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
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

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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
C18891 Imaging vessel angiography collateral status anatomic other text ImgVessAngioCollatStatAntOTH The free-text field related to 'Imaging vessel angiography collateral status anatomic site' specifying other text. Indicates vessel angiography collateral status location The free-text field related to 'Imaging vessel angiography collateral status anatomic site' specifying other text. Indicates vessel angiography collateral status location Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

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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
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
C56390 Conners Continuous Performance Test 3rd Edition (CPT3) - Impulsivity perseveration count ConnersCPT3ImpPersCt The number of random or anticipatory responses, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). The number of random or anticipatory responses, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:39:31.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0
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

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

C21487 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest trial score WAISIVDSFTrlScore Score for the digit span forward subtest, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest Score for the digit span forward subtest, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest 0;1;0;1;0;1 0;1;0;1;0;1 Numeric Values Adult;Pediatric Supplemental 2.00 2018-07-30 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

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
C00322 Medical history condition text MedclHistCondTxt Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

2003874 DeBaun Forms
C21498 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest total raw score WAISIVDSBTtlScore Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest Total raw score, 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 16
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

C12493 Imaging brainstem abnormality type ImgBrnstmAbnrmlyTyp The type of abnormality in the brainstem on the image The type of abnormality in the brainstem on the image Hypoplasia;Anterior concavity;Posterior concavity;Other, specify Hypoplasia;Anterior concavity;Posterior concavity;Other, specify 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

C18611 Imaging field of view axis 2 measurement ImgFieldViewAxis2Measr Axis 2 of the image that is visible through the camera at a particular position in orientation and space in millimeters Axis 2 of the image that is visible through the camera at a particular position in orientation and space in millimeters Numeric Values Adult;Pediatric Supplemental 1.00 2013-09-12 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

millimeter
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
C02307 Adverse event verbatim term text AdvrsEvntVerbatimTermText Text that describes the adverse event word for word as described by the participant/subject Adverse event verbatim term text Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-18 16:35:19.49 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

2188132 DeBaun Forms
C54693 PROMIS - Global Health carry out physical activity scale PROMISGlbHlthCrryOutPHysActScl Scale related to an individual's rating of his/her ability to carry out everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair, as part of the PROMIS Global Health Scale related to an individual's rating of his/her ability to carry out everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair, 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

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

C13241 National Institutes of Health Stroke Scale (NIHSS) - Sensory score NIHSSSensoryScore Sensory abilities assessed using the NIH Stroke Scale (NIHSS) Sensory abilities assessed using the NIH Stroke Scale (NIHSS) 0;1;2;UN;0;1;2;UN 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.;Unexaminable (intubated/paralyzed);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.;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
C19166 Special care unit admittance indicator SCUAddmittanceInd Indicator for the admittance of participant to special care unit, including any Intensive Care or Step-Down Unit Indicator for the admittance of participant to special care unit, including any Intensive Care or Step-Down Unit No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2014-05-29 13:03:57.0 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

C56439 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 percentile rank value WASIIIFullScale2PrcntRankVal The percentile rank the subject placed in with respect to Full Scale IQ for two subtests (Vocabulary and Matrix Reasoning), as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The percentile rank the subject placed in with respect to Full Scale IQ for two subtests (Vocabulary and Matrix Reasoning), as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-12 13:04:39.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0 100 percent
C10682 Imaging anatomic site ImgAntmicSite Type of body part or anatomy scanned in the imaging study Type of body part or anatomy scanned in the imaging study Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify;Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify;Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify 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

C56410 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Block Design T score WASIIIBDTScore The T score converted from the raw score that the subject received on the Block Design 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 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

20 80
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

C56422 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid assist listen device used indicator WASIIIExVisHearAidALDUsedInd The indicator relating to whether the examinee used his/her assisted listening device during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The indicator relating to whether the examinee used his/her assisted listening device during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Used;Not used Used;Not used Alphanumeric Adult;Pediatric Supplemental 1.00 2017-06-12 11:56:04.0 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

C01535 Respiratory rate RespRate Rate of the participant/subject's breathing (inhalation and exhalation). Rate of the participant/subject's breathing (inhalation and exhalation). 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

0 120 breaths per minute 2644399 DeBaun Forms
C51670 School name SchoolName The name of the school that the subject currently attends, if applicable. The name of the school that the subject currently attends, if applicable. Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-12 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

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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

C12504 Imaging gray matter hyperintensity T2 fluid attenuated inversion recovery site ImgGryMtrHyperT2FLAIRSiteTyp The type of anatomical site of the grey matter hyperintensity on T2/FLAIR (fluid attenuated inversion recovery) images The type of anatomical site of the grey matter hyperintensity on T2/FLAIR images Putamen;Caudate;Other, specify;Cerebellar nuclei;Colliculi;Floor of the fourth ventricle;Pallidum;Periaqueductal grey;Red nucleus;Substantia nigra;Mammillary body;Subthalmic nucleus;Thalamus Putamen;Caudate;Other, specify;Cerebellar nuclei;Colliculi;Floor of the fourth ventricle;Pallidum;Periaqueductal grey;Red nucleus;Substantia nigra;Mammillary body;Subthalmic nucleus;Thalamus 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

C18805 Hospitalization other text HospitOTH The free-text field related to 'Hospitalization reason' specifying other text. Reason why the participant/subject was hospitalized, excluding all surgeries The free-text field related to 'Hospitalization reason' specifying other text. Reason why the participant/subject was hospitalized, excluding all surgeries Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

DeBaun Forms
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

C05408 Hospital admission date and time HospitlAdmissDateTime Date (and time, if applicable and known) the participant/subject was admitted to the hospital Date (and time, if applicable and known) the participant/subject was admitted to 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
C55781 Imaging statistical test significance level outline text ImagStatTestSigLevOutTxt Text outlining the statistical test(s) and significance levels for comparison between the test and control groups of the imaging study. Text outlining the statistical test(s) and significance levels for comparison between the test and control groups of the imaging study. Alphanumeric Adult;Pediatric Supplemental 1.00 2017-05-31 12:39:11.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

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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

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millimeter
C13459 Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - language deficit-production description text PSOMSNELangDefProdDescTxt Description of the language production deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). Description of the language production deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). 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

DeBaun Forms
C20415 Serious adverse event report completed date SerAdvrsEvntRprtCompDt Date when the report on the adverse event was completed. Date when the report on the adverse event was completed. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-03-24 11:55:24.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

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
C12468 Imaging magnetic resonance imaging performed multiple count ImgMRIPerfMultiCt The count representing of the number of magnetic resonance imaging (MRI) sessions performed on the participant/subject The count representing of the number of magnetic resonance imaging (MRI) sessions performed on the participant/subject 2;3;4;5;6;>6;2;3;4;5;6;>6 2;3;4;5;6;>6;2;3;4;5;6;>6 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

491 results.
CSV