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

Displaying 201 - 250 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
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
C13940 Imaging minimum interadventitial diameter measurement ImgMinInteradventlDiamtMeasr Indicates minimum interadventitial diameter measurement (mm) Indicates minimum 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
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
C18719 Imaging slice orientation other text ImgSliceOrientOTH The free-text field related to 'Imaging slice orientation type' specifying other text. The slice orientation used in imaging acquisition The free-text field related to 'Imaging slice orientation type' specifying other text. The slice orientation used in imaging acquisition 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

C17499 Special education indicator SpecialEduInd Indicator as to whether the participant/subject has or had special education Indicator as to whether the participant/subject has or had special education 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

C55779 Imaging automated evaluation vascular MRI data indicator ImagAutoEvalVasMRIDataInd The indicator relating to whether or not an automated evaluation of vascular magnetic resonance imaging (MRI) data has been given. The indicator relating to whether or not an automated evaluation of vascular magnetic resonance imaging (MRI) data has been given. No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2017-05-31 12:26:23.0 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

C14010 Intracranial stenosis collateral vessel anatomic site IntracrnStnoColltVsslAntmicSit Indicates intracranial stenosis collateral vessel(s) Indicates intracranial stenosis collateral vessel(s) ICA;Basilar;MCA;Other, specify;ACA;VA;PCA Internal carotid artery;Basilar;Middle cerebral artery;Other, specify;Anterior carotid artery;Vertebral artery;Posterior carotid 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

C19840 Medical history medication change since last visit indicator MedHistMedctnChngeSLVInd Indicator of medication changes since last study visit Indicator of medication changes since last study visit No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-06 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

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
C13908 Imaging echo pattern result ImgEchoPattReslt Indicates echo pattern Indicates echo pattern Homogeneous;Heterogeneous Homogeneous;Heterogeneous 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

C56438 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 composite score WASIIIFullScaleIQ2CompScore The subject's Full Scale IQ composite score for only 2 subtests (Vocabulary and Matrix Reasoning), converted from his/her Full Scale T score for two subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The subject's Full Scale IQ composite score for only 2 subtests (Vocabulary and Matrix Reasoning), converted from his/her Full Scale T score for two subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-12 13:02:44.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

40 160
C56420 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid glasses used indicator WASIIIExVisHearAidGlassUsedInd The indicator relating to whether the examine used his/her glasses during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The indicator relating to whether the examine used his/her glasses 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 11:53:18.0 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
C14424 Epilepsy etiology specific classification type EpilepsyEtioSpecClassTyp The specific etiologies preceeding the development of epilepsy in the participant/subject, as described by the International League Against Epilepsy (ILAE). The specific etiologies preceding the development of epilepsy in the participant/subject. Viral, bacterial and parasitic infections;Traumatic brain injury;Stroke;Intraventricular hemorrhage;Hypoxic-ischemic encephalopathy;Other metabolic or toxic insults;Neurocutaneous syndromes;Inborn errors of metabolism;Genetic and chromosomal development encephalopathies;Malformations of cortical or other brain development with or without known genetic determinants;Neoplasia;Dementia;Other degenerative neurologic diseases;Genetic or presumed genetic;Epilepsy of unknown cause, without relevant abnormalities on examination, cognition, history, or imaging;Other, specify;Developmental encephalopathy of unknown cause;Mesial Temporal Sclerosis Viral, bacterial and parasitic infections;Traumatic brain injury;Stroke;Intraventricular hemorrhage;Hypoxic-ischemic encephalopathy;Other metabolic or toxic insults;Neurocutaneous syndromes;Inborn errors of metabolism;Genetic and chromosomal development encephalopathies;Malformations of cortical or other brain development with or without known genetic determinants;Neoplasia;Dementia;Other degenerative neurologic diseases;Genetic or presumed genetic;Epilepsy of unknown cause, without relevant abnormalities on examination, cognition, history, or imaging;Other, specify;Developmental encephalopathy of unknown cause as evidenced by the presence of mental retardation, cerebral palsy, or autism with no evidence of a specific insult or disorder to which cause can be attributed preceding the onset of epilepsy;Mesial Temporal Sclerosis 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
C21507 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span subtest total raw score WAISIVDSTtlScore Total score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span subtest Total score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span 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 48
C54609 Brief Test of Executive Function Second Edition (BRIEF 2) - Emotional control total raw scale score BRIEF2EmtnlCntrlTtlRwSclScore Total score of the raw scale for the emotional control function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Total score of the raw scale for the emotional control 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

C10568 Imaging radio frequency coil channel count ImgRFCoilChannelCt Number of the coil channels in the radio frequency (RF) coil used for the imaging scan Number of the coil channels in the radio frequency (RF) coil used for the imaging scan 1;8;12;16;24;32;Other, specify;1;8;12;16;24;32;Other, specify Single coil;8 channels;12 channels;16 channels;24 channels;32 channels;Other, specify;Single coil;8 channels;12 channels;16 channels;24 channels;32 channels;Other, specify 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

C13951 Imaging spectrum end diastolic ratio value ImgSpectrumEndDiastlRatioVal Indicates spectrum end diastolic ratio result Indicates spectrum end diastolic 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

C18888 Imaging acquisition reason other text ImgAcquisitionRsnOTH The free-text field related to 'Imaging acquisition reason' specifying other text. Describes why the imaging study was performed The free-text field related to 'Imaging acquisition reason' specifying other text. Describes why the imaging study was performed 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

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
C13886 Imaging vessel angiography cause type ImgVesselAngioCauseTyp Indicates vessel imaging angiography cause Indicates vessel imaging angiography cause Atherosclerotic;Embolic;Other;Unknown;Vasospasm Atherosclerotic;Embolic;Other;Unknown;Vasospasm 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

C56388 Conners Continuous Performance Test 3rd Edition (CPT3) - Impulsivity commission count ConnersCPT3ImpCommCt The number of incorrect responses to non-targets, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). The number of incorrect responses to non-targets, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:38:27.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0
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

C14022 Sickle cell disease criterion result text SickleCellCriterResltTxt Indicates sickle cell criterion result Indicates sickle cell criterion 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

DeBaun Forms
C21486 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest trial number WAISIVDSFTrialNum Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward 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

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
C13919 Imaging percent stenosis criterion type ImgPercentStenosisCriterionTyp The criteria used to find indicate stenosis. The criteria used to find indicate stenosis. PSV;PSV/EDV;Other, specify Peak systolic velocity;Peak systolic velocity/end diastolic velocity;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

C56431 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Perceptual Reasoning confidence interval lower bound value WASIIIPercRsngConfIntrvlLowVal The lower bound of the subject's Perceptual Reasoning confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The lower bound of the subject's Perceptual Reasoning 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

C13237 National Institutes of Health Stroke Scale (NIHSS) - Facial palsy score NIHSSLvlConscFaclPlsyScore Facial palsy assessed using the NIH Stroke Scale (NIHSS) Facial palsy assessed using the NIH Stroke Scale (NIHSS) 0;1;2;3;UN;0;1;2;3;UN Normal symmetrical movement;Minor paralysis (flattened nasolabial fold, asymmetry on smiling);Partial paralysis (total or near total paralysis of lower face);Complete paralysis of one or both sides (absence of facial movement in the upper and lower face);Unexaminable (intubated/paralyzed);Normal symmetrical movement;Minor paralysis (flattened nasolabial fold, asymmetry on smiling);Partial paralysis (total or near total paralysis of lower face);Complete paralysis of one or both sides (absence of facial movement in the upper and lower face);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

C14683 Pediatric Migraine Disability Assessment (MIDAS) - headache decrease other activity function day count PedMIDASHeadDecOActFuncDayCt Count the days you participate in these activities, but functioned at less than half your ability, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. Count the days you participate in these activities, but functioned at less than half your ability, 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

C13248 National Institutes of Health Stroke Scale (NIHSS) Supplemental - Limb sensory loss status NIHSSSupLimbSensoryLossStatus The indicator to determine if any limbs have sensory loss The indicator to determine if any limbs have sensory loss 0;1;2 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. 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

C18610 Imaging in plane resolution axis 2 measurement ImgInPlaneRsltnAxis2Measr Axis 2 of in-plane spatial resolution used in imaging acquisition Axis 2 of in-plane spatial resolution used in imaging acquisition 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
C16100 Symptoms new or worsening neurologic indicator SymptmNewWrseNeuroInd Indicates whether the participant/subject has new neurologic symptoms or an acute worsening of preexisting neurologic symptoms Indicates whether the participant/subject has new neurologic symptoms or an acute worsening of preexisting neurologic symptoms Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C54692 PROMIS - Global Health carry out social role scale PROMISGlbHlthCrryOutSocRlScl Scale related to an individual's rating of his/her ability to carry out usual social activities and roles, as part of the PROMIS Global Health Scale related to an individual's rating of his/her ability to carry out usual social activities and roles, 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

C11026 Neuromuscular Exam Muscle weakness indicator NeuromuExmCranlMuscleWeaknInd Indicator whether there is muscle weakness in the muscle or muscle group examined Whether there is muscle weakness in the muscle or muscle group examined Yes;No;Not assessed;Unknown Yes;No;Not assessed;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
C14000 Extracranial stenosis present indicator ExtracranStenPresInd Indicates presence of extracranial stenosis Indicates presence of extracranial stenosis 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

C19151 Discontinuation date DiscontinuationDate The date of discontinuation The date of discontinuation Date or Date & Time Adult;Pediatric Supplemental 1.00 2014-05-29 11:10:46.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

DeBaun Forms
C01507 Blood pressure diastolic measurement BldPressrDiastlMeasr Measurement of pressure of the participant's/subject's blood against the artery walls during diastole (the relaxation phase) in millimeters of mercury (mmHg) Measurement of pressure of the participant's/subject's blood against the artery walls during diastole (the relaxation phase) in millimeters of mercury (mmHg) 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

0 300 millimeter of mercury 2004291 DeBaun Forms
C13898 Imaging vessel angiography collateral grade ImgVesselAngioCollateralGrad Indicates vessel angiography collateral grade Indicates vessel angiography collateral grade Grade 0;Grade 1;Grade 2;Grade 3;Grade 4 No collaterals visible to the ischemic site;Slow collaterals to the periphery of the ischemic site with persistence of some of the defect;Rapid collaterals to the periphery of ischemic site with persistence of some of the defect and to only a portion of the ischemic territory;Collaterals with slow but complete angiographic blood flow of the ischemic bed by the late venous phase;Complete and rapid collateral blood flow to the vascular bed in the entire ischemic territory by retrograde perfusion. 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

C56409 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Similarities raw score WASIIISimRawScore The raw score that the subject received on the Similarities subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) . 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

0 45
C12500 Imaging corpus callosum type indicator ImgCrpsClsmTypInd The condition of the corpus callosum fibers The condition of the corpus callosum fibers 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

C14033 Vasospasm vessel anatomic site VasospasmVesselAntmicSite Indicates vasospasm vessel(s) Indicates vasospasm vessel(s) ICA;Basilar;MCA;Other, specify;ACA;VA Internal carotid artery;Basilar;Middle cerebral artery;Other, specify;Anterior cerebral artery;Vertebral 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

C21497 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest last trial correct digit score WAISIVLDSBScore Score for correctly recalled digits for the last trial, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest Score for correctly recalled digits for the last trial, 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 8
C02495 Imaging scanner strength value ImgScannerStrgthVal Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported 1.5T;3.0T;4.0T;7.0T;Other, specify;1.5T;3.0T;4.0T;7.0T;Other, specify 1.5T;3.0T;4.0T;7.0T;Other, specify;1.5T;3.0T;4.0T;7.0T;Other, specify 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

Tesla
C13930 Intima media thickness (IMT) timing type IMTTimingTyp Indicates intima media thickness (IMT) timing type Indicates intima media thickness (IMT) timing type ECG Gating;End Diastolic;Peak Systolic;ECG Gating;End Diastolic;Peak Systolic ECG Gating;End Diastolic;Peak Systolic;ECG Gating;End Diastolic;Peak Systolic 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

C50680 Examiner name ExaminerName The name of the person performing the exam. The name of the person performing the exam. 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

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
C13941 Imaging insonation plane type ImgInsonPlaneTyp Indicates insonation plane Indicates insonation plane Free;Coronal;Axial mesencephalic Free;Coronal;Axial mesencephalic 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

C13469 Stroke Adjudication Worksheet - neuroimaging indicator StrokeAdjudWksNeuroimagInd The indicator for whether neuro-imaging done for this stroke event. The indicator for whether neuro-imaging done for this stroke event. 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
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