CDE Detailed Report
Disease: general-data-protection-regulation-gdpr
Sub-Domain: Additional Proposed Instruments
CRF:

Displaying 51 - 100 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
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

C14031 Vasospasm status VasospasmStatus Indicates vasospasm result Indicates vasospasm result Abnormal;Normal;Abnormal;Normal Abnormal;Normal;Abnormal;Normal 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

C18693 Imaging contrast agent method other text ImgContrastAgentMethodOTH The free-text field related to 'Imaging contrast agent method type' specifying other text. Indicates imaging contrast agent method of administration The free-text field related to 'Imaging contrast agent method type' specifying other text. Indicates imaging contrast agent method of administration 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

C56444 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 4 expected score WASIIIFullScaleIQ4ExpScore The Full Scale IQ score for all four subtests that the subject was expected to receive, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The Full Scale IQ score for all four subtests that the subject was expected to receive, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-12 13:20:27.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

C02203 Off study reason OffStdyRsn Primary reason participant/ subject is no longer participating in study (i.e., is not being followed and will not receive intervention/treatment). Primary reason participant/ subject is no longer participating in study (i.e., is not being followed and will not receive intervention/treatment). Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died;Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died;Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died 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

2979313 DeBaun Forms
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

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

C13236 National Institutes of Health Stroke Scale (NIHSS) - Visual field score NIHSSLvlConscVisuFldScore Visual fields assessed using the NIH Stroke Scale (NIHSS) Visual fields assessed using the NIH Stroke Scale (NIHSS) 0;1;2;3;UN;0;1;2;3;UN No visual loss;Partial hemianopia;Complete hemianopia;Bilateral hemianopia (blind including cortical blindness);Unexaminable (intubated/paralyzed);No visual loss;Partial hemianopia;Complete hemianopia;Bilateral hemianopia (blind including cortical blindness);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
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

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

Free-Form Entry

C10567 Imaging radio frequency coil type ImgRFCoilTyp Type of radio frequency (RF) coil(s) used for the body part scanned Type of RF coil(s) used for the body part scanned Head coil;Neck coil;Spine array;Body coil (transmit);Double-cone;Circular;Figure 8;Other, specify Head coil;Neck coil;Spine array;Body coil (transmit);Double-cone;Circular;Figure 8;Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Multiple Pre-Defined Values Selected

C56413 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Similarities T score WASIIISimTScore The T score converted from the raw score that the subject received on the Similarities 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 Similarities 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
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

C56425 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Verbal Comprehension percentile rank value WASIIIVerbCompPrcntRankVal The percentile rank the subject placed into with respect to the Verbal Comprehension subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The percentile rank the subject placed into with respect to the Verbal Comprehension subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-12 12:05:57.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0 100 percent
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

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
C54603 Informant participant familiar grade InfrmntPrtcpntFmlrGrade Grade denoting the degree to which the informant knows the subject/participant Grade denoting the degree to which the informant knows the subject/participant Very well;Moderately well;Not well Very well;Moderately well;Not well Alphanumeric Adult;Pediatric Supplemental 1.00 2017-03-22 09:39:15.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

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

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

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
C18855 Imaging other cortical abnormality other text ImgOthrCorticalAbnrmlyOTH The free-text field related to 'Imaging other cortical abnormality type' specifying other text. The type of other cortical abnormality The free-text field related to 'Imaging other cortical abnormality type' specifying other text. The type of other cortical abnormality 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

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

C56380 Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness omission count ConnersCPT3InaOmmCt The number of missed targets, as part of the Conners Continuous Performance Test 3rd Edition (CPT3) The number of missed targets, as part of the Conners Continuous Performance Test 3rd Edition (CPT3) Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:29:58.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0
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
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

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
C20419 National Institutes of Health Stroke Scale (NIHSS) - Limb ataxia amputation text NIHSSLimbAtaxiaAmputTxt The text field for explaining the amputation or joint fusion for question related to Limb ataxia assessed using the NIH Stroke Scale (NIHSS). The text field for explaining the amputation or joint fusion for question related to Limb ataxia 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

DeBaun Forms
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
C21491 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subset response text WAISIVDSBRespnsTxt Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-22 11:32:44.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 50

Free-Form Entry

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

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

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
C17925 Imaging contrast agent dose ImgContrastAgentDose Dosage of the contrast agent used Dosage of the contrast agent used 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

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
C54614 Brief Test of Executive Function Second Edition (BRIEF 2) - Task monitor total raw scale score BRIEF2TskMntrTtlRwSclScore Total score of the raw scale for the task-monitor function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Total score of the raw scale for the task-monitor function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Numeric Values Adult;Pediatric Supplemental 1.00 2017-03-22 09:57:02.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

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

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
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
C18901 Sickle cell disease vessel anatomic other text SickleCellDisVesselAntmicOTH The free-text field related to 'Sickle cell disease vessel anatomic site' specifying other text. Indicates sickle cell vessel The free-text field related to 'Sickle cell disease vessel anatomic site' specifying other text. Indicates sickle cell vessel 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

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
C56395 Conners Continuous Performance Test 3rd Edition (CPT3) - Vigilance hit reaction time inter-stimulus interval change value ConnersCPT3VigHRTISIChngVal The change in response speed at various inter-stimulus intervals (ISIs), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). The change in response speed at various inter-stimulus intervals (ISIs), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:46:09.0 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

C13961 Microembolic signals present indicator MicroembolSignalPresentInd Indicates presence of microembolic signals Indicates presence of microembolic signals 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

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
C21502 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest trial number WAISIVDSSSubtestTrialNum Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest 1;2 Trial 1;Trial 2 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

C13897 Imaging vessel angiography collateral status anatomic site ImgVessAngioCollatStatAntSite Indicates vessel angiography collateral status location Indicates vessel angiography collateral status location ECA/OA-ICA;ECA/Other-ICA;AComA-A1-MCA;AComA-A2-MCA pial;PComA-ICA;PCA-ACA pial;PCA-MCA pial;ICA to MCA/ACA Moyamoya;Other, specify;ECA/OA-ICA;ECA/Other-ICA;AComA-A1-MCA;AComA-A2-MCA pial;PComA-ICA;PCA-ACA pial;PCA-MCA pial;ICA to MCA/ACA Moyamoya;Other, specify External carotid artery/OA-Internal Carotid Artery;External carotid artery/Other-Internal Carotid Artery;AComA-A1-Middle cerebral artery;AComA-A2-Middle cerebral artery pial;PComA-Internal Carotid Artery;PCA-Anterior cerebral artery pial;PCA-Middle cerebral artery pial;ICA to Middle cerebral artery/Anterior cerebral artery Moyamoya;Other, specify;External carotid artery/OA-Internal Carotid Artery;External carotid artery/Other-Internal Carotid Artery;AComA-A1-Middle cerebral artery;AComA-A2-Middle cerebral artery pial;PComA-Internal Carotid Artery;PCA-Anterior cerebral artery pial;PCA-Middle cerebral artery pial;ICA to Middle cerebral artery/Anterior cerebral artery Moyamoya;Other, specify 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

C12489 Imaging subcortical cysts site type ImgSubCorticalCystSiteTyp The anatomical site(s) of the subcortical cysts The anatomical site(s) of the subcortical cysts Temporal;Frontoparietal;Occipital Temporal;Frontoparietal;Occipital Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

C14032 Vasospasm severity grade VasospasmSeverGrade Indicates severity of vasospasm Indicates severity of vasospasm Mild;Moderate;Severe Mild;Moderate;Severe 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

C18708 Imaging pulse sequence other text ImgPulseSeqOTH The free-text field related to 'Imaging pulse sequence type' specifying other text. Type of imaging pulse sequence used The free-text field related to 'Imaging pulse sequence type' specifying other text. Type of imaging pulse sequence used 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

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
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