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[EEG] EEG Acquisition form (aces#8443)
Add new EEG Acquisition Form sample instrument.
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title{@}EEG Acquisition Form | ||
date{@}Date_taken{@}Date of Administration{@}{@} | ||
static{@}Candidate_Age{@}Candidate Age (Months) | ||
static{@}Window_Difference{@}Window Difference (+/- Days) | ||
select{@}Examiner{@}Examiner{@}NULL=>'' | ||
textarea{@}general_comments{@}General session notes, any important details (e.g. technical error, issue with net, etc.) | ||
select{@}general_comments_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
header{@}{@}<b><h3>General information</h3></b> | ||
text{@}research_staff_one{@}Research staff 1 initials | ||
select{@}research_staff_one_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
text{@}research_staff_two{@}Research staff 2 initials | ||
select{@}research_staff_two_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
text{@}research_staff_three{@}Research staff 3 initials | ||
select{@}research_staff_three_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
text{@}session_testing_room{@}Testing room information | ||
select{@}session_testing_room_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}behavioural_assistant_present{@}Is there a behavioural assistant?{@}NULL=>''{-}'yes'=>'Yes'{-}'no'=>'No'{-}'not_known'=>'Not known'{-}'not_answered'=>'Not Answered' | ||
text{@}behavioural_assistant{@}Behavioural assistant initials | ||
select{@}behavioural_assistant_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}subject_medication{@}Is subject under medication?{@}NULL=>''{-}'yes'=>'Yes'{-}'no'=>'No'{-}'not_known'=>'Not known'{-}'not_answered'=>'Not Answered' | ||
textarea{@}subject_medication_dosage{@}Specify medication and dosage | ||
select{@}subject_medication_dosage_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}head_measurement_taken{@}Was head measured?{@}NULL=>''{-}'yes'=>'Yes'{-}'no'=>'No'{-}'not_answered'=>'Not Answered' | ||
select{@}head_measurement_unit{@}What is the unit used for head measurement?{@}NULL=>''{-}'cm'=>'Centimeters (cm)'{-}'in'=>'Inches (in)'{-}'not_answered'=>'Not Answered' | ||
numeric{@}head_measurement{@}What is the head measurement value?{@}undefined{@}undefined | ||
select{@}head_measurement_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}ecg_collected{@}ECG Collected?{@}NULL=>''{-}'yes'=>'Yes'{-}'no'=>'No'{-}'not_known'=>'Not known'{-}'not_answered'=>'Not Answered' | ||
select{@}subject_away_60cm_from_monitor{@}Subject is 60cm away from monitor?{@}NULL=>''{-}'yes'=>'Yes'{-}'no'=>'No'{-}'not_known'=>'Not known'{-}'not_answered'=>'Not Answered' | ||
textarea{@}subject_away_60cm_from_monitor_reason{@}If No, please explain the reason | ||
select{@}subject_away_60cm_from_monitor_reason_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}head_rest_used{@}Was a head rest used?{@}NULL=>''{-}'yes'=>'Yes'{-}'no'=>'No'{-}'not_known'=>'Not known'{-}'not_answered'=>'Not Answered' | ||
header{@}{@}<b><h3>Device information</h3></b> | ||
text{@}device_id{@}Device ID | ||
select{@}device_id_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}impedance_measured_before_applied{@}Impedances measure before application on subject?{@}NULL=>''{-}'yes'=>'Yes'{-}'no'=>'No'{-}'not_known'=>'Not known'{-}'not_answered'=>'Not Answered' | ||
numeric{@}impedance_measure{@}Impedance measured{@}undefined{@}undefined | ||
select{@}impedance_measure_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}bad_electrodes_present{@}Were there any bad electrodes during impedances?{@}NULL=>''{-}'yes'=>'Yes'{-}'no'=>'No'{-}'not_known'=>'Not known'{-}'not_answered'=>'Not Answered' | ||
textarea{@}bad_electrodes{@}If Yes, please register all bad electrodes | ||
select{@}bad_electrodes_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}bad_channels_measured_after_applied{@}Bad channels measured after application on subject?{@}NULL=>''{-}'yes'=>'Yes'{-}'no'=>'No'{-}'not_known'=>'Not known'{-}'not_answered'=>'Not Answered' | ||
textarea{@}bad_channels{@}Bad channels | ||
select{@}bad_channels_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
header{@}{@}<h6>About placement:<br/> <b>Excellent</b> - meets all criteria for proper placement.<br/> <b>Average</b> - 1-2cm shift from proper placement (1 pinky finger width distance).<br/> <b>Poor</b> - >2 cm shift from proper placement (>1 pinky finger width distance). </h6> | ||
select{@}placement_rating{@}Rate placement{@}NULL=>''{-}'na'=>'n/a'{-}'excellent'=>'Excellent'{-}'average'=>'Average'{-}'poor'=>'Poor'{-}'not_answered'=>'Not Answered' | ||
textarea{@}placement_comment{@}Comments on placement | ||
select{@}placement_comment_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}placement_photos_taken{@}Placement photos taken?{@}NULL=>''{-}'yes'=>'Yes'{-}'no'=>'No'{-}'not_known'=>'Not known'{-}'not_answered'=>'Not Answered' | ||
select{@}acquisition_software{@}Acquisition software used{@}NULL=>''{-}'eemagine'=>'Eemagine'{-}'neuro_scan'=>'(Neuro)scan'{-}'insep'=>'InsEP'{-}'biosemi'=>'BioSemi'{-}'netstation'=>'NetStation'{-}'brain_vision_recorder'=>'Brain Vision Recorder'{-}'emotiv'=>'Emotiv'{-}'actiview605_lores'=>'ActiView605-Lores'{-}'eeprobe'=>'EEProbe'{-}'tmsi'=>'TMSi'{-}'other'=>'Other'{-}'not_answered'=>'Not Answered' | ||
text{@}acquisition_software_other{@}If other, please specify | ||
select{@}acquisition_software_other_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}recording_reference{@}Recording reference used{@}NULL=>''{-}'left_mastoid'=>'left mastoid'{-}'right_mastoid'=>'right mastoid'{-}'left_earlobe'=>'left earlobe'{-}'right_earlobe'=>'right earlobe'{-}'physically_linked_mastoids'=>'physically linked mastoids'{-}'physically_linked_earlobes'=>'physically linked earlobes'{-}'cz'=>'Cz'{-}'tip_nose'=>'tip of the nose'{-}'balanced_non_cephalic_reference'=>'balanced non-cephalic reference'{-}'other'=>'Other'{-}'not_answered'=>'Not Answered' | ||
text{@}recording_reference_other{@}If other, please specify | ||
select{@}recording_reference_other_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
text{@}number_active_channels{@}Number of active channels | ||
select{@}number_active_channels_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}eog_channels{@}EOG channels{@}NULL=>''{-}'no_eog_channels'=>'no EOG channels'{-}'two_heog_channels_only'=>'two HEOG channels only'{-}'two_veog_channels_only'=>'two VEOG channels only'{-}'two_heog_two_veog_channels'=>'two HEOG and two VEOG channels'{-}'other'=>'Other'{-}'not_answered'=>'Not Answered' | ||
text{@}eog_channels_other{@}If other, please specify | ||
select{@}eog_channels_other_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
textarea{@}artefacted_channels{@}Artefacted channels | ||
select{@}artefacted_channels_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
header{@}{@}<b><h3>Filters</h3></b> | ||
textarea{@}software_filters_applied{@}What software filters were applied during acquisition? | ||
select{@}software_filters_applied_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
textarea{@}hardware_filters_applied{@}What hardware filters were applied before acquisition? | ||
select{@}hardware_filters_applied_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
text{@}eeg_session_start_time{@}EEG session Start time | ||
select{@}eeg_session_start_time_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
text{@}eeg_session_end_time{@}EEG session End time | ||
select{@}eeg_session_end_time_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
header{@}{@}<h3>Resting state task</h3> | ||
select{@}resting_state_eeg_acquired{@}Resting State EEG Acquired?{@}NULL=>''{-}'not_started'=>'Not Started'{-}'complete'=>'Complete'{-}'incomplete'=>'Incomplete'{-}'not_answered'=>'Not Answered' | ||
textarea{@}resting_state_eeg_incomplete_reason{@}If Incomplete, why were you unable to complete the task? | ||
select{@}resting_state_eeg_incomplete_reason_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}resting_state_attempts{@}Number of attempts{@}NULL=>''{-}'1'=>'1'{-}'2'=>'2'{-}'3'=>'3'{-}'4'=>'4'{-}'more_than_5'=>'More than 5'{-}'not_answered'=>'Not Answered' | ||
select{@}resting_state_subject_mood_rating{@}Resting State Subject Mood Rating{@}NULL=>''{-}'1'=>'1 - Screaming, fussed out'{-}'2'=>'2'{-}'3'=>'3'{-}'4'=>'4'{-}'5'=>'5 - Very calm the whole time'{-}'not_answered'=>'Not Answered' | ||
textarea{@}resting_state_subject_mood_rating_comments{@}Comments on subject mood | ||
select{@}resting_state_subject_mood_rating_comments_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
textarea{@}resting_state_comments{@}Comments on the resting state | ||
select{@}resting_state_comments_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
header{@}{@}<h3>Task 1</h3> | ||
select{@}task1_eeg_acquired{@}Task 1 EEG Acquired?{@}NULL=>''{-}'not_started'=>'Not Started'{-}'complete'=>'Complete'{-}'incomplete'=>'Incomplete'{-}'not_answered'=>'Not Answered' | ||
textarea{@}task1_eeg_incomplete_reason{@}If Incomplete, why were you unable to complete the task? | ||
select{@}task1_eeg_incomplete_reason_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}task1_attempts{@}Number of attempts{@}NULL=>''{-}'1'=>'1'{-}'2'=>'2'{-}'3'=>'3'{-}'4'=>'4'{-}'more_than_5'=>'More than 5'{-}'not_answered'=>'Not Answered' | ||
select{@}task1_subject_mood_rating{@}Task 1 Subject Mood Rating{@}NULL=>''{-}'1'=>'1 - Screaming, fussed out'{-}'2'=>'2'{-}'3'=>'3'{-}'4'=>'4'{-}'5'=>'5 - Very calm the whole time'{-}'not_answered'=>'Not Answered' | ||
textarea{@}task1_subject_mood_rating_comments{@}Comments on subject mood | ||
select{@}task1_subject_mood_rating_comments_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
textarea{@}task1_comments{@}Comments on Task 1 | ||
select{@}task1_comments_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
header{@}{@}<h3>Task 2</h3> | ||
select{@}task2_eeg_acquired{@}Task 2 EEG Acquired?{@}NULL=>''{-}'not_started'=>'Not Started'{-}'complete'=>'Complete'{-}'incomplete'=>'Incomplete'{-}'not_answered'=>'Not Answered' | ||
textarea{@}task2_eeg_incomplete_reason{@}If Incomplete, why were you unable to complete the task? | ||
select{@}task2_eeg_incomplete_reason_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}task2_attempts{@}Number of attempts{@}NULL=>''{-}'1'=>'1'{-}'2'=>'2'{-}'3'=>'3'{-}'4'=>'4'{-}'more_than_5'=>'More than 5'{-}'not_answered'=>'Not Answered' | ||
select{@}task2_subject_mood_rating{@}Task 2 Subject Mood Rating{@}NULL=>''{-}'1'=>'1 - Screaming, fussed out'{-}'2'=>'2'{-}'3'=>'3'{-}'4'=>'4'{-}'5'=>'5 - Very calm the whole time'{-}'not_answered'=>'Not Answered' | ||
textarea{@}task2_subject_mood_rating_comments{@}Comments on subject mood | ||
select{@}task2_subject_mood_rating_comments_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
textarea{@}task2_comments{@}Comments on Task 2 | ||
select{@}task2_comments_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
header{@}{@}<h3>Task 3</h3> | ||
select{@}task3_eeg_acquired{@}Task 3 EEG Acquired?{@}NULL=>''{-}'not_started'=>'Not Started'{-}'complete'=>'Complete'{-}'incomplete'=>'Incomplete'{-}'not_answered'=>'Not Answered' | ||
textarea{@}task3_eeg_incomplete_reason{@}If Incomplete, why were you unable to complete the task? | ||
select{@}task3_eeg_incomplete_reason_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}task3_attempts{@}Number of attempts{@}NULL=>''{-}'1'=>'1'{-}'2'=>'2'{-}'3'=>'3'{-}'4'=>'4'{-}'more_than_5'=>'More than 5'{-}'not_answered'=>'Not Answered' | ||
select{@}task3_subject_mood_rating{@}Task 3 Subject Mood Rating{@}NULL=>''{-}'1'=>'1 - Screaming, fussed out'{-}'2'=>'2'{-}'3'=>'3'{-}'4'=>'4'{-}'5'=>'5 - Very calm the whole time'{-}'not_answered'=>'Not Answered' | ||
textarea{@}task3_subject_mood_rating_comments{@}Comments on subject mood | ||
select{@}task3_subject_mood_rating_comments_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
textarea{@}task3_comments{@}Comments on Task 3 | ||
select{@}task3_comments_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
header{@}{@}<h3>Task 4</h3> | ||
select{@}task4_eeg_acquired{@}Task 4 EEG Acquired?{@}NULL=>''{-}'not_started'=>'Not Started'{-}'complete'=>'Complete'{-}'incomplete'=>'Incomplete'{-}'not_answered'=>'Not Answered' | ||
textarea{@}task4_eeg_incomplete_reason{@}If Incomplete, why were you unable to complete the task? | ||
select{@}task4_eeg_incomplete_reason_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
select{@}task4_attempts{@}Number of attempts{@}NULL=>''{-}'1'=>'1'{-}'2'=>'2'{-}'3'=>'3'{-}'4'=>'4'{-}'more_than_5'=>'More than 5'{-}'not_answered'=>'Not Answered' | ||
select{@}task4_subject_mood_rating{@}Task 4 Subject Mood Rating{@}NULL=>''{-}'1'=>'1 - Screaming, fussed out'{-}'2'=>'2'{-}'3'=>'3'{-}'4'=>'4'{-}'5'=>'5 - Very calm the whole time'{-}'not_answered'=>'Not Answered' | ||
textarea{@}task4_subject_mood_rating_comments{@}Comments on subject mood | ||
select{@}task4_subject_mood_rating_comments_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' | ||
textarea{@}task4_comments{@}Comments on Task 4 | ||
select{@}task4_comments_status{@}{@}NULL=>''{-}'not_answered'=>'Not Answered' |
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testname{@}eeg_acquisition_form | ||
table{@}eeg_acquisition_form | ||
jsondata{@}true |
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general_comments{-}Not Required{-}general_comments{@}=={@}NEVER_REQUIRED | ||
research_staff_two{-}Not Required{-}research_staff_two{@}=={@}NEVER_REQUIRED | ||
research_staff_three{-}Not Required{-}research_staff_three{@}=={@}NEVER_REQUIRED | ||
session_testing_room{-}Not Required{-}session_testing_room{@}=={@}NEVER_REQUIRED | ||
behavioural_assistant{-}Required if there is a behavioural assistant{-}behavioural_assistant_present{@}=={@}yes | ||
subject_medication_dosage{-}Required if there is an ongoing medication{-}subject_medication{@}=={@}yes | ||
head_measurement_unit{-}Required if head measurement was taken{-}head_measurement_taken{@}=={@}yes | ||
head_measurement{-}Required if head measurement was taken{-}head_measurement_taken{@}=={@}yes | ||
subject_away_60cm_from_monitor_reason{-}Required if subject cannot be 60cm away from monitor{-}subject_away_60cm_from_monitor{@}=={@}no | ||
impedance_measure{-}Required when impedance is measured{-}impedance_measured_before_applied{@}=={@}yes | ||
bad_electrodes{-}Required when bad electrodes are present{-}bad_electrodes_present{@}=={@}yes | ||
bad_channels{-}Required when bad channels are present{-}bad_channels_measured_after_applied{@}=={@}yes | ||
placement_comment{-}Required when placement is not available{-}placement_rating{@}=={@}na | ||
acquisition_software_other{-}Required when acquisition software is other{-}acquisition_software{@}=={@}other | ||
recording_reference_other{-}Required when recording reference is other{-}recording_reference{@}=={@}other | ||
eog_channels_other{-}Required when EOG channels is other{-}eog_channels{@}=={@}other | ||
artefacted_channels{-}Not Required{-}artefacted_channels{@}=={@}NEVER_REQUIRED | ||
hardware_filters_applied{-}Not Required{-}hardware_filters_applied{@}=={@}NEVER_REQUIRED | ||
software_filters_applied{-}Not Required{-}software_filters_applied{@}=={@}NEVER_REQUIRED | ||
resting_state_eeg_incomplete_reason{-}Required when resting state acquiring is incomplete{-}resting_state_eeg_acquired{@}=={@}incomplete | ||
resting_state_subject_mood_rating_comments{-}Not Required{-}resting_state_subject_mood_rating_comments{@}=={@}NEVER_REQUIRED | ||
resting_state_comments{-}Not Required{-}resting_state_comments{@}=={@}NEVER_REQUIRED | ||
task1_eeg_incomplete_reason{-}Required when task 1 acquiring is incomplete{-}task1_eeg_acquired{@}=={@}incomplete | ||
task1_subject_mood_rating_comments{-}Not Required{-}task1_subject_mood_rating_comments{@}=={@}NEVER_REQUIRED | ||
task1_comments{-}Not Required{-}vep_comments{@}=={@}NEVER_REQUIRED | ||
task2_eeg_incomplete_reason{-}Required when task 2 acquiring is incomplete{-}task2_eeg_acquired{@}=={@}incomplete | ||
task2_subject_mood_rating_comments{-}Not Required{-}task2_subject_mood_rating_comments{@}=={@}NEVER_REQUIRED | ||
task2_comments{-}Not Required{-}aep_comments{@}=={@}NEVER_REQUIRED | ||
task3_eeg_incomplete_reason{-}Required when task 3 acquiring is incomplete{-}task3_eeg_acquired{@}=={@}incomplete | ||
task3_subject_mood_rating_comments{-}Not Required{-}task3_subject_mood_rating_comments{@}=={@}NEVER_REQUIRED | ||
task3_comments{-}Not Required{-}mmn_comments{@}=={@}NEVER_REQUIRED | ||
task4_eeg_incomplete_reason{-}Required when task 4 acquiring is incomplete{-}task4_eeg_acquired{@}=={@}incomplete | ||
task4_subject_mood_rating_comments{-}Not Required{-}task4_subject_mood_rating_comments{@}=={@}NEVER_REQUIRED | ||
task4_comments{-}Not Required{-}faces_comments{@}=={@}NEVER_REQUIRED |