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

491 results.
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
C54612 Brief Test of Executive Function Second Edition (BRIEF 2) - Working memory total raw scale score BRIEF2WrkngMmryTtlRwSclScore Total score of the raw scale for the working memory function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Total score of the raw scale for the working memory function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Numeric Values Adult;Pediatric Supplemental 1.00 2017-03-22 09:57:02.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

C13928 Intima media thickness (IMT) electronic caliper indicator IMTElectronicCaliperInd Indicates intima media thickness (IMT) electronic caliper use Indicates intima media thickness (IMT) electronic caliper use 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

C02306 Adverse event start date and time AdvrsEvntStartDateTime Date (and time, if applicable and known) on which the adverse event was first evident Date (and time, if applicable and known) on which the adverse event was first evident 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

2744993 DeBaun Forms
C15568 Imaging post-processing method name ImgPstprocssMethdName Method used for image post-processing Method used for image post-processing Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

Free-Form Entry

C18899 Imaging brain death vessel anatomic other text ImgBrainDeathVesseIAntmicOTH The free-text field related to 'Imaging brain death vessel anatomic site' specifying other text. Indicates brain death vessel(s) The free-text field related to 'Imaging brain death vessel anatomic site' specifying other text. Indicates brain death vessel(s) Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

C13240 National Institutes of Health Stroke Scale (NIHSS) - Limb ataxia score NIHSSLimbAtaxiaScore Limb ataxia assessed using the NIH Stroke Scale (NIHSS) Limb ataxia assessed using the NIH Stroke Scale (NIHSS) 0;1;2;UN;0;1;2;UN Absent;Present in one limb;Present in two limbs;Amputation or joint fusion, explain;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

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

Free-Form Entry

0
C13960 Microembolic signal vessel anatomic site MicroembolSignVesselAntmicSite Indicates microembolic signal vessel category Indicates microembolic signal vessel category M1;A1;P1;Siphon;Ophthalmic;Vert;Basilar M1;A1;P1;Siphon;Ophthalmic;Vert;Basilar Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

C10609 Hospitalization reason HospitRsn Reason why the participant/subject was hospitalized, excluding all surgeries Reason why the participant/subject was hospitalized, excluding all surgeries Pneumonia or Respiratory;Dehydration;Trauma;Fracture;Cardiomyopathy/Arrhythmia;Failure to Thrive;Other, specify;Infection other than pneumonia;Seizures;Cardiovascular Pneumonia or Respiratory;Dehydration;Trauma;Fracture;Cardiomyopathy/Arrhythmia;Failure to Thrive;Other, specify;Infection other than pneumonia;Seizures;Cardiovascular 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

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

Free-Form Entry

0 9
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
C13907 Imaging B-mode finding result ImgBModFindReslt Indicates B-mode finding Indicates B-mode finding Normal;Plaque Normal;Plaque 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

C01522 Height measurement HgtMeasr Measurement of participant's/subject's height. Measurement of participant's/subject's height. 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

0 400 centimeter 649 DeBaun Forms
C14127 Seizure generalized classification type SeizGenClassTyp The type of generalized epileptic seizures, considered to originate at some point within, and rapidly engage, bilaterally distributed networks and may include such bilateral networks as ortical and subcortical structures, but do not necessarily include the entire cortex, experienced by the participant/subject. The type of generalized epileptic seizures, considered to originate at some point within, and rapidly engage, bilaterally distributed networks, experienced by the participant/subject. Tonic clonic;Absence;Typical;Atypical;Myoclonic absence;Eyelid myoclonia;Myoclonic;Myoclonic atonic;Myoclonic tonic;Clonic;Tonic;Atonic;Epileptic spasms, focal or generalized Tonic clonic (in any combination);Absence;Absence-Typical;Absence-Atypical;Absence-Myoclonic absence;Absence-Eyelid myoclonia;Myoclonic;Myoclonic-Myoclonic atonic;Myoclonic-Myoclonic tonic;Clonic;Tonic;Atonic;Epileptic spasms, focal or generalized 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

DeBaun Forms
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

C12503 Imaging gray matter hyperintensity T2 fluid attenuated inversion recovery indicator ImgGryMtrHyperT2FLAIRInd Indicator of whether there is grey matter hyperintensity on T2/FLAIR (fluid attenuated inversion recovery) images Indicator of whether there is grey matter hyperintensity on T2/FLAIR images 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

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

C13939 Imaging mean interadventitial diameter measurement ImgMeanInteradventlDiamtMeasr Indicates mean interadventitial diameter measurement (mm) Indicates mean interadventitial diameter measurement (mm) Numeric Values Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

millimeter
C04804 Hospital discharge date and time HospitDischgDateTime Date (and time, if applicable and known) the participant/subject was discharged from the hospital Date (and time, if applicable and known) the participant/subject was discharged from the hospital 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

DeBaun Forms
C17495 Delay motor milestone indicator DelayMotorMilestoneInd Indicator as to whether the participant/subject has or had delayed motor milestones, as diagnosed by a pediatrician or neurologist Indicator as to whether the participant/subject has or had delayed motor milestones, as diagnosed by a pediatrician or neurologist Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
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
C13458 Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - language deficit-production scale PSOMSNELangDefProdScale The scale for language deficit - production (including dysarthria) based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). The scale for language deficit - production (including dysarthria) 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
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
C14009 Imaging window quality result ImgWindowQualityReslt Indicates window quality result for all categories Indicates window quality result for all categories Fair;Excellent;Poor;Fair;Excellent;Poor Fair;Excellent;Poor;Fair;Excellent;Poor 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

C12467 Imaging magnetic resonance imaging performed multiple indicator ImgMRIPerfMultiInd Indicator as to whether or not multiple magnetic resonance imaging (MRI) sessions have been performed on the participant/subject Indicator as to whether or not multiple magnetic resonance imaging (MRI) sessions have been performed on the participant/subject Yes;No,single brain MRI;Unknown Yes;No,single brain MRI;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

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
C14021 Sickle cell disease velocity measurement SickleCellVelMeasr The velocity measurement of sickle cell. The velocity measurement of sickle cell. 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 centimeter per second DeBaun Forms
C12482 Imaging cortex lissencephaly (LIS type 1) thickness measurement ImgCortexLISThickMeasr The measurement of cortex thickness, in , of the lissencephaly (LIS type 1) site The measurement of cortex thickness, in , of the lissencephaly (LIS type 1) site 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

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

C13918 Imaging no signal indicator ImgNoSignalInd Indicates no signal on the carotid ultrasound Indicates no signal on the carotid ultrasound 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

C02005 Study drug returned date and time StdyDrugRetrnDateTime Date (and time, if applicable and known) on which the study drug was returned Date (and time, if applicable and known) on which the study drug was returned 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

3164209 DeBaun Forms
C14682 Pediatric Migraine Disability Assessment (MIDAS) - headache cease other activity function day count PedMIDASHeadCeasOActFuncDayCt Count the days you were not able to participate in other activities due to headaches (i.e., play, go out, sports, etc.), as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. Count the days you were not able to participate in other activities due to headaches (i.e., play, go out, sports, etc.), as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0 92
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

C13198 Questionnaire for Verifying Stroke Free Status (QVSFS) - understanding status QVSFSUndstandStatus Have you ever suddenly lost the ability to understand what people were saying? Have you ever suddenly lost the ability to understand what people were saying? 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
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

C13950 Imaging spectrum asymmetry index result ImgSpectrumAsymmetryIndexReslt Indicates spectrum asymmetry index result Indicates spectrum asymmetry index 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

C08241 Imaging field of view axis 1 measurement ImgFieldViewAxis1Measr Axis 1 of the image that is visible through the camera at a particular position in orientation and space in millimeters Axis 1 of the image that is visible through the camera at a particular position in orientation and space in millimeters 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

millimeter
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

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
C13751 Imaging acquisition reason ImgAcquisitionRsn Describes why the imaging study was performed Describes why the imaging study was performed Diagnostic;Post-treatment;Monitoring;Other, specify;Diagnostic;Post-treatment;Monitoring;Other, specify Diagnostic;Post-treatment;Monitoring;Other, specify;Diagnostic;Post-treatment;Monitoring;Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

C13885 Imaging vessel angiography arterial result ImgVesselAngioArterialReslt Indicates vessel imaging angiography arterial findings Indicates vessel imaging angiography arterial findings Normal;Occlusion;Aneurysm;Stenosis;AVM;Not visualized Normal;Occlusion;Aneurysm;Stenosis;AVM;Not visualized 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

491 results.
CSV