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

Displaying 101 - 150 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
C13895 Imaging vessel angiography presumed pathogenesis type ImgVesselAngioPresmPathogenTyp Indicates vessel angiography presumed pathogenesis Indicates vessel angiography presumed pathogenesis Congenital Hypoplasia;Thrombosis;Stenosis;Congenital Hypoplasia;Thrombosis;Stenosis Congenital Hypoplasia;Thrombosis;Stenosis;Congenital Hypoplasia;Thrombosis;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

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

C13462 Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - cognitive or behavioral deficit scale PSOMSNECogBehavDefScale The scale for cognitive or behavioral deficit based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). The scale for cognitive or behavioral deficit based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). 0;0.5;1;2;0;0.5;1;2;0;0.5;1;2 None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function 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
C14030 Vasospasm resistive index indicator VasospasmRestistIndexInd Indicates vasospasm resistive Index (RI) Indicates vasospasm resistive Index (RI) 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

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

C12475 Imaging magnetic resonance imaging T1 T2 sequence name ImgMRIT1T2SeqName The name of the T1 or T2 sequences used for Magnetic Resonance Imaging (MRI) The name of the T1 or T2 sequences used for MRI 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

C13927 Intima media thickness (IMT) B Mode guided M mode indicator IMTBModeGuidedMModeInd Indicates intima media thickness (IMT) B mode guided M mode Indicates intima media thickness (IMT) B mode guided M mode 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

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

C15565 Imaging angiography time of flight method duration ImgAngioTOFMethdDur Time of flight (TOF) method duration Time of flight (TOF) method duration Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

second
C01554 Oxygen saturation measurement O2SatMeasr Value, as a percent, of baseline O2 saturation (SPO2) in nocturnal oximetry, as part of Nocturnal Oximetry. Value, as a percent, of baseline O2 saturation (SPO2) in nocturnal oximetry, as part of Nocturnal Oximetry. Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-22 16:57:17.79 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0 100 percent DeBaun Forms
C02016 Medication prior or concomitant start date and time MedctnPriorConcomStrtDateTime The date (and time, if applicable and known) on which the prior/concomitant medication usage began. The date (and time, if applicable and known) on which the prior/concomitant medication usage began. Date or Date & Time Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

3162752 DeBaun Forms
C21489 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest last trial correct digit score WAISIVLDSFScore Score for the digits reported correctly by the subject/participant during the last trial of the Digit Span Forward subtest, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Score for the digits reported correctly by the subject/participant during the last trial of the Digit Span Forward subtest, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-22 11:32:44.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0 9
C13234 National Institutes of Health Stroke Scale (NIHSS) - Level of consciousness tertiary question score NIHSSLvlConscTertryQScore Level of consciousness (LOC) commands assessed using the NIH Stroke Scale (NIHSS) Level of consciousness (LOC) commands assessed using the NIH Stroke Scale (NIHSS) 0;1;2;0;1;2;0;1;2 Performs both tasks correctly.;Performs one task correctly;Performs neither task correctly;Performs both tasks correctly.;Performs one task correctly;Performs neither task correctly;Performs both tasks correctly.;Performs one task correctly;Performs neither task 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
C14008 Imaging window quality category ImgWindowQualityCat Indicates window quality category Indicates window quality category Temporal;Posterior;Orbital Temporal;Posterior;Orbital 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

C17738 Informant participant relationship type InformantPartcpntRelateTyp The relationship of the informant to participant/subject The relationship of the informant to participant/subject Family member, specify;Friend;Study Investigator/Study Coordinator;Other, specify:;Family member, specify;Friend;Study Investigator/Study Coordinator;Other, specify: Family member, specify;Friend;Study Investigator/Study Coordinator;Other, specify:;Family member, specify;Friend;Study Investigator/Study Coordinator;Other, specify: Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-30 17:06:52.8 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C08254 Imaging visual analysis location performed type ImgVisAnlysisLocPerfTyp Location where visual analysis of the imaging data are performed Location where visual analysis of the imaging data are performed Central;Central read;Local - Site;Local read;Local report;Other, specify Central;Central read;Local - Site;Local read;Local report;Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C13906 Imaging B-mode artery name ImgBModArtName Indicates B-mode artery name Indicates B-mode artery name CCA;ICA;ECA;CCA;ICA;ECA Common carotid artery;Internal carotid artery;External carotid artery;Common carotid artery;Internal carotid artery;External carotid 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

C54612 Brief Test of Executive Function Second Edition (BRIEF 2) - Working memory total raw scale score BRIEF2WrkngMmryTtlRwSclScore Total score of the raw scale for the working memory function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Total score of the raw scale for the working memory 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

C14056 Imaging depth measurement ImgDepthMeasr The depth measurement (mm) of imaging. The depth measurement (mm) of imaging. 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

0 999 millimeter
C00008 Age value AgeVal Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject. Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject. Numeric Values Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0 1800 month 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

C12486 Imaging other cortical abnormality type ImgOthrCorticalAbnrmlyTyp The type of other cortical abnormality The type of other cortical abnormality Schizencephaly;Porencephaly;Other, specify Schizencephaly;Porencephaly;Other, specify 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

C13938 Imaging minimum lumen diameter measurement ImgMinLumenDiameterMeasr Indicates minimum lumen diameter measurement (mm) Indicates minimum lumen diameter 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
C56393 Conners Continuous Performance Test 3rd Edition (CPT3) - Sustained attention omission block count ConnersCPT3SusAttnOmiBlkCt The number of missed targets by block, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). The number of missed targets by block, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:42:50.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0
C17494 Delay language cognitive milestone indicator DelayLangCogMilestoneInd Indicator as to whether the participant/subject has or had delayed acquisition of language or cognitive milestones, as diagnosed by a pediatrician or neurologist Indicator as to whether the participant/subject has or had delayed acquisition of language or cognitive milestones, as diagnosed by a pediatrician or neurologist Yes;No;Unknown Yes;No;Unknown Alphanumeric 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
C56412 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Matrix Reasoning T score WASIIIMRTScore The T score converted from the raw score that the subject received on the Matrix Reasoning 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 Matrix Reasoning 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
C02311 Adverse event MedDRA lower level term code AdvsEvntMedDRALowerLvlTermCode Code that corresponds to the Medical Dictionary for Regulatory Activities (MedDRA) Lower Level Term (LLT) for an adverse event Code that corresponds to the Medical Dictionary for Regulatory Activities (MedDRA) Lower Level Term (LLT) for an adverse event Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-18 16:35:19.49 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

Free-Form Entry

3133353 DeBaun Forms
C13884 Imaging vessel angiography arterial anatomic site ImgVesselAngioArterAntmicSite Indicates vessel imaging angiography arterial findings location Indicates vessel imaging angiography arterial findings location CCA origin;CCA to bifurcation;ICA at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA;CCA origin;CCA to bifurcation;ICA at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA Common carotid artery origin;Common carotid artery to bifurcation;Internal carotid artery at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA;Common carotid artery origin;Common carotid artery to bifurcation;Internal carotid artery at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA 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

C21500 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest number series text WAISIVDSSNumTxt Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-22 11:32:44.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0 50
C13245 National Institutes of Health Stroke Scale (NIHSS) - Severity total score NIHSSSevTotalScore The level of stroke severity as measured by the NIH Stroke Scale (NIHSS) scoring system (i.e., total of the subscale item scores). The level of stroke severity as measured by the NIH Stroke Scale (NIHSS) scoring system (i.e., total of the subscale item scores). 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

0 42
C14020 Sickle cell disease vessel anatomic site SickleCellDisVesselAntmicSite Indicates sickle cell vessel Indicates sickle cell vessel ICA;MCA;ACA;Other, specify Internal carotid artery;Middle cerebral artery;Anterior carotid artery;Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

C56439 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 percentile rank value WASIIIFullScale2PrcntRankVal The percentile rank the subject placed in with respect to Full Scale IQ for two subtests (Vocabulary and Matrix Reasoning), as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The percentile rank the subject placed in with respect to Full Scale IQ for two subtests (Vocabulary and Matrix Reasoning), as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-12 13:04:39.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0 100 percent
C18689 Imaging anatomic site other text ImgAntmicSitOTH The free-text field related to 'Imaging anatomic site' specifying other text. Type of body part or anatomy scanned in the imaging study The free-text field related to 'Imaging anatomic site' specifying other text. Type of body part or anatomy scanned in the imaging study 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

C10931 Imaging quality of images technically satisfactory indicator ImgQualImgTechnSatisInd Indicator of whether the quality of the images were technically satisfactory. Indicator of whether the quality of the images were technically satisfactory. Yes;No;Unknown;Not applicable Yes;No;Unknown;Not applicable Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C13917 Imaging end diastolic velocity measurement ImgEndDiastVeloMears Indicates end diastolic velocity (cm/sec) Indicates end diastolic velocity (cm/sec) 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

centimeter per second
C54695 PROMIS - Global Health fatigue rate scale PROMISGlbHlthFtgRtScl Scale related to an individual's rating of his/her fatigue, as part of the PROMIS Global Health Scale related to an individual's rating of his/her fatigue, 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

C14681 Pediatric Migraine Disability Assessment (MIDAS) - headache cease home function day count PedMIDASHeadCeasHomFuncDayCt Count the days you were not able to do things at home (i.e., chores, homework, etc.) in the last 3 months due to a headache, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. Count the days you were not able to do things at home (i.e., chores, homework, etc.) in the last 3 months due to a headache, 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

Free-Form Entry

0 92
C01013 Physical exam description text PhysExamDescripTxt Free text field to describe the abnormality in a specific body system or an explanation of why the body system was not examined Free text field to describe the abnormality in a specific body system or an explanation of why the body system was not examined Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

Free-Form Entry

2201880 DeBaun Forms
C19358 Lab test type LabTstTyp Type of lab test performed on body fluid(s) and tissues. Test names are typically comprised of the analyte name, properties (%, Ratio, etc.), the type of body fluid tested, and any special instructions. Type of lab test performed on body fluid(s) and tissues. Test names are typically comprised of the analyte name, properties (%, Ratio, etc.), the type of body fluid tested, and any special instructions. Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

2003746 DeBaun Forms
C12497 Imaging cerebellum abnormality type ImgCrblmAbnrmlyTyp The type of abnormality in the cerebellum on the image The type of abnormality in the cerebellum on the image Other, specify;Cleft;Vermal hypoplasia;Hemispheric hypoplasia;Vermal dysplasia;Hemispheric dysplasia;Cysts Other, specify;Cleft;Vermal hypoplasia;Hemispheric hypoplasia;Vermal dysplasia;Hemispheric dysplasia;Cysts 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

C13949 Imaging flow/probe direction type ImgFlowProbDireTyp Indicates flow/probe direction Indicates flow/probe direction Towards;Away from Towards;Away from 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

C20417 National Institutes of Health Stroke Scale (NIHSS) - Motor leg amputation text NIHSSMotLegAmpTxt The text field for explaining the amputation or joint fusion for question related to motor ability of the leg (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 leg (both left and right) assessed using the NIH Stroke Scale (NIHSS). Alphanumeric Adult;Pediatric Supplemental 4.00 2015-04-27 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

C13147 Stroke Specific Quality of Life Scale (SS-QOL) - trouble phone language scale SSQOLTroubPhonScale The scale for trouble speaking on phone based on Stroke Specific Quality of Life Scale (SS-QOL). The scale for trouble speaking on phone based on Stroke Specific Quality of Life Scale (SS-QOL). 1;2;3;4;5;1;2;3;4;5 Total help - Couldn't do it at all - Strongly agree;A lot of help - A lot of trouble - Moderately agree;Some help - Some trouble - Neither agree nor disagree;A little help - A little trouble - Moderately disagree;No help needed - No trouble at all - Strongly disagree;Total help - Couldn't do it at all - Strongly agree;A lot of help - A lot of trouble - Moderately agree;Some help - Some trouble - Neither agree nor disagree;A little help - A little trouble - Moderately disagree;No help needed - No trouble at all - Strongly disagree 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
C13960 Microembolic signal vessel anatomic site MicroembolSignVesselAntmicSite Indicates microembolic signal vessel category Indicates microembolic signal vessel category M1;A1;P1;Siphon;Ophthalmic;Vert;Basilar M1;A1;P1;Siphon;Ophthalmic;Vert;Basilar Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

C56424 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Verbal Comprehension IQ composite score WASIIIVerbCompIQCompScore The subject's Verbal Comprehension IQ composite score, converted from his/her Verbal Comprehension T score, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The subject's Verbal Comprehension IQ composite score, converted from his/her Verbal Comprehension T score, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-12 11:58:34.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

40 160
C08147 Data source DataSource Source of the data provided on the case report form Source of the data provided on the case report form Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Other, specify;Unknown;Spouse Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Other, specify;Unknown;Spouse Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-20 10:46:24.96 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

DeBaun Forms
C13896 Imaging vessel angiography level of confidence status ImgVesselAngioLvlConfidTyp Indicates vessel angiography level of confidence Indicates vessel angiography level of confidence Low;Moderate;High Low;Moderate;High 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

C54602 Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) - Form version name BRIEF2FormVersionName Name of the version of the form, as part of the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) Name of the version of the form, as part of the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) Parent form;Self form;Teacher form Parent form;Self form;Teacher form Alphanumeric Adult;Pediatric Supplemental 1.00 2017-03-20 15:13:56.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C13463 Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - cognitive or behavioral deficit description text PSOMSNECogBehavDeficitDescTxt Description of the cognitive or behavioral deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). Description of the cognitive or behavioral 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

Free-Form Entry

DeBaun Forms
C14031 Vasospasm status VasospasmStatus Indicates vasospasm result Indicates vasospasm 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

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