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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
C13954 | Consensus on Grading Intracranial Flow Obstruction (COGIF) - follow-up date and time | COGIFFollowupDateTime | The date and time for consensus on grading intracranial flow obstruction (COGIF) follow-up. | The date and time for consensus on grading intracranial flow obstruction (COGIF) follow-up. | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C54604 | Informant participant relationship duration | InfrmntPrtcpntRltnshpDur | Duration for which the informant has known the subject/participant | Duration for which the informant has known the subject/participant | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-03-22 09:46:35.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C00023 | Hand preference type | HandPrefTyp | Hand which the participant/subject uses predominantly, not necessarily the hand he/she writes with exclusively. | Hand which the participant/subject uses predominantly, not necessarily the hand he/she writes with exclusively. | Left hand;Right hand;Both hands;Unknown;Forced right | Left hand;Right hand;Both hands;Unknown;Forced right | 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 |
2180147 | DeBaun Forms | ||||||||||||||||||||||||||||||
C13889 | Thrombolysis In Myocardial Infarction (TIMI) scale - global score | TIMIScaleGlobalScore | Indicates TIMI perfusion scale global score | Indicates TIMI perfusion scale global score | 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 |
||||||||||||||||||||||||||||||||
C18856 | Imaging ventricle abnormality other text | ImgVentrclAbnrmlyOTH | The free-text field related to 'Imaging ventricle abnormality type' specifying other text. The type of abnormality in the ventricles on the image | The free-text field related to 'Imaging ventricle abnormality type' specifying other text. The type of abnormality in the ventricles 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 |
|||||||||||||||||||||||||||||||||
C12488 | Imaging subcortical cyst indicator | ImgSubCorticalCystInd | Indicator of whether subcortical cysts are found in the image studies | Indicator of whether subcortical cysts are found in 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 |
||||||||||||||||||||||||||||||||
C18902 | Vasospasm vessel anatomic other text | VasospasmVesselAntmicOTH | The free-text field related to 'Vasospasm vessel anatomic site' specifying other text. Indicates vasospasm vessel(s) | The free-text field related to 'Vasospasm vessel anatomic site' specifying other text. Indicates vasospasm 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 |
|||||||||||||||||||||||||||||||||
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 |
||||||||||||||||||||||||||||||||
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 |
|||||||||||||||||||||||||||||||||
C56396 | Conners Continuous Performance Test 3rd Edition (CPT3) - Vigilance omission inter-stimulus interval change value | ConnersCPT3VigOmiISIChngVal | The number of missed targets by inter-stimulus interval (ISI), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The number of missed targets by inter-stimulus interval (ISI), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:47:31.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
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 |
||||||||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||||||||||||
C21492 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest number series text | WAISIVDSBNumTxt | Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward 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 | ||||||||||||||||||||||||||||||||
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 |
||||||||||||||||||||||||||||||||
C16679 | Cambridge Brain Repair Center Sleep Questionnaire (BRC-Sleep) - intentionally nap day indicator | BRCIntentNapDayInd | The yes/no indicator for napping intentionally during the day from Cambridge Brain Repair Center Sleep Questionnaire (BRC-Sleep). | The yes/no indicator for napping intentionally during the day from Cambridge Brain Repair Center Sleep Questionnaire (BRC-Sleep). | No;Yes | No;Yes | 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 |
DeBaun Forms | |||||||||||||||||||||||||||||||
C17931 | Imaging magnetic resonance imaging performed indicator | ImgMRIPerfInd | Indicator as to whether or not Magnetic Resonance Imaging (MRI) on the brain has been performed on the participant/subject | Indicator as to whether or not Magnetic Resonance Imaging (MRI) on the brain has been performed on the participant/subject | 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 |
||||||||||||||||||||||||||||||||
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 |
||||||||||||||||||||||||||||||||
C14003 | Imaging brain death present indicator | ImgBrainDeathPresInd | Indicates presence of brain death | Indicates presence of brain death | 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 |
||||||||||||||||||||||||||||||||
C54615 | Brief Test of Executive Function Second Edition (BRIEF 2) - Organize material total raw scale score | BRIEF2OrgnzMtrlTtlRwSclScore | Total score of the raw scale for the organization of materials function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the organization of materials 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 |
||||||||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||||||||||
C13901 | Imaging patient type | ImgPatientTyp | Indicates imaging patient type | Indicates imaging patient type | Asymptomatic;Acute Stroke;Chronic Stroke;Brain Edema;Vasopasm;Asymptomatic;Acute Stroke;Chronic Stroke;Brain Edema;Vasopasm | Asymptomatic;Acute Stroke;Chronic Stroke;Brain Edema;Vasopasm;Asymptomatic;Acute Stroke;Chronic Stroke;Brain Edema;Vasopasm | 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 |
||||||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||
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 |
|||||||||||||||||||||||||||||||||
C19779 | Medical history asthma pulmonary assessment indicator | MedHistAsthmaPulAssesInd | Indicator of history of asthma | Indicator of history of asthma | 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 | |||||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||||||||||
C56416 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale 4 T score sum value | WASIIIFullScale4TScoreSumVal | The sum of all four of the subject's T scores, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The sum of all four of the subject's T scores, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:40:41.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
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 | |||||||||||||||||||||||||||||||
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 |
||||||||||||||||||||||||||||||||
C21503 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest trial score | WAISIVDSSTrialScore | Trial score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Trial score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | 0;1;0;1;0;1 | 0;1;0;1;0;1 | 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 |
||||||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||||||||||
C18714 | Imaging radio frequency coil channel other text | ImgRFCoilChannelOTH | The free-text field related to 'Imaging radio frequency coil channel count' specifying other text. Number of the coil channels in the radio frequency (RF) coil used for the imaging scan | The free-text field related to 'Imaging radio frequency coil channel count' specifying other text. Number of the coil channels in the radio frequency (RF) coil used for the imaging scan | 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 |
|||||||||||||||||||||||||||||||||
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 |
||||||||||||||||||||||||||||||||
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 |
|||||||||||||||||||||||||||||||||
C55775 | Imaging ictal pain intensity value | ImagIctPainIntensVal | The value related to the intensity of the subject's pain if the timing is ictal | The value related to the intensity of the subject's pain if the timing is ictal | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:19:15.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 10 | ||||||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||||||||||
C56382 | Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness hit reaction time value | ConnersCPT3InaHRTVal | The value representing the subject's response speed time, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The value representing the subject's response speed time, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:32:03.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
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 | ||||||||||||||||||||||||||||||
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 |
||||||||||||||||||||||||||||||||
C21117 | Subject name | SubjectName | Name of subject/participant. | Name of subject/participant. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-06-12 15:16:39.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
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 |
||||||||||||||||||||||||||||||||
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 |
||||||||||||||||||||||||||||||||
C56427 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Verbal Comprehension confidence interval lower bound value | WASIIIVerbCompConfIntrvlLowVal | The lower bound of the subject's Verbal Comprehension confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The lower bound of the subject's Verbal Comprehension 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 12:55:22.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
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 |
||||||||||||||||||||||||||||||||
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 |
||||||||||||||||||||||||||||||||||
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 |
||||||||||||||||||||||||||||||||
C54605 | Informant participant relationship duration unit of measure | InfrmntPrtcpntRltnshpDurUOM | Field related to 'Informant participant relationship duration' specifying the unit of measure of the duration for which the informant has known the participant | Field related to 'Informant participant relationship duration' specifying the unit of measure of the duration for which the informant has known the participant | Weeks;Months;Years | Weeks;Months;Years | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-03-22 09:46:35.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
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 | ||||||||||||||||||||||||||||||
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 |