CDE Detailed Report
Disease: general-data-protection-regulation-gdpr
Sub-Domain: Additional Proposed Instruments
CRF:
Sub-Domain: Additional Proposed Instruments
CRF:
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Additional Notes (Question Text) | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guideline) | Sub Domain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | Source | Form Set | Form | Field | Domain | CDASH Variable | CDASH Definition | CDASH Label | Controlled Terminology | Prompt | Essentiality | Question Text | CDASH imp guidance | SDTM IG target | csDSR | PhenX | Data Type | CRF Completion Inst | SDTMIG Target Var | SDTMIG Target Map | Codelist Name | PVs | Pre Pop Value | Query Display | List Style |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C21504 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest item score | WAISIVDSSSubtestItemScore | Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | 0;1;2 | 0;1;2 | Numeric Values | Adult;Pediatric | Supplemental | 1.10 | 2018-07-30 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| C13915 | Imaging plaque thickness measurement | ImgPlaqThicknessMeasr | Indicates plaque thickness | Indicates plaque thickness | 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 |
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| C13464 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - total score | PSOMSNETotalScore | The total score on the Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | The total score on the Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | 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 | 10 | DeBaun Forms | |||||||||||||||||||||||||||||||
| C14679 | Pediatric Migraine Disability Assessment (MIDAS) - headache school partial absence day count | PedMIDASHeadSchPrtlAbseDayCt | Count missed partial school days in the last 3 months due to headaches, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. | Count missed partial school days in the last 3 months due to headaches, 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 | ||||||||||||||||||||||||||||||||
| C18715 | Imaging radio frequency coil other text | ImgRFCoilOTH | The free-text field related to 'Imaging radio frequency coil type' specifying other text. Type of radio frequency (RF) coil(s) used for the body part scanned | The free-text field related to 'Imaging radio frequency coil type' specifying other text. Type of radio frequency (RF) coil(s) used for the body part scanned | 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 |
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| C12477 | Imaging other incidental finding type | ImgOthrIncidentalFindTyp | The type of other incidental findings found within the image studies | The type of other incidental findings found within the image studies | PVL;Other white matter intensities;Venous malformations;Vascular malformations;Other, specify | PVL;Other white matter intensities;Venous malformations;Vascular malformations;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 |
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| C55776 | Imaging ictal headache since onset duration | ImagIctHeadSinceOnsetDur | The duration of time since the onset of the subject's headache if it was ictal. | The duration of time since the onset of the subject's headache if it was ictal. | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:21:21.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C13947 | Imaging peak velocity measurement | ImgPeakVelocityMeasr | Indicates peak velocity measurement (cm/sec) | Indicates peak velocity measurement (cm/sec) | 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 | |||||||||||||||||||||||||||||||
| 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 | ||||||||||||||||||||||||||||||
| C21483 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest response text | WAISIVDSFRespnsTxt | Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward 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 |
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| C13894 | Imaging vessel angiography overall assessment type | ImgVesselAngioOverallAssmTyp | Indicates vessel angiography overall assessment | Indicates vessel angiography overall assessment | Normal;Small Caliber;Impaired flow | Normal;Small Caliber;Impaired 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 |
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| 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 | |||||||||||||||||||||||||||||||
| C56428 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Verbal Comprehension confidence interval upper bound value | WASIIIVerbCompConfIntrvlUppVal | The upper bound of the subject's Verbal Comprehension confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The upper bound of the subject's Verbal Comprehension confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 12:55:22.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C14029 | Vasospasm posterior ratio result | VasoPosterRatioReslt | Indicates vasospasm posterior ratio result | Indicates vasospasm posterior ratio 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 | 10 | ||||||||||||||||||||||||||||||||
| 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 |
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| C54606 | Brief Test of Executive Function Second Edition (BRIEF 2) - Inhibit total raw scale score | BRIEF2InhbtTtlRwSclScore | Total score of the raw scale for the inhibit function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the inhibit 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 |
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| C13926 | Intima media thickness (IMT) B mode indicator | IMTBModeInd | Indicates intima media thickness (IMT) B mode | Indicates intima media thickness (IMT) B mode | 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 |
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| C00023 | Hand preference type | HandPrefTyp | Hand which the participant/subject uses predominantly, not necessarily the hand he/she writes with exclusively. | Hand which the participant/subject uses predominantly, not necessarily the hand he/she writes with exclusively. | Left hand;Right hand;Both hands;Unknown;Forced right | Left hand;Right hand;Both hands;Unknown;Forced right | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
2180147 | DeBaun Forms | ||||||||||||||||||||||||||||||
| C15561 | Imaging angiography contrast enhanced text | ImgAngioContrastEnhancTxt | If contrast enhanced in angiography, specify the method | If contrast enhanced in angiography, specify the method | 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 |
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| C18858 | Imaging pons abnormality other text | ImgPonsAbnrmlyOTH | The free-text field related to 'Imaging pons abnormality type' specifying other text. The type of abnormality in the pons on the image | The free-text field related to 'Imaging pons abnormality type' specifying other text. The type of abnormality in the pons on the image | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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| 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 |
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| C56384 | Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness hit reaction time standard deviation value | ConnersCPT3InaHRTStDevVal | The standard deviation of the subject's response speed consistency, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The standard deviation of the subject's response speed consistency, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:33:41.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C13958 | Microembolic signal settings type | MicroembolSignalSettingTyp | Indicates microembolic signal settings category | Indicates microembolic signal settings category | Leading cols;Trailing cols;Threshold;Rejection | Leading cols;Trailing cols;Threshold;Rejection | 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 |
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| 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 |
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| C56441 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 confidence interval upper bound value | WASIIIFullSclIQ2ConfIntUppVal | The upper bound of the subject's Full Scale IQ-2 confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The upper bound of the subject's Full Scale IQ-2 confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 13:06:29.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C56406 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Block Design raw score | WASIIIBDRawScore | The raw score that the subject received on the Block Design subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) . | 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 |
0 | 71 | ||||||||||||||||||||||||||||||||
| C14007 | Imaging Transcranial Doppler (TCD) findings result type | ImgTCDFindResltTyp | Indicates Transcranial Doppler (TCD) findings | Indicates Transcranial Doppler (TCD) findings | Reversed Diastolic Flow;Systolic spike;No signals;Reduced upstroke/Pulsatility Index (PI) | Reversed Diastolic Flow;Systolic spike;No signals;Reduced upstroke/Pulsatility Index (PI) | 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 |
DeBaun Forms | |||||||||||||||||||||||||||||||
| 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 |
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| C21494 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest trial number | WAISIVDSBTrialNum | Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | 1;2 | Trial 1;Trial 2 | Alphanumeric | 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 |
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| C13905 | Imaging contrast agent method type | ImgContrastAgentMethodTyp | Indicates imaging contrast agent method of administration | Type of imaging contrast agent used for the scan. | Bolus;Infusion;Other, specify;Bolus;Infusion;Other, specify | Bolus;Infusion;Other, specify;Bolus;Infusion;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 |
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| 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 |
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| C14052 | Hemoglobin measurement | HemoglobMeasr | The measurement for hemoglobin. | The measurement for hemoglobin. | 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 |
g/dL | DeBaun Forms | ||||||||||||||||||||||||||||||||
| C18027 | Comment text | CmmntTxt | Provide any additional information that pertains to the question. | Provide any additional information that pertains to the question. | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
| 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 |
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| C54689 | PROMIS - Global Health physical health rate scale | PROMISGlbHlthPhysHlthRtScl | Scale related to an individual's rating of his/her physical health, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her physical health, as part of the PROMIS Global Health | 1;2;3;4;5;1;2;3;4;5 | Poor;Fair;Good;Very Good;Excellent;Poor;Fair;Good;Very Good;Excellent | Numeric Values | 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 |
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| C13937 | Imaging mean lumen diameter measurement | ImgMeanLumenDiameterMeasr | Indicates mean lumen diameter measurement (mm) | Indicates mean lumen 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 | |||||||||||||||||||||||||||||||||
| 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 | |||||||||||||||||||||||||||||||
| C17432 | EEG focal slowing indicator | EEGFocalSlowingInd | The yes/no indicator for electroencephalography (EEG) focal slowing. | The yes/no indicator for Electroencephalography (EEG) focal slowing. | Yes;No;Unknown | Yes;No;Unknown | 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 | |||||||||||||||||||||||||||||||
| C18942 | Cerebellar or coordination assessment abnormality present other text | CerbllCoordAssmtAbnrmlyPrsOTH | The free-text field related to 'Cerebellar or coordination assessment abnormality present status' specifying other text. Whether the cerebellar/coordination assessment found abnormalities | The free-text field related to 'Cerebellar or coordination assessment abnormality present status' specifying other text. Whether the cerebellar/coordination assessment found abnormalities | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
| 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 | |||||||||||||||||||||||
| C19810 | Medical history abdominal kidney problem indicator | MedHistAbdmnlKdnyProbInd | Indicator of history of kidney problem | Indicator of history of kidney problem | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
| C13883 | Computer tomography (CT) angiography type | CTAngioTyp | The type of computer tomography angiography being performed. | The type of computer tomography angiography being performed. | Head;Neck;Computer Tomography Venography (CTV) | Head;Neck;Computer Tomography Venography (CTV) | Alphanumeric | Adult;Pediatric | Supplemental | 4.00 | 2017-04-11 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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| 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 | |||||||||||||||||||||||||||||||
| C56418 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid type | WASIIIExVisHearAidTyp | The type of visual or hearing aid or aids that the examinee needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The type of visual or hearing aid or aids that the examinee needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Glasses;Assisted Listening Device;Other;Prescription Lenses | Glasses;Assisted Listening Device;Other;Prescription Lenses | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:43:19.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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| C14019 | Sickle cell disease present indicator | SickleCellPresInd | Indicates presence of sickle cell | Indicates presence of sickle cell | 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 |
DeBaun Forms | |||||||||||||||||||||||||||||||
| 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 | |||||||||||||||||||||||||||||||
| C21505 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest last trial correct digit score | WAISIVLDSSScore | Last digit correct, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Last digit correct, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Numeric Values | Adult;Pediatric | Supplemental | 1.10 | 2018-07-30 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 9 | ||||||||||||||||||||||||||||||||
| C13916 | Imaging color flow angle measurement | ImgColorFlowAngleMeasr | Indicates color flow angle (degrees) | Indicates color flow angle (degrees) | 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 | 360 | degree of arc | |||||||||||||||||||||||||||||||
| 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 | |||||||||||||||||||||||||||||||
| C14680 | Pediatric Migraine Disability Assessment (MIDAS) - headache decrease school function day count | PedMIDASHeadDecSchFuncDayCt | Count days functioning at less than half your ability in school in the last 3 months due to headaches, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. | Count days functioning at less than half your ability in school in the last 3 months due to headaches, 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 |