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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C12503 | Imaging gray matter hyperintensity T2 fluid attenuated inversion recovery indicator | ImgGryMtrHyperT2FLAIRInd | Indicator of whether there is grey matter hyperintensity on T2/FLAIR (fluid attenuated inversion recovery) images | Indicator of whether there is grey matter hyperintensity on T2/FLAIR images | 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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| C54695 | PROMIS - Global Health fatigue rate scale | PROMISGlbHlthFtgRtScl | Scale related to an individual's rating of his/her fatigue, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her fatigue, 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 |
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| C13911 | Imaging plaque texture text | ImgPlaqTextureTxt | Indicates plaque texture | Indicates plaque texture | 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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| C04804 | Hospital discharge date and time | HospitDischgDateTime | Date (and time, if applicable and known) the participant/subject was discharged from the hospital | Date (and time, if applicable and known) the participant/subject was discharged from 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 | |||||||||||||||||||||||||||||||||
| C14462 | Reflex plantar right response result | RflxPlntrRtRespnsReslt | The results from reflex plantar response on the right side | The results from reflex plantar response on the right 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 | |||||||||||||||||||||||||||||||
| C19358 | Lab test type | LabTstTyp | Type of lab test performed on body fluid(s) and tissues. Test names are typically comprised of the analyte name, properties (%, Ratio, etc.), the type of body fluid tested, and any special instructions. | Type of lab test performed on body fluid(s) and tissues. Test names are typically comprised of the analyte name, properties (%, Ratio, etc.), the type of body fluid tested, and any special instructions. | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
2003746 | DeBaun Forms | ||||||||||||||||||||||||||||||||
| C13458 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - language deficit-production scale | PSOMSNELangDefProdScale | The scale for language deficit - production (including dysarthria) based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | The scale for language deficit - production (including dysarthria) based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | 0;0.5;1;2;0;0.5;1;2;0;0.5;1;2 | None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function | Numeric values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
| C56441 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 confidence interval upper bound value | WASIIIFullSclIQ2ConfIntUppVal | The upper bound of the subject's Full Scale IQ-2 confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The upper bound of the subject's Full Scale IQ-2 confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 13:06:29.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C56412 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Matrix Reasoning T score | WASIIIMRTScore | The T score converted from the raw score that the subject received on the Matrix Reasoning subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) . | The T score converted from the raw score that the subject received on the Matrix Reasoning subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:23:35.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
20 | 80 | ||||||||||||||||||||||||||||||||
| C13943 | Imaging B-mode result | ImgBModReslt | Indicates B mode | Indicates B mode | Normal;Occlusion;Stenosis | Normal;Occlusion;Stenosis | 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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| C12467 | Imaging magnetic resonance imaging performed multiple indicator | ImgMRIPerfMultiInd | Indicator as to whether or not multiple magnetic resonance imaging (MRI) sessions have been performed on the participant/subject | Indicator as to whether or not multiple magnetic resonance imaging (MRI) sessions have been performed on the participant/subject | Yes;No,single brain MRI;Unknown | Yes;No,single brain MRI;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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| C17524 | Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex ankle jerk right score | FARSPNSNeuExDTenRAnkJRtScore | Score for right-side ankle 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 ankle 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 | |||||||||||||||||||||||||||||||
| C21500 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest number series text | WAISIVDSSNumTxt | Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing 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 | 50 | ||||||||||||||||||||||||||||||||
| C01522 | Height measurement | HgtMeasr | Measurement of participant's/subject's height. | Measurement of participant's/subject's height. | 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 | 400 | centimeter | 649 | DeBaun Forms | |||||||||||||||||||||||||||||
| C14013 | Intracranial stenosis mean velocity criterion value | IntracranStenoMnVlctyCriterVal | Indicates intracranial stenosis mean velocity criterion | Indicates intracranial stenosis mean velocity criterion | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C02005 | Study drug returned date and time | StdyDrugRetrnDateTime | Date (and time, if applicable and known) on which the study drug was returned | Date (and time, if applicable and known) on which the study drug was returned | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
3164209 | DeBaun Forms | ||||||||||||||||||||||||||||||||
| C14025 | Vasospasm Lindegaard ratio value | VasoLinegaardRatioVal | Indicates vasospasm Lindegaard ratio result | Indicates vasospasm Lindegaard 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 |
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| C18854 | Imaging other incidental finding other text | ImgOthrIncidentalFindOTH | The free-text field related to 'Imaging other incidental finding type' specifying other text. The type of other incidental findings found within the image studies | The free-text field related to 'Imaging other incidental finding type' specifying other text. The type of other incidental findings found within the image studies | 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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| C13198 | Questionnaire for Verifying Stroke Free Status (QVSFS) - understanding status | QVSFSUndstandStatus | Have you ever suddenly lost the ability to understand what people were saying? | Have you ever suddenly lost the ability to understand what people were saying? 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 | |||||||||||||||||||||||||||||||
| C56378 | Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness detectability score | ConnersCPT3InaDetectScore | Ability to discriminate between targets (non-X) and non-targets (X), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Ability to discriminate between targets (non-X) and non-targets (X), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:27:57.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C13922 | Imaging common carotid artery (CCA) externalization indicator | ImgCCAExternalizInd | Indicates common carotid artery (CCA) externalization | Indicates common carotid artery (CCA) externalization | 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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| C08241 | Imaging field of view axis 1 measurement | ImgFieldViewAxis1Measr | Axis 1 of the image that is visible through the camera at a particular position in orientation and space in millimeters | Axis 1 of the image that is visible through the camera at a particular position in orientation and space in millimeters | 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 |
millimeter | |||||||||||||||||||||||||||||||||
| C14686 | Pediatric Migraine Disability Assessment (MIDAS) - headache severity score | PedMIDASHeadSevScore | Score for headache severity, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. | Score for headache severity, 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 |
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| C20417 | National Institutes of Health Stroke Scale (NIHSS) - Motor leg amputation text | NIHSSMotLegAmpTxt | The text field for explaining the amputation or joint fusion for question related to motor ability of the leg (both left and right) assessed using the NIH Stroke Scale (NIHSS). | The text field for explaining the amputation or joint fusion for question related to motor ability of the leg (both left and right) assessed using the NIH Stroke Scale (NIHSS). | Alphanumeric | Adult;Pediatric | Supplemental | 4.00 | 2015-04-27 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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| C13751 | Imaging acquisition reason | ImgAcquisitionRsn | Describes why the imaging study was performed | Describes why the imaging study was performed | Diagnostic;Post-treatment;Monitoring;Other, specify;Diagnostic;Post-treatment;Monitoring;Other, specify | Diagnostic;Post-treatment;Monitoring;Other, specify;Diagnostic;Post-treatment;Monitoring;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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| C56424 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Verbal Comprehension IQ composite score | WASIIIVerbCompIQCompScore | The subject's Verbal Comprehension IQ composite score, converted from his/her Verbal Comprehension T score, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The subject's Verbal Comprehension IQ composite score, converted from his/her Verbal Comprehension T score, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:58:34.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
40 | 160 | ||||||||||||||||||||||||||||||||
| C13954 | Consensus on Grading Intracranial Flow Obstruction (COGIF) - follow-up date and time | COGIFFollowupDateTime | The date and time for consensus on grading intracranial flow obstruction (COGIF) follow-up. | The date and time for consensus on grading intracranial flow obstruction (COGIF) follow-up. | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C12482 | Imaging cortex lissencephaly (LIS type 1) thickness measurement | ImgCortexLISThickMeasr | The measurement of cortex thickness, in , of the lissencephaly (LIS type 1) site | The measurement of cortex thickness, in , of the lissencephaly (LIS type 1) site | 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 |
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| C54602 | Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) - Form version name | BRIEF2FormVersionName | Name of the version of the form, as part of the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) | Name of the version of the form, as part of the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) | Parent form;Self form;Teacher form | Parent form;Self form;Teacher form | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-03-20 15:13:56.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| C13889 | Thrombolysis In Myocardial Infarction (TIMI) scale - global score | TIMIScaleGlobalScore | Indicates TIMI perfusion scale global score | Indicates TIMI perfusion scale global score | 0;1;2;3;0;1;2;3;0;1;2;3 | No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches;No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches;No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches | 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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| C12493 | Imaging brainstem abnormality type | ImgBrnstmAbnrmlyTyp | The type of abnormality in the brainstem on the image | The type of abnormality in the brainstem on the image | Hypoplasia;Anterior concavity;Posterior concavity;Other, specify | Hypoplasia;Anterior concavity;Posterior concavity;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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| C54613 | Brief Test of Executive Function Second Edition (BRIEF 2) - Plan organize total raw scale score | BRIEF2PlnOrgnzTtlRwSclScore | Total score of the raw scale for the plan/organize function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the plan/organize 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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| C13901 | Imaging patient type | ImgPatientTyp | Indicates imaging patient type | Indicates imaging patient type | Asymptomatic;Acute Stroke;Chronic Stroke;Brain Edema;Vasopasm;Asymptomatic;Acute Stroke;Chronic Stroke;Brain Edema;Vasopasm | Asymptomatic;Acute Stroke;Chronic Stroke;Brain Edema;Vasopasm;Asymptomatic;Acute Stroke;Chronic Stroke;Brain Edema;Vasopasm | 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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| 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 | |||||||||||||||||||||||||||||||
| 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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| C18900 | Intracranial stenosis collateral vessel anatomic other text | IntracrnStnoColltVsslAntmicOTH | The free-text field related to 'Intracranial stenosis collateral vessel anatomic site' specifying other text. Indicates intracranial stenosis collateral vessel(s) | The free-text field related to 'Intracranial stenosis collateral vessel anatomic site' specifying other text. Indicates intracranial stenosis collateral 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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| C13241 | National Institutes of Health Stroke Scale (NIHSS) - Sensory score | NIHSSSensoryScore | Sensory abilities assessed using the NIH Stroke Scale (NIHSS) | Sensory abilities assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;UN;0;1;2;UN | 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.;Unexaminable (intubated/paralyzed);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.;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 | |||||||||||||||||||||||||||||||
| C56394 | Conners Continuous Performance Test 3rd Edition (CPT3) - Sustained attention commission block count | ConnersCPT3SusAtnCommBlkCt | The number of incorrect responses to non-targets by block, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The number of incorrect responses to non-targets by block, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:44:12.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | |||||||||||||||||||||||||||||||||
| C13933 | Intima media thickness (IMT) mean far-wall measurement | IMTMeanFarWallMeasr | Indicates mean intima media thickness (IMT) far-wall measurement (mm) | Indicates mean intima media thickness (IMT) far-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 | |||||||||||||||||||||||||||||||||
| C10682 | Imaging anatomic site | ImgAntmicSite | Type of body part or anatomy scanned in the imaging study | Type of body part or anatomy scanned in the imaging study | Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify;Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify | Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify;Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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| C16679 | Cambridge Brain Repair Center Sleep Questionnaire (BRC-Sleep) - intentionally nap day indicator | BRCIntentNapDayInd | The yes/no indicator for napping intentionally during the day from Cambridge Brain Repair Center Sleep Questionnaire (BRC-Sleep). | The yes/no indicator for napping intentionally during the day from Cambridge Brain Repair Center Sleep Questionnaire (BRC-Sleep). | No;Yes | No;Yes | 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 |
DeBaun Forms | |||||||||||||||||||||||||||||||
| C21490 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest total raw score | WAISIVDSFTtlScore | Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-07-22 11:32:44.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 16 | ||||||||||||||||||||||||||||||||
| C00322 | Medical history condition text | MedclHistCondTxt | Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history | Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
2003874 | DeBaun Forms | |||||||||||||||||||||||||||||||
| C14003 | Imaging brain death present indicator | ImgBrainDeathPresInd | Indicates presence of brain death | Indicates presence of brain death | 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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| C17798 | Imaging contrast agent name | ImgContrastAgentName | Name of imaging contrast agent used | Name of imaging contrast agent used | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | 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 |
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| C18693 | Imaging contrast agent method other text | ImgContrastAgentMethodOTH | The free-text field related to 'Imaging contrast agent method type' specifying other text. Indicates imaging contrast agent method of administration | The free-text field related to 'Imaging contrast agent method type' specifying other text. Indicates imaging contrast agent method of administration | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
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| 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 |
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| C55773 | Imaging MRI scanner used count | ImagMRIScanUsedCt | The number of different MRI scanners that were used on the subject. | The number of different MRI scanners that were used on the subject. | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:11:13.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
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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 |
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