CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Additional Proposed Instruments
CRF: Miscellaneous Sickle Cell-related CDEs

Displaying 1 - 50 of 491
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
C18892 Imaging percent stenosis criterion other text ImgPercentStenosisCriterionOTH The free-text field related to 'Imaging percent stenosis criterion type' specifying other text. The criteria used to find indicate stenosis. The free-text field related to 'Imaging percent stenosis criterion type' specifying other text. The criteria used to find indicate stenosis. Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

C14024 Vasospasm criterion value VasoCriterionVal Indicates vasospasm criterion value Indicates vasospasm criterion value Numeric Values Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

C56437 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 4 confidence interval upper bound value WASIIIFullSclIQ4ConfIntUppVal The upper bound of the subject's Full Scale IQ-4 confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The upper bound of the subject's Full Scale IQ-4 confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-12 13:06:29.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

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C02309 Serious adverse event indicator SeriousAdvrsEvntInd The indicator of whether the adverse event is serious. The indicator of whether the adverse event is serious. Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

2199908 DeBaun Forms
C56391 Conners Continuous Performance Test 3rd Edition (CPT3) - Sustained attention hit reaction time block change value ConnersCPT3SusAttnHRTBlkChaVal The change in the subject's response speed across blocks of trials, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). The change in the subject's response speed across blocks of trials, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:41:29.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

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0
C13243 National Institutes of Health Stroke Scale (NIHSS) - Dysarthria score NIHSSDysarthriaScore Dysarthria assessed using the NIH Stroke Scale (NIHSS) Dysarthria assessed using the NIH Stroke Scale (NIHSS) 0;1;2;UN;0;1;2;UN Normal;Mild to moderate: patient slurs at least some words and, at worst, can be understood with some difficulty.;Severe: patient's speech is so slurred as to be unintelligible in the absence of or out of proportion to any dysphasia, or is mute/anarthric.;Intubated or other physical barrier, explain;Normal;Mild to moderate: patient slurs at least some words and, at worst, can be understood with some difficulty.;Severe: patient's speech is so slurred as to be unintelligible in the absence of or out of proportion to any dysphasia, or is mute/anarthric.;Intubated or other physical barrier, explain Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C13921 Imaging other carotid ultrasound result ImgOthrCarotidUltrasoundReslt Indicates other carotid ultrasound findings Indicates other carotid ultrasound findings Turbulence;Spectral broadening Turbulence;Spectral broadening Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C21488 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest item score WAISIVDSFItemScore Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest 0;1;2 0;1;2 Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-22 11:32:44.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C14685 Pediatric Migraine Disability Assessment (MIDAS) - headache frequency PedMIDASHeadFreq Headache frequency, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. Headache frequency, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

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C10837 Imaging gap between slices measurement ImgGapBetwnSlicesMeasr Measurement of the gap between slices used in imaging acquisition Measurement of the gap between slices used in imaging acquisition Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

millimeter
C56434 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 4 composite score WASIIIFullScaleIQ4CompScore The subject's Full Scale IQ composite score for all four subtests, converted from his/her Full Scale T score for all four subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The subject's Full Scale IQ composite score for all four subtests, converted from his/her Full Scale T score for all four subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-12 13:02:44.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

40 160
C17529 Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex knee jerk left score FARSPNSNeuExDTenRKneeJLtScore Score for left-side knee jerk in the peripheral nervous system section of the neurological exam, as part of the Friedreich's Ataxia Rating Scale (FARS). Score for left-side knee jerk in the peripheral nervous system section of the neurological exam, as part of the Friedreich's Ataxia Rating Scale (FARS). 0;1;2;3;4;0;1;2;3;4;0;1;2;3;4 0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia;0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia;0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C13953 Consensus on Grading Intracranial Flow Obstruction (COGIF) - follow-up indicator COGIFFollowupInd Indicates the consensus on grading intracranial flow obstruction (COGIF) follow-up Indicates the consensus on grading intracranial flow obstruction (COGIF) follow-up Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C00721 Family history medical condition indicator FamHistMedclCondInd Indicator of whether a family member or first and second degree blood relatives of the participant/subject has had a history of the particular medical condition or health related event Indicator of whether a family member or first and second degree blood relatives of the participant/subject has had a history of the particular medical condition or health related event Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

3165788 DeBaun Forms
C54611 Brief Test of Executive Function Second Edition (BRIEF 2) - Initiate total raw scale score BRIEF2IntiatTtlRwSclScore Total score of the raw scale for the initiate function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Total score of the raw scale for the initiate function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Numeric Values Adult;Pediatric Supplemental 1.00 2017-03-22 09:57:02.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

C12495 Imaging pons abnormality type ImgPonsAbnrmlyTyp The type of abnormality in the pons on the image The type of abnormality in the pons on the image Hypoplasia;Other, specify;Cleft Hypoplasia;Other, specify;Cleft Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

C13888 Thrombolysis In Myocardial Infarction (TIMI) scale - individual vessel score TIMIScaleIndVesselScore The score related to the Thrombolysis In Myocardial Infarction (TIMI) scale individual vessel. The score related to the Thrombolysis In Myocardial Infarction (TIMI) scale individual vessel. 0;1;2;3;0;1;2;3;0;1;2;3 No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches;No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches;No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches Numeric values Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C12506 Imaging eye abnormality type ImgEyeAbnrmlyTyp The type of eye abnormalities The type of eye abnormalities Optic nerve abnormalities;Microphthalmia;Cataract Optic nerve abnormalities;Microphthalmia;Cataract Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C13900 Imaging probe frequency ImgProbeFreq Indicates imaging probe frequency (Hz) Indicates imaging probe frequency (Hz) Numeric Values Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

Hertz
C19167 Special care unit type SCUTyp Type of special care unit Type of special care unit Intensive Care Unit;Step-Down Unit Intensive Care Unit (ICU);Step-Down Unit (SDU) Alphanumeric Adult;Pediatric Supplemental 1.00 2014-05-29 14:04:21.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C14035 VMR response result VMRResponseReslt Indicates vasomotor response (VMR) response result Indicates vasomotor response (VMR) response result Abnormal;Normal;Abnormal;Normal Abnormal;Normal;Abnormal;Normal Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C08023 Imaging abnormal finding text ImgAbnrmlFindTxt Text description of the abnormal findings on the imaging study Text description of the abnormal findings on the imaging study Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

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C56411 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Vocabulary T score WASIIIVocabTScore The T score converted from the raw score that the subject received on the Vocabulary subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) . The T score converted from the raw score that the subject received on the Vocabulary subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-12 11:23:35.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

20 80
C13461 Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - language deficit-comprehension description text PSOMSNELangDefCompDescTxt Description of the language comprehension deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). Description of the language comprehension deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

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DeBaun Forms
C13932 Intima media thickness (IMT) mean near-wall measurement IMTMeanNearWallMeasr Indicates mean intima media thickness (IMT) near-wall measurement (mm) Indicates mean intima media thickness (IMT) near-wall measurement (mm) Numeric Values Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

millimeter
C21499 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest response text WAISIVDSSRespnsTxt Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-22 11:32:44.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 50

Free-Form Entry

C16188 Vaccine received indicator VaccRcvdInd Indicates whether participant/subject received the vaccine Indicates whether participant/subject received the vaccine Yes;No;Unknown;Not Asked Yes;No;Unknown;Not Asked Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C12474 Imaging field of view measurement description text ImgFOVMeasrDescTxt The general description of field of view (FOV) or anatomical positioning The general description of field of view (FOV) or anatomical positioning Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

C18666 Body system other text BodySysOTH The free-text field related to 'Body system category' specifying other text. Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured Free-text category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured interview and physical examination of all the body systems. Alphanumeric Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

2002895 DeBaun Forms
C14002 Extracranial stenosis collateral artery anatomic site ExtracranStenCollArtAntmicSite The site of parallel arteries having extracranial stenosis. The site of parallel arteries having extracranial stenosis. OA;ACA;VA Ophthalmic artery;Anterior cerebral artery;Vertebral artery Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C01541 Weight measurement WgtMeasr Measurement of participant's/subject's weight Measurement of participant's/subject's weight Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0 500 kilogram 2179689 DeBaun Forms
C54694 PROMIS - Global Health bother emotional problem scale PROMISGlbHlthBthrEmtnlPrbScl Scale related to an individual's rating of how often he/she has been bothered by emotional problems such as feeling anxious, depressed or irritable, as part of the PROMIS Global Health Scale related to an individual's rating of how often he/she has been bothered by emotional problems such as feeling anxious, depressed or irritable, as part of the PROMIS Global Health 1;2;3;4;5;1;2;3;4;5 Excellent;Very good;Good;Fair;Poor;Excellent;Very good;Good;Fair;Poor Alphanumeric Adult;Pediatric Supplemental 1.00 2017-04-07 15:34:25.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C55782 Imaging scanner software hardware update text ImagScanSoftHardUpdateTxt Text describing any scanner software or hardware updates during the time the study was performed. Text describing any scanner software or hardware updates during the time the study was performed. Alphanumeric Adult;Pediatric Supplemental 1.00 2017-05-31 12:43:09.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

Free-Form Entry

C13233 National Institutes of Health Stroke Scale (NIHSS) - Level of consciousness secondary question score NIHSSLvlConscSecdryQScore Level of consciousness (LOC) questions assessed using the NIH Stroke Scale (NIHSS) Level of consciousness (LOC) questions assessed using the NIH Stroke Scale (NIHSS) 0;1;2;0;1;2;0;1;2 Answers both questions correctly;Answers one question correctly;Answers neither question correctly;Answers both questions correctly;Answers one question correctly;Answers neither question correctly;Answers both questions correctly;Answers one question correctly;Answers neither question correctly Numeric values Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C13911 Imaging plaque texture text ImgPlaqTextureTxt Indicates plaque texture Indicates plaque texture Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

Free-Form Entry

C20416 National Institutes of Health Stroke Scale (NIHSS) - Motor arm amputation text NIHSSMotArmAmpTxt The text field for explaining the amputation or joint fusion for question related to motor ability of the arm (both left and right) assessed using the NIH Stroke Scale (NIHSS). The text field for explaining the amputation or joint fusion for question related to motor ability of the arm (both left and right) assessed using the NIH Stroke Scale (NIHSS). Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

DeBaun Forms
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 Flexor;Extensor;Equivocal;Cannot Assess;Other, specify Flexor;Extensor;Equivocal;Cannot Assess;Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2012-10-05 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

DeBaun Forms
C08245 Imaging slice count ImgSliceCt Count representing the total number of single image planes captured during imaging acquisition Count representing the total number of single image planes captured during imaging acquisition Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

C56423 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid other used indicator WASIIIExVisHearAidOthrUsedInd The indicator relating to whether the examinee used his/her other visual or hearing aid during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The indicator relating to whether the examinee used his/her other visual or hearing aid during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Used;Not used Used;Not used Alphanumeric Adult;Pediatric Supplemental 1.00 2017-06-12 11:58:34.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C13881 Digital Subtraction Angiography (DSA) injection site anatomic site DSAInjectionSiteAntmicSite The site of injection for digital subtraction angiography (DSA), a type of fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment. The site of injection for digital subtraction angiography (DSA), a type of fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment. Arch;Common carotid;Internal carotid;Vertebral;subclavian;Arch;Common carotid;Internal carotid;Vertebral;subclavian Arch;Common carotid;Internal carotid;Vertebral;subclavian;Arch;Common carotid;Internal carotid;Vertebral;subclavian Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C13943 Imaging B-mode result ImgBModReslt Indicates B mode Indicates B mode Normal;Occlusion;Stenosis Normal;Occlusion;Stenosis Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C00007 Birth date BirthDate Date (and time, if applicable and known) the participant/subject was born Date (and time, if applicable and known) the participant/subject was born Date or Date & Time Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

793 DeBaun Forms
C52699 Sickle cell anemia blood transfusion treatment indicator SickleCellAnemBloodTransfInd The indicator related to whether blood transfusions are used for treatment for sickle cell anemia The indicator related to whether blood transfusions are used for treatment for sickle cell anemia Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C17524 Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex ankle jerk right score FARSPNSNeuExDTenRAnkJRtScore Score for right-side ankle jerk in the peripheral nervous system section of the neurological exam, as part of the Friedreich's Ataxia Rating Scale (FARS). Score for right-side ankle jerk in the peripheral nervous system section of the neurological exam, as part of the Friedreich's Ataxia Rating Scale (FARS). 0;1;2;3;4;0;1;2;3;4;0;1;2;3;4 0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia;0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia;0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C12485 Imaging other cortical abnormality indicator ImgOthrCorticalAbnrmlyInd Indicator of whether other cortical abnormalities of the brain are present Indicator of whether other cortical abnormalities of the brain are present Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C18813 Imaging lesion found other text ImgLesnFoundOTH The free-text field related to 'Imaging lesion found type' specifying other text. Type of lesions found within the imaging study The free-text field related to 'Imaging lesion found type' specifying other text. Type of lesions found within the imaging study Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

C14013 Intracranial stenosis mean velocity criterion value IntracranStenoMnVlctyCriterVal Indicates intracranial stenosis mean velocity criterion Indicates intracranial stenosis mean velocity criterion Numeric Values Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

C02014 Medication prior or concomitant name MedctnPriorConcomName Name of the prior/concomitant agent or drug administered. Name of the prior/concomitant agent or drug administered. Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

3162728 DeBaun Forms
C18899 Imaging brain death vessel anatomic other text ImgBrainDeathVesseIAntmicOTH The free-text field related to 'Imaging brain death vessel anatomic site' specifying other text. Indicates brain death vessel(s) The free-text field related to 'Imaging brain death vessel anatomic site' specifying other text. Indicates brain death vessel(s) Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

C14025 Vasospasm Lindegaard ratio value VasoLinegaardRatioVal Indicates vasospasm Lindegaard ratio result Indicates vasospasm Lindegaard ratio result Numeric Values Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

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