CDE Detailed Report
Disease: Traumatic Brain Injury
Sub-Domain: Post-concussive/TBI-Related Symptoms
CRF: Neurobehavioral Symptom Inventory (NSI)
Displaying 1 - 26 of 26
Sub-Domain: Post-concussive/TBI-Related Symptoms
CRF: Neurobehavioral Symptom Inventory (NSI)
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 / 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C07344 | Neurobehavioral Symptom Inventory (NSI) - Irritability impairment score | NSIIrrabltyImprmntScore | Score of subject's irritability, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's irritability, as part of the Neurobehavioral Symptom Inventory (NSI) | Irritability easily annoyed | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07334 | Neurobehavioral Symptom Inventory (NSI) - Taste impairment score | NSITastImprmntScore | Score of subject's taste impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's taste impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Change in taste and or smell | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07345 | Neurobehavioral Symptom Inventory (NSI) - Frustration impairment score | NSIFrustrtnImprmntScore | Score of subject's frustration tolerance, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's frustration tolerance, as part of the Neurobehavioral Symptom Inventory (NSI) | Poor frustration tolerance feeling easily overwhelmed by things | 0;1;2;3;4 | None - rarely if ever present, not a problem at all;Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
Please rate the following symptoms with refard to how much they have DISTURBED you IN THE LAST 2 Weeks. The prupose of this inventory is to track symptoms over time. Please do not attempt to score. |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07324 | Neurobehavioral Symptom Inventory (NSI) - Dizzy score | NSIDizScore | Score of subject's dizziness, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's dizziness, as part of the Neurobehavioral Symptom Inventory (NSI) | Feeling Dizzy | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score. |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07335 | Neurobehavioral Symptom Inventory (NSI) - Appetite impairment score | NSIApptitImprmntScore | Score of subject's appetite impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's appetite impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Loss of appetite or increased appetite | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07350 | Neurobehavioral Symptom Inventory (NSI) - Total score | NSITotalScore | Total Score for the Neurobehavioral Symptom Inventory (NSI) (0-88) | Total Score for the Neurobehavioral Symptom Inventory (NSI) (0-88) | Numeric Values |
Please rate the following symptoms with refard to how much they have DISTURBED you IN THE LAST 2 Weeks. The prupose of this inventory is to track symptoms over time. Please do not attempt to score. |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Free-Form Entry |
0 | 88 | |||||||||
| C07325 | Neurobehavioral Symptom Inventory (NSI) - Balance impairment score | NSIBalncImprmntScore | Score of subject's loss of balance, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's loss of balance, as part of the Neurobehavioral Symptom Inventory (NSI) | Loss of balance | 0;1;2;3;4 | None - rarely if ever present, not a problem at all;Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score. |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07336 | Neurobehavioral Symptom Inventory (NSI) - Concentration impairment score | NSIConctrtnImprmntScore | Score of subject's concentration impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's concentration impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Poor concentration cant pay attention easily distracted | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C18489 | Neurobehavioral Symptom Inventory (NSI) - Form completion name | NSIFrmCompltNm | Name of the person who completed the form, as part of the Neurobehavioral Symptom Inventory (NSI) | Name of the person who completed the form, as part of the Neurobehavioral Symptom Inventory (NSI) | Name | Alphanumeric |
Please rate the following symptoms with refard to how much they have DISTURBED you IN THE LAST 2 Weeks. The prupose of this inventory is to track symptoms over time. Please do not attempt to score. |
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 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points | 255 |
Free-Form Entry |
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| C07326 | Neurobehavioral Symptom Inventory (NSI) - Coordination impairment score | NSICoordntnImprmntScore | Score of subject's coordination impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's coordination impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Poor coordination clumsy | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score. |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07337 | Neurobehavioral Symptom Inventory (NSI) - Memory impairment score | NSIMmryImprmntScore | Score of subject's memory impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's memory impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Forgetfulness cant remember things | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C18490 | Neurobehavioral Symptom Inventory (NSI) - Form completion date | NSIFrmCompltDate | Date of form completion, as part of the Neurobehavioral Symptom Inventory (NSI) | Date of form completion, as part of the Neurobehavioral Symptom Inventory (NSI) | Date | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, 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 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Free-Form Entry |
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| C07327 | Neurobehavioral Symptom Inventory (NSI) - Headaches score | NSIHdcheScore | Score of subject's headache, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's headache, as part of the Neurobehavioral Symptom Inventory (NSI) | Headaches | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score. |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07338 | Neurobehavioral Symptom Inventory (NSI) - Decision impairment score | NSIDecsnImprmntScore | Score of subject's indecisiveness, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's indecisiveness, as part of the Neurobehavioral Symptom Inventory (NSI) | Difficulty making decisions | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C18491 | Neurobehavioral Symptom Inventory (NSI) - Medical record number | NSIMedRecrdNum | Medical record number of the form completion, as part of the Neurobehavioral Symptom Inventory (NSI) | Medical record number of the form completion, as part of the Neurobehavioral Symptom Inventory (NSI) | Medical Record | Numeric Values |
Please rate the following symptoms with refard to how much they have DISTURBED you IN THE LAST 2 Weeks. The prupose of this inventory is to track symptoms over time. Please do not attempt to score. |
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 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Free-Form Entry |
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| C07328 | Neurobehavioral Symptom Inventory (NSI) - Nausea score | NSINausScore | Score of subject's nausea, as part of the Neurobehavioral Symptom Inventory (NSI) | Nausea | Nausea | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score. |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07339 | Neurobehavioral Symptom Inventory (NSI) - Slow thinking impairment score | NSISlwThnkngImprmntScore | Score of subject's slow thinking impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's slow thinking impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Slowed thinking difficulty getting organized cant finish things | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07329 | Neurobehavioral Symptom Inventory (NSI) - Vision impairment score | NSIVisnImprmntScore | Score of subject's vision impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's vision impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Vision problem blurring troubling seeing | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score. |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07340 | Neurobehavioral Symptom Inventory (NSI) - Fatigue impairment score | NSIFatigImprmntScore | Score of subject's fatigue, loss of energy and getting tired easily, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's fatigue, loss of energy and getting tired easily, as part of the Neurobehavioral Symptom Inventory (NSI) | Fatigue loss of energy getting tired easily | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07330 | Neurobehavioral Symptom Inventory (NSI) - Sensitive light score | NSISenstvLgtScore | Score of subject's sensitivity to light, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's sensitivity to light, as part of the Neurobehavioral Symptom Inventory (NSI) | Sensitivity to light | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
Please rate the following symptoms with regard to how much they have disturbed you IN THE LAST 2 Weeks. The purpose of this inventory is to track symptoms over time. Please do not attempt to score. |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07341 | Neurobehavioral Symptom Inventory (NSI) - Sleep impairment score | NSISlpImprmntScore | Score of subject's sleep impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's sleep impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Difficulty falling or staying asleep | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07331 | Neurobehavioral Symptom Inventory (NSI) - Hearing impairment score | NSIHearngImprmntScore | Score of subject's hearing impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's hearing impairment, as part of the Neurobehavioral Symptom Inventory (NSI) | Hearing difficulty | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07342 | Neurobehavioral Symptom Inventory (NSI) - Anxiety impairment score | NSIAnxtyImprmntScore | Score of subject's anxiety , as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's anxiety , as part of the Neurobehavioral Symptom Inventory (NSI) | Feeling anxious or tense | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07332 | Neurobehavioral Symptom Inventory (NSI) - Sensitive noise score | NSiSenstvNoisScore | Score of subject's sensitivity to noise, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's sensitivity to noise, as part of the Neurobehavioral Symptom Inventory (NSI) | Sensitivity to noise | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07343 | Neurobehavioral Symptom Inventory (NSI) - Depression impairment score | NSIDeprsnImprmntScore | Score of subject's depression , as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's depression , as part of the Neurobehavioral Symptom Inventory (NSI) | Feeling depressed or sad | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C07333 | Neurobehavioral Symptom Inventory (NSI) - Numbness impairment score | NSINumbnssImprmntScore | Score of subject's numbness or tingling on parts of the body, as part of the Neurobehavioral Symptom Inventory (NSI) | Score of subject's numbness or tingling on parts of the body, as part of the Neurobehavioral Symptom Inventory (NSI) | Numbness or tingling on parts of my body | 0;1;2;3;4 | 0= None - rarely if ever present, not a problem at all;1= Mild - occasionally present, but it does not disrupt activities, I can usually continue what I'm doing, doesn't really concern me;2= Moderate - Often present, occasionally disrupts my activities, I can usually continue what I'm doing with some effort, I feel somewhat concerned;3= Severe - Frequently present and disrupts activities, I can only do things that are fairly simple or take little effort, I feel like I need help;4= Very severe - Almost always present and I have been unable to perform at work, school or home due to this problem, I probably cannot function without help | Numeric Values |
See the instructions on the form |
Cicerone, K.D., and Kalmar, K. (1995). Persistent Postconcussion Syndrome: The Structure of Subjective Complaints after Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 10(3) 1-17. | Adult | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Neurobehavioral Symptom Inventory (NSI) | Post-concussive/TBI-Related Symptoms | Outcomes and End Points |
Single Pre-Defined Value Selected |
