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

Displaying 251 - 300 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
C54689 PROMIS - Global Health physical health rate scale PROMISGlbHlthPhysHlthRtScl Scale related to an individual's rating of his/her physical health, as part of the PROMIS Global Health Scale related to an individual's rating of his/her physical 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

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

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

C14036 Breath-holding index result BreathHoldingIndexReslt Indicates breath-holding index (BHI) result Indicates breath-holding index (BHI) result 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

C18942 Cerebellar or coordination assessment abnormality present other text CerbllCoordAssmtAbnrmlyPrsOTH The free-text field related to 'Cerebellar or coordination assessment abnormality present status' specifying other text. Whether the cerebellar/coordination assessment found abnormalities The free-text field related to 'Cerebellar or coordination assessment abnormality present status' specifying other text. Whether the cerebellar/coordination assessment found abnormalities 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

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

C13933 Intima media thickness (IMT) mean far-wall measurement IMTMeanFarWallMeasr Indicates mean intima media thickness (IMT) far-wall measurement (mm) Indicates mean 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
C56406 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Block Design raw score WASIIIBDRawScore The raw score that the subject received on the Block Design subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) . The raw score that the subject received on the Block Design 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 71
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
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
C17525 Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex biceps jerk left score FARSPNSNeuExDTenRefBicJLftScr Score for left-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 left-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
C21505 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest last trial correct digit score WAISIVLDSSScore Last digit correct, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Last digit correct, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Numeric Values Adult;Pediatric Supplemental 1.10 2018-07-30 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0 9
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
C14014 Intracranial stenosis other criteria result IntracranStenoOthCriteriaReslt Other criteria for intracranial stenosis Other criteria for intracranial stenosis 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

C18716 Imaging scanner manufacturer other text ImgScannerManufOTH The free-text field related to 'Imaging scanner manufacturer name' specifying other text. Name of manufacturer of imaging scanner The free-text field related to 'Imaging scanner manufacturer name' specifying other text. Name of manufacturer of imaging scanner 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

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
C13912 Imaging plaque composition result ImgPlaqCompositionReslt Indicates plaque composition Indicates plaque composition 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

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

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
C14463 Reflex plantar left response result RflxPlntrLftRespnsReslt The results from reflex plantar response on the left side The results from reflex plantar response on the left side 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
C19810 Medical history abdominal kidney problem indicator MedHistAbdmnlKdnyProbInd Indicator of history of kidney problem Indicator of history of kidney 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
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

C13944 Imaging color flow indicator ImgColorFlowInd Indicates color flow Indicates color flow 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

C56418 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid type WASIIIExVisHearAidTyp The type of visual or hearing aid or aids that the examinee needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The type of visual or hearing aid or aids that the examinee needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Glasses;Assisted Listening Device;Other;Prescription Lenses Glasses;Assisted Listening Device;Other;Prescription Lenses Alphanumeric Adult;Pediatric Supplemental 1.00 2017-06-12 11:43:19.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

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

C13955 Imaging transcranial color-coded sonography symptomatic indicator ImgTCCSSymptomaticInd Indicates symptomatic presentation by Transcranial Color-Coded Sonography (TCCS) Indicates symptomatic presentation by Transcranial Color-Coded Sonography (TCCS) 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

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
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
C13891 Thrombolysis in Cerebral Infarction (TICI) perfusion scale grade TICIPerfScaleGrade Indicates Thrombolysis in Cerebral Infarction (TICI) perfusion scale grade indicator Indicates Thrombolysis in Cerebral Infarction (TICI) perfusion scale grade indicator Grade 0;Grade 1;Grade 2;Grade 2b;Grade 3 No perfusion. No antegrade flow beyond the point of occlusion;Penetration with Minimal Perfusion. The contrast material passes beyond the area of obstruction but fails to opacify the entire cerebral bed distal to the obstruction for the duration of the angiographic run;Partial Perfusion. The contrast material passes beyond the obstruction and opacifies the arterial bed distal to the obstruction. However, the rate of entry of contrast into the vessel distal to the obstruction and/or its rate of clearance from the distal bed are perceptibly slower than its entry into and/or clearance from comparable areas not perfused by the previously occluded vessel, eg, the opposite cerebral artery or the arterial bed proximal to the obstruction. Grade 2a=Only partial filling (<2/3) of the entire vascular territory is visualized;Complete filling of all of the expected vascular territory is visualized, but the filling is slower than normal;Complete Perfusion. antegrade flow into the bed distal to the obstruction occurs as promptly as into the obstruction and clearance of contrast material from the involved bed is as rapid as from an uninvolved other bed of the same vessel or the opposite cerebral 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

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

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

C14026 Intracranial pressure imaging result ICPReslt Indicates intracranial pressure (ICP) imaging result Indicates vasospasm intracranial pressure (ICP) imaging 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

0 999 millimeter of mercury
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

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

C13923 Imaging power doppler result ImgPowerDopplerReslt Indicates power doppler result Indicates power Doppler result Flow;No flow Flow;No flow 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

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
C14964 Sedation used indicator SedationUsedInd Whether the participant/subject was administered any sedation Whether the participant/subject was administered any sedation Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-14 19:48:50.273 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value 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
C01507 Blood pressure diastolic measurement BldPressrDiastlMeasr Measurement of pressure of the participant's/subject's blood against the artery walls during diastole (the relaxation phase) in millimeters of mercury (mmHg) Measurement of pressure of the participant's/subject's blood against the artery walls during diastole (the relaxation phase) in millimeters of mercury (mmHg) 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

0 300 millimeter of mercury 2004291 DeBaun Forms
C17397 Visit number VisitNum The numeric value associated with a particular assessment/examination of a participant/subject on a study The numeric value associated with a particular assessment/examination of a participant/subject on a study Numeric Values Adult;Pediatric Supplemental 1.00 2012-12-20 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

DeBaun Forms
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

C12500 Imaging corpus callosum type indicator ImgCrpsClsmTypInd The condition of the corpus callosum fibers The condition of the corpus callosum fibers Involved;Spared Involved;Spared 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

C14004 Imaging brain death vessel anatomic site ImgBrainDeathVesseIAntmicSite Indicates brain death vessel(s) Indicates brain death vessel(s) ICA;Basilar;MCA;Other, specify;ACA;VA;PCA;Ophthalmic artery Internal carotid artery;Basilar;Middle cerebral artery;Other, specify;Anterior carotid artery;Vertebral artery;Posterior carotid artery;Ophthalmic artery 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

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
C02495 Imaging scanner strength value ImgScannerStrgthVal Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported 1.5T;3.0T;4.0T;7.0T;Other, specify;1.5T;3.0T;4.0T;7.0T;Other, specify 1.5T;3.0T;4.0T;7.0T;Other, specify;1.5T;3.0T;4.0T;7.0T;Other, specify 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

Tesla
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

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

C56438 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 composite score WASIIIFullScaleIQ2CompScore The subject's Full Scale IQ composite score for only 2 subtests (Vocabulary and Matrix Reasoning), converted from his/her Full Scale T score for two subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The subject's Full Scale IQ composite score for only 2 subtests (Vocabulary and Matrix Reasoning), converted from his/her Full Scale T score for two 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
C13248 National Institutes of Health Stroke Scale (NIHSS) Supplemental - Limb sensory loss status NIHSSSupLimbSensoryLossStatus The indicator to determine if any limbs have sensory loss The indicator to determine if any limbs have sensory loss 0;1;2 Normal: no sensory loss.;Mild to moderate sensory loss: patient feels pinprick is less sharp or is dull on the affected side, or there is a loss of superficial pain with pinprick but patient is aware he/she is being touched.;Severe to total sensory loss: patient is not aware of being touched in the face, arm, and leg. 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

Displaying 251 - 300 of 491
CSV