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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C19904 | Symptom disease lab data known disease other text | SymptSignDisLabDataOTH | Text of other symptoms, signs, known diseases, and lab data | Text of other symptoms, signs, known diseases, and lab data | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-09 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
C13949 | Imaging flow/probe direction type | ImgFlowProbDireTyp | Indicates flow/probe direction | Indicates flow/probe direction | Towards;Away from | Towards;Away from | 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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C00035 | Gender Type | GenderTyp | Self-reported gender of the participant/subject. Gender is the socially constructed identity of sex. Gender is equated with phenotypic sex. Gender may differ from the sex of an individual determined genetically. | Self-reported gender of the participant/subject. Gender is the socially constructed identity of sex. | Female;Male;Unknown;Unspecified;Not reported | Female;Male;Unknown;Undifferentiated/Indeterminant/Intersex;Not reported | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
2200604 | DeBaun Forms | ||||||||||||||||||||||||||||||
C56421 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid prescription lens used indicator | WASIIIExVisHeaAidPreLensUseInd | The indicator relating to the examine used his/her prescription lenses during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The indicator relating to the examine used his/her prescription lenses during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Used;Not used | Used;Not used | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:54:51.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C13884 | Imaging vessel angiography arterial anatomic site | ImgVesselAngioArterAntmicSite | Indicates vessel imaging angiography arterial findings location | Indicates vessel imaging angiography arterial findings location | CCA origin;CCA to bifurcation;ICA at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA;CCA origin;CCA to bifurcation;ICA at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA | Common carotid artery origin;Common carotid artery to bifurcation;Internal carotid artery at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA;Common carotid artery origin;Common carotid artery to bifurcation;Internal carotid artery at origin;C1 cervical;C2 petrous;C3 lacerum;C4 cavernous;C5 clinoidal;C6 - ophthalmic to PCOM;C6 - PCOM to terminus;A1;A2;M1 proximal to striate;M1 distal to striate;M2 single;M2 multiple;M3 single;M3 multiple;M4 single;M4 multiple;Vertebral origin;Vertebral- cervical;Vertebral-intracranial proximal to PICA;Vertebral-distal to PICA;Basilar-distal to AICA;Basilar-mid;Basilar-proximal to AICA;PCOM;P1;P2;P3;SCA;AICA;PICA | 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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C12489 | Imaging subcortical cysts site type | ImgSubCorticalCystSiteTyp | The anatomical site(s) of the subcortical cysts | The anatomical site(s) of the subcortical cysts | Temporal;Frontoparietal;Occipital | Temporal;Frontoparietal;Occipital | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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C50680 | Examiner name | ExaminerName | The name of the person performing the exam. | The name of the person performing the exam. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-12-12 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C14020 | Sickle cell disease vessel anatomic site | SickleCellDisVesselAntmicSite | Indicates sickle cell vessel | Indicates sickle cell vessel | ICA;MCA;ACA;Other, specify | Internal carotid artery;Middle cerebral artery;Anterior carotid 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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C12500 | Imaging corpus callosum type indicator | ImgCrpsClsmTypInd | The condition of the corpus callosum fibers | The condition of the corpus callosum fibers | Involved;Spared | Involved;Spared | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C54610 | Brief Test of Executive Function Second Edition (BRIEF 2) - Task completion total raw scale score | BRIEF2TskCmpltnTtlRwSclScore | Total score of the raw scale for the task completion function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the task completion 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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C14031 | Vasospasm status | VasospasmStatus | Indicates vasospasm result | Indicates vasospasm 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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C02495 | Imaging scanner strength value | ImgScannerStrgthVal | Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | 1.5T;3.0T;4.0T;7.0T;Other, specify;1.5T;3.0T;4.0T;7.0T;Other, specify | 1.5T;3.0T;4.0T;7.0T;Other, specify;1.5T;3.0T;4.0T;7.0T;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
Tesla | |||||||||||||||||||||||||||||||
C18891 | Imaging vessel angiography collateral status anatomic other text | ImgVessAngioCollatStatAntOTH | The free-text field related to 'Imaging vessel angiography collateral status anatomic site' specifying other text. Indicates vessel angiography collateral status location | The free-text field related to 'Imaging vessel angiography collateral status anatomic site' specifying other text. Indicates vessel angiography collateral status location | 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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C13928 | Intima media thickness (IMT) electronic caliper indicator | IMTElectronicCaliperInd | Indicates intima media thickness (IMT) electronic caliper use | Indicates intima media thickness (IMT) electronic caliper use | 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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C13248 | National Institutes of Health Stroke Scale (NIHSS) Supplemental - Limb sensory loss status | NIHSSSupLimbSensoryLossStatus | The indicator to determine if any limbs have sensory loss | The indicator to determine if any limbs have sensory loss | 0;1;2 | Normal: no sensory loss.;Mild to moderate sensory loss: patient feels pinprick is less sharp or is dull on the affected side, or there is a loss of superficial pain with pinprick but patient is aware he/she is being touched.;Severe to total sensory loss: patient is not aware of being touched in the face, arm, and leg. | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C56390 | Conners Continuous Performance Test 3rd Edition (CPT3) - Impulsivity perseveration count | ConnersCPT3ImpPersCt | The number of random or anticipatory responses, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The number of random or anticipatory responses, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:39:31.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | |||||||||||||||||||||||||||||||||
C15568 | Imaging post-processing method name | ImgPstprocssMethdName | Method used for image post-processing | Method used for image post-processing | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C11026 | Neuromuscular Exam Muscle weakness indicator | NeuromuExmCranlMuscleWeaknInd | Indicator whether there is muscle weakness in the muscle or muscle group examined | Whether there is muscle weakness in the muscle or muscle group examined | Yes;No;Not assessed;Unknown | Yes;No;Not assessed;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C21487 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest trial score | WAISIVDSFTrlScore | Score for the digit span forward subtest, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | Score for the digit span forward subtest, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | 0;1;0;1;0;1 | 0;1;0;1;0;1 | Numeric Values | Adult;Pediatric | Supplemental | 2.00 | 2018-07-30 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C13960 | Microembolic signal vessel anatomic site | MicroembolSignVesselAntmicSite | Indicates microembolic signal vessel category | Indicates microembolic signal vessel category | M1;A1;P1;Siphon;Ophthalmic;Vert;Basilar | M1;A1;P1;Siphon;Ophthalmic;Vert;Basilar | 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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C01507 | Blood pressure diastolic measurement | BldPressrDiastlMeasr | Measurement of pressure of the participant's/subject's blood against the artery walls during diastole (the relaxation phase) in millimeters of mercury (mmHg) | Measurement of pressure of the participant's/subject's blood against the artery walls during diastole (the relaxation phase) in millimeters of mercury (mmHg) | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 300 | millimeter of mercury | 2004291 | DeBaun Forms | |||||||||||||||||||||||||||||
C56433 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Perceptual Reasoning confidence interval upper bound value | WASIIIPercRsngConfIntrvlUppVal | The upper bound of the subject's Perceptual Reasoning confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The upper bound of the subject's Perceptual Reasoning confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 12:55:22.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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C13896 | Imaging vessel angiography level of confidence status | ImgVesselAngioLvlConfidTyp | Indicates vessel angiography level of confidence | Indicates vessel angiography level of confidence | Low;Moderate;High | Low;Moderate;High | 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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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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C18611 | Imaging field of view axis 2 measurement | ImgFieldViewAxis2Measr | Axis 2 of the image that is visible through the camera at a particular position in orientation and space in millimeters | Axis 2 of the image that is visible through the camera at a particular position in orientation and space in millimeters | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2013-09-12 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
millimeter | |||||||||||||||||||||||||||||||||
C13907 | Imaging B-mode finding result | ImgBModFindReslt | Indicates B-mode finding | Indicates B-mode finding | Normal;Plaque | Normal;Plaque | 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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C13195 | Questionnaire for Verifying Stroke Free Status (QVSFS) - numbness status | QVSFSNumbStatus | Have you ever had sudden numbness or a dead feeling on one side of your body? | Have you ever had sudden numbness or a dead feeling on one side of your body? Questionnaire for Verifying Stroke Free Status (QVSFS) | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C54693 | PROMIS - Global Health carry out physical activity scale | PROMISGlbHlthCrryOutPHysActScl | Scale related to an individual's rating of his/her ability to carry out everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her ability to carry out everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair, 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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C14127 | Seizure generalized classification type | SeizGenClassTyp | The type of generalized epileptic seizures, considered to originate at some point within, and rapidly engage, bilaterally distributed networks and may include such bilateral networks as ortical and subcortical structures, but do not necessarily include the entire cortex, experienced by the participant/subject. | The type of generalized epileptic seizures, considered to originate at some point within, and rapidly engage, bilaterally distributed networks, experienced by the participant/subject. | Tonic clonic;Absence;Typical;Atypical;Myoclonic absence;Eyelid myoclonia;Myoclonic;Myoclonic atonic;Myoclonic tonic;Clonic;Tonic;Atonic;Epileptic spasms, focal or generalized | Tonic clonic (in any combination);Absence;Absence-Typical;Absence-Atypical;Absence-Myoclonic absence;Absence-Eyelid myoclonia;Myoclonic;Myoclonic-Myoclonic atonic;Myoclonic-Myoclonic tonic;Clonic;Tonic;Atonic;Epileptic spasms, focal or generalized | 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 | |||||||||||||||||||||||||||||||
C08238 | Imaging repetition gap value | ImgRepetitionGapVal | Duration between successive pulse sequences, in milliseconds, applied to the same slice during imaging acquisition | Duration between successive pulse sequences, in milliseconds, applied to the same slice during imaging acquisition | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
millisecond | |||||||||||||||||||||||||||||||||
C19166 | Special care unit admittance indicator | SCUAddmittanceInd | Indicator for the admittance of participant to special care unit, including any Intensive Care or Step-Down Unit | Indicator for the admittance of participant to special care unit, including any Intensive Care or Step-Down Unit | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2014-05-29 13:03:57.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C13939 | Imaging mean interadventitial diameter measurement | ImgMeanInteradventlDiamtMeasr | Indicates mean interadventitial diameter measurement (mm) | Indicates mean interadventitial diameter measurement (mm) | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
millimeter | |||||||||||||||||||||||||||||||||
C13469 | Stroke Adjudication Worksheet - neuroimaging indicator | StrokeAdjudWksNeuroimagInd | The indicator for whether neuro-imaging done for this stroke event. | The indicator for whether neuro-imaging done for this stroke event. | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C56410 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Block Design T score | WASIIIBDTScore | The T score converted from the raw score that the subject received on the Block Design 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 Block Design 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 | ||||||||||||||||||||||||||||||||
C17495 | Delay motor milestone indicator | DelayMotorMilestoneInd | Indicator as to whether the participant/subject has or had delayed motor milestones, as diagnosed by a pediatrician or neurologist | Indicator as to whether the participant/subject has or had delayed motor milestones, as diagnosed by a pediatrician or neurologist | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C12479 | Imaging cortex-pachygyria site type | ImgCortexPachygyriaSiteTyp | The anatomical site(s) of the cortex-pachygyria | The anatomical site(s) of the cortex-pachygyria | Temporal;Frontoparietal;Occipital | Temporal;Frontoparietal;Occipital | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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C21498 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest total raw score | WAISIVDSBTtlScore | Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-07-22 11:32:44.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 16 | ||||||||||||||||||||||||||||||||
C14009 | Imaging window quality result | ImgWindowQualityReslt | Indicates window quality result for all categories | Indicates window quality result for all categories | Fair;Excellent;Poor;Fair;Excellent;Poor | Fair;Excellent;Poor;Fair;Excellent;Poor | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C01702 | Pregnancy test date and time | PregTestDateTime | The date (and time if applicable and known) when the pregnancy test was performed | The date (and time if applicable and known) when the pregnancy test was performed | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||||||
C14021 | Sickle cell disease velocity measurement | SickleCellVelMeasr | The velocity measurement of sickle cell. | The velocity measurement of sickle cell. | 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 | centimeter per second | DeBaun Forms | ||||||||||||||||||||||||||||||
C02212 | Informed consent obtained date and time | InformConsntObtnDateTime | Date (and time, if applicable and known) on which the participant/subject (or the legal representative on behalf of the participant/subject) agrees to participate in a protocol, treatment, or other activity by signing an informed consent document. | Date (and time, if applicable and known) on which the participant/subject (or the legal representative on behalf of the participant/subject) agrees to participate in a protocol, treatment, or other activity by signing an informed consent document. | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
2435038,656 | DeBaun Forms | ||||||||||||||||||||||||||||||||
C18805 | Hospitalization other text | HospitOTH | The free-text field related to 'Hospitalization reason' specifying other text. Reason why the participant/subject was hospitalized, excluding all surgeries | The free-text field related to 'Hospitalization reason' specifying other text. Reason why the participant/subject was hospitalized, excluding all surgeries | 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 |
DeBaun Forms | ||||||||||||||||||||||||||||||||
C13918 | Imaging no signal indicator | ImgNoSignalInd | Indicates no signal on the carotid ultrasound | Indicates no signal on the carotid ultrasound | 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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C13238 | National Institutes of Health Stroke Scale (NIHSS) - Motor arm score | NIHSSLvlConscMotArmScore | Motor ability of the arm (both left and right) assessed using the NIH Stroke Scale (NIHSS) | Motor ability of the arm (both left and right) assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;3;4;UN;0;1;2;3;4;UN | No drift: limb holds 90 (or 45) degrees for full 10 seconds;Drift: limb holds 90 (or 45) degrees, but drifts down before full 10 seconds, does not hit bed or other support;Some effort against gravity: limb cannot get to or maintain (if cued) 90 (or 45) degrees, drifts down to bed, but has some effort against gravity.;No effort against gravity: limb falls;No movement;Amputation or joint fusion, explain;No drift: limb holds 90 (or 45) degrees for full 10 seconds;Drift: limb holds 90 (or 45) degrees, but drifts down before full 10 seconds, does not hit bed or other support;Some effort against gravity: limb cannot get to or maintain (if cued) 90 (or 45) degrees, drifts down to bed, but has some effort against gravity.;No effort against gravity: limb falls;No movement;Amputation or joint fusion, explain | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C55781 | Imaging statistical test significance level outline text | ImagStatTestSigLevOutTxt | Text outlining the statistical test(s) and significance levels for comparison between the test and control groups of the imaging study. | Text outlining the statistical test(s) and significance levels for comparison between the test and control groups of the imaging study. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:39:11.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C14682 | Pediatric Migraine Disability Assessment (MIDAS) - headache cease other activity function day count | PedMIDASHeadCeasOActFuncDayCt | Count the days you were not able to participate in other activities due to headaches (i.e., play, go out, sports, etc.), as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. | Count the days you were not able to participate in other activities due to headaches (i.e., play, go out, sports, etc.), 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 |
0 | 92 | ||||||||||||||||||||||||||||||||
C10570 | Imaging contrast agent used indicator | ImgContrastAgentUsedInd | Indicator as to whether or not an imaging contrast agent was used for the scan as part of Diffusion Tensor Imaging (DTI). | Indicator as to whether or not an imaging contrast agent was used for the scan. | Yes;No;Unknown;Not applicable | Yes;No;Unknown;Not applicable | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C20415 | Serious adverse event report completed date | SerAdvrsEvntRprtCompDt | Date when the report on the adverse event was completed. | Date when the report on the adverse event was completed. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-03-24 11:55:24.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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C13950 | Imaging spectrum asymmetry index result | ImgSpectrumAsymmetryIndexReslt | Indicates spectrum asymmetry index result | Indicates spectrum asymmetry index 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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C00312 | Body system category | BodySysCat | Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured interview and physical examination of all the body systems. | Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured interview and physical examination of all the body systems. | Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify:;Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify: | Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify:;Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify: | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
2002895 | DeBaun Forms |