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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C18857 | Imaging brainstem abnormality other text | ImgBrnstmAbnrmlyOTH | The free-text field related to 'Imaging brainstem abnormality type' specifying other text. The type of abnormality in the brainstem on the image | The free-text field related to 'Imaging brainstem abnormality type' specifying other text. The type of abnormality in the brainstem 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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| 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 |
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| C18903 | Vasomotor response (VMR) vessel anatomic other text | VMRVesselAntmicOTH | The free-text field related to 'Vasomotor response (VMR) vessel anatomic site' specifying other text. Indicates vasomotor response (VMR) vessel type | The free-text field related to 'Vasomotor response (VMR) vessel anatomic site' specifying other text. Indicates vasomotor response (VMR) vessel type | 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 |
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| 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 |
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| C14037 | Imaging power M mode left middle cerebral artery result | ImgPowerMModeLeftMCARes | Indicates power M mode for left middle cerebral artery (MCA) result | Indicates power M mode for left middle cerebral artery (MCA) result | Absent;High Resistance;Low Resistance;Absent;High Resistance;Low Resistance | Absent;High Resistance;Low Resistance;Absent;High Resistance;Low Resistance | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| C56397 | Conners Continuous Performance Test 3rd Edition (CPT3) - Vigilance commission inter-stimulus interval change value | ConnersCPT3VigCommISIChngVal | The number of incorrect responses to non-targets by inter-stimulus interval (ISI), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The number of incorrect responses to non-targets by inter-stimulus interval (ISI), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:48:46.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| 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 | |||||||||||||||||||||||||||||||
| C13934 | Intima media thickness (IMT) max near-wall measurement | IMTMaxNearWallMeasr | Indicates max intima media thickness (IMT) near-wall measurement (mm) | Indicates max intima media thickness (IMT) near-wall measurement (mm) | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
millimeter | |||||||||||||||||||||||||||||||||
| C21493 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest item number | WAISIVDSBItemNum | Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | 1;2;3;4;5;6;7;8 | Item 1;Item 2;Item 3;Item 4;Item 5;Item 6;Item 7;Item 8 | 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 |
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| 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 |
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| C17397 | Visit number | VisitNum | The numeric value associated with a particular assessment/examination of a participant/subject on a study | The numeric value associated with a particular assessment/examination of a participant/subject on a study | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2012-12-20 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||||||
| C17972 | Medication prior concomitant dose frequency Clinical Data Interchange Standards Consortium Standard Data Tabulation Model code | MedPriConDoseFreqCDISCSDTMCode | Code that represents the frequency of the dosage of the prior or concomitant medication administered. Clinical Data Interchange Standards Consortium Standard Data Tabulation Model (CDISC SDTM) | Code that represents the frequency of the dosage of the prior or concomitant medication administered. Clinical Data Interchange Standards Consortium Standard Data Tabulation Model (CDISC SDTM) | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:36:20.083 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
| 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 | |||||||||||||||||||||||||||||||
| C14004 | Imaging brain death vessel anatomic site | ImgBrainDeathVesseIAntmicSite | Indicates brain death vessel(s) | Indicates brain death vessel(s) | ICA;Basilar;MCA;Other, specify;ACA;VA;PCA;Ophthalmic artery | Internal carotid artery;Basilar;Middle cerebral artery;Other, specify;Anterior carotid artery;Vertebral artery;Posterior carotid artery;Ophthalmic artery | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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| C54688 | PROMIS - Global Health quality of life scale | PROMISGlbHlthQualOfLfScl | Scale related to an individual's rating of his/her quality of life, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her quality of life, 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 | 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 |
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| 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 | |||||||||||||||||||||||||||||
| C13902 | Imaging acute stroke study type | ImgAcutStokStudTyp | Indicates imaging acute stroke study type | Indicates imaging acute stroke study type | Initial;Follow-up 1;Follow-up 2 | Initial;Follow-up 1;Follow-up 2 | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| 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 |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||||||
| C13913 | Imaging plaque motion result | ImgPlaqMotionReslt | Indicates plaque motion | Indicates plaque motion | 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 |
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| C19805 | Medical history endocrine osteoporosis indicator | MedHistEndcrnOstprsisInd | Indicator of history of osteoporosis | Indicator of history of osteoporosis | 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 | |||||||||||||||||||||||||||||||
| 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 | |||||||||||||||||||||||||||||||
| C14559 | EEG recording start date and time | EEGRecordingStrtDateTime | Date (and time, if applicable and known) the electroencephalogram (EEG) recording began | Date the electroencephalogram (EEG) recording began | 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 |
DeBaun Forms | |||||||||||||||||||||||||||||||||
| C56417 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale 2 T score sum value | WASIIIFullScale2TScoreSumVal | The sum of two of the subject's T scores (Vocabulary and Matrix Reasoning), as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The sum of two of the subject's T scores (Vocabulary and Matrix Reasoning), as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:40:41.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| 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 | |||||||||||||||||||||||||||||||||
| C13945 | Imaging spectrum depth measurement | ImgSpectrumDepthMeasr | Indicates spectrum depth measurement (mm) | Indicates spectrum depth 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 |
0 | 999 | millimeter | |||||||||||||||||||||||||||||||
| 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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| 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 | |||||||||||||||||||||||||||||||
| C17526 | Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex biceps jerk right score | FARSPNSNeuExDTenRefBicJRtScore | Score for right-side biceps jerk in the peripheral nervous system section of the neurological exam, as part of the Friedreich's Ataxia Rating Scale (FARS). | Score for right-side biceps jerk in the peripheral nervous system section of the neurological exam, as part of the Friedreich's Ataxia Rating Scale (FARS). | 0;1;2;3;4;0;1;2;3;4;0;1;2;3;4 | 0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia;0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia;0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
| 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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| C12479 | Imaging cortex-pachygyria site type | ImgCortexPachygyriaSiteTyp | The anatomical site(s) of the cortex-pachygyria | The anatomical site(s) of the cortex-pachygyria | 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 |
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| C14015 | Microembolic signal count | MicroembolSignalCt | Numeric value counting the number of microembolic signals. | Indicates microembolic signal number | 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 | ||||||||||||||||||||||||||||||||
| 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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| C14027 | Intracranial pressure (ICP) other measurement text | ICPOtherMeasrTxt | Indicates other method of measuring intracranial pressure (ICP) | Indicates other method of measuring intracranial pressure (ICP) | 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 |
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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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| 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 |
Free-Form Entry |
2435038,656 | DeBaun Forms | ||||||||||||||||||||||||||||||||
| C13924 | Imaging vertebral origin result | ImgVertebralOriginReslt | Indicates vertebral origin | Indicates vertebral origin | Normal;Stenosis;Occluded | Normal;Stenosis;Occluded | 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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| 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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| 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 | |||||||||||||||||||||||||||||||
| C15555 | Imaging visual analysis performed indicator | ImgVisAnlysisPerfrmInd | Whether visual analysis was performed while blind to clinical data | Whether visual analysis was performed while blind to clinical data | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| 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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| 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 |
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| 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 | ||||||||||||||||||||||||||||||||
| C13956 | Microembolic signal duration | MicroembolSignalDur | Indicates microembolic signal duration time (msec) | Indicates microembolic signal duration time (msec) | 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 | millisecond | |||||||||||||||||||||||||||||||
| 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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| 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 | ||||||||||||||||||||||||||||||
| C13892 | Arterial occlusive lesion (AOL) recanalization score | AOLRecanalScore | The score as related to recanalization of the primary arterial occlusive lesion (AOL). | The score as related to recanalization of the primary arterial occlusive lesion (AOL). | 0;1;2;3;0;1;2;3;0;1;2;3 | No recanalization of the primary occlusive lesion;Incomplete or partial recanalization of the primary occlusive lesion with no distal flow;Incomplete or partial recanalization of the primary occlusive lesion with any distal flow;Complete recanalization of the primary occlusion with any distal flow;No recanalization of the primary occlusive lesion;Incomplete or partial recanalization of the primary occlusive lesion with no distal flow;Incomplete or partial recanalization of the primary occlusive lesion with any distal flow;Complete recanalization of the primary occlusion with any distal flow;No recanalization of the primary occlusive lesion;Incomplete or partial recanalization of the primary occlusive lesion with no distal flow;Incomplete or partial recanalization of the primary occlusive lesion with any distal flow;Complete recanalization of the primary occlusion with any distal flow | 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 |
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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 |
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| 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 |
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| 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 |
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| 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 |