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

Displaying 101 - 150 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
C01702 Pregnancy test date and time PregTestDateTime The date (and time if applicable and known) when the pregnancy test was performed The date (and time if applicable and known) when the pregnancy test was performed 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

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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
C14030 Vasospasm resistive index indicator VasospasmRestistIndexInd Indicates vasospasm resistive Index (RI) Indicates vasospasm resistive Index (RI) 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

C13195 Questionnaire for Verifying Stroke Free Status (QVSFS) - numbness status QVSFSNumbStatus Have you ever had sudden numbness or a dead feeling on one side of your body? Have you ever had sudden numbness or a dead feeling 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
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
C13927 Intima media thickness (IMT) B Mode guided M mode indicator IMTBModeGuidedMModeInd Indicates intima media thickness (IMT) B mode guided M mode Indicates intima media thickness (IMT) B mode guided M 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

C08238 Imaging repetition gap value ImgRepetitionGapVal Duration between successive pulse sequences, in milliseconds, applied to the same slice during imaging acquisition Duration between successive pulse sequences, in milliseconds, applied to the same slice during imaging acquisition 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

millisecond
C13938 Imaging minimum lumen diameter measurement ImgMinLumenDiameterMeasr Indicates minimum lumen diameter measurement (mm) Indicates minimum 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
C10570 Imaging contrast agent used indicator ImgContrastAgentUsedInd Indicator as to whether or not an imaging contrast agent was used for the scan as part of Diffusion Tensor Imaging (DTI). Indicator as to whether or not an imaging contrast agent was used for the scan. Yes;No;Unknown;Not applicable Yes;No;Unknown;Not applicable 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

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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C17494 Delay language cognitive milestone indicator DelayLangCogMilestoneInd Indicator as to whether the participant/subject has or had delayed acquisition of language or cognitive milestones, as diagnosed by a pediatrician or neurologist Indicator as to whether the participant/subject has or had delayed acquisition of language or cognitive 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
C00312 Body system category BodySysCat Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured interview and physical examination of all the body systems. Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured interview and physical examination of all the body systems. Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify:;Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify: Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify:;Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify: 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

2002895 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

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DeBaun Forms
C14008 Imaging window quality category ImgWindowQualityCat Indicates window quality category Indicates window quality category Temporal;Posterior;Orbital Temporal;Posterior;Orbital 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

C12490 Imaging ventricle abnormal indicator ImgVentrclAbnrmlInd Indicator of whether the ventricles appear normal or abnormal in the image studies Indicator of whether the ventricles appear normal or abnormal in the image studies Abnormal;Normal;Abnormal;Normal Abnormal;Normal;Abnormal;Normal Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

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

C13906 Imaging B-mode artery name ImgBModArtName Indicates B-mode artery name Indicates B-mode artery name CCA;ICA;ECA;CCA;ICA;ECA Common carotid artery;Internal carotid artery;External carotid artery;Common carotid artery;Internal carotid artery;External carotid 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

C02212 Informed consent obtained date and time InformConsntObtnDateTime Date (and time, if applicable and known) on which the participant/subject (or the legal representative on behalf of the participant/subject) agrees to participate in a protocol, treatment, or other activity by signing an informed consent document. Date (and time, if applicable and known) on which the participant/subject (or the legal representative on behalf of the participant/subject) agrees to participate in a protocol, treatment, or other activity by signing an informed consent document. Date or Date & Time Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

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2435038,656 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

Free-Form Entry

C14056 Imaging depth measurement ImgDepthMeasr The depth measurement (mm) of imaging. The depth measurement (mm) of imaging. 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
C13238 National Institutes of Health Stroke Scale (NIHSS) - Motor arm score NIHSSLvlConscMotArmScore Motor ability of the arm (both left and right) assessed using the NIH Stroke Scale (NIHSS) Motor ability of the arm (both left and right) assessed using the NIH Stroke Scale (NIHSS) 0;1;2;3;4;UN;0;1;2;3;4;UN No drift: limb holds 90 (or 45) degrees for full 10 seconds;Drift: limb holds 90 (or 45) degrees, but drifts down before full 10 seconds, does not hit bed or other support;Some effort against gravity: limb cannot get to or maintain (if cued) 90 (or 45) degrees, drifts down to bed, but has some effort against gravity.;No effort against gravity: limb falls;No movement;Amputation or joint fusion, explain;No drift: limb holds 90 (or 45) degrees for full 10 seconds;Drift: limb holds 90 (or 45) degrees, but drifts down before full 10 seconds, does not hit bed or other support;Some effort against gravity: limb cannot get to or maintain (if cued) 90 (or 45) degrees, drifts down to bed, but has some effort against gravity.;No effort against gravity: limb falls;No movement;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

DeBaun Forms
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

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DeBaun Forms
C18892 Imaging percent stenosis criterion other text ImgPercentStenosisCriterionOTH The free-text field related to 'Imaging percent stenosis criterion type' specifying other text. The criteria used to find indicate stenosis. The free-text field related to 'Imaging percent stenosis criterion type' specifying other text. The criteria used to find indicate stenosis. 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

C13949 Imaging flow/probe direction type ImgFlowProbDireTyp Indicates flow/probe direction Indicates flow/probe direction Towards;Away from Towards;Away from 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

C11061 Gait assessment result GaitAssmtReslt Result of the gait assessment Result of the gait assessment Normal;Abnormal;Cannot Assess;Other, specify Normal;Abnormal;Cannot Assess;Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-22 16:57:17.79 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C56391 Conners Continuous Performance Test 3rd Edition (CPT3) - Sustained attention hit reaction time block change value ConnersCPT3SusAttnHRTBlkChaVal The change in the subject's response speed across blocks of trials, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). The change in the subject's response speed across blocks of trials, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:41:29.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0
C13884 Imaging vessel angiography arterial anatomic site ImgVesselAngioArterAntmicSite Indicates vessel imaging angiography arterial findings location Indicates vessel imaging angiography arterial findings location CCA origin;CCA to bifurcation;ICA at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA;CCA origin;CCA to bifurcation;ICA at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA Common carotid artery origin;Common carotid artery to bifurcation;Internal carotid artery at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA;Common carotid artery origin;Common carotid artery to bifurcation;Internal carotid artery at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA 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

C01520 Head circumference measurement HeadCircumfMeasr Circumferential measurement of the head at the widest point - the distance from above the eyebrows and ears and around the back of the head Circumferential measurement of the head at the widest point - the distance from above the eyebrows and ears and around the back of the head 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

0 100 centimeter 3181613
C21488 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest item score WAISIVDSFItemScore Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest 0;1;2 0;1;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

C14020 Sickle cell disease vessel anatomic site SickleCellDisVesselAntmicSite Indicates sickle cell vessel Indicates sickle cell vessel ICA;MCA;ACA;Other, specify Internal carotid artery;Middle cerebral artery;Anterior carotid artery;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

C12501 Imaging internal capsule type indicator ImgIntCpslTypInd The condition of the internal capsule. The condition of the internal capsule. Involved;Spared Involved;Spared 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

C56434 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 4 composite score WASIIIFullScaleIQ4CompScore The subject's Full Scale IQ composite score for all four subtests, converted from his/her Full Scale T score for all four subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The subject's Full Scale IQ composite score for all four subtests, converted from his/her Full Scale T score for all four 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
C17529 Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex knee jerk left score FARSPNSNeuExDTenRKneeJLtScore Score for left-side knee 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 knee 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
C13917 Imaging end diastolic velocity measurement ImgEndDiastVeloMears Indicates end diastolic velocity (cm/sec) Indicates end diastolic velocity (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

centimeter per second
C02496 Imaging scanner manufacturer name ImgScannerManufName Name of manufacturer of imaging scanner Imaging scanner manufacturer name Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify;Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify;Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify 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

C54611 Brief Test of Executive Function Second Edition (BRIEF 2) - Initiate total raw scale score BRIEF2IntiatTtlRwSclScore Total score of the raw scale for the initiate function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Total score of the raw scale for the initiate 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

C14681 Pediatric Migraine Disability Assessment (MIDAS) - headache cease home function day count PedMIDASHeadCeasHomFuncDayCt Count the days you were not able to do things at home (i.e., chores, homework, etc.) in the last 3 months due to a headache, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. Count the days you were not able to do things at home (i.e., chores, homework, etc.) in the last 3 months due to a headache, 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
C13456 Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - sensorimotor deficit scale PSOMSNESensDefScale The scale for sensorimotor deficit (any motor or sensory abnormality including cranial nerve deficits, visual, and hearing deficits) based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). The scale for sensorimotor deficit (any motor or sensory abnormality including cranial nerve deficits, visual, and hearing deficits) 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
C54694 PROMIS - Global Health bother emotional problem scale PROMISGlbHlthBthrEmtnlPrbScl Scale related to an individual's rating of how often he/she has been bothered by emotional problems such as feeling anxious, depressed or irritable, as part of the PROMIS Global Health Scale related to an individual's rating of how often he/she has been bothered by emotional problems such as feeling anxious, depressed or irritable, 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

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

C13470 Stroke Adjudication Worksheet - neuroimaging type StrokeAdjudWksNeuroimagTyp Type of neuro-imaging done for the stroke event Type of neuro-imaging done for the stroke event Single brain CT;Multiple brain CTs separated in time;MRI;DWI Single brain CT;Multiple brain CTs separated in time;MRI;DWI 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
C19167 Special care unit type SCUTyp Type of special care unit Type of special care unit Intensive Care Unit;Step-Down Unit Intensive Care Unit (ICU);Step-Down Unit (SDU) Alphanumeric Adult;Pediatric Supplemental 1.00 2014-05-29 14:04:21.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
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

C12480 Imaging cortex-pachygyria thickness measurement ImgCortexPachygyriaThickMeasr The measurement of cortex thickness, in , of the cortex The measurement of cortex thickness, in , of the cortex 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

C56411 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Vocabulary T score WASIIIVocabTScore The T score converted from the raw score that the subject received on the Vocabulary 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 Vocabulary 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
C13896 Imaging vessel angiography level of confidence status ImgVesselAngioLvlConfidTyp Indicates vessel angiography level of confidence Indicates vessel angiography level of confidence Low;Moderate;High Low;Moderate;High 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

C01705 Lab test name LabTestName Name representing the 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. Name representing the 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 LB LBTEST

Lab Test or Examination Name

Laboratory Test Name

What was the lab test name?

LBTEST; LBTESTCD Char Record the name of the Lab measurement or finding, if not preprinted on the CRF. If collected on the CRF, the sponsor may provide additional instructions to ensure the data is entered as intended. (LBTEST)

[Select appropriate values from the LBTEST codelist]

Prompt Radio
C21499 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest response text WAISIVDSSRespnsTxt Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing 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

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

C13196 Questionnaire for Verifying Stroke Free Status (QVSFS) - painless vision loss status QVSFSPainlsVisnLossStatus Have you ever had sudden painless loss of vision in one or both eyes? Have you ever had sudden painless loss of vision in one or both eyes? 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

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