CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Additional Proposed Instruments
CRF: PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric

40 results.
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (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 Source Form Set Form Field Domain CDASH Variable CDASH Definition CDASH Label Controlled Terminology Prompt Essentiality Question Text CDASH imp guidance SDTM IG target csDSR PhenX Data Type CRF Completion Inst SDTMIG Target Var SDTMIG Target Map Codelist Name PVs Pre Pop Value Query Display List Style
C59408 Child stroke subsequent clot clinical symptom new other text ChdStrSubCltClnSympNewOthTxt Text description of type of new symptom not otherwise specified presented by the respondent's child at the time of the clot subsequent to his or her initial stroke Text description of type of new symptom not otherwise specified presented by the respondent's child at the time of the clot subsequent to his or her initial stroke Other, describe Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 12:55:50.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X 255

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3.NewSymptom.Describe
C59387 Child recover stroke completely indicator ChldRcvrStrkCmpltInd Indicator of whether the respondent's child has recovered completely from his or her stroke Indicator of whether the respondent's child has recovered completely from his or her stroke Has your child recovered completely from the stroke? No;Yes No;Yes Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-02 15:12:55.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q1
C59420 Child stroke treatment current type ChldStrokTxCurrTyp Type of treatment for stroke that the respondent's child is currently taking Type of treatment for stroke that the respondent's child is currently taking What medications are being used right now for stroke treatment? None;Aspirin;Other, describe;Low molecular weight Heparin;Coumadin None;Aspirin;Other, describe;Low molecular weight Heparin (Enoxaparin, Loxaprin, injections under the skin);Coumadin (blood thinning pill) Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 15:46:06.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Multiple Pre-Defined Values Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q6
C59398 Child stroke problem thinking behavior score code ChdStrokProbThnkBhvrScorCode Code for the score of the respondent's child's problem with thinking or behavior as a result of his or her stroke Code for the score of the respondent's child's problem with thinking or behavior as a result of his or her stroke Does your child have difficulty with his/her thinking or behavior? n/t;0;0.5;1;2 Not Done;None;Mild but no impact on function;Moderate with some limitations with daily functions;Severe or profound with missing function Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 10:42:49.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1D
C59409 Child stroke subsequent clot clinical symptom new duration range ChdStrSubCltClnSympNewDurRng Range of duration of new symptoms presented by the respondent's child at the time of his or her most recent stroke or other clot. Range of duration of new symptoms presented by the respondent's child at the time of his or her most recent stroke or other clot. Describe how long the symptoms lasted with the most recent attack: Less than 6 hrs;6-24 hours;More than 24 hours Less than 6 hrs;6-24 hours;More than 24 hours Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 12:55:50.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3.HowLong
C59388 Child stroke problem strength coordination sensation indicator ChldStrkPrblmStgthCoordSensInd Indicator of whether the respondent's child has any problems with strength, coordination, or sensation including vision or hearing as a result of his or her stroke Indicator of whether the respondent's child has any problems with strength, coordination, or sensation including vision or hearing as a result of his or her stroke Does your child have any problems with strength, coordination, or sensation including vision or hearing, as a result of the stroke? No;Yes No;Yes Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-02 15:17:35.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1A
C59421 Child stroke treatment current type other text ChldStrokTxCurrTypOthTxt Text describing the type of treatment for stroke not otherwise specified that the respondent's child is currently on Text describing the type of treatment for stroke not otherwise specified that the respondent's child is currently on Other (describe) Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 15:46:06.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X 100

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q6.Other
C59399 Child stroke problem thinking behavior describe text ChdStrokProbThnkngBhvrDscrTxt Text description of the respondent's child's problem with thinking or behavior as a result of his or her stroke Text description of the respondent's child's problem with thinking or behavior as a result of his or her stroke Please describe Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 10:42:49.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X 255

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1D.Describe
C59410 Child stroke episode count ChildStrokeEpisodeCt Count of episodes of stroke or internal clotting experienced by the respondent's child since his or her initial stroke Count of episodes of stroke or internal clotting experienced by the respondent's child since his or her initial stroke If there was more than one episode, how many episodes occurred? Numeric Values PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 15:33:42.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Free-Form Entry

0 100 PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3.HowManyEpisodes
C59389 Child stroke problem strength coordination sensation type ChldStkPrblmStgthCoordSensTyp Type of problems with strength, coordination, or sensation including vision or hearing exhibited by the respondent's child as a result of his or her stroke Type of problems with strength, coordination, or sensation including vision or hearing exhibited by the respondent's child as a result of his or her stroke Please choose which of the following are present in your child: Developmental delay;Abnormal tone;Weakness on one side of the body;Weakness on one side of the face;Unsteadiness on one side of the body;Difficulty with hearing;Difficulty with vision;Difficulty with drinking, chewing, or swallowing;Difficulty with speaking clearly;Loss of sensation on one side of the body;Other sensory problems;Other problems with strength or coordination Developmental delay;Abnormal tone;Weakness on one side of the body;Weakness on one side of the face;Unsteadiness on one side of the body;Difficulty with hearing;Difficulty with vision;Difficulty with drinking, chewing, or swallowing;Difficulty with speaking clearly (problem with pronouncing words);Loss of sensation on one side of the body;Other sensory problems;Other problems with strength or coordination Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-02 15:17:35.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Multiple Pre-Defined Values Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1A.2
C59422 Child stroke rehabilitation treatment current type ChldStrokRehabTxCurrTyp Type of stroke rehabilitation treatment the respondent's child is currently receiving Type of stroke rehabilitation treatment the respondent's child is currently receiving What rehabilitation treatments is your child receiving now? None;Occupational therapy;Physical therapy;Speech therapy;Other, describe;Special education services None;Occupational therapy;Physical therapy;Speech therapy;Other, describe;Special education services Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-04 11:10:44.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Multiple Pre-Defined Values Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q7
C59400 Child need help daily activity compare peer indicator ChdNedHlpDlyActCmprPeerInd Indicator of whether the respondent's child needs help with daily activities compared to his or her peers Indicator of whether the respondent's child needs help with daily activities compared to his or her peers Does your child need extra help with day-to-day activities compared with other children of the same age? No;Yes No;Yes Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 11:50:59.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q2
C59411 Child stroke treatment initial type ChldStrokTxInitlTyp Type of treatment for stroke that the respondent's child was being given at the beginning of the stroke or clotting episode subsequent to his or her initial stroke Type of treatment for stroke that the respondent's child was being given at the beginning of the stroke or clotting episode subsequent to his or her initial stroke What stroke treatment was he/she on at the beginning of the episode? None;Aspirin;Other, describe;Low molecular weight Heparin;Coumadin None;Aspirin;Other, describe;Low molecular weight Heparin (Enoxaparin, Loxaprin, injections under the skin);Coumadin (blood thinning pill) Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 15:46:06.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Multiple Pre-Defined Values Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3.Treatment
C59390 Child problem strength coordination result stroke describe text ChdPrbStgCrdRstStrkDscTxt Text field for describing other problems with strength or coordination exhibited by the respondent's child as a result of his or her stroke Text field for describing other problems with strength or coordination exhibited by the respondent's child as a result of his or her stroke Other problems with strength or coordination; describe: Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-02 15:50:09.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X 255

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1A.2 Describe
C59423 Child stroke rehabilitation treatment current type other text ChldStrokRehabTxCurrTypOthTxt Text describing the type of stroke rehabilitation treatment not otherwise specified that the respondent's child is currently receiving Text describing the type of stroke rehabilitation treatment not otherwise specified that the respondent's child is currently receiving Other (describe): Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-04 11:10:44.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X 255

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q7.Describe
C59401 Child stroke any subsequent clot indicator ChldStrokAnySbsqntClotInd Indicator of whether the respondent's child has had any blood clot at any anatomic site since his or her initial stroke Indicator of whether the respondent's child has had any blood clot at any anatomic site since his or her initial stroke Since the first stroke, has your child had another Stroke or Transient Ischemic Attack (TIA) or blood clot in any other blood vessel (e.g. in the leg, lung, heart, other location) ? No;Yes;Unknown No;Yes;Unknown Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 11:54:17.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3
C59412 Child stroke treatment initial type other text ChldStrokTxInitlTypOthTxt Text describing the type of treatment for stroke not otherwise specified that the respondent's child was being given at the beginning of the stroke or clotting episode subsequent to his or her initial stroke Text describing the type of treatment for stroke not otherwise specified that the respondent's child was being given at the beginning of the stroke or clotting episode subsequent to his or her initial stroke Other (describe) Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 15:46:06.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X 100

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3.Treatment.Describe
C59391 Child stroke problem strength coordination sensation affect daily activity indicator ChStPrStgCrdSnsAffDlyActInd Indicator of whether the problems with strength, coordination, or sensation including vision or hearing exhibited by the respondent's child as a result of his or her stroke, affect his or her daily activities Indicator of whether the problems with strength, coordination, or sensation including vision or hearing exhibited by the respondent's child as a result of his or her stroke, affect his or her daily activities Does the problem affect your child's day-to-day activities? No;Yes No;Yes Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-02 15:17:35.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1A.3
C59424 Death reason DeathRsn Reason or cause of death Reason or cause of death Cause of death: Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-04 11:26:59.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X 255

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q8.Cause
C59402 Child stroke any subsequent clot type ChldStrokAnySbsqntClotTyp Type of the respondent's child's blood clot at any anatomic site, if any, since his or her initial stroke Type of the respondent's child's blood clot at any anatomic site, if any, since his or her initial stroke Which type? Unknown;Stroke in a brain artery;Stroke in a brain vein;Other blood clot;Transient Ischemic Attack (TIA) Unknown;Stroke in a brain artery (usual form of 'stroke');Stroke in a brain vein ('sinus thrombosis');Other blood clot;Transient Ischemic Attack (TIA) Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 11:54:17.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3.Type
C59413 Child headache seizure since discharge after stroke indicator ChHdchSeizSncDschgAfStrkInd Indicator of whether the respondent's child experiences headaches or seizures since his or her discharge from hospital after a stroke Indicator of whether the respondent's child experiences headaches or seizures since his or her discharge from hospital after a stroke Does your child suffer from headaches or seizures since being discharged after the stroke(s)? No;Yes No;Yes Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 15:55:37.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q4
C59392 Child stroke problem strength coordination right side face body code ChStrProStgCrdRtSdFcBdyCode Code for the score of the respondent's child's problems with strength or coordination of the right side of the face or body as a result of his or her stroke. Code for the score of the respondent's child's problems with strength or coordination of the right side of the face or body as a result of his or her stroke. Right side face or body n/t;0;0.5;1;2 Not Done;None;Mild but no impact on function;Moderate with some limitations with daily functions;Severe or profound with missing function Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 10:28:55.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1A.Right side
C59403 Child stroke subsequent clot anatomic site ChldStrokSbsqntClotAnatSite Anatomic site of the respondent's child's blood clot, if any, since his or her initial stroke Anatomic site of the respondent's child's blood clot, if any, since his or her initial stroke State location of blood clot Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 11:54:17.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X 100

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3.Type.location
C59414 Child headache since discharge after stroke indicator ChHdchSncDschgAfStrkInd Indicator of whether the respondent's child experiences headaches since his or her discharge from hospital after a stroke Indicator of whether the respondent's child experiences headaches since his or her discharge from hospital after a stroke Headache: No;Yes No;Yes Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 15:55:37.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q4.Headache
C59393 Child stroke problem strength coordination left side face body code ChStrProStgCrdLfSdFcBdyCode Code for the score of the respondent's child's problems with strength or coordination of the left side of the face or body as a result of his or her stroke. Code for the score of the respondent's child's problems with strength or coordination of the left side of the face or body as a result of his or her stroke. Left side face or body n/t;0;0.5;1;2 Not Done;None;Mild but no impact on function;Moderate with some limitations with daily functions;Severe or profound with missing function Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 10:28:55.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1A.Left side
C59404 Child stroke subsequent clot occur date ChldStrokSbsqntClotOcurDate Date of the respondent's child's subsequent blood clot, if any, since his or her initial stroke Date of the respondent's child's subsequent blood clot, if any, since his or her initial stroke When was the recurrence (if unknown, please estimate)? Date or Date & Time PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 11:54:17.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3.When
C59415 Child seizure since discharge after stroke indicator ChSeizSncDschgAfStrkInd Indicator of whether the respondent's child experiences seizures since his or her discharge from hospital after a stroke Indicator of whether the respondent's child experiences seizures since his or her discharge from hospital after a stroke Seizures No;Yes No;Yes Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 15:55:37.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q4.Seizure
C59394 Child stroke problem verbal expression score code ChdStrokProbVrblExprsnScorCode Code for the score of the respondent's child's problem with verbal expression as a result of his or her stroke Code for the score of the respondent's child's problem with verbal expression as a result of his or her stroke Does your child have difficulty expressing him/herself verbally? (Exclude dysarthrias or pronunciation problems) n/t;0;0.5;1;2 Not Done;None;Mild but no impact on function;Moderate with some limitations with daily functions;Severe or profound with missing function Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 10:42:49.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1B
C59405 Child stroke subsequent clot CT MRI indicator ChldStrokSbsqntClotCTMRIInd Indicator of whether the respondent's child had a CT or MRI scan at the time of the subsequent blood clot, if any, since his or her initial stroke Indicator of whether the respondent's child had a CT or MRI scan at the time of the subsequent blood clot, if any, since his or her initial stroke Did your child have a CT / MRI at the time of the recurrence? No;Yes;Unknown No;Yes;Unknown Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 11:54:17.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3.CTMRI
C13464 Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - total score PSOMSNETotalScore The total score on the Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). The total score on the Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). Total Parental PSOM Score Numeric Values PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 3.00 2013-06-21 00:00:00.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Free-Form Entry

0 10 DeBaun Forms
C59416 Child seizure medication indicator ChSeizMdctnInd Indicator of whether the respondent's child takes a seizure medication Indicator of whether the respondent's child takes a seizure medication Is he/she on a seizure medicine now? No;Yes No;Yes Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 15:55:37.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q4.SeizureMed
C59395 Child stroke problem verbal expression describe text ChdStrokProbVrblExprsnDscrTxt Text description of the respondent's child's problem with verbal expression as a result of his or her stroke Text description of the respondent's child's problem with verbal expression as a result of his or her stroke Please describe Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 10:42:49.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X 255

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1B.Describe
C59406 Imaging CT MRI new stroke indicator ImgCTMRINewStrokeInd Indicator of whether a CT or MRI scan showed a new stroke Indicator of whether a CT or MRI scan showed a new stroke Did the CT/MRI show a new stroke? No;Yes;Unknown No;Yes;Unknown Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 12:49:52.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3.CTMRI.New
C22354 Imaging diagnostic method type ImgDiagMethodType The type of imaging method utilized for diagnosis. The type of imaging method utilized for diagnosis. Which test was done? MRI;CT;Unknown MRI;CT;Unknown Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2016-06-09 14:44:44.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

C59418 Health problem procedure result from stroke or treatment indicator HthPrbPrcdrRstFrStrOrTxInd Indicator of whether health problems or procedures resulted from the stroke or stroke treatment Indicator of whether health problems or procedures resulted from the stroke or stroke treatment Have there been any other major health problems or procedures resulting from the stroke(s) or the stroke(s) treatment? No;Yes No;Yes Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-04 10:55:58.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q5
C59396 Child stroke problem verbal comprehension score code ChdStrokProbVrblCmphnsScorCode Code for the score of the respondent's child's problem with verbal comprehension as a result of his or her stroke Code for the score of the respondent's child's problem with verbal comprehension as a result of his or her stroke Does your child have difficulty understanding what is said to her/him? n/t;0;0.5;1;2 Not Done;None;Mild but no impact on function;Moderate with some limitations with daily functions;Severe or profound with missing function Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 10:42:49.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1C
C59407 Child stroke subsequent clot clinical symptom new type ChdStrSubCltClnSympNewTyp Type of new symptom presented by the respondent's child at the time of the clot subsequent to his or her initial stroke Type of new symptom presented by the respondent's child at the time of the clot subsequent to his or her initial stroke Describe the new clinical symptoms at the time of the recurrence: Difficulty walking;Difficulty with drinking, chewing, or swallowing;Difficulty with vision;Difficulty speaking;Difficulty using hands;Other, describe Difficulty walking;Difficulty with drinking, chewing, or swallowing;Difficulty with vision;Difficulty speaking;Difficulty using hands;Other, describe Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 12:55:50.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Multiple Pre-Defined Values Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q3.NewSymptom
C58800 Death date DeathDate Date on which the subject/participant died Date on which the subject/participant died If your child is deceased, please specify: Date of death: Date or Date & Time PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2018-12-12 12:24:18.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X

Free-Form Entry

BMTCTN 1507A Release 5.10 Follow Up Status Form - 1507 (F23) F23DTHDT
C59419 Health problem procedure result from stroke or treatment describe text HthPrbPrcdrRstFrStrOrTxDscrTxt Text describing health problems or procedures that resulted from the stroke or stroke treatment Text describing health problems or procedures that resulted from the stroke or stroke treatment If yes, describe: Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-04 10:55:58.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X 255

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric Q5.Describe
C59397 Child stroke problem verbal comprehension describe text ChdStrokProbVrblCmprhnDscrTxt Text description of the respondent's child's problem with verbal comprehension as a result of his or her stroke Text description of the respondent's child's problem with verbal comprehension as a result of his or her stroke Please describe Alphanumeric PhenX Protocol: Recovery and Recurrence Questionnaire (RRQ) - Pediatrics (#820702) Pediatric Proposed 1.00 2019-04-03 10:42:49.0 PhenX Toolkit: Neurology, QOL Health Services Recovery and Recurrence Questionnaire - Pediatric Additional Proposed Instruments Phen-X 255

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Recovery and Recurrence Questionnaire - Pediatric 1C.Describe
40 results.
CSV