form B score MACEImmdtMemWagnFormBScore Immediate memory wagon score from form B, as part of Military Acute Concussion Evaluation (MACE) Immediate memory wagon score from form B, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

Repeat two more times for a total of three trials. (1 point for each correct, total over 3 trials.) Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M 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. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07259 Military Acute Concussion Evaluation (MACE) - Unremembered events before indicator MACEUnremmbrdEvntBfrInd Indicator of whether or not there were events just BEFORE the injury that are not remembered, as part of Military Acute Concussion Evaluation (MACE) Indicator of whether or not there were events just BEFORE the injury that are not remembered, as part of Military Acute Concussion Evaluation (MACE Amnesia Before Are there any events just BEFORE the injury that are not remembered? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Assess for continuous memory prior to injury. Determine whether and length of time that the person wasn't registering continuous memory both prior to injury and after the injury. Approximate the amount of time in seconds, minutes or hours, whichever time increment is most appropriate. For example, if the assessment of the patient yields a possible time of 20 minutes, then 20 minutes should be documented in the "how long?" section.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07270 Military Acute Concussion Evaluation (MACE) - Neurological screening result MACENrlgclScrnngReslt Neurological Screening - As the clinical condition permits, check: Eyes-pupillary response and tracking; Verbal-speech fluency and word finding; Motor-pronator drift, gait/coordination. Record of any abnormalities, as part of Military Acute Concussion Evaluation (MACE) Neurological Screening - As the clinical condition permits, check: Eyes-pupillary response and tracking; Verbal-speech fluency and word finding; Motor-pronator drift, gait/coordination. Record of any abnormalities, as part of Military Acute Concussion Evaluation (MACE Neurological Screening - As the clinical condition permits, check: Eyes-pupillary response and tracking; Verbal-speech fluency and word finding; Motor-pronator drift, gait/coordination. Record any abnormalities. Alphanumeric

Neurological screening Eyes; check pupil size and reactivity. Verbal: notice speech fluency and word finding Motor: pronator drift- ask patient to lift arms with palms up, ask patient to then close their eyes, assess for either arm to "drift" down. Assess gait and coordination if possible. Document any abnormalities. No points are given for this section.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points 255

Free-Form Entry

C18459 Military Acute Concussion Evaluation (MACE) - Delayed recall perfume form C score MACEDlydRcllPerfmFormCScore Delayed recall perfume score from form C, as part of Military Acute Concussion Evaluation (MACE) Delayed recall perfume score from form C, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test DO NOT reread the word list. 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C19528 Military Acute Concussion Evaluation (MACE) - Diagnosis other specify MACEDiagnOth The free-text field related to Military Acute Concussion Evaluation (MACE) - Diagnosis name specifying other text, as part of Military Acute Concussion Evaluation (MACE) The free-text field related to Military Acute Concussion Evaluation (MACE) - Diagnosis name specifying other text, as part of Military Acute Concussion Evaluation (MACE Other diagnoses Alphanumeric Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points 4000

Free-Form Entry

C18438 Military Acute Concussion Evaluation (MACE) - Concentration 62971 score MACEConc62971Score Subject's concentration score for correctly repeating the number 6-2-9-7-1 in reverse order then 1-5-2-8-5 also in reverse order , as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly repeating the number 6-2-9-7-1 in reverse order then 1-5-2-8-5 also in reverse order , as part of Military Acute Concussion Evaluation (MACE Reverse Digits 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18470 Military Acute Concussion Evaluation (MACE) - Immediate memory elbow score MACEImmdtMemryElbScore Immediate memory elbow score, as part of Military Acute Concussion Evaluation (MACE) Immediate memory elbow score, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

1 point for each correct, total over 3 trials. Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M 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. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18449 Military Acute Concussion Evaluation (MACE) - Delayed recall baby form C score MACEDlydRcllBabyFormCScore Delayed recall baby score from form C, as part of Military Acute Concussion Evaluation (MACE) Delayed recall baby score from form C, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test DO NOT reread the word list. 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18481 Military Acute Concussion Evaluation (MACE) - Incident description daze indicator MACEIncdntDescrptDazeInd Indicator of whether or not the subject was dazed, confused or "saw stars", as part of Military Acute Concussion Evaluation (MACE) Indicator of whether or not the subject was dazed, confused or "saw stars", as part of Military Acute Concussion Evaluation (MACE Were you dazed, confused, saw stars? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Ask for a description of the incident that resulted in the injury; how the injury occurred, type of force.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07260 Military Acute Concussion Evaluation (MACE) - Unremembered events before time duration MACEUnremmbrdEvntBfrTm Duration of time of unremembered events from before the trauma, as part of Military Acute Concussion Evaluation (MACE) Duration of time of unremembered events from before the trauma, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Numeric Values

Assess for continuous memory prior to injury. Determine whether and length of time that the person wasn't registering continuous memory both prior to injury and after the injury. Approximate the amount of time in seconds, minutes or hours, whichever time

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points 255

Free-Form Entry

C07271 Military Acute Concussion Evaluation (MACE) - Concentration score MACEConcScore Concentration total score (0-5), as part of Military Acute Concussion Evaluation (MACE) Concentration total score (0-5), as part of Military Acute Concussion Evaluation (MACE Concentration Total Score Numeric Values

See instructions on form

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 5
C18460 Military Acute Concussion Evaluation (MACE) - Delayed recall saddle score MACEDlydRcllSaddlScore Delayed recall saddle score, as part of Military Acute Concussion Evaluation (MACE) Delayed recall saddle score, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C20386 Military Acute Concussion Evaluation (MACE) - Unremembered events before time duration unit of measure MACEUnremmbrdEvntBfrTmUoM Unit of measure associated with the duration of time of unremembered events from before the trauma, as part of Military Acute Concussion Evaluation (MACE) Unit of measure associated with the duration of time of unremembered events from before the trauma, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Second;Minute;Hour;Day Second;Minute;Hour;Day Alphanumeric

Assess for continuous memory prior to injury. Determine whether and length of time that the person wasn't registering continuous memory both prior to injury and after the injury. Approximate the amount of time in seconds, minutes or hours, whichever time

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18439 Military Acute Concussion Evaluation (MACE) - Concentration 6831 form C score MACEConc6831FormCScore Subject's concentration score for correctly repeating the number 6-8-3-1 in reverse order then 3-4-8-1 also in reverse order , as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly repeating the number 6-8-3-1 in reverse order then 3-4-8-1 also in reverse order , as part of Military Acute Concussion Evaluation (MACE Reverse Digits 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18471 Military Acute Concussion Evaluation (MACE) - Immediate memory form B score MACEImmdtMemFormBScore Immediate memory score from form B, as part of Military Acute Concussion Evaluation (MACE) Immediate memory score from form B, as part of Military Acute Concussion Evaluation (MACE Immediate Memory Numeric Values Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

C18450 Military Acute Concussion Evaluation (MACE) - Delayed recall bubble score MACEDlydRcllBubblScore Delayed recall bubble score, as part of Military Acute Concussion Evaluation (MACE) Delayed recall bubble score, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18482 Military Acute Concussion Evaluation (MACE) - Incident description hit head indicator MACEIncdntDescrptHitHeadInd Indicator of whether or not the subject hit his or her head, as part of Military Acute Concussion Evaluation (MACE) Indicator of whether or not the subject hit his or her head, as part of Military Acute Concussion Evaluation (MACE Did you hit your head? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Ask for a description of the incident that resulted in the injury; how the injury occurred, type of force.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07261 Military Acute Concussion Evaluation (MACE) - Unremembered events after indicator MACEUnremmbrdEvntAftrInd Indicator of whether or not there were events just AFTER the injury that are not remembered, as part of Military Acute Concussion Evaluation (MACE) Indicator of whether or not there were events just AFTER the injury that are not remembered, as part of Military Acute Concussion Evaluation (MACE Amnesia After Are there any events just AFTER the injuries that are not remembered? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Assess time until continuous memory after the injury. Determine whether and length of time that the person wasn't registering continuous memory both prior to injury and after the injury. Approximate the amount of time in seconds, minutes or hours, whichever time increment is most appropriate. For example, if the assessment of the patient yields a possible time of 20 minutes, then 20 minutes should be documented in the "how long?" section.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07272 Military Acute Concussion Evaluation (MACE) - Delayed recall score MACEDlydRcllScore Delayed recall total score (0-5), as part of Military Acute Concussion Evaluation (MACE) Delayed recall total score (0-5), as part of Military Acute Concussion Evaluation (MACE Delayed Recall Total Score Numeric Values

See instructions on form

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 5
C18461 Military Acute Concussion Evaluation (MACE) - Delayed recall sandwich form B score MACEDlydRcllSandwichFormBScore Delayed recall sandwich from form B, as part of Military Acute Concussion Evaluation (MACE) Delayed recall sandwich from form B, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C20387 Military Acute Concussion Evaluation (MACE) - Unremembered events after time unit of measure MACEUnrememEvntAfterTmUoM Unit of measure for the duration of time of unremembered events from after the trauma, as part of Military Acute Concussion Evaluation (MACE) Unit of measure for the duration of time of unremembered events from after the trauma, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Second;Minute;Hour;Day Second;Minute;Hour;Day Alphanumeric

Assess time until continuous memory after the injury. Determine whether and length of time that the person wasn't registering continuous memory both prior to injury and after the injury. Approximate the amount of time in seconds, minutes or hours, whichev

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18440 Military Acute Concussion Evaluation (MACE) - Concentration 718462 score MACEConc718462Score Subject's concentration score for correctly repeating the number 7-1-8-4-6-2 in reverse order then 5-3-9-1-4-8 also in reverse order , as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly repeating the number 7-1-8-4-6-2 in reverse order then 5-3-9-1-4-8 also in reverse order , as part of Military Acute Concussion Evaluation (MACE Reverse Digits 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18472 Military Acute Concussion Evaluation (MACE) - Immediate memory form C score MACEImmdtMemFormCScore Immediate memory score from form C, as part of Military Acute Concussion Evaluation (MACE) Immediate memory score from form C, as part of Military Acute Concussion Evaluation (MACE Immediate Memory Numeric Values Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

C18451 Military Acute Concussion Evaluation (MACE) - Delayed recall candle form B score MACEDlydRcllCandlFormBScore Delayed recall candle score from form B, as part of Military Acute Concussion Evaluation (MACE) Delayed recall candle score from form B, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18483 Military Acute Concussion Evaluation (MACE) - Orientation date score MACEOrientDateScore Orientation date score, as part of Military Acute Concussion Evaluation (MACE) Orientation date score, as part of Military Acute Concussion Evaluation (MACE Date 0;1 0;1 Numeric Values

Ask: WHAT IS THE DATE OR DAY OF THE MONTH? One point for each correct response for a total of 5 possible points. It should be noted that a correct response on time of day must be within 1 hour of the actual time.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07262 Military Acute Concussion Evaluation (MACE) - Unremembered events after time duration MACEUnrememEvntAfterTm Duration of time of unremembered events from after the trauma, as part of Military Acute Concussion Evaluation (MACE) Duration of time of unremembered events from after the trauma, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Numeric Values

Assess time until continuous memory after the injury. Determine whether and length of time that the person wasn't registering continuous memory both prior to injury and after the injury. Approximate the amount of time in seconds, minutes or hours, whichev

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points 255

Free-Form Entry

C07273 Military Acute Concussion Evaluation (MACE) - Total score MACETotScore The total score for the MACE (0-30), as part of Military Acute Concussion Evaluation (MACE) The total score for the MACE (0-30), as part of Military Acute Concussion Evaluation (MACE TOTAL SCORE Numeric Values

In studies of non-concussed patients, the mean total score was 28. Therefore, a score less than 30 does not imply that a concussion has occurred. Definitive normative data for a "cut-off" score are not available. However, scores below 25 may represent clinically relevant neurocognitive impairment and require further evaluation for the possibility of a more serious brain injury. The scoring system also takes on particular clinical significance during serial assessment where it can be used to document either a decline or an improvement in cognitive functioning.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 30
C18462 Military Acute Concussion Evaluation (MACE) - Delayed recall sugar form B score MACEDlydRcllSugrFormBScore Delayed recall sugar from form B, as part of Military Acute Concussion Evaluation (MACE) Delayed recall sugar from form B, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C20388 Military Acute Concussion Evaluation (MACE) - Individual loss consciousness time unit of measure MACEIndvdlLossConcsnTmUoM Unit of measure associated with the duration of those incidents where the subject reports losing consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE) Unit of measure associated with the duration of those incidents where the subject reports losing consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Second;Minute;Hour;Day Second;Minute;Hour;Day Alphanumeric

Determine whether and length of time of self reported loss of consciousness (LOC) or witnessed/observed LOC. Again, approximate the amount of time in second, minutes or hours, whichever time increment is most appropriate.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18441 Military Acute Concussion Evaluation (MACE) - Concentration form C score MACEDConcFormCScore Concentration score from form C, as part of Military Acute Concussion Evaluation (MACE) Concentration score from form C, as part of Military Acute Concussion Evaluation (MACE Concentration Numeric Values Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Free-Form Entry

0 5
C18473 Military Acute Concussion Evaluation (MACE) - Immediate memory iron form C score MACEImmdtMemryIronFormCScore Immediate memory iron score from form C, as part of Military Acute Concussion Evaluation (MACE) Immediate memory iron score from form C, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

1 point for each correct, total over 3 trials. Repeat two more times for a total of three trials. (1 point for each correct, total over 3 trials.) Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M 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. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18452 Military Acute Concussion Evaluation (MACE) - Delayed recall carpet score MACEDlydRcllCarptScore Delayed recall carpet score, as part of Military Acute Concussion Evaluation (MACE) Delayed recall carpet score, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18484 Military Acute Concussion Evaluation (MACE) - Orientation month score MACEOrientMnthScore Orientation month score, as part of Military Acute Concussion Evaluation (MACE) Orientation month score, as part of Military Acute Concussion Evaluation (MACE Month 0;1 0;1 Numeric Values

Ask: WHAT MONTH IS THIS? One point for each correct response for a total of 5 possible points. It should be noted that a correct response on time of day must be within 1 hour of the actual time.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07263 Military Acute Concussion Evaluation (MACE) - Individual loss consciousness indicator MACEIndvdlLossConcsnInd Indicator of whether or not the individual reports loss of consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE) Indicator of whether or not the individual reports loss of consciousness or blacking out, as part of Military Acute Concussion Evaluation (MACE Does the individual report loss of consciousness or blacking out? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Determine whether and length of time of self reported loss of consciousness (LOC) or witnessed/observed LOC. Again, approximate the amount of time in second, minutes or hours, whichever time increment is most appropriate.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C07274 Military Acute Concussion Evaluation (MACE) - Diagnosis name MACEDiagnNam The diagnosis based on the MACE total score, as part of Military Acute Concussion Evaluation (MACE) The diagnosis based on the MACE total score, as part of Military Acute Concussion Evaluation (MACE Diagnosis No concussion;850.0 Concussion without Loss of Consciousness (LOC);850.1 Concussion with Loss of Consciousness (LOC);Other diagnoses No concussion;850.0 Concussion without Loss of Consciousness (LOC);850.1 Concussion with Loss of Consciousness (LOC);Other diagnoses Alphanumeric

Circle the ICD-9 code that corresponds to the evaluation. If loss

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18463 Military Acute Concussion Evaluation (MACE) - Delayed recall sunset form C score MACEDlydRcllSunstFormCScore Delayed recall sunset score from form C, as part of Military Acute Concussion Evaluation (MACE) Delayed recall sunset score from form C, as part of Military Acute Concussion Evaluation (MACE Ask the patient to recall the 5 words from the earlier memory test DO NOT reread the word list. 0;1 0;1 Numeric Values

Do NOT reread the word list. Delayed Recall Assess the patient's ability to retain previously learned information by asking he/she to recall as many words as possible from the initial word list, without having the word list read again for this trial. DO YOU REMEMBER THAT LIST OF WORDS I READ A FEW MINUTES EARLIER? I WANT YOU TO TELL ME AS MANY WORDS FROM THE LIST AS YOU CAN REMEMBER IN ANY ORDER. One point for each word remembered for a total of 5 possible points. Total score= Add up from the 4 assessed domains: immediate memory, orientation, concentration and memory recall.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C20389 Military Acute Concussion Evaluation (MACE) - Anyone loss consciousness time unit of measure MACEAnyoneLossConcsnTmUoM Unit of measure associated with the duration of time where anyone observed a period of loss of consciousness or unresponsiveness, as part of Military Acute Concussion Evaluation (MACE) Unit of measure associated with the duration of time where anyone observed a period of loss of consciousness or unresponsiveness, as part of Military Acute Concussion Evaluation (MACE If yes, how long? Second;Minute;Hour;Day Second;Minute;Hour;Day Alphanumeric

Determine whether and length of time of self reported loss of consciousness (LOC) or witnessed/observed LOC. Again, approximate the amount of time in second, minutes or hours, whichever time increment is most appropriate.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18442 Military Acute Concussion Evaluation (MACE) - Concentration months score MACEConcMnthScore Subject's concentration score for correctly reciting the months in reverse order, as part of Military Acute Concussion Evaluation (MACE) Subject's concentration score for correctly reciting the months in reverse order, as part of Military Acute Concussion Evaluation (MACE Months in reverse order 0;1 0;1 Numeric Values

go to next string length if correct on first trial. Stop if incorrect on both trials. Concentration: Inform the patient: I'M GOING TO READ YOU A STRING OF NUMBERS AND WHEN I AM FINISHED, REPEAT THEM BACK TO ME BACKWARDS, THAT IS, IN REVERSE ORDER OF HOW I READ THEM TO YOU. FOR EXAMPLE, IF I SAY 7-1-9, YOU WOULD SAY 9-1-7. If the patient is correct on the first trial of each string length, proceed to the next string length. If incorrect, administer the 2nd trial of the same string length. Proceed to the next string length if correct on the second trial. Discontinue after failure on both trials of the same string length. Total of 4 different string lengths; 1 point for each string length for a total of 4 points. NOW TELL ME THE MONTHS IN REVERSE ORDER, THAT IS, START WITH DECEMBER AND END IN JANUARY. 1 point if able to recite ALL months in reverse order. 0 points if not able to recite ALL of them in reverse order. Total possible score for concentration portion: 5.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

C18474 Military Acute Concussion Evaluation (MACE) - Immediate memory monkey form C score MACEImmdtMemryMnkyFormCScore Immediate memory monkey score from form C, as part of Military Acute Concussion Evaluation (MACE) Immediate memory monkey score from form C, as part of Military Acute Concussion Evaluation (MACE Read all 5 words and ask the patient to recall them in any order. Repeat two more times for a total of three trials. 0;1 0;1 Numeric Values

1 point for each correct, total over 3 trials. Repeat two more times for a total of three trials. (1 point for each correct, total over 3 trials.) Immediate memory is assessed using a brief repeated list learning test. Read the patient the list of 5 words once and then ask them to repeat it back to you, as many as they can recall in any order. Repeat this procedure 2 more times for a total of 3 trials, even if the patient scores perfectly on the first trial. Trial 1: I'M 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. Trial 2 &3: I AM GOING TO REPEAT THAT LIST AGAIN. AGAIN, REPEAT BACK AS MANY AS YOU CAN REMEMBER IN ANY ORDER, EVEN IF YOU SAID THEM BEFORE. One point is given for each correct answer for a total of 15 possible points.

Kay, S., Wolkenfeld, F., and Murrill, L. (1988). Profiles of aggression among psychiatric patients. I. Nature and prevalence. J Nerv Ment Dis 176(9), 539-546. Yudofsky, S., Silver, J., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry 143(1), 35-39. Adult Supplemental 3.00 2013-07-20 10:21:25.65 Military Acute Concussion Evaluation (MACE) Military Studies Outcomes and End Points

Single Pre-Defined Value Selected

CSV