Sub-Domain: Additional Proposed Instruments
CRF: scdc
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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C14034 | Vasomotor response (VMR) vessel anatomic site | VMRVesselAntmicSite | Indicates vasomotor response (VMR) vessel type | Indicates vasomotor response (VMR) vessel type | M1;A1;P1;Siphon;Ophthalmic;Vert;Basilar;MCA;Other, specify | M1;A1;P1;Siphon;Ophthalmic;Vert;Basilar;Middle cerebral artery;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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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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C01013 | Physical exam description text | PhysExamDescripTxt | Free text field to describe the abnormality in a specific body system or an explanation of why the body system was not examined | Free text field to describe the abnormality in a specific body system or an explanation of why the body system was not examined | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
2201880 | DeBaun Forms | |||||||||||||||||||||||||||||||
C12497 | Imaging cerebellum abnormality type | ImgCrblmAbnrmlyTyp | The type of abnormality in the cerebellum on the image | The type of abnormality in the cerebellum on the image | Other, specify;Cleft;Vermal hypoplasia;Hemispheric hypoplasia;Vermal dysplasia;Hemispheric dysplasia;Cysts | Other, specify;Cleft;Vermal hypoplasia;Hemispheric hypoplasia;Vermal dysplasia;Hemispheric dysplasia;Cysts | 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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C13931 | Intima media thickness (IMT) findings artery type | IMTFindArteryTyp | Indicates intima media thickness (IMT) artery used for mean and max measurements | Indicates intima media thickness (IMT) artery used for mean and max measurements | CCA - right;CCA - left;Bulb - right;Bulb - left;ICA - right;ICA - left;CCA - right;CCA - left;Bulb - right;Bulb - left;ICA - right;ICA - left | Common carotid artery - right;Common carotid artery - left;Bulb - right;Bulb - left;Internal Carotid Artery - right;Internal Carotid Artery - left;Common carotid artery - right;Common carotid artery - left;Bulb - right;Bulb - left;Internal Carotid Artery - right;Internal Carotid Artery - left | 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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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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C16187 | Vaccine type | VaccTyp | Vaccination received by pediatric patient | Vaccination received by pediatric patient | Routine: measles, mumps, rubella;Routine: tetanus, pertussis, diptheria, polio;Hepatitis B;Hemophilus Influenza Type B;Chicken pox vaccine | Routine: measles, mumps, rubella;Routine: tetanus, pertussis, diptheria, polio;Hepatitis B;Hemophilus Influenza Type B;Chicken pox vaccine | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||||||||||||
C02311 | Adverse event MedDRA lower level term code | AdvsEvntMedDRALowerLvlTermCode | Code that corresponds to the Medical Dictionary for Regulatory Activities (MedDRA) Lower Level Term (LLT) for an adverse event | Code that corresponds to the Medical Dictionary for Regulatory Activities (MedDRA) Lower Level Term (LLT) for an adverse event | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
3133353 | DeBaun Forms | |||||||||||||||||||||||||||||||
C13245 | National Institutes of Health Stroke Scale (NIHSS) - Severity total score | NIHSSSevTotalScore | The level of stroke severity as measured by the NIH Stroke Scale (NIHSS) scoring system (i.e., total of the subscale item scores). | The level of stroke severity as measured by the NIH Stroke Scale (NIHSS) scoring system (i.e., total of the subscale item scores). | 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 | 42 | ||||||||||||||||||||||||||||||||
C14001 | Extracranial stenosis type | ExtracranStenosisTyp | Indicates extracranial stenosis type | Indicates extracranial stenosis type | Collateral;Reduced upstroke;Reduced pulsatility index (Pi);VMR;Reduced velocity;Collateral;Reduced upstroke;Reduced pulsatility index (Pi);VMR;Reduced velocity | Collateral;Reduced upstroke;Reduced pulsatility index (Pi);VMR;Reduced velocity;Collateral;Reduced upstroke;Reduced pulsatility index (Pi);VMR;Reduced velocity | 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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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 | ||||||||||||||||||||||||||||||||
C10931 | Imaging quality of images technically satisfactory indicator | ImgQualImgTechnSatisInd | Indicator of whether the quality of the images were technically satisfactory. | Indicator of whether the quality of the images were technically satisfactory. | Yes;No;Unknown;Not applicable | Yes;No;Unknown;Not applicable | 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 |
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C13899 | Imaging probe type text | ImgProbeTypTxt | The text describing the type of imaging probe | Describes imaging probe type | 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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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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C12476 | Imaging other incidental finding indicator | ImgOthrIncidentalFindInd | Indicator of whether other incidental findings are found within the image studies | Indicator of whether other incidental findings are found within the image studies | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C13910 | Imaging plaque severity grade | ImgPlaqSevGrade | Indicates plaque severity grade | Indicates plaque severity grade | Mild;Moderate;Severe | Mild;Moderate;Severe | 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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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 |
Free-Form Entry |
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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 | ||||||||||||||||||||||||||||||||
C14444 | Muscle tone assessment abnormality indicator | MuscToneAbnrmlyAssmtInd | Whether the muscle tone assessment found any abnormalities | Whether the muscle tone assessment found any abnormalities | 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 | |||||||||||||||||||||||||||||||
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 |
Free-Form Entry |
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C01559 | Arterial partial pressure carbon dioxide value | ArterialPPCO2Val | Measurement of how much carbon dioxide is dissolved in the arterial blood and how well carbon dioxide is able to move out of the body (PaCO2) | Measurement of how much carbon dioxide is dissolved in the arterial blood and how well carbon dioxide is able to move out of the body (PaCO2) | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 100 | millimeter of mercury | |||||||||||||||||||||||||||||||
C13147 | Stroke Specific Quality of Life Scale (SS-QOL) - trouble phone language scale | SSQOLTroubPhonScale | The scale for trouble speaking on phone based on Stroke Specific Quality of Life Scale (SS-QOL). | The scale for trouble speaking on phone based on Stroke Specific Quality of Life Scale (SS-QOL). | 1;2;3;4;5;1;2;3;4;5 | Total help - Couldn't do it at all - Strongly agree;A lot of help - A lot of trouble - Moderately agree;Some help - Some trouble - Neither agree nor disagree;A little help - A little trouble - Moderately disagree;No help needed - No trouble at all - Strongly disagree;Total help - Couldn't do it at all - Strongly agree;A lot of help - A lot of trouble - Moderately agree;Some help - Some trouble - Neither agree nor disagree;A little help - A little trouble - Moderately disagree;No help needed - No trouble at all - Strongly disagree | 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 | |||||||||||||||||||||||||||||||
C13942 | Imaging vessel category | ImgVesselCat | Indicates vessel category | Indicates vessel category | M1;Insular M2;A1;ICA;P1;P2;EC ICA;Siphon;Vert;Basilar;Ophthalmic | M1;Insular M2;A1;Internal Carotid Artery (ICA);P1;P2;EC Internal Carotid Artery (ICA);Siphon;Vert;Basilar;Ophthalmic 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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C19500 | Assessment performed date | AssessmentPerformedDate | The date of assessment of the examination being performed. | The date of assessment of the examination being performed. | Date or Date & Time | Adult;Pediatric | Supplemental | 1.00 | 2014-06-18 08:10:12.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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C17523 | Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex ankle jerk left score | FARSPNSNeuExDTenRAnkJLftScore | Score for left-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 left-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 | |||||||||||||||||||||||||||||||
C56413 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Similarities T score | WASIIISimTScore | The T score converted from the raw score that the subject received on the Similarities 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 Similarities subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:23:35.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
20 | 80 | ||||||||||||||||||||||||||||||||
C08147 | Data source | DataSource | Source of the data provided on the case report form | Source of the data provided on the case report form | Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Other, specify;Unknown;Spouse | Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Other, specify;Unknown;Spouse | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:46:24.96 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C13463 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - cognitive or behavioral deficit description text | PSOMSNECogBehavDeficitDescTxt | Description of the cognitive or behavioral deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Description of the cognitive or behavioral 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 | ||||||||||||||||||||||||||||||||
C14012 | Intracranial stenosis peak systolic velocity (PSV) criterion result | IntracranStenoPSVCriterReslt | Indicates intracranial stenosis peak systolic velocity (PSV) criterion | Indicates intracranial stenosis peak systolic velocity (PSV) criterion | 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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C21501 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest item number | WAISIVDSSItemNum | Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing 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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C00012 | Education level USA type | EduLvlUSATyp | Highest grade or level of school participant/subject has completed or the highest degree received | Highest grade or level of school participant/subject has completed or the highest degree received | Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational/technical/vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown | Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational/technical/vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown | 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 |
3134878 | |||||||||||||||||||||||||||||||
C12487 | Imaging other cortical abnormality site type | ImgOthrCorticalAbnrmlySiteTyp | The anatomical site(s) of the other cortical abnormality | The anatomical site(s) of the other cortical abnormality | 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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C13921 | Imaging other carotid ultrasound result | ImgOthrCarotidUltrasoundReslt | Indicates other carotid ultrasound findings | Indicates other carotid ultrasound findings | Turbulence;Spectral broadening | Turbulence;Spectral broadening | 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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C18855 | Imaging other cortical abnormality other text | ImgOthrCorticalAbnrmlyOTH | The free-text field related to 'Imaging other cortical abnormality type' specifying other text. The type of other cortical abnormality | The free-text field related to 'Imaging other cortical abnormality type' specifying other text. The type of other cortical abnormality | 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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C14685 | Pediatric Migraine Disability Assessment (MIDAS) - headache frequency | PedMIDASHeadFreq | Headache frequency, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. | Headache frequency, 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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C56380 | Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness omission count | ConnersCPT3InaOmmCt | The number of missed targets, as part of the Conners Continuous Performance Test 3rd Edition (CPT3) | The number of missed targets, as part of the Conners Continuous Performance Test 3rd Edition (CPT3) | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:29:58.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | |||||||||||||||||||||||||||||||||
C02022 | Medication prior or concomitant dose unit of measure | MedctnPriorConcomDoseUo | Dosage unit of measure of the prior or concomitant medication administered. | Dosage unit of measure of the prior or concomitant medication administered. | g;mcg;mcL;mg;mL;oz;Other, specify;Unknown;NA | gram;microgram;microliter;milligram;milliliter;ounce;Other, specify;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 |
3162730 | DeBaun Forms | ||||||||||||||||||||||||||||||
C13235 | National Institutes of Health Stroke Scale (NIHSS) - Best gaze score | NIHSSLvlConscBestGazeScore | Best gaze assessed using the NIH Stroke Scale (NIHSS) | Best gaze assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;0;1;2 | Normal;Partial gaze palsy. This score is given when gaze is abnormal in one or both eyes, but where forced deviation or total gaze paresis are not present;Forced deviation, or total gaze paresis not overcome by the oculocephalic maneuver;Normal;Partial gaze palsy. This score is given when gaze is abnormal in one or both eyes, but where forced deviation or total gaze paresis are not present;Forced deviation, or total gaze paresis not overcome by the oculocephalic maneuver | 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 | |||||||||||||||||||||||||||||||
C13953 | Consensus on Grading Intracranial Flow Obstruction (COGIF) - follow-up indicator | COGIFFollowupInd | Indicates the consensus on grading intracranial flow obstruction (COGIF) follow-up | Indicates the consensus on grading intracranial flow obstruction (COGIF) follow-up | 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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C20419 | National Institutes of Health Stroke Scale (NIHSS) - Limb ataxia amputation text | NIHSSLimbAtaxiaAmputTxt | The text field for explaining the amputation or joint fusion for question related to Limb ataxia assessed using the NIH Stroke Scale (NIHSS). | The text field for explaining the amputation or joint fusion for question related to Limb ataxia 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 |
DeBaun Forms | ||||||||||||||||||||||||||||||||
C56425 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Verbal Comprehension percentile rank value | WASIIIVerbCompPrcntRankVal | The percentile rank the subject placed into with respect to the Verbal Comprehension subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The percentile rank the subject placed into with respect to the Verbal Comprehension subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 12:05:57.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 100 | percent | |||||||||||||||||||||||||||||||
C08255 | Imaging visual analysis blinded indicator | ImgVisAnlysisBlindInd | Indicator of whether the visual analysis was performed blinded to clinical data | Indicator of whether the visual analysis was performed blinded to clinical data | Yes;No;Unknown | Yes;No;Unknown | 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 |
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C13888 | Thrombolysis In Myocardial Infarction (TIMI) scale - individual vessel score | TIMIScaleIndVesselScore | The score related to the Thrombolysis In Myocardial Infarction (TIMI) scale individual vessel. | The score related to the Thrombolysis In Myocardial Infarction (TIMI) scale individual vessel. | 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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C14024 | Vasospasm criterion value | VasoCriterionVal | Indicates vasospasm criterion value | Indicates vasospasm criterion value | 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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C54603 | Informant participant familiar grade | InfrmntPrtcpntFmlrGrade | Grade denoting the degree to which the informant knows the subject/participant | Grade denoting the degree to which the informant knows the subject/participant | Very well;Moderately well;Not well | Very well;Moderately well;Not well | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-03-22 09:39:15.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C14035 | VMR response result | VMRResponseReslt | Indicates vasomotor response (VMR) response result | Indicates vasomotor response (VMR) response result | Abnormal;Normal;Abnormal;Normal | Abnormal;Normal;Abnormal;Normal | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C54614 | Brief Test of Executive Function Second Edition (BRIEF 2) - Task monitor total raw scale score | BRIEF2TskMntrTtlRwSclScore | Total score of the raw scale for the task-monitor function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the task-monitor 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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C01041 | Alteration consciousness indicator | AOCInd | The indicator of whether the participant/subject experienced any period of alteration of consciousness (AOC). | The indicator of whether the participant/subject experienced any period of alteration of consciousness (AOC). | Yes;No;Suspected;Unknown | Yes;No;Suspected;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C12498 | Imaging white matter T2 abnormal indicator | ImgT2WWMAbnrmlInd | Indicator of whether the white matter appears normal or abnormal on T2 weighted images | Indicator of whether the white matter appears normal or abnormal on T2 weighted images | 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 |