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

Displaying 401 - 450 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
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

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

C12483 Imaging cortex-polymicrogyria indicator ImgCortexPolymicrogyriaInd Indicator of whether a developmental malformation of the human brain characterized by an excessive number of small convolutions (gyri) on the surface of the brain is present Indicator of whether a developmental malformation of the human brain characterized by an excessive number of small convolutions (gyri) on the surface of the brain is present Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

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
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
C02006 Medication prior or concomitant dose MedctnPriorConcomDose Dose of prior/concomitant medication taken per administration. Dose of prior/concomitant medication taken per administration. 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

3162729 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
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

C13199 Questionnaire for Verifying Stroke Free Status (QVSFS) - verbal status QVSFSVerbalStatus Have you ever suddenly lost the ability to express yourself verbally or in writing? Have you ever suddenly lost the ability to express yourself verbally or in writing? 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
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

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
C08242 Imaging acquisition duration ImgAcquisitionDur Duration of the imaging scan in minutes The duration of the imaging acquisition, in minutes Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

minute
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

C13879 Imaging modality vessel imaging angiography type ImgModltyVesselImgAngioTyp Indicates imaging modality for vessel imaging angiography Indicates imaging modality for vessel imaging angiography DSA;MRA;CTA;CBCT Digital subtraction angiography;Magnetic resonance angiography;Computer tomography angiography;CBCT 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

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

C18854 Imaging other incidental finding other text ImgOthrIncidentalFindOTH The free-text field related to 'Imaging other incidental finding type' specifying other text. The type of other incidental findings found within the image studies The free-text field related to 'Imaging other incidental finding type' specifying other text. The type of other incidental findings found within the image studies 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

C00720 Family history medical condition type FamHistMedclCondTyp Type of medical condition or health related event for which the family history is taken Type of medical condition or health related event for which the family history is taken 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

3165585 DeBaun Forms
C56378 Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness detectability score ConnersCPT3InaDetectScore Ability to discriminate between targets (non-X) and non-targets (X), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Ability to discriminate between targets (non-X) and non-targets (X), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:27:57.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

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

C12494 Imaging pons abnormal indicator ImgPonsAbnrmlInd Indicator of whether the pons appears normal or abnormal in the image studies Indicator of whether the pons appears normal or abnormal in the image studies Abnormal;Normal;Abnormal;Normal Abnormal;Normal;Abnormal;Normal 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

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

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

C02308 Adverse event during study indicator AdvrsEvntDuringStudyInd Indicator of whether the participant/subject experienced any adverse events during the study Indicator of whether the participant/subject experienced any adverse events during the 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

2188132;3177812 DeBaun Forms
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
C13934 Intima media thickness (IMT) max near-wall measurement IMTMaxNearWallMeasr Indicates max intima media thickness (IMT) near-wall measurement (mm) Indicates max intima media thickness (IMT) near-wall measurement (mm) Numeric Values Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

millimeter
C13242 National Institutes of Health Stroke Scale (NIHSS) - Best language score NIHSSBestLangScore Language ability assessed using the NIH Stroke Scale (NIHSS) Language ability assessed using the NIH Stroke Scale (NIHSS) 0;1;2;3;UN;0;1;2;3;UN No aphasia, normal;Mild to moderate aphasia: some obvious loss of fluency or facility of comprehension, without significant limitation on ideas expressed or form of expression. Reduction of speech and/or comprehension, however, makes conversation about provided material difficult or impossible. For example in conversation about provided materials examiner can identify picture or naming card from patient's response.;Severe aphasia: all communication is through fragmentary expression, great need for inference, questioning, and guessing by the listener. Range of information that can be exchanged is limited: listener carries burden of communication. Examiner cannot identify materials provided from patient response.;Mute, global aphasia: no usable speech or auditory comprehension.;Unexaminable (intubated/paralyzed);No aphasia, normal;Mild to moderate aphasia: some obvious loss of fluency or facility of comprehension, without significant limitation on ideas expressed or form of expression. Reduction of speech and/or comprehension, however, makes conversation about provided material difficult or impossible. For example in conversation about provided materials examiner can identify picture or naming card from patient's response.;Severe aphasia: all communication is through fragmentary expression, great need for inference, questioning, and guessing by the listener. Range of information that can be exchanged is limited: listener carries burden of communication. Examiner cannot identify materials provided from patient response.;Mute, global aphasia: no usable speech or auditory comprehension.;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
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
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

C10685 Imaging slice orientation type ImgSliceOrientTyp The slice orientation used in imaging acquisition The slice orientation used in imaging acquisition Axial;Coronal;Sagittal;Oblique;Transversal;Other, specify;Axial;Coronal;Sagittal;Oblique;Transversal;Other, specify Axial;Coronal;Sagittal;Oblique;Transversal;Other, specify;Axial;Coronal;Sagittal;Oblique;Transversal;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

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

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
C18900 Intracranial stenosis collateral vessel anatomic other text IntracrnStnoColltVsslAntmicOTH The free-text field related to 'Intracranial stenosis collateral vessel anatomic site' specifying other text. Indicates intracranial stenosis collateral vessel(s) The free-text field related to 'Intracranial stenosis collateral vessel anatomic site' specifying other text. Indicates intracranial stenosis collateral 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

C01539 Temperature measurement TempMeasr Measurement of the participant's/subject's body temperature. Measurement of the participant's/subject's body temperature. 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 50 degree Celsius 2644401 DeBaun Forms
C56394 Conners Continuous Performance Test 3rd Edition (CPT3) - Sustained attention commission block count ConnersCPT3SusAtnCommBlkCt The number of incorrect responses to non-targets by block, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). The number of incorrect responses to non-targets by block, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:44:12.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0
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

C12505 Imaging eye abnormality indicator ImgEyeAbnrmlyInd Indicator of whether eye abnormalities are present Indicator of whether eye abnormalities are present Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

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
C21490 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest total raw score WAISIVDSFTtlScore Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest Total raw score, 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

0 16
C06421 SCI Classification light touch single side score SCIClssLghtTchSnglSdScore Score of sensation of light touch for the specific side of the body. Score of sensation of light touch for the specific side of the body. Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-17 09:26:36.973 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

DeBaun Forms
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
C13460 Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - language deficit-comprehension scale PSOMSNELangDefCompScale The scale for language deficit - comprehension based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). The scale for language deficit - comprehension 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
C17798 Imaging contrast agent name ImgContrastAgentName Name of imaging contrast agent used Name of imaging contrast agent used Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-22 16:57:17.79 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

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
C54613 Brief Test of Executive Function Second Edition (BRIEF 2) - Plan organize total raw scale score BRIEF2PlnOrgnzTtlRwSclScore Total score of the raw scale for the plan/organize function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Total score of the raw scale for the plan/organize 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

C12469 Imaging magnetic resonance imaging session number ImgMRISessnNum Number distinguishing the Magnetic Resonance Imaging (MRI) session from other sessions Number distinguishing the Magnetic Resonance Imaging (MRI) session from other sessions Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

1 3
C55773 Imaging MRI scanner used count ImagMRIScanUsedCt The number of different MRI scanners that were used on the subject. The number of different MRI scanners that were used on the subject. Numeric Values Adult;Pediatric Supplemental 1.00 2017-05-31 12:11:13.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

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

C12484 Imaging cortex-polymicrogyria site type ImgCortexPolymicrogyriaSiteTyp The type of anatomical site(s) of the cortex-polymicrogyria The type of anatomical site(s) of the cortex-polymicrogyria 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

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

C19500 Assessment performed date AssessmentPerformedDate The date of assessment of the examination being performed. The date of assessment of the examination being performed. Date or Date & Time Adult;Pediatric Supplemental 1.00 2014-06-18 08:10:12.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

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