Sub-Domain: Additional Proposed Instruments
CRF:
CDE ID | CDE Name | Variable Name | Definition | Short Description | Additional Notes (Question Text) | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guideline) | Sub Domain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | Source | Form Set | Form | Field | Domain | CDASH Variable | CDASH Definition | CDASH Label | Controlled Terminology | Prompt | Essentiality | Question Text | CDASH imp guidance | SDTM IG target | csDSR | PhenX | Data Type | CRF Completion Inst | SDTMIG Target Var | SDTMIG Target Map | Codelist Name | PVs | Pre Pop Value | Query Display | List Style |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
C13902 | Imaging acute stroke study type | ImgAcutStokStudTyp | Indicates imaging acute stroke study type | Indicates imaging acute stroke study type | Initial;Follow-up 1;Follow-up 2 | Initial;Follow-up 1;Follow-up 2 | 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 |
||||||||||||||||||||||||||||||||
C13236 | National Institutes of Health Stroke Scale (NIHSS) - Visual field score | NIHSSLvlConscVisuFldScore | Visual fields assessed using the NIH Stroke Scale (NIHSS) | Visual fields assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;3;UN;0;1;2;3;UN | No visual loss;Partial hemianopia;Complete hemianopia;Bilateral hemianopia (blind including cortical blindness);Unexaminable (intubated/paralyzed);No visual loss;Partial hemianopia;Complete hemianopia;Bilateral hemianopia (blind including cortical blindness);Unexaminable (intubated/paralyzed) | 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 | |||||||||||||||||||||||||||||||
C55777 | Imaging inter peri ictal headache since end duration | ImagInterPeriIctHeadSincEndDur | The duration of time since the end of the subject's last inter-ictal or peri-ictal headahe. | The duration of time since the end of the subject's last inter-ictal or peri-ictal headahe. | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:23:34.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C14037 | Imaging power M mode left middle cerebral artery result | ImgPowerMModeLeftMCARes | Indicates power M mode for left middle cerebral artery (MCA) result | Indicates power M mode for left middle cerebral artery (MCA) result | Absent;High Resistance;Low Resistance;Absent;High Resistance;Low Resistance | Absent;High Resistance;Low Resistance;Absent;High Resistance;Low Resistance | 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 |
||||||||||||||||||||||||||||||||
C56385 | Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness variability value | ConnersCPT3InaVarVal | The variability of the subject's response speed consistency, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The variability of the subject's response speed consistency, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:36:25.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C14559 | EEG recording start date and time | EEGRecordingStrtDateTime | Date (and time, if applicable and known) the electroencephalogram (EEG) recording began | Date the electroencephalogram (EEG) recording 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 |
DeBaun Forms | |||||||||||||||||||||||||||||||||
C10933 | Imaging lesion found type | ImgLesnFoundTyp | Type of lesions found within the imaging study | Type of lesions found within the imaging study | Grey matter hyperintensity;Infarct;Malformation;Other, specify;WM hyperintensity | Grey matter hyperintensity;Infarct;Malformation;Other, specify;WM hyperintensity | 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 |
||||||||||||||||||||||||||||||||
C21484 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest number series text | WAISIVDSFNumTxt | Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward 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 |
50 | |||||||||||||||||||||||||||||||||
C13945 | Imaging spectrum depth measurement | ImgSpectrumDepthMeasr | Indicates spectrum depth measurement (mm) | Indicates spectrum depth 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 |
0 | 999 | millimeter | |||||||||||||||||||||||||||||||
C01052 | Loss of consciousness indicator | LOCInd | The indicator for whether the participant/subject experienced any period of loss of consciousness (LOC). | The indicator for whether the participant/subject experienced any period of loss of consciousness (LOC). | Yes;No;Suspected;Unknown | Yes;No;Suspected;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C56429 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Perceptual Reasoning IQ composite score | WASIIIPercRsngIQCompScore | The subject's Perceptual Reasoning IQ composite score, converted from his/her Perceptual Reasoning T score, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The subject's Perceptual Reasoning IQ composite score, converted from his/her Perceptual Reasoning 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 | ||||||||||||||||||||||||||||||||
C17526 | Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex biceps jerk right score | FARSPNSNeuExDTenRefBicJRtScore | Score for right-side biceps 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 biceps 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 | |||||||||||||||||||||||||||||||
C12499 | Imaging T2 weighted white matter abnormality site type | ImgT2WWMAbnrmlySiteTyp | The type of anatomical site of the white matter abnormality on T2 weighted images | The type of anatomical site of the white matter abnormality on T2 weighted images | Frontal;Parietal;Temporal;Cerebellar WM;Deep WM;Diffuse;Occipital;Periventricular | Frontal;Parietal;Temporal;Cerebellar WM;Deep WM;Diffuse;Occipital;Periventricular | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
||||||||||||||||||||||||||||||||
C54607 | Brief Test of Executive Function Second Edition (BRIEF 2) - Self monitor total raw scale score | BRIEF2SlfMntrTtlRwSclScore | Total score of the raw scale for the self monitor function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the self monitor 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 |
||||||||||||||||||||||||||||||||||
C14015 | Microembolic signal count | MicroembolSignalCt | Numeric value counting the number of microembolic signals. | Indicates microembolic signal number | 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 | ||||||||||||||||||||||||||||||||
C02494 | Imaging study date and time | ImgStdyDateTime | Date (and time, if applicable and known) the radiologic study was obtained. | Date (and time, if applicable and known) the radiologic study was obtained. | 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 |
||||||||||||||||||||||||||||||||||
C18859 | Imaging cerebellum abnormality other text | ImgCrblmAbnrmlyOTH | The free-text field related to 'Imaging cerebellum abnormality type' specifying other text. The type of abnormality in the cerebellum on the image | The free-text field related to 'Imaging cerebellum abnormality type' specifying other text. The type of abnormality in the cerebellum on the image | 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 |
|||||||||||||||||||||||||||||||||
C13913 | Imaging plaque motion result | ImgPlaqMotionReslt | Indicates plaque motion | Indicates plaque motion | 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 |
|||||||||||||||||||||||||||||||||
C13247 | National Institutes of Health Stroke Scale (NIHSS) Supplemental - Limb ataxia status | NIHSSSupLimbAtaxiaStatus | The indicator to determine if ataxia is present in the limbs | The indicator to determine if ataxia is present in the limbs | 0;1;2;UN | Absent;Present in one limb;Present in two limbs;Amputation or joint fusion, 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 |
||||||||||||||||||||||||||||||||
C13924 | Imaging vertebral origin result | ImgVertebralOriginReslt | Indicates vertebral origin | Indicates vertebral origin | Normal;Stenosis;Occluded | Normal;Stenosis;Occluded | 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 |
||||||||||||||||||||||||||||||||
C13468 | Stroke Adjudication Worksheet - symptom duration | StrokeAdjudWksSymDur | How long the symptom(s) experienced around the time of the stroke event lasted | How long the symptom(s) experienced around the time of the stroke event lasted | Confirmed to be greater than or equal to 24 hours;Confirmed to be less than 24 hours;Duration of symptoms could not be confirmed;Confirmed to be greater than or equal to 24 hours;Confirmed to be less than 24 hours;Duration of symptoms could not be confirmed | Confirmed to be greater than or equal to 24 hours;Confirmed to be less than 24 hours;Duration of symptoms could not be confirmed;Confirmed to be greater than or equal to 24 hours;Confirmed to be less than 24 hours;Duration of symptoms could not be confirmed | 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 | |||||||||||||||||||||||||||||||
C56440 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 confidence interval lower bound value | WASIIIFullSclIQ2ConfIntLowVal | The lower bound of the subject's Full Scale IQ-2 confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The lower bound of the subject's Full Scale IQ-2 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 |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C56407 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Vocabulary raw score | WASIIIVocabRawScore | The raw score that the subject received on the Vocabulary subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) . | 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 |
0 | 59 | ||||||||||||||||||||||||||||||||
C15555 | Imaging visual analysis performed indicator | ImgVisAnlysisPerfrmInd | Whether visual analysis was performed while blind to clinical data | Whether visual analysis was performed while blind to clinical data | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C12478 | Imaging cortex-pachygyria indicator | ImgCortexPachygyriaInd | Indicator of whether cortex-pachygyria are found within the image studies | Indicator of whether cortex-pachygyria are found within the image studies | 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 |
||||||||||||||||||||||||||||||||
C21495 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest trial score | WAISIVDSBTrialScore | Trial score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Trial score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | 0;1;0;1;0;1 | 0;1;0;1;0;1 | Alphanumeric | 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 |
||||||||||||||||||||||||||||||||
C13956 | Microembolic signal duration | MicroembolSignalDur | Indicates microembolic signal duration time (msec) | Indicates microembolic signal duration time (msec) | 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 | millisecond | |||||||||||||||||||||||||||||||
C01701 | Lab specimen collection date and time | LabSpecmnCollDateTime | Date (and time if applicable and known) when the specimen was collected | Date (and time if applicable and known) when the specimen was collected | 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 |
2004004 | DeBaun Forms | LB | LBDTC |
Specimen Collection Date |
Collection Date |
What was the date of the lab specimen collection? |
LBDTC | Char | Record the date when specimen collection was done using this format (DD-MON-YYYY). | Prompt | |||||||||||||||||||||||
C18492 | Screening visit date and time | ScreenVisitDateTime | Date (and time, if applicable and known) the participant/subject was interviewed and screened for potential enrollment into the study | Subject screened date and time | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||||||
C13892 | Arterial occlusive lesion (AOL) recanalization score | AOLRecanalScore | The score as related to recanalization of the primary arterial occlusive lesion (AOL). | The score as related to recanalization of the primary arterial occlusive lesion (AOL). | 0;1;2;3;0;1;2;3;0;1;2;3 | No recanalization of the primary occlusive lesion;Incomplete or partial recanalization of the primary occlusive lesion with no distal flow;Incomplete or partial recanalization of the primary occlusive lesion with any distal flow;Complete recanalization of the primary occlusion with any distal flow;No recanalization of the primary occlusive lesion;Incomplete or partial recanalization of the primary occlusive lesion with no distal flow;Incomplete or partial recanalization of the primary occlusive lesion with any distal flow;Complete recanalization of the primary occlusion with any distal flow;No recanalization of the primary occlusive lesion;Incomplete or partial recanalization of the primary occlusive lesion with no distal flow;Incomplete or partial recanalization of the primary occlusive lesion with any distal flow;Complete recanalization of the primary occlusion with any distal flow | 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 |
||||||||||||||||||||||||||||||||
C13194 | Questionnaire for Verifying Stroke Free Status (QVSFS) - painless weakness status | QVSFSPainlsWeaknsStatus | Have you ever had sudden painless weakness on one side of your body? | Have you ever had sudden painless weakness on one side of your body? Questionnaire for Verifying Stroke Free Status (QVSFS) | No;Yes | No;Yes | 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 | |||||||||||||||||||||||||||||||
C54690 | PROMIS - Global Health mental health rate scale | PROMISGlbHlthMntlHlthRtScl | Scale related to an individual's rating of his/her mental health, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her mental health, as part of the PROMIS Global Health | 1;2;3;4;5;1;2;3;4;5 | Poor;Fair;Good;Very Good;Excellent;Poor;Fair;Good;Very Good;Excellent | Numeric Values | 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 |
||||||||||||||||||||||||||||||||
C14027 | Intracranial pressure (ICP) other measurement text | ICPOtherMeasrTxt | Indicates other method of measuring intracranial pressure (ICP) | Indicates other method of measuring intracranial pressure (ICP) | 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 |
|||||||||||||||||||||||||||||||||
C08177 | Hemorrhage indicator | HemrrhgInd | Indicator of the presence of cerebral hemorrhages, regardless of size in any region of the brain | Indicator of the presence of cerebral hemorrhages, regardless of size in any region of the brain | Yes;No;Unknown;Not assessed | Yes;No;Unknown;Not assessed | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C19015 | Imaging angiography method other text | ImgAngioMethdOTH | The free-text field related to 'Imaging angiography method type' specifying other text. Type of angiography method performed | The free-text field related to 'Imaging angiography method type' specifying other text. Type of angiography method performed | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
|||||||||||||||||||||||||||||||||
C10568 | Imaging radio frequency coil channel count | ImgRFCoilChannelCt | Number of the coil channels in the radio frequency (RF) coil used for the imaging scan | Number of the coil channels in the radio frequency (RF) coil used for the imaging scan | 1;8;12;16;24;32;Other, specify;1;8;12;16;24;32;Other, specify | Single coil;8 channels;12 channels;16 channels;24 channels;32 channels;Other, specify;Single coil;8 channels;12 channels;16 channels;24 channels;32 channels;Other, specify | 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 |
||||||||||||||||||||||||||||||||
C19811 | Medical history abdominal liver problem indicator | MedHistAbdmnlLiverProbInd | Indicator of history of liver problem | Indicator of history of liver problem | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C13935 | Intima media thickness (IMT) max far-wall measurement | IMTMaxFarWallMeasr | Indicates max intima media thickness (IMT) far-wall measurement (mm) | Indicates max intima media thickness (IMT) far-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 | |||||||||||||||||||||||||||||||||
C00035 | Gender Type | GenderTyp | Self-reported gender of the participant/subject. Gender is the socially constructed identity of sex. Gender is equated with phenotypic sex. Gender may differ from the sex of an individual determined genetically. | Self-reported gender of the participant/subject. Gender is the socially constructed identity of sex. | Female;Male;Unknown;Unspecified;Not reported | Female;Male;Unknown;Undifferentiated/Indeterminant/Intersex;Not reported | 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 |
2200604 | DeBaun Forms | ||||||||||||||||||||||||||||||
C56419 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid other text | WASIIIExVisHearAidOthrTxt | Text describingg another visual or hearing aid the subject needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Text describingg another visual or hearing aid the subject needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:51:49.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
|||||||||||||||||||||||||||||||||
C17402 | Site name | SiteName | The name of the site for the study | The name of the site for the study | 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 |
|||||||||||||||||||||||||||||||||
C12489 | Imaging subcortical cysts site type | ImgSubCorticalCystSiteTyp | The anatomical site(s) of the subcortical cysts | The anatomical site(s) of the subcortical cysts | Temporal;Frontoparietal;Occipital | Temporal;Frontoparietal;Occipital | 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 |
||||||||||||||||||||||||||||||||
C21506 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest total raw score | WAISIVDSSTtlScore | Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Total raw score, 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 | 16 | ||||||||||||||||||||||||||||||||
C14005 | Imaging brain death diagnosis result | ImgBrainDeathDiagReslt | Indicates brain death diagnosis result | Indicates brain death diagnosis result | Reversed Diastolic Flow;Systolic spike;No signals | Reversed Diastolic Flow;Systolic spike;No signals | 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 |
||||||||||||||||||||||||||||||||
C02209 | Informed consent obtained indicator | InfConsntObtInd | Indicator of whether informed consent was obtained for the participant/subject to participate in the clinical research study. | Indicator of whether informed consent was obtained for the participant/subject to participate in the clinical research study | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
2186028 | DeBaun Forms | ||||||||||||||||||||||||||||||
C18718 | Imaging scanner strength other text | ImgScannerStrgthOTH | The free-text field related to 'Imaging scanner strength value' specifying other text. Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | The free-text field related to 'Imaging scanner strength value' specifying other text. Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | 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 |
Tesla | ||||||||||||||||||||||||||||||||
C13903 | Imaging interpretation site indicator | ImgInterpretSiteInd | Indicates imaging interpretation site | Indicates imaging interpretation site | Onsite;Offsite | Onsite;Offsite | 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 |
||||||||||||||||||||||||||||||||
C13237 | National Institutes of Health Stroke Scale (NIHSS) - Facial palsy score | NIHSSLvlConscFaclPlsyScore | Facial palsy assessed using the NIH Stroke Scale (NIHSS) | Facial palsy assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;3;UN;0;1;2;3;UN | Normal symmetrical movement;Minor paralysis (flattened nasolabial fold, asymmetry on smiling);Partial paralysis (total or near total paralysis of lower face);Complete paralysis of one or both sides (absence of facial movement in the upper and lower face);Unexaminable (intubated/paralyzed);Normal symmetrical movement;Minor paralysis (flattened nasolabial fold, asymmetry on smiling);Partial paralysis (total or near total paralysis of lower face);Complete paralysis of one or both sides (absence of facial movement in the upper and lower face);Unexaminable (intubated/paralyzed) | 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 |
||||||||||||||||||||||||||||||||
C55778 | Imaging inter peri ictal next headache start duration | ImagInterPeriIctNextHeStartDur | The duration of time until the start of the subject's next inter-ictal or peri-ictal headache. | The duration of time until the start of the subject's next inter-ictal or peri-ictal headache. | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:23:34.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C14038 | Imaging power M mode right middle cerebral artery result | ImgPowerMModeRightMCARes | Indicates power M mode for right middle cerebral artery (MCA) result | Indicates power M mode for right middle cerebral artery (MCA) result | Absent;High Resistance;Low Resistance;Absent;High Resistance;Low Resistance | Absent;High Resistance;Low Resistance;Absent;High Resistance;Low Resistance | 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 |