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 |
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C18902 | Vasospasm vessel anatomic other text | VasospasmVesselAntmicOTH | The free-text field related to 'Vasospasm vessel anatomic site' specifying other text. Indicates vasospasm vessel(s) | The free-text field related to 'Vasospasm vessel anatomic site' specifying other text. Indicates vasospasm vessel(s) | 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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C14036 | Breath-holding index result | BreathHoldingIndexReslt | Indicates breath-holding index (BHI) result | Indicates breath-holding index (BHI) 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 |
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C02307 | Adverse event verbatim term text | AdvrsEvntVerbatimTermText | Text that describes the adverse event word for word as described by the participant/subject | Adverse event verbatim term text | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
2188132 | DeBaun Forms | |||||||||||||||||||||||||||||||
C56396 | Conners Continuous Performance Test 3rd Edition (CPT3) - Vigilance omission inter-stimulus interval change value | ConnersCPT3VigOmiISIChngVal | The number of missed targets by inter-stimulus interval (ISI), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The number of missed 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 15:47:31.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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C56416 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale 4 T score sum value | WASIIIFullScale4TScoreSumVal | The sum of all four of the subject's T scores, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The sum of all four of the subject's T scores, 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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C13459 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - language deficit-production description text | PSOMSNELangDefProdDescTxt | Description of the language production deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Description of the language production deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | 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 | ||||||||||||||||||||||||||||||||
C13944 | Imaging color flow indicator | ImgColorFlowInd | Indicates color flow | Indicates color flow | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C21503 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest trial score | WAISIVDSSTrialScore | Trial score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Trial score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | 0;1;0;1;0;1 | 0;1;0;1;0;1 | 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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C17525 | Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex biceps jerk left score | FARSPNSNeuExDTenRefBicJLftScr | Score for left-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 left-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 | |||||||||||||||||||||||||||||||
C12468 | Imaging magnetic resonance imaging performed multiple count | ImgMRIPerfMultiCt | The count representing of the number of magnetic resonance imaging (MRI) sessions performed on the participant/subject | The count representing of the number of magnetic resonance imaging (MRI) sessions performed on the participant/subject | 2;3;4;5;6;>6;2;3;4;5;6;>6 | 2;3;4;5;6;>6;2;3;4;5;6;>6 | 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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C18714 | Imaging radio frequency coil channel other text | ImgRFCoilChannelOTH | The free-text field related to 'Imaging radio frequency coil channel count' specifying other text. Number of the coil channels in the radio frequency (RF) coil used for the imaging scan | The free-text field related to 'Imaging radio frequency coil channel count' specifying other text. Number of the coil channels in the radio frequency (RF) coil used for the imaging scan | 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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C14014 | Intracranial stenosis other criteria result | IntracranStenoOthCriteriaReslt | Other criteria for intracranial stenosis | Other criteria for intracranial stenosis | 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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C01535 | Respiratory rate | RespRate | Rate of the participant/subject's breathing (inhalation and exhalation). | Rate of the participant/subject's breathing (inhalation and exhalation). | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 120 | breaths per minute | 2644399 | DeBaun Forms | |||||||||||||||||||||||||||||
C56444 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 4 expected score | WASIIIFullScaleIQ4ExpScore | The Full Scale IQ score for all four subtests that the subject was expected to receive, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The Full Scale IQ score for all four subtests that the subject was expected to receive, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 13:20:27.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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C55775 | Imaging ictal pain intensity value | ImagIctPainIntensVal | The value related to the intensity of the subject's pain if the timing is ictal | The value related to the intensity of the subject's pain if the timing is ictal | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:19:15.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 10 | ||||||||||||||||||||||||||||||||
C12504 | Imaging gray matter hyperintensity T2 fluid attenuated inversion recovery site | ImgGryMtrHyperT2FLAIRSiteTyp | The type of anatomical site of the grey matter hyperintensity on T2/FLAIR (fluid attenuated inversion recovery) images | The type of anatomical site of the grey matter hyperintensity on T2/FLAIR images | Putamen;Caudate;Other, specify;Cerebellar nuclei;Colliculi;Floor of the fourth ventricle;Pallidum;Periaqueductal grey;Red nucleus;Substantia nigra;Mammillary body;Subthalmic nucleus;Thalamus | Putamen;Caudate;Other, specify;Cerebellar nuclei;Colliculi;Floor of the fourth ventricle;Pallidum;Periaqueductal grey;Red nucleus;Substantia nigra;Mammillary body;Subthalmic nucleus;Thalamus | 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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C13912 | Imaging plaque composition result | ImgPlaqCompositionReslt | Indicates plaque composition | Indicates plaque composition | 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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C19779 | Medical history asthma pulmonary assessment indicator | MedHistAsthmaPulAssesInd | Indicator of history of asthma | Indicator of history of asthma | 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 | |||||||||||||||||||||||||||||||
C14463 | Reflex plantar left response result | RflxPlntrLftRespnsReslt | The results from reflex plantar response on the left side | The results from reflex plantar response on the left side | Flexor;Extensor;Equivocal;Cannot Assess;Other, specify | Flexor;Extensor;Equivocal;Cannot Assess;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2012-10-05 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C05408 | Hospital admission date and time | HospitlAdmissDateTime | Date (and time, if applicable and known) the participant/subject was admitted to the hospital | Date (and time, if applicable and known) the participant/subject was admitted to the hospital | 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 | |||||||||||||||||||||||||||||||||
C21117 | Subject name | SubjectName | Name of subject/participant. | Name of subject/participant. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-06-12 15:16:39.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C14964 | Sedation used indicator | SedationUsedInd | Whether the participant/subject was administered any sedation | Whether the participant/subject was administered any sedation | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C08242 | Imaging acquisition duration | ImgAcquisitionDur | Duration of the imaging scan in minutes | The duration of the imaging acquisition, in minutes | 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 |
minute | |||||||||||||||||||||||||||||||||
C56427 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Verbal Comprehension confidence interval lower bound value | WASIIIVerbCompConfIntrvlLowVal | The lower bound of the subject's Verbal Comprehension confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The lower 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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C13879 | Imaging modality vessel imaging angiography type | ImgModltyVesselImgAngioTyp | Indicates imaging modality for vessel imaging angiography | Indicates imaging modality for vessel imaging angiography | DSA;MRA;CTA;CBCT | Digital subtraction angiography;Magnetic resonance angiography;Computer tomography angiography;CBCT | 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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C13955 | Imaging transcranial color-coded sonography symptomatic indicator | ImgTCCSSymptomaticInd | Indicates symptomatic presentation by Transcranial Color-Coded Sonography (TCCS) | Indicates symptomatic presentation by Transcranial Color-Coded Sonography (TCCS) | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C54605 | Informant participant relationship duration unit of measure | InfrmntPrtcpntRltnshpDurUOM | Field related to 'Informant participant relationship duration' specifying the unit of measure of the duration for which the informant has known the participant | Field related to 'Informant participant relationship duration' specifying the unit of measure of the duration for which the informant has known the participant | Weeks;Months;Years | Weeks;Months;Years | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-03-22 09:46:35.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C12483 | Imaging cortex-polymicrogyria indicator | ImgCortexPolymicrogyriaInd | Indicator of whether a developmental malformation of the human brain characterized by an excessive number of small convolutions (gyri) on the surface of the brain is present | Indicator of whether a developmental malformation of the human brain characterized by an excessive number of small convolutions (gyri) on the surface of the brain is present | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C13891 | Thrombolysis in Cerebral Infarction (TICI) perfusion scale grade | TICIPerfScaleGrade | Indicates Thrombolysis in Cerebral Infarction (TICI) perfusion scale grade indicator | Indicates Thrombolysis in Cerebral Infarction (TICI) perfusion scale grade indicator | Grade 0;Grade 1;Grade 2;Grade 2b;Grade 3 | No perfusion. No antegrade flow beyond the point of occlusion;Penetration with Minimal Perfusion. The contrast material passes beyond the area of obstruction but fails to opacify the entire cerebral bed distal to the obstruction for the duration of the angiographic run;Partial Perfusion. The contrast material passes beyond the obstruction and opacifies the arterial bed distal to the obstruction. However, the rate of entry of contrast into the vessel distal to the obstruction and/or its rate of clearance from the distal bed are perceptibly slower than its entry into and/or clearance from comparable areas not perfused by the previously occluded vessel, eg, the opposite cerebral artery or the arterial bed proximal to the obstruction. Grade 2a=Only partial filling (<2/3) of the entire vascular territory is visualized;Complete filling of all of the expected vascular territory is visualized, but the filling is slower than normal;Complete Perfusion. antegrade flow into the bed distal to the obstruction occurs as promptly as into the obstruction and clearance of contrast material from the involved bed is as rapid as from an uninvolved other bed of the same vessel or the opposite cerebral 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 |
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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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C14026 | Intracranial pressure imaging result | ICPReslt | Indicates intracranial pressure (ICP) imaging result | Indicates vasospasm intracranial pressure (ICP) imaging result | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 999 | millimeter of mercury | |||||||||||||||||||||||||||||||
C02006 | Medication prior or concomitant dose | MedctnPriorConcomDose | Dose of prior/concomitant medication taken per administration. | Dose of prior/concomitant medication taken per administration. | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
3162729 | DeBaun Forms | ||||||||||||||||||||||||||||||||
C56382 | Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness hit reaction time value | ConnersCPT3InaHRTVal | The value representing the subject's response speed time, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The value representing the subject's response speed time, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:32:03.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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C13199 | Questionnaire for Verifying Stroke Free Status (QVSFS) - verbal status | QVSFSVerbalStatus | Have you ever suddenly lost the ability to express yourself verbally or in writing? | Have you ever suddenly lost the ability to express yourself verbally or in writing? 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 | |||||||||||||||||||||||||||||||
C13923 | Imaging power doppler result | ImgPowerDopplerReslt | Indicates power doppler result | Indicates power Doppler result | Flow;No flow | Flow;No flow | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C13242 | National Institutes of Health Stroke Scale (NIHSS) - Best language score | NIHSSBestLangScore | Language ability assessed using the NIH Stroke Scale (NIHSS) | Language ability assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;3;UN;0;1;2;3;UN | No aphasia, normal;Mild to moderate aphasia: some obvious loss of fluency or facility of comprehension, without significant limitation on ideas expressed or form of expression. Reduction of speech and/or comprehension, however, makes conversation about provided material difficult or impossible. For example in conversation about provided materials examiner can identify picture or naming card from patient's response.;Severe aphasia: all communication is through fragmentary expression, great need for inference, questioning, and guessing by the listener. Range of information that can be exchanged is limited: listener carries burden of communication. Examiner cannot identify materials provided from patient response.;Mute, global aphasia: no usable speech or auditory comprehension.;Unexaminable (intubated/paralyzed);No aphasia, normal;Mild to moderate aphasia: some obvious loss of fluency or facility of comprehension, without significant limitation on ideas expressed or form of expression. Reduction of speech and/or comprehension, however, makes conversation about provided material difficult or impossible. For example in conversation about provided materials examiner can identify picture or naming card from patient's response.;Severe aphasia: all communication is through fragmentary expression, great need for inference, questioning, and guessing by the listener. Range of information that can be exchanged is limited: listener carries burden of communication. Examiner cannot identify materials provided from patient response.;Mute, global aphasia: no usable speech or auditory comprehension.;Unexaminable (intubated/paralyzed) | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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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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 | |||||||||||||||||||||||||||||||||
C10685 | Imaging slice orientation type | ImgSliceOrientTyp | The slice orientation used in imaging acquisition | The slice orientation used in imaging acquisition | Axial;Coronal;Sagittal;Oblique;Transversal;Other, specify;Axial;Coronal;Sagittal;Oblique;Transversal;Other, specify | Axial;Coronal;Sagittal;Oblique;Transversal;Other, specify;Axial;Coronal;Sagittal;Oblique;Transversal;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 |
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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 | ||||||||||||||||||||||||||||||||
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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C00720 | Family history medical condition type | FamHistMedclCondTyp | Type of medical condition or health related event for which the family history is taken | Type of medical condition or health related event for which the family history is taken | 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 |
3165585 | DeBaun Forms | ||||||||||||||||||||||||||||||||
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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C12494 | Imaging pons abnormal indicator | ImgPonsAbnrmlInd | Indicator of whether the pons appears normal or abnormal in the image studies | Indicator of whether the pons appears 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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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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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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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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C02308 | Adverse event during study indicator | AdvrsEvntDuringStudyInd | Indicator of whether the participant/subject experienced any adverse events during the study | Indicator of whether the participant/subject experienced any adverse events during the 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 |
2188132;3177812 | DeBaun Forms | ||||||||||||||||||||||||||||||
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 |