Sub-Domain: Additional Proposed Instruments
CRF:
CDE ID | CDE Name | Variable Name | Definition | Short Description | Additional Notes (Question Text) | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guideline) | Sub Domain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | Source | Form Set | Form | Field | Domain | CDASH Variable | CDASH Definition | CDASH Label | Controlled Terminology | Prompt | Essentiality | Question Text | CDASH imp guidance | SDTM IG target | csDSR | PhenX | Data Type | CRF Completion Inst | SDTMIG Target Var | SDTMIG Target Map | Codelist Name | PVs | Pre Pop Value | Query Display | List Style |
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C18858 | Imaging pons abnormality other text | ImgPonsAbnrmlyOTH | The free-text field related to 'Imaging pons abnormality type' specifying other text. The type of abnormality in the pons on the image | The free-text field related to 'Imaging pons abnormality type' specifying other text. The type of abnormality in the pons on the image | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy | 4000 |
Free-Form Entry |
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C13924 | Imaging vertebral origin result | ImgVertebralOriginReslt | Indicates vertebral origin | Indicates vertebral origin | Normal;Stenosis;Occluded | Normal;Stenosis;Occluded | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C00722 | Family history medical condition relative type | FamHistMedclCondReltvTy | Relationship of the family member or ancestor with the medical condition or health related event to the participant/subject | Relationship of the family member or ancestor with the medical condition or health related event to the participant/subject | Mother;Father;Full sibling;Half sibling;Child;Maternal grandmother;Paternal grandmother;Maternal grandfather;Paternal grandfather;Maternal aunt;Paternal aunt;Maternal uncle;Paternal uncle;Maternal niece/nephew;Paternal niece/nephew;Grandchild;Other, specify;Maternal cousin;Paternal cousin;Great-grandchild | Mother;Father;Full sibling;Half sibling;Child;Maternal grandmother;Paternal grandmother;Maternal grandfather;Paternal grandfather;Maternal aunt;Paternal aunt;Maternal uncle;Paternal uncle;Maternal niece/nephew;Paternal niece/nephew;Grandchild;Other, specify;Maternal cousin;Paternal cousin;Great-grandchild | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Multiple Pre-Defined Values Selected |
3165810 | DeBaun Forms | ||||||||||||||||||||||||||||||
C56384 | Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness hit reaction time standard deviation value | ConnersCPT3InaHRTStDevVal | The standard deviation of the subject's response speed consistency, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The standard deviation of the subject's response speed consistency, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:33:41.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
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C15555 | Imaging visual analysis performed indicator | ImgVisAnlysisPerfrmInd | Whether visual analysis was performed while blind to clinical data | Whether visual analysis was performed while blind to clinical data | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C12496 | Imaging cerebellum abnormal indicator | ImgCrblmAbnrmlInd | Indicator as to whether the cerebellum appears normal or abnormal in the image studies | Indicator as to whether the cerebellum appears normal or abnormal in the image studies | Abnormal;Normal;Abnormal;Normal | Abnormal;Normal;Abnormal;Normal | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C17402 | Site name | SiteName | The name of the site for the study | The name of the site for the study | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy | 255 |
Free-Form Entry |
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C13138 | Hague Side Effects Scale (HASES) - chronic side effects sub scale | HASESChronSESubscale | Hague Side Effects Scale (HASES)- Chronic Side Effects Subscale (6-24) | HASES Chronic Side Effects Subscale (6-24) | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
0 | 24 | DeBaun Forms | |||||||||||||||||||||||||||||||
C21494 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest trial number | WAISIVDSBTrialNum | Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | 1;2 | Trial 1;Trial 2 | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-07-22 11:32:44.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C14005 | Imaging brain death diagnosis result | ImgBrainDeathDiagReslt | Indicates brain death diagnosis result | Indicates brain death diagnosis result | Reversed Diastolic Flow;Systolic spike;No signals | Reversed Diastolic Flow;Systolic spike;No signals | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Multiple Pre-Defined Values Selected |
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C08088 | Age value unit of measure | AgeValUoM | Unit of measure used to initially record the age value | Unit of measure used to initially record the age value | Days;Weeks;Months;Years;Days;Weeks;Months;Years | Days;Weeks;Months;Years;Days;Weeks;Months;Years | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C18027 | Comment text | CmmntTxt | Provide any additional information that pertains to the question. | Provide any additional information that pertains to the question. | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy | 4000 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
C13462 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - cognitive or behavioral deficit scale | PSOMSNECogBehavDefScale | The scale for cognitive or behavioral deficit based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | The scale for cognitive or behavioral deficit 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 | cookie-policy |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C13903 | Imaging interpretation site indicator | ImgInterpretSiteInd | Indicates imaging interpretation site | Indicates imaging interpretation site | Onsite;Offsite | Onsite;Offsite | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C54689 | PROMIS - Global Health physical health rate scale | PROMISGlbHlthPhysHlthRtScl | Scale related to an individual's rating of his/her physical health, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her physical health, as part of the PROMIS Global Health | 1;2;3;4;5;1;2;3;4;5 | Poor;Fair;Good;Very Good;Excellent;Poor;Fair;Good;Very Good;Excellent | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-04-07 15:34:25.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C14038 | Imaging power M mode right middle cerebral artery result | ImgPowerMModeRightMCARes | Indicates power M mode for right middle cerebral artery (MCA) result | Indicates power M mode for right middle cerebral artery (MCA) result | Absent;High Resistance;Low Resistance;Absent;High Resistance;Low Resistance | Absent;High Resistance;Low Resistance;Absent;High Resistance;Low Resistance | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C12475 | Imaging magnetic resonance imaging T1 T2 sequence name | ImgMRIT1T2SeqName | The name of the T1 or T2 sequences used for Magnetic Resonance Imaging (MRI) | The name of the T1 or T2 sequences used for MRI | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy | 4000 |
Free-Form Entry |
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C18942 | Cerebellar or coordination assessment abnormality present other text | CerbllCoordAssmtAbnrmlyPrsOTH | The free-text field related to 'Cerebellar or coordination assessment abnormality present status' specifying other text. Whether the cerebellar/coordination assessment found abnormalities | The free-text field related to 'Cerebellar or coordination assessment abnormality present status' specifying other text. Whether the cerebellar/coordination assessment found abnormalities | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy | 4000 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
C13935 | Intima media thickness (IMT) max far-wall measurement | IMTMaxFarWallMeasr | Indicates max intima media thickness (IMT) far-wall measurement (mm) | Indicates max intima media thickness (IMT) far-wall measurement (mm) | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
millimeter | |||||||||||||||||||||||||||||||||
C01554 | Oxygen saturation measurement | O2SatMeasr | Value, as a percent, of baseline O2 saturation (SPO2) in nocturnal oximetry, as part of Nocturnal Oximetry. | Value, as a percent, of baseline O2 saturation (SPO2) in nocturnal oximetry, as part of Nocturnal Oximetry. | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
0 | 100 | percent | DeBaun Forms | ||||||||||||||||||||||||||||||
C56406 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Block Design raw score | WASIIIBDRawScore | The raw score that the subject received on the Block Design subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) . | 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 | cookie-policy |
Free-Form Entry |
0 | 71 | ||||||||||||||||||||||||||||||||
C56418 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid type | WASIIIExVisHearAidTyp | The type of visual or hearing aid or aids that the examinee needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The type of visual or hearing aid or aids that the examinee needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Glasses;Assisted Listening Device;Other;Prescription Lenses | Glasses;Assisted Listening Device;Other;Prescription Lenses | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:43:19.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Multiple Pre-Defined Values Selected |
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C17527 | Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex brachioradialis jerk left score | FARSPNSNeuExDTenRefBrJLftScore | Score for left-side brachioradialis 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 brachioradialis 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 | cookie-policy |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C13234 | National Institutes of Health Stroke Scale (NIHSS) - Level of consciousness tertiary question score | NIHSSLvlConscTertryQScore | Level of consciousness (LOC) commands assessed using the NIH Stroke Scale (NIHSS) | Level of consciousness (LOC) commands assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;0;1;2;0;1;2 | Performs both tasks correctly.;Performs one task correctly;Performs neither task correctly;Performs both tasks correctly.;Performs one task correctly;Performs neither task correctly;Performs both tasks correctly.;Performs one task correctly;Performs neither task correctly | Numeric values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C21505 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest last trial correct digit score | WAISIVLDSSScore | Last digit correct, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Last digit correct, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Numeric Values | Adult;Pediatric | Supplemental | 1.10 | 2018-07-30 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
0 | 9 | ||||||||||||||||||||||||||||||||
C14016 | Microembolic signal start time | MicroembolSignalStartTime | Indicates microembolic signal start time | Indicates microembolic signal start time | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
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C08254 | Imaging visual analysis location performed type | ImgVisAnlysisLocPerfTyp | Location where visual analysis of the imaging data are performed | Location where visual analysis of the imaging data are performed | Central;Central read;Local - Site;Local read;Local report;Other, specify | Central;Central read;Local - Site;Local read;Local report;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C18716 | Imaging scanner manufacturer other text | ImgScannerManufOTH | The free-text field related to 'Imaging scanner manufacturer name' specifying other text. Name of manufacturer of imaging scanner | The free-text field related to 'Imaging scanner manufacturer name' specifying other text. Name of manufacturer of imaging scanner | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy | 4000 |
Free-Form Entry |
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C13914 | Imaging plaque residual lumen result | ImgPlaqResidualLumenReslt | Indicates plaque residual lumen | Indicates plaque residual lumen | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy | 255 |
Free-Form Entry |
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C00008 | Age value | AgeVal | Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject. | Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject. | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
0 | 1800 | month | DeBaun Forms | ||||||||||||||||||||||||||||||
C55777 | Imaging inter peri ictal headache since end duration | ImagInterPeriIctHeadSincEndDur | The duration of time since the end of the subject's last inter-ictal or peri-ictal headahe. | The duration of time since the end of the subject's last inter-ictal or peri-ictal headahe. | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:23:34.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
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C14678 | Pediatric Migraine Disability Assessment (MIDAS) - headache school absence day count | PedMIDASHeadSchAbseDayCt | Count missed full school days in the last 3 months due to headaches, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. | Count missed full school days in the last 3 months due to headaches, 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 | cookie-policy |
Free-Form Entry |
0 | 92 | ||||||||||||||||||||||||||||||||
C12486 | Imaging other cortical abnormality type | ImgOthrCorticalAbnrmlyTyp | The type of other cortical abnormality | The type of other cortical abnormality | Schizencephaly;Porencephaly;Other, specify | Schizencephaly;Porencephaly;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Multiple Pre-Defined Values Selected |
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C19810 | Medical history abdominal kidney problem indicator | MedHistAbdmnlKdnyProbInd | Indicator of history of kidney problem | Indicator of history of kidney problem | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C13946 | Imaging spectrum angle correction indicator | ImgSpectrumAngleCorrectionInd | Indicates spectrum angle correction | Indicates spectrum angle correction | 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 | cookie-policy |
Single Pre-Defined Value Selected |
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C02016 | Medication prior or concomitant start date and time | MedctnPriorConcomStrtDateTime | The date (and time, if applicable and known) on which the prior/concomitant medication usage began. | The date (and time, if applicable and known) on which the prior/concomitant medication usage began. | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
3162752 | DeBaun Forms | ||||||||||||||||||||||||||||||||
C21484 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest number series text | WAISIVDSFNumTxt | Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | Series of numbers, 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 | cookie-policy |
Free-Form Entry |
50 | |||||||||||||||||||||||||||||||||
C13957 | Microembolic signal intensity value | MicroembolSignalIntensVal | Indicates microembolic signal intensity value (dB) | Indicates microembolic signal intensity value (dB) | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
decibel | |||||||||||||||||||||||||||||||||
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 | cookie-policy | 255 |
Free-Form Entry |
3133353 | DeBaun Forms | |||||||||||||||||||||||||||||||
C56429 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Perceptual Reasoning IQ composite score | WASIIIPercRsngIQCompScore | The subject's Perceptual Reasoning IQ composite score, converted from his/her Perceptual Reasoning T score, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The subject's Perceptual Reasoning IQ composite score, converted from his/her Perceptual Reasoning T score, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:58:34.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
40 | 160 | ||||||||||||||||||||||||||||||||
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 | cookie-policy |
Free-Form Entry |
0 | 42 | ||||||||||||||||||||||||||||||||
C13893 | Imaging vessel angiography venous findings type | ImgVesselAngioVenousFindTyp | Indicates vessel angiography venous findings type | Indicates vessel angiography venous findings type | Superior Sagittal Sinus;Inferior Sagittal Sinus;Straight Sinus;Transverse Sinus;Sigmoid Sinus;Jugular Bulb;Cavernous Sinus;Internal Cerebral Vein;Vein of Galen;Frontal Cortical Vein;Parietal Cortical Vein;Temporal Cortical Vein;Occipital Cortical Vein | Superior Sagittal Sinus;Inferior Sagittal Sinus;Straight Sinus;Transverse Sinus;Sigmoid Sinus;Jugular Bulb;Cavernous Sinus;Internal Cerebral Vein;Vein of Galen;Frontal Cortical Vein;Parietal Cortical Vein;Temporal Cortical Vein;Occipital Cortical Vein | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C54607 | Brief Test of Executive Function Second Edition (BRIEF 2) - Self monitor total raw scale score | BRIEF2SlfMntrTtlRwSclScore | Total score of the raw scale for the self monitor function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the self 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 | cookie-policy |
Free-Form Entry |
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C14028 | Vasospasm present indicator | VasoPresInd | Indicates presence of vasospasm | Indicates presence of vasospasm | 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 | cookie-policy |
Single Pre-Defined Value Selected |
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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 | cookie-policy |
Single Pre-Defined Value Selected |
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C56439 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 percentile rank value | WASIIIFullScale2PrcntRankVal | The percentile rank the subject placed in with respect to Full Scale IQ for two subtests (Vocabulary and Matrix Reasoning), as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The percentile rank the subject placed in with respect to Full Scale IQ for two subtests (Vocabulary and Matrix Reasoning), as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 13:04:39.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
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C18859 | Imaging cerebellum abnormality other text | ImgCrblmAbnrmlyOTH | The free-text field related to 'Imaging cerebellum abnormality type' specifying other text. The type of abnormality in the cerebellum on the image | The free-text field related to 'Imaging cerebellum abnormality type' specifying other text. The type of abnormality in the cerebellum on the image | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy | 4000 |
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C13925 | Imaging vertebral interosseous result | ImgVertebralInterosseousReslt | Indicates vertebral interosseous | Indicates vertebral interosseous | Normal;Occlusion;Stenosis | Normal;Occlusion;Stenosis | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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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 | cookie-policy | 255 |
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2201880 | DeBaun Forms | |||||||||||||||||||||||||||||||
C56385 | Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness variability value | ConnersCPT3InaVarVal | The variability of the subject's response speed consistency, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The variability of the subject's response speed consistency, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:36:25.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
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