CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Additional Proposed Instruments
CRF: Neurological Exam

75 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
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 Other

Multiple Pre-Defined Values Selected

DeBaun Forms
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 Other 4000

Free-Form Entry

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 Other

Single Pre-Defined Value Selected

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 Other 255

Free-Form Entry

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 Other

Multiple Pre-Defined Values Selected

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 Other 4000

Free-Form Entry

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 Other

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 Other

Multiple Pre-Defined Values Selected

DeBaun Forms
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 Other 4000

Free-Form Entry

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 Other

Single Pre-Defined Value Selected

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 Other

Single Pre-Defined Value Selected

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 Other

Multiple Pre-Defined Values Selected

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 Other 4000

Free-Form Entry

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 Other

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 Other

Single Pre-Defined Value Selected

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 Other 4000

Free-Form Entry

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 Other

Single Pre-Defined Value Selected

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 Other

Single Pre-Defined Value Selected

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 Other

Single Pre-Defined Value Selected

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 Other 4000

Free-Form Entry

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 Other

Single Pre-Defined Value Selected

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 Other

Single Pre-Defined Value Selected

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 Other 4000

Free-Form Entry

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 Other

Single Pre-Defined Value Selected

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 Other

Single Pre-Defined Value Selected

75 results.
CSV