Sub-Domain: Additional Proposed Instruments
CRF:
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 |
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C14448 | Muscle strength abnormality assessment type | MuscStrAbnrmlyAssmtTyp | The muscle strength abnormality type | The muscle strength abnormality type | If abnormal, indicate type | Abnormal - Decreased;Abnormal - Increased;Other, specify | Abnormal - Decreased;Abnormal - Increased;Other, specify | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C18931 | Global change since prior examination other text | GlobalChangeSincPriorExamOTH | The free-text field related to 'Global change since prior examination result' specifying other text. Global assessment of the difference between the prior and follow-up examinations | The free-text field related to 'Global change since prior examination result' specifying other text. Global assessment of the difference between the prior and follow-up examinations | Other, specify | Alphanumeric |
Record change from prior exam if follow-up exam |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C18942 | Cerebellar or coordination assessment abnormality present other text | CerbllCoordAssmtAbnrmlyPrsOTH | The free-text field related to 'Cerebellar or coordination assessment abnormality present status' specifying other text. Whether the cerebellar/coordination assessment found abnormalities | The free-text field related to 'Cerebellar or coordination assessment abnormality present status' specifying other text. Whether the cerebellar/coordination assessment found abnormalities | Other, specify | Alphanumeric |
Choose one for each assessment type. Cannot Assess means the examiner does not know if the patient is normal or not; i.e. an uncooperative patient. |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||
C06005 | Data collected date and time | DataCollDateTime | Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. | Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. | Date form completed | 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.). |
EPILEPSY: Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia. 2010 Apr;51(4):676-85. http://www.ilae-epilepsy.org/Visitors/Centre/ctf/ctfoverview.cfm | Adult;Pediatric | Proposed | 3.00 | 2013-07-24 21:00:23.88 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Free-Form Entry |
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C14462 | Reflex plantar right response result | RflxPlntrRtRespnsReslt | The results from reflex plantar response on the right side | The results from reflex plantar response on the right side | Plantar Response Right | Flexor;Extensor;Equivocal;Cannot Assess;Other, specify | Flexor;Extensor;Equivocal;Cannot Assess;Other, specify | Alphanumeric |
Choose all that apply. If other, explain. |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Multiple Pre-Defined Values Selected |
DeBaun Forms | ||||||||||||||||||||||||||||
C14438 | Motor exam global abnormality present indicator | MotorExamGloblAbnrmlyPresInd | Global assessment whether an abnormality was present following the motor exam. | Global assessment whether an abnormality was present following the motor exam. | Abnormality present? | Yes;No;Cannot Assess | Yes;No;Cannot Assess | Alphanumeric |
Choose one for each global assessment type |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C18508 | Muscle weakness peripheral nerve lesion present text | MuscWeakPerphrlNervLesnPresTxt | The free-text field to describe the peripheral nerve lesion present resultling in muscle weakness. | The free-text field to describe the peripheral nerve lesion present resultling in muscle weakness. | Peripheral Nerve Lesion(s), describe | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 255 |
Free-Form Entry |
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C14450 | Muscle weakness brain pattern type | MuscWeakBrainPattrnTyp | Patterns describing weakness in location of brain | Patterns describing weakness in location of brain | Does the weakness suggest one of the following patterns? | Right Hemiparesis;Left Hemiparesis;Diplegia / Paraparesis;Quadriplegia / Quadraparesis;Peripheral Nerve Lesion(s), Neuropathic Weakness;Neuropathic weakness;Myopathic Weakness;Other, specify | Right Hemiparesis;Left Hemiparesis;Diplegia / Paraparesis;Quadriplegia / Quadraparesis;Peripheral Nerve Lesion(s), Neuropathic Weakness;Neuropathic weakness;Myopathic Weakness;Other, specify | Alphanumeric |
Choose all that apply. Describe if applicable. |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Multiple Pre-Defined Values Selected |
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C18932 | Cranial nerves global assessment other text | CranlNerveGlobAssmtOTH | The free-text field related to 'Cranial nerves global assessment result' specifying other text. The condition of Cranial Nerves | The free-text field related to 'Cranial nerves global assessment result' specifying other text. The condition of Cranial Nerves | Other, specify | Alphanumeric |
Choose only one |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C18943 | Cerebellar or coordination assessment abnormality explain other text | CerbllCoordAssmtAbnrmlyExplOTH | The free-text field related to 'Cerebellar or coordination assessment abnormality present type' specifying other text for explaining the type of abnormality found by the cerebellar/coordination assessment | The free-text field related to 'Cerebellar or coordination assessment abnormality present type' specifying other text. Type of abnormality found by the cerebellar/coordination assessment | Other, specify | Alphanumeric |
Choose all that apply. If abnormal, explain. "Cannot Assess due to Weakness" meant that the test of coordination is abnormal, but abnormal because of weakness (presumably not cerebellar in origin) rather than cerebellar dysfunction. |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C11026 | Neuromuscular Exam Muscle weakness indicator | NeuromuExmCranlMuscleWeaknInd | Indicator whether there is muscle weakness in the muscle or muscle group examined | Whether there is muscle weakness in the muscle or muscle group examined | Weakness? | Yes;No | Yes;No | Alphanumeric |
Choose one. If yes, answer questions A and B. |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
DeBaun Forms | ||||||||||||||||||||||||||||
C14463 | Reflex plantar left response result | RflxPlntrLftRespnsReslt | The results from reflex plantar response on the left side | The results from reflex plantar response on the left side | Plantar Response Left | Flexor;Extensor;Equivocal;Cannot Assess;Other, specify | Flexor;Extensor;Equivocal;Cannot Assess;Other, specify | Alphanumeric |
Choose all that apply. If other, explain. |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Multiple Pre-Defined Values Selected |
DeBaun Forms | ||||||||||||||||||||||||||||
C14439 | Motor exam global assessment abnormality type | MotorExamGloblAbnrmlyAssmtTyp | Global assessment abnormality type found during the motor exam | Global assessment abnormality type found during the motor exam | If abnormal, indicate type | Abnormal and symmetric;Abnormal and asymmetric;Abnormal - Increased;Abnormal - Decreased;Other, specify | Abnormal and symmetric;Abnormal and asymmetric;Abnormal - Increased;Abnormal - Decreased;Other, specify | Alphanumeric |
If the global assessment found an abnormality, then record the abnormality type |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C18509 | Reflex left arm assessment status | RflxLftArmAssmtStatus | The status of the relfex assessment for the left arm. | The status of the relfex assessment for the left arm. | Left Arm | Increased with clonus;Increased without clonus;Hypoactive;Absent | Increased with clonus;Increased without clonus;Hypoactive;Absent | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C14451 | Muscle weakness neurological anatomic site | MuscWeakNeuroAntmicSite | Anatomic location of neurological muscle weakness. | Neurological location of the muscle weakness | Specify the neurological location of the weakness | Brain;Spinal Cord;Peripheral Nervous System;Other, specify;Brain;Spinal Cord;Peripheral Nervous System;Other, specify | Brain;Spinal Cord;Peripheral Nervous System;Other, specify;Brain;Spinal Cord;Peripheral Nervous System;Other, specify | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Multiple Pre-Defined Values Selected |
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C18933 | Nystagmus other text | NystagmusOTH | The free-text field related to 'Nystagmus type' specifying other text. Type of involuntary movement of the eyeballs; its presence or absence is used to diagnose a variety of neurological and visual disorders | The free-text field related to 'Nystagmus type' specifying other text. Type of involuntary movement of the eyeballs; its presence or absence is used to diagnose a variety of neurological and visual disorders | Other, specify | Alphanumeric |
Enter type of nystagmus; physiological nystagmus is normal nystagmus (i.e. a few beats at end gaze) |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C18944 | Reflex exam global assessment other text | RflxExmGlobAssmtOTH | The free-text field related to 'Reflex exam global assessment result' specifying other text. The global assessment of the ability and condition of reflexes | The free-text field related to 'Reflex exam global assessment result' specifying other text. The global assessment of the ability and condition of reflexes | Other, specify | Alphanumeric |
Choose one. If abnormal answer questions A and B. |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C11061 | Gait assessment result | GaitAssmtReslt | Result of the gait assessment | Result of the gait assessment | Gait - global assessment | Normal;Abnormal;Cannot Assess;Other, specify | Normal;Abnormal;Cannot Assess;Other, specify | Alphanumeric |
Choose one. Indicate type if abnormal |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-22 16:57:17.79 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
DeBaun Forms | ||||||||||||||||||||||||||||
C14465 | Gait abnormality assessment type | GaitAbnrmlyAssmtTyp | Type of abnormal gait | Type of abnormal gait | Type of Abnormal Gait | Ataxic Gait;Hemiparetic Gait - Left side;Hemiparetic Gait - Right side;Diplegic Gait;Parkinsonian Gait;Other gait abnormalities | Ataxic Gait;Hemiparetic Gait - Left side;Hemiparetic Gait - Right side;Diplegic Gait;Parkinsonian Gait;Other gait abnormalities | Alphanumeric |
Choose best response |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C14440 | Muscle bulk assessment anatomic site | MuscBulkAssmtAntmicSite | Anatomic location of the muscle bulk exam as part of the motor examination. | Anatomic location of the muscle bulk exam as part of the motor examination. | Muscle Bulk - global assessment | Right upper extremity;Left upper extremity;Right lower extremity;Left lower extremity | Right upper extremity (RUE);Left upper extremity (LUE);Right lower extremity (RLE);Left lower extremity (LLE) | Alphanumeric |
Evaluate all extremities |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C18510 | Reflex left leg assessment status | RflxLftLegAssmtStatus | The status of the relfex assessment for the left leg. | The status of the relfex assessment for the left leg. | Left Leg | Increased with clonus;Increased without clonus;Hypoactive;Absent | Increased with clonus;Increased without clonus;Hypoactive;Absent | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C14452 | Tremor assessment status | TremAssessStatus | The status indicating whether tremors could be detected during the exam | Whether tremors are detected during the exam | Tremor | Yes;No;Cannot Assess;Other, specify | Yes;No;Cannot Assess;Other, specify | Alphanumeric |
Choose only one |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C18934 | Motor exam global assessment abnormality other text | MotorExamGloblAbnrmlyAssmtOTH | The free-text field related to 'Motor exam global assessment abnormality type' specifying other text. Global assessment abnormality type found during the motor exam | The free-text field related to 'Motor exam global assessment abnormality type' specifying other text. Global assessment abnormality type found during the motor exam | Other, specify | Alphanumeric |
If the global assessment found an abnormality, then record the abnormality type |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C18945 | Reflex plantar right response other text | RflxPlntrRtRespnsOTH | The free-text field related to 'Reflex plantar right response result' specifying other text. The results from reflex plantar response on the right side | The free-text field related to 'Reflex plantar right response result' specifying other text. The results from reflex plantar response on the right side | Other, specify | Alphanumeric |
Choose all that apply. If other, explain. |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C14429 | Global change since prior examination result | GlobalChangeSincPriorExamReslt | Global assessment of the difference between the prior and follow-up examinations | Global assessment of the difference between the prior and follow-up examinations | If follow-up exam, change from prior exam | No change;Improved;Worse;Unknown;Other, specify | No change;Improved;Worse;Unknown;Other, specify | Alphanumeric |
Record change from prior exam if follow-up exam |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C14466 | Sensory system global assessment result | SensySytGlobAssmtReslt | The condition and ability of sensory system | The condition and ability of sensory system | Sensory System - global assessment | Abnormal;Normal;Cannot Assess;Other, specify;Abnormal;Normal;Cannot Assess;Other, specify | Abnormal;Normal;Cannot Assess;Other, specify;Abnormal;Normal;Cannot Assess;Other, specify | Alphanumeric |
Choose one. If abnormal answer questions A-D. |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C14441 | Muscle bulk assessment abnormality indicator | MuscBulkAbnrmlyAssmtInd | Whether the muscle bulk assessment found any abnormalities | Whether the muscle bulk assessment found any abnormalities | Abnormality present? | Yes;No;Cannot Assess | Yes;No;Cannot Assess | Alphanumeric |
Choose one for each anatomic site |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C18511 | Reflex right arm assessment status | RflxRtArmAssmtStatus | The status of the relfex assessment for the right arm. | The status of the relfex assessment for the right arm. | Right Arm | Increased with clonus;Increased without clonus;Hypoactive;Absent | Increased with clonus;Increased without clonus;Hypoactive;Absent | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C14453 | Tremor type | TremTyp | The type of tremor detected during the exam | The type of tremor detected during the exam | Type of tremor | Postural;Rest;Intention;Other, specify | Postural;Rest;Intention;Other, specify | Alphanumeric |
Choose only one |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C18935 | Muscle bulk assessment abnormality other text | MuscBulkAbnrmlyAssmtOTH | The free-text field related to 'Muscle bulk assessment abnormality type' specifying other text. The muscle bulk abnormality type | The free-text field related to 'Muscle bulk assessment abnormality type' specifying other text. The muscle bulk abnormality type | Other, specify | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C18946 | Reflex plantar left response other text | RflxPlntrLftRespnsOTH | The free-text field related to 'Reflex plantar left response result' specifying other text. The results from reflex plantar response on the left side | The free-text field related to 'Reflex plantar left response result' specifying other text. The results from reflex plantar response on the left side | Other, specify | Alphanumeric |
Choose all that apply. If other, explain. |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C14431 | Mental status examined type | MentlStatExamTyp | Type of mental status assessment performed | Type of mental status assessment performed | Mental assessments | Attention;Working Memory;Recent Memory;Remote Memory;Spontaneous speech;Comprehension;Naming;Repetition;Reading;Affect | Attention;Working Memory;Recent Memory;Remote Memory;Spontaneous speech;Language Comprehension;Language Naming;Language Repetition;Language Reading;Affect | Alphanumeric |
Answer where applicable Recommended tests are: Attention-forward digit span (6 is normal for adults), Working Memory-reverse digit span (4 is normal for adults), Recent (Episodic) Memory-immediate recall of 3 objects and then recall again after 3-5 minute delay, Remote (Semantic) Memory-either recall of verifiable personal information from the patient's past (i.e. previous addresses or schools) or well-known current events (i.e. naming the Presidents backwards) |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Multiple Pre-Defined Values Selected |
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C14467 | Sensory system abnormality symmetry type | SensySysAbnrmlySymmTyp | Symmetry of abnormality for sensory system results | Symmetry of abnormality for sensory system results | Symmetry of Abnormality | Symmetric;Asymmetric | Symmetric;Asymmetric | Alphanumeric |
Choose only one |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C14442 | Muscle bulk assessment abnormality type | MuscBulkAbnrmlyAssmtTyp | The muscle bulk abnormality type | The muscle bulk abnormality type | If abnormal, indicate type: | Abnormal - Increased;Abnormal - Decreased;Other, specify | Abnormal - Increased;Abnormal - Decreased;Other, specify | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C18512 | Reflex right leg assessment status | RflxRtLegAssmtStatus | The status of the relfex assessment for the right leg. | The status of the relfex assessment for the right leg. | Right Leg | Increased with clonus;Increased without clonus;Hypoactive;Absent | Increased with clonus;Increased without clonus;Hypoactive;Absent | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C18936 | Muscle tone assessment abnormality other text | MuscToneAbnrmlyAssmtOTH | The free-text field related to 'Muscle tone assessment abnormality type' specifying other text. The muscle tone abnormality type | The free-text field related to 'Muscle tone assessment abnormality type' specifying other text. The muscle tone abnormality type | Other, specify | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C14454 | Cerebellar or coordination assessment type | CerbllrCoordinationAssmtTyp | Type of cerebellar/coordination assessment performed | Type of cerebellar/coordination assessment performed | Cerebellar/Coordination assessments | Finger-to-Nose;Rapid Alternating Movements;Heel-to-Shin | Finger-to-Nose;Rapid Alternating Movements;Heel-to-Shin | Alphanumeric |
For each assessment type record whether an abnormality is present and if so the type of abnormality |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C18947 | Sensory system global assessment other text | SensySysGlobAssmtOTH | The free-text field related to 'Sensory system global assessment result' specifying other text. The condition and ability of sensory system | The free-text field related to 'Sensory system global assessment result' specifying other text. The condition and ability of sensory system | Other, specify | Alphanumeric |
Choose one. If abnormal answer questions A-D. |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C14432 | Mental status exam abnormality indicator | MentlStatExamAbnrmlyInd | Whether the mental assessment showed abnormal results | Whether the mental assessment showed abnormal results | Abnormality present? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose only one |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C14468 | Sensory system abnormality anatomic site | SensySysAbnrmlySymmAntmicSite | The location of abnormality for sensory system | The location of abnormality for sensory system | Location of Abnormality | Stocking;Stocking/Glove;Dermatome;Sensory Nerve;Other, specify | Stocking;Stocking/Glove;Dermatome;Sensory Nerve;Other, specify | Alphanumeric |
Choose all that apply. If other, explain. |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Multiple Pre-Defined Values Selected |
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C14443 | Muscle tone assessment anatomic site | MuscToneAssmtAntmicSite | Anatomic location of the muscle tone as part of the motor examination. | Anatomic location of the muscle tone as part of the motor examination. | Muscle Tone - global assessment | Right upper extremity;Left upper extremity;Right lower extremity;Left lower extremity;Truncal tone | Right upper extremity (RUE);Left upper extremity (LUE);Right lower extremity (RLE);Left lower extremity (LLE);Truncal tone | Alphanumeric |
Evaluate all extremities. Truncal tone - is recommended for pediatric studies only |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
DeBaun Forms | ||||||||||||||||||||||||||||
C18513 | Sensory system abnormality dermatome present text | SensySysAbnrmlyDermtPresTxt | The free-text field to describe the dermatome sensory abnormality, the area of skin supplied with afferent nerve fibers by a single posterior spinal root. | The free-text field to describe the dermatome sensory abnormality, the area of skin supplied with afferent nerve fibers by a single posterior spinal root. | Dermatome, explain | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 255 |
Free-Form Entry |
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C18937 | Muscle strength abnormality assessment other text | MuscStrAbnrmlyAssmtOTH | The free-text field related to 'Muscle strength abnormality assessment type' specifying other text. The muscle strength abnormality type | The free-text field related to 'Muscle strength abnormality assessment type' specifying other text. The muscle strength abnormality type | Other, specify | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C14455 | Cerebellar or coordination assessment abnormality present status | CerbllCoordAssmtAbnrmlyPrsStat | Whether the cerebellar/coordination assessment found abnormalities | Whether the cerebellar/coordination assessment found abnormalities | Abnormality present? | Yes;No;Cannot Assess;Other, specify | Yes;No;Cannot Assess;Other, specify | Alphanumeric |
Choose one for each assessment type. Cannot Assess means the examiner does not know if the patient is normal or not; i.e. an uncooperative patient. |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C18948 | Sensory system abnormality anatomic other text | SensySysAbnrmlySymmAntmicOTH | The free-text field related to 'Sensory system abnormality anatomic site' specifying other text. The location of abnormality for sensory system | The free-text field related to 'Sensory system abnormality anatomic site' specifying other text. The location of abnormality for sensory system | Location of Abnormality | Alphanumeric |
Choose all that apply. If other, explain. |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |
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C14433 | Cranial nerves global assessment result | CranlNerveGlobAssmtReslt | The condition of Cranial Nerves | The condition of Cranial Nerves | Cranial nerves - global assessment | Normal;Abnormal;Cannot Assess;Other, specify | Normal;Abnormal;Cannot Assess;Other, specify | Alphanumeric |
Choose only one |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
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C14469 | Sensory system modalities affected type | SensyModltyAffctTyp | The type and location of the sensory receptor activated by a stimulus plays the primary role in coding the stimulus modality | The type and location of the sensory receptor activated by a stimulus plays the primary role in coding the stimulus modality | Sensory Modalities Affected | Light Touch;Pain and Temperature;Vibration;Proprioception;Other, specify | Light Touch;Pain and Temperature;Vibration;Proprioception;Other, specify | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Multiple Pre-Defined Values Selected |
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C14444 | Muscle tone assessment abnormality indicator | MuscToneAbnrmlyAssmtInd | Whether the muscle tone assessment found any abnormalities | Whether the muscle tone assessment found any abnormalities | Abnormality present? | Yes;No;Not assessed;Unknown | Yes;No;Not assessed;Unknown | Alphanumeric |
Choose one for each anatomic site |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr |
Single Pre-Defined Value Selected |
DeBaun Forms | ||||||||||||||||||||||||||||
C18514 | Sensory system abnormality participant description text | SensySysAbnrmlyPrtpDescTxt | The free-text field to capture the participant's description of the sensory abnormality. | The free-text field to capture the participant's description of the sensory abnormality. | Patient Description of abnormal symptoms | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 255 |
Free-Form Entry |
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C18938 | Muscle weakness brain pattern other text | MuscWeakBrainPattrnOTH | The free-text field related to 'Muscle weakness brain pattern type' specifying other text. Patterns describing weakness in location of brain | The free-text field related to 'Muscle weakness brain pattern type' specifying other text. Patterns describing weakness in location of brain | Other, specify | Alphanumeric |
Choose all that apply. Describe if applicable. |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | general-data-protection-regulation-gdpr | 4000 |
Free-Form Entry |