CDE Detailed Report
Disease: sites
Sub-Domain: Additional Proposed Instruments
CRF: scdc

Displaying 201 - 250 of 491
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
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
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

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

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

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

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
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

DeBaun Forms
C12490 Imaging ventricle abnormal indicator ImgVentrclAbnrmlInd Indicator of whether the ventricles appear normal or abnormal in the image studies Indicator of whether the ventricles appear normal or abnormal in the image studies Abnormal;Normal;Abnormal;Normal Abnormal;Normal;Abnormal;Normal Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

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

C56422 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid assist listen device used indicator WASIIIExVisHearAidALDUsedInd The indicator relating to whether the examinee used his/her assisted listening device during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The indicator relating to whether the examinee used his/her assisted listening device 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 11:56:04.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

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

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C02212 Informed consent obtained date and time InformConsntObtnDateTime Date (and time, if applicable and known) on which the participant/subject (or the legal representative on behalf of the participant/subject) agrees to participate in a protocol, treatment, or other activity by signing an informed consent document. Date (and time, if applicable and known) on which the participant/subject (or the legal representative on behalf of the participant/subject) agrees to participate in a protocol, treatment, or other activity by signing an informed consent document. Date or Date & Time Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

2435038,656 DeBaun Forms
C51670 School name SchoolName The name of the school that the subject currently attends, if applicable. The name of the school that the subject currently attends, if applicable. 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

C13238 National Institutes of Health Stroke Scale (NIHSS) - Motor arm score NIHSSLvlConscMotArmScore Motor ability of the arm (both left and right) assessed using the NIH Stroke Scale (NIHSS) Motor ability of the arm (both left and right) assessed using the NIH Stroke Scale (NIHSS) 0;1;2;3;4;UN;0;1;2;3;4;UN No drift: limb holds 90 (or 45) degrees for full 10 seconds;Drift: limb holds 90 (or 45) degrees, but drifts down before full 10 seconds, does not hit bed or other support;Some effort against gravity: limb cannot get to or maintain (if cued) 90 (or 45) degrees, drifts down to bed, but has some effort against gravity.;No effort against gravity: limb falls;No movement;Amputation or joint fusion, explain;No drift: limb holds 90 (or 45) degrees for full 10 seconds;Drift: limb holds 90 (or 45) degrees, but drifts down before full 10 seconds, does not hit bed or other support;Some effort against gravity: limb cannot get to or maintain (if cued) 90 (or 45) degrees, drifts down to bed, but has some effort against gravity.;No effort against gravity: limb falls;No movement;Amputation or joint fusion, explain Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
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

C13456 Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - sensorimotor deficit scale PSOMSNESensDefScale The scale for sensorimotor deficit (any motor or sensory abnormality including cranial nerve deficits, visual, and hearing deficits) based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). The scale for sensorimotor deficit (any motor or sensory abnormality including cranial nerve deficits, visual, and hearing deficits) 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
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

C18892 Imaging percent stenosis criterion other text ImgPercentStenosisCriterionOTH The free-text field related to 'Imaging percent stenosis criterion type' specifying other text. The criteria used to find indicate stenosis. The free-text field related to 'Imaging percent stenosis criterion type' specifying other text. The criteria used to find indicate stenosis. 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

C11061 Gait assessment result GaitAssmtReslt Result of the gait assessment Result of the gait assessment Normal;Abnormal;Cannot Assess;Other, specify Normal;Abnormal;Cannot Assess;Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-22 16:57:17.79 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
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

C56391 Conners Continuous Performance Test 3rd Edition (CPT3) - Sustained attention hit reaction time block change value ConnersCPT3SusAttnHRTBlkChaVal The change in the subject's response speed across blocks of trials, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). The change in the subject's response speed across blocks of trials, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:41:29.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0
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
C01520 Head circumference measurement HeadCircumfMeasr Circumferential measurement of the head at the widest point - the distance from above the eyebrows and ears and around the back of the head Circumferential measurement of the head at the widest point - the distance from above the eyebrows and ears and around the back of the head 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

0 100 centimeter 3181613
C21488 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest item score WAISIVDSFItemScore Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest 0;1;2 0;1;2 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

C12501 Imaging internal capsule type indicator ImgIntCpslTypInd The condition of the internal capsule. The condition of the internal capsule. Involved;Spared Involved;Spared Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

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
C56434 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 4 composite score WASIIIFullScaleIQ4CompScore The subject's Full Scale IQ composite score for all four subtests, converted from his/her Full Scale T score for all four subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The subject's Full Scale IQ composite score for all four subtests, converted from his/her Full Scale T score for all four 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
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
C17529 Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex knee jerk left score FARSPNSNeuExDTenRKneeJLtScore Score for left-side knee 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 knee 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
C02496 Imaging scanner manufacturer name ImgScannerManufName Name of manufacturer of imaging scanner Imaging scanner manufacturer name Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify;Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify;Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;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

C54611 Brief Test of Executive Function Second Edition (BRIEF 2) - Initiate total raw scale score BRIEF2IntiatTtlRwSclScore Total score of the raw scale for the initiate function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Total score of the raw scale for the initiate 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

C13885 Imaging vessel angiography arterial result ImgVesselAngioArterialReslt Indicates vessel imaging angiography arterial findings Indicates vessel imaging angiography arterial findings Normal;Occlusion;Aneurysm;Stenosis;AVM;Not visualized Normal;Occlusion;Aneurysm;Stenosis;AVM;Not visualized 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

C54694 PROMIS - Global Health bother emotional problem scale PROMISGlbHlthBthrEmtnlPrbScl Scale related to an individual's rating of how often he/she has been bothered by emotional problems such as feeling anxious, depressed or irritable, as part of the PROMIS Global Health Scale related to an individual's rating of how often he/she has been bothered by emotional problems such as feeling anxious, depressed or irritable, 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

C13470 Stroke Adjudication Worksheet - neuroimaging type StrokeAdjudWksNeuroimagTyp Type of neuro-imaging done for the stroke event Type of neuro-imaging done for the stroke event Single brain CT;Multiple brain CTs separated in time;MRI;DWI Single brain CT;Multiple brain CTs separated in time;MRI;DWI 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

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
C19167 Special care unit type SCUTyp Type of special care unit Type of special care unit Intensive Care Unit;Step-Down Unit Intensive Care Unit (ICU);Step-Down Unit (SDU) Alphanumeric Adult;Pediatric Supplemental 1.00 2014-05-29 14:04:21.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C12480 Imaging cortex-pachygyria thickness measurement ImgCortexPachygyriaThickMeasr The measurement of cortex thickness, in , of the cortex The measurement of cortex thickness, in , of the cortex 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

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

C56411 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Vocabulary T score WASIIIVocabTScore The T score converted from the raw score that the subject received on the Vocabulary 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 Vocabulary 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
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
C01705 Lab test name LabTestName Name representing the 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. Name representing the 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 LB LBTEST

Lab Test or Examination Name

Laboratory Test Name

What was the lab test name?

LBTEST; LBTESTCD Char Record the name of the Lab measurement or finding, if not preprinted on the CRF. If collected on the CRF, the sponsor may provide additional instructions to ensure the data is entered as intended. (LBTEST)

[Select appropriate values from the LBTEST codelist]

Prompt Radio
C21499 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest response text WAISIVDSSRespnsTxt Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-22 11:32:44.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 50

Free-Form Entry

C13196 Questionnaire for Verifying Stroke Free Status (QVSFS) - painless vision loss status QVSFSPainlsVisnLossStatus Have you ever had sudden painless loss of vision in one or both eyes? Have you ever had sudden painless loss of vision in one or both eyes? 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
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

C18666 Body system other text BodySysOTH The free-text field related to 'Body system category' specifying other text. 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 Free-text 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. 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

2002895 DeBaun Forms
C08239 Imaging echo duration ImgEchoDur Duration between the application of the 90 degree pulse and the peak of the echo signal, in milliseconds, during the spin echo and inversion recovery pulse sequences in imaging acquisition Duration between the application of the 90° pulse and the peak of the echo signal, in milliseconds, during the spin echo and inversion recovery pulse sequences in imaging acquisition 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

millisecond
C18813 Imaging lesion found other text ImgLesnFoundOTH The free-text field related to 'Imaging lesion found type' specifying other text. Type of lesions found within the imaging study The free-text field related to 'Imaging lesion found type' specifying other text. Type of lesions found within the imaging study 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

C10576 Imaging in plane resolution axis 1 measurement ImgInPlaneRsltnAxis1Measr Axis 1 of in-plane spatial resolution used in imaging acquisition Axis 1 of in-plane spatial resolution used in imaging acquisition 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

millimeter
C13897 Imaging vessel angiography collateral status anatomic site ImgVessAngioCollatStatAntSite Indicates vessel angiography collateral status location Indicates vessel angiography collateral status location ECA/OA-ICA;ECA/Other-ICA;AComA-A1-MCA;AComA-A2-MCA pial;PComA-ICA;PCA-ACA pial;PCA-MCA pial;ICA to MCA/ACA Moyamoya;Other, specify;ECA/OA-ICA;ECA/Other-ICA;AComA-A1-MCA;AComA-A2-MCA pial;PComA-ICA;PCA-ACA pial;PCA-MCA pial;ICA to MCA/ACA Moyamoya;Other, specify External carotid artery/OA-Internal Carotid Artery;External carotid artery/Other-Internal Carotid Artery;AComA-A1-Middle cerebral artery;AComA-A2-Middle cerebral artery pial;PComA-Internal Carotid Artery;PCA-Anterior cerebral artery pial;PCA-Middle cerebral artery pial;ICA to Middle cerebral artery/Anterior cerebral artery Moyamoya;Other, specify;External carotid artery/OA-Internal Carotid Artery;External carotid artery/Other-Internal Carotid Artery;AComA-A1-Middle cerebral artery;AComA-A2-Middle cerebral artery pial;PComA-Internal Carotid Artery;PCA-Anterior cerebral artery pial;PCA-Middle cerebral artery pial;ICA to Middle cerebral artery/Anterior cerebral artery Moyamoya;Other, specify 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

C55782 Imaging scanner software hardware update text ImagScanSoftHardUpdateTxt Text describing any scanner software or hardware updates during the time the study was performed. Text describing any scanner software or hardware updates during the time the study was performed. Alphanumeric Adult;Pediatric Supplemental 1.00 2017-05-31 12:43:09.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

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