CDE Detailed Report
Disease:
Sub-Domain: Additional Proposed Instruments
CRF:

79 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
C59264 Child health plan name verify indicate code ChildHlthPlanNameVerfyIndCode Code indicating that the study has the correct name of the child's health plan on file Code indicating that the study has the correct name of the child's health plan on file Our records show that your child is now in [INSERT HEALTH PLAN NAME]. Is that right? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-28 11:45:40.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 1
C59306 Child able talk about health care indicate code ChdAblTlkAbtHlthCarIndCode Code indicating whether the child is able to talk to doctors about his or her health care Code indicating whether the child is able to talk to doctors about his or her health care is your child able to talk with doctors about his or her health care? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-04-01 09:24:49.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 14
C59349 Respondent relation patient code RespondRelatePtCode Code for the relationship to the patient of the individual answering the questionnaire. Code for the relationship to the patient of the individual answering the questionnaire. How are you related to the child? 1;2;3;4;5;6 Mother or father;Grandparent;Aunt or uncle;Older sibling;Other relative;Legal guardian Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Adult;Pediatric Proposed 1.00 2019-04-01 13:45:19.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 39
C59275 Child health care rating last 6 month scale ChldHCRtngLst6MoScl Scale for rating the child's health care over the last 6 months. Scale for rating the child's health care over the last 6 months. Using any number from 0 to 10, where 0 is the worst health care possible and 10 is the best health care possible, what number would you use to rate all your child's health care in the last 6 months? 0;1;2;3;4;5;6;7;8;9;10 Worst health care possible;1;2;3;4;5;6;7;8;9;Best health care possible Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-28 15:33:42.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 8
C59317 Specialist seen most often rating scale SpcstSeenMostOftnRatingScl Scale for rating the specialist the subject/participant saw most often in the last 6 months. Scale for rating the specialist the subject/participant saw most often in the last 6 months. We want to know your rating of the specialist your child saw most often in the last 6 months. Using any number from 0 to 10, where 0 is the worst specialist possible and 10 is the best specialist possible, what number would you use to rate that specialist? 1;2;3;4;5;6;7;8;9;0;10 1;2;3;4;5;6;7;8;9;Worst specialist possible;Best specialist possible Numeric Values

Do not include dental visits or care your child got when he or she stayed overnight in a hospital.

PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-28 15:33:42.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 22
C59328 Receive assistance obtain prescription medication indicate code RcvAsstObtPrscrpMdIndCode Code indicating whether assistance was received in obtaining prescription medications Code indicating whether assistance was received in obtaining prescription medications Did anyone from your child's health plan, doctor's office, or clinic help you get your child's prescription medicines? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-04-01 11:37:53.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC24
C59292 Easy obtain counseling child last 6 month frequency scale EsyObtCounslChLst6MoFrqScl Scale of the frequency in the last 6 months that it was easy to obtain counseling or treatment for emotional, developmental, or behavioral problems for the child. Scale of the frequency in the last 6 months that it was easy to obtain counseling or treatment for emotional, developmental, or behavioral problems for the child. In the last 6 months, how often was it easy to get this treatment o r counseling for your child? 1;2;3 Never;Sometimes;usually Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-28 15:16:41.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC15
C59339 Special therapy due health condition indicate code SpcTherDueHlthCondIndCode Code indicating whether the subject/participant needs or receives special therapy such as physical, occupational, or speech therapy due to a health condition Code indicating whether the subject/participant needs or receives special therapy such as physical, occupational, or speech therapy due to a health condition Is this because of any medical, behavioral, or other health condition? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-04-01 12:38:12.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC35
C59265 Child health plan name ChildHlthPlanName Name of the child's health plan Name of the child's health plan What is the name of your child's health plan? Alphanumeric

Collect if "Child health plan name verify indicate code" is answered 2 (No).

PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-28 11:50:08.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr 100

Free-Form Entry

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 2
C59307 Child personal physician explain clearly to child last 6 month frequency scale ChPslPhyExpClrToChLst6MoFrqScl Scale for the frequency over the past 6 months that the child's personal physician explained things in a way that was easy for the child to understand Scale for the frequency over the past 6 months that the child's personal physician explained things in a way that was easy for the child to understand In the last 6 months, how often did your child's personal doctor explain things in a way that was easy for your child to understand? 1;2;4;3 Never;Sometimes;Always;usually Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-29 10:22:22.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 15
C59350 Respondent receive help complete questionnaire indicate code RespRcvHlpCmpltQaireIndCode Code indicating whether the respondent received assistance in completing the questionnaire. Code indicating whether the respondent received assistance in completing the questionnaire. Did someone help you complete this survey? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Adult;Pediatric Proposed 1.00 2019-04-01 13:50:03.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 40
C59276 Child enroll school daycare indicate code ChildEnrolSchlDycrIndCode Code indicating whether the child is currently enrolled in school or daycare. Code indicating whether the child is currently enrolled in school or daycare. is your child now enrolled in any kind of school or daycare? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-28 15:40:46.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC5
C59318 Care via health plan last 6 month indicate code CareViaHlthPlanLst6MoIndCode Code indicating whether care was sought through the subject/participant's health plan in the last 6 months Code indicating whether care was sought through the subject/participant's health plan in the last 6 months In the last 6 months, did you try to get any kind of care, tests, or treatment for your child through his or her health plan? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-04-01 10:28:51.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 23
C59329 Prescription medication need use indicate code PrscrpMdNeedUseIndCode Code indicating whether the subject/participant needs or uses prescription medications other than vitamins Code indicating whether the subject/participant needs or uses prescription medications other than vitamins Does your child currently need or use medicine prescribed by a doctor (other than vitamins)? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-04-01 11:46:19.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC25
C59293 Receive help obtain counseling child last 6 month indicate code RcvHpObtCounslChLst6MoIndCode Code indicating whether help obtaining counseling or treatment for emotional, developmental, or behavioral problems for the child was received in the last 6 months Code indicating whether help obtaining counseling or treatment for emotional, developmental, or behavioral problems for the child was received in the last 6 months Did anyone from your child's health plan, doctor's office, or clinic help you get this treatment or counseling for your child? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-29 09:26:29.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC16
C59340 Special therapy due health condition endure 12 month indicate code SpThrDuHlthCndEnd12MoIndCode Code indicating whether the subject/participant needs or receives special therapy such as physical, occupational, or speech therapy due to a health condition that has endured or is expected to endure for at least 12 months Code indicating whether the subject/participant needs or receives special therapy such as physical, occupational, or speech therapy due to a health condition that has endured or is expected to endure for at least 12 months Is this a condition that has lasted or is expected to last for at least 12 months? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-04-01 12:38:12.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC36
C59266 Child need urgent care last 6 month indicate code ChldNeedUrgtCareLst6MoIndCode Code indicating whether the child needed urgent care in the last 6 months. Code indicating whether the child needed urgent care in the last 6 months. In the last 6 months, did your child have an illness, injury, or condition that needed care right away in a clinic, emergency room, or doctor's office? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-28 11:52:32.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 3
C59308 Child personal physician spend enough time with child last 6 month frequency scale ChPslPhySpEnTmWChLst6MoFrqScl Scale for the frequency over the past 6 months that the child's personal physician spent enough time with the child Scale for the frequency over the past 6 months that the child's personal physician spent enough time with the child In the last 6 months, how often did your child's personal doctor spend enough time with your child? 1;2;4;3 Never;Sometimes;Always;usually Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-29 10:22:22.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 16
C59277 Child health care provider contact school daycare last 6 month indicate code ChdHCPvdCntSchDycLst6MoIndCode Code indicating whether the child's health care providers contacted school or daycare about the child's health or care in the last 6 months. Code indicating whether the child's health care providers contacted school or daycare about the child's health or care in the last 6 months. In the last 6 months, did you need your child's doctors or other health providers to contact a school or daycare center about your child's health or health care? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-28 15:44:38.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC6
C59319 Easy obtain care child health plan last 6 month frequency scale EsyObtCrChHlthPlnLst6MoFrqScl Scale of the frequency in the last 6 months that it was easy to obtain care for the child through his or her health plan Scale of the frequency in the last 6 months that it was easy to obtain care for the child through his or her health plan In the last 6 months, how often was it easy to get the care, tests, or treatment you thought your child needed through his or her health plan? 1;2;4;3 Never;Sometimes;Always;usually Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-28 15:16:41.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 24
C59330 Prescription medication health condition indicate code PrscrpMdHlthCondIndCode Code indicating whether the subject/participant needs or uses prescription medications other than vitamins because of a health condition Code indicating whether the subject/participant needs or uses prescription medications other than vitamins because of a health condition Is this because of any medical, behavioral, or other health condition? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-04-01 11:46:19.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC26
C59294 Child more one kind health care provider service last 6 month indicate code ChlMr1KdHthCrPvSvLst6MoIndCode Code indicating whether child received care from more than one health care provider or service in the last 6 months. Code indicating whether child received care from more than one health care provider or service in the last 6 months. In the last 6 months, did your child get care from more than one kind of health care provider or use more than one kind of health care service? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-29 09:53:45.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC17
C59341 Problem emotion behavior development indicate code PrbEmBhvDevIndCode Code indicating whether the subject/participant has emotional, developmental, or behavioral problems for which he or she needs or receives treatment Code indicating whether the subject/participant has emotional, developmental, or behavioral problems for which he or she needs or receives treatment Does your child have any kind of emotional, developmental, or behavioral problem for which he or she needs or gets treatment or counseling? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-04-01 12:45:35.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC37
C59267 Child receive timely urgent care last 6 month reliability scale ChdRcvTmlyUrgtCrLst6MoRelScl Scale of how reliably the child received timely urgent care in the last 6 months. Scale of how reliably the child received timely urgent care in the last 6 months. In the last 6 months, when your child needed care right away, how often did your child get care as soon as you thought he or she needed? 1;2;4;3 Never;Sometimes;Always;usually Numeric Values

Collect if "Child need urgent care last 6 month indicate code" is answered 1 (Yes).

PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-28 11:52:32.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 4
C59309 Child personal physician talk about child feel grow behave last 6 month indicate code ChPrPhTkAbChFlGrBhLs6MoIndCode Code indicating whether the child's personal physician talked in the last 6 months about how the child is feeling, growing, or behaving Code indicating whether the child's personal physician talked in the last 6 months about how the child is feeling, growing, or behaving In the last 6 months, did your child's personal doctor talk with you about how your child is feeling, growing, or behaving? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-04-01 09:24:49.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 17
C59278 Child health care provider help contact school daycare last 6 month indicate code ChdHCPvHpCntSchDycLst6MoInCode Code indicating whether the child's health care providers helped contact school or daycare about the child's health or care in the last 6 months. Code indicating whether the child's health care providers helped contact school or daycare about the child's health or care in the last 6 months. In the last 6 months, did you get the help you needed from your child's doctors or other health providers in contacting your child's school or daycare? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-28 15:44:38.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC7
C59320 Use health plan customer service last 6 month indicate code UseHlthPlnCustSvcLst6MoIndCode Code indicating whether attempts were made to use customer service at the subject/participant's health plan in the last 6 months Code indicating whether attempts were made to use customer service at the subject/participant's health plan in the last 6 months In the last 6 months, did you try to get information or help from customer service at your child's health plan? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-04-01 10:38:36.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children 25
C59331 Prescription medication health condition endure 12 month indicate code PrscrpMdHlthCondEnd12MoIndCode Code indicating whether the subject/participant needs or uses prescription medications other than vitamins because of a health condition that has endured or is expected to endure for at least 12 months Code indicating whether the subject/participant needs or uses prescription medications other than vitamins because of a health condition that has endured or is expected to endure for at least 12 months Is this a condition that has lasted or is expected to last for at least 12 months? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-04-01 11:46:19.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC27
C59295 Receive help coordinate different health care provider service last 6 month indicate code RcHpCordDfHlCrPvSvLs6MoIndCode Code indicating whether child's health plan, doctor's office, or clinic helped coordinate your child's care among different providers or services in the last 6 months Code indicating whether child's health plan, doctor's office, or clinic helped coordinate your child's care among different providers or services in the last 6 months In the last 6 months, did anyone from your child's health plan, doctor's office, or clinic help coordinate your child's care among these different providers or services? 1;2;1;2 Yes;No;Yes;No Numeric Values PhenX Protocol: Quality of Care - Children (#820102) Pediatric Proposed 1.00 2019-03-29 10:03:32.0 PhenX Toolkit: Quality of Care - Children Additional Proposed Instruments general-data-protection-regulation-gdpr

Single Pre-Defined Value Selected

PhenX Neurology, Quality of Life, and Health Services Specialty Collection Quality of Care - Children CC18
79 results.
CSV