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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C54690 | PROMIS - Global Health mental health rate scale | PROMISGlbHlthMntlHlthRtScl | Scale related to an individual's rating of his/her mental health, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her mental 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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C55778 | Imaging inter peri ictal next headache start duration | ImagInterPeriIctNextHeStartDur | The duration of time until the start of the subject's next inter-ictal or peri-ictal headache. | The duration of time until the start of the subject's next inter-ictal or peri-ictal headache. | 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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C13945 | Imaging spectrum depth measurement | ImgSpectrumDepthMeasr | Indicates spectrum depth measurement (mm) | Indicates spectrum depth 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 |
0 | 999 | millimeter | |||||||||||||||||||||||||||||||
C02004 | Study drug dispensed date and time | StdyDrugDispnsdDateTime | Date (and time, if applicable and known) on which a participant/subject was given or applied a therapeutic agent (drug, intervention therapy) used in a clinical trial protocol | Date (and time, if applicable and known) on which a participant/subject was given or applied a therapeutic agent (drug, intervention therapy) used in a clinical trial protocol | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
3163963 | DeBaun Forms | ||||||||||||||||||||||||||||||||
C19811 | Medical history abdominal liver problem indicator | MedHistAbdmnlLiverProbInd | Indicator of history of liver problem | Indicator of history of liver 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 | |||||||||||||||||||||||||||||||
C17526 | Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex biceps jerk right score | FARSPNSNeuExDTenRefBicJRtScore | Score for right-side biceps jerk in the peripheral nervous system section of the neurological exam, as part of the Friedreich's Ataxia Rating Scale (FARS). | Score for right-side biceps 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 | |||||||||||||||||||||||||||||||
C13197 | Questionnaire for Verifying Stroke Free Status (QVSFS) - sudden vision loss status | QVSFSSussVisnLossStatus | Have you ever suddenly lost one half of your vision? | Have you ever suddenly lost one half of your vision? Questionnaire for Verifying Stroke Free Status (QVSFS) - numbness status | 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 | cookie-policy |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C56419 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid other text | WASIIIExVisHearAidOthrTxt | Text describingg another visual or hearing aid the subject needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Text describingg another visual or hearing aid the subject needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:51:49.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy | 255 |
Free-Form Entry |
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C14015 | Microembolic signal count | MicroembolSignalCt | Numeric value counting the number of microembolic signals. | Indicates microembolic signal number | 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 | 999 | ||||||||||||||||||||||||||||||||
C08240 | Imaging flip angle measurement | ImgFlipAngleMeasr | Measurement of the angle, in degrees, over which the radio frequency changes proton spin angle | Measurement of the angle, in degrees, over which the radio frequency changes proton spin angle | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
degree | |||||||||||||||||||||||||||||||||
C21506 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest total raw score | WAISIVDSSTtlScore | Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-07-22 11:32:44.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
0 | 16 | ||||||||||||||||||||||||||||||||
C13750 | Imaging study ID number | ImgStudyIDNum | Unique identification number assigned to the study or assessment session. | Unique identification number assigned to 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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C13913 | Imaging plaque motion result | ImgPlaqMotionReslt | Indicates plaque motion | Indicates plaque motion | 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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C18718 | Imaging scanner strength other text | ImgScannerStrgthOTH | The free-text field related to 'Imaging scanner strength value' specifying other text. Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | The free-text field related to 'Imaging scanner strength value' specifying other text. Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | 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 |
Tesla | ||||||||||||||||||||||||||||||||
C14559 | EEG recording start date and time | EEGRecordingStrtDateTime | Date (and time, if applicable and known) the electroencephalogram (EEG) recording began | Date the electroencephalogram (EEG) recording 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 |
DeBaun Forms | |||||||||||||||||||||||||||||||||
C12481 | Imaging cortex lissencephaly (LIS type 1) indicator | ImgCortexLISInd | Indicator of whether cortex lissencephaly is found within the image studies | Indicator of whether cortex lissencephaly is found within the image studies | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C18860 | Imaging gray matter hyperintensity T2 fluid attenuated inversion recovery other text | ImgGryMtrHyperT2FLAIRSiteOTH | The free-text field related to 'Imaging gray matter hyperintensity T2 fluid attenuated inversion recovery site' specifying other text. The type of anatomical site of the grey matter hyperintensity on T2/FLAIR (fluid attenuated inversion recovery) images | The free-text field related to 'Imaging gray matter hyperintensity T2 fluid attenuated inversion recovery site' specifying other text. The type of anatomical site of the grey matter hyperintensity on T2/FLAIR (fluid attenuated inversion recovery) images | 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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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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C12492 | Imaging brainstem abnormal indicator | ImgBrnstmAbnrmlInd | Indicator of whether the brainstem appears normal or abnormal in the image studies | Indicator of whether the brainstem 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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C56387 | Conners Continuous Performance Test 3rd Edition (CPT3) - Impulsivity hit reaction time value | ConnersCPT3ImpHRTVal | The value representing the subject's response speed, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The value representing the subject's response speed, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:37:43.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
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C13956 | Microembolic signal duration | MicroembolSignalDur | Indicates microembolic signal duration time (msec) | Indicates microembolic signal duration time (msec) | 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 | 999 | millisecond | |||||||||||||||||||||||||||||||
C02306 | Adverse event start date and time | AdvrsEvntStartDateTime | Date (and time, if applicable and known) on which the adverse event was first evident | Date (and time, if applicable and known) on which the adverse event was first evident | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
2744993 | DeBaun Forms | ||||||||||||||||||||||||||||||||
C21485 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest item number | WAISIVDSFItemNum | Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | 1;2;3;4;5;6;7;8 | Item 1;Item 2;Item 3;Item 4;Item 5;Item 6;Item 7;Item 8 | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-07-22 11:32:44.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C13240 | National Institutes of Health Stroke Scale (NIHSS) - Limb ataxia score | NIHSSLimbAtaxiaScore | Limb ataxia assessed using the NIH Stroke Scale (NIHSS) | Limb ataxia assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;UN;0;1;2;UN | Absent;Present in one limb;Present in two limbs;Amputation or joint fusion, explain;Absent;Present in one limb;Present in two limbs;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 | cookie-policy |
Single Pre-Defined Value Selected |
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C13892 | Arterial occlusive lesion (AOL) recanalization score | AOLRecanalScore | The score as related to recanalization of the primary arterial occlusive lesion (AOL). | The score as related to recanalization of the primary arterial occlusive lesion (AOL). | 0;1;2;3;0;1;2;3;0;1;2;3 | No recanalization of the primary occlusive lesion;Incomplete or partial recanalization of the primary occlusive lesion with no distal flow;Incomplete or partial recanalization of the primary occlusive lesion with any distal flow;Complete recanalization of the primary occlusion with any distal flow;No recanalization of the primary occlusive lesion;Incomplete or partial recanalization of the primary occlusive lesion with no distal flow;Incomplete or partial recanalization of the primary occlusive lesion with any distal flow;Complete recanalization of the primary occlusion with any distal flow;No recanalization of the primary occlusive lesion;Incomplete or partial recanalization of the primary occlusive lesion with no distal flow;Incomplete or partial recanalization of the primary occlusive lesion with any distal flow;Complete recanalization of the primary occlusion with any distal flow | 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 |
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C56430 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Perceptual Reasoning percentile rank value | WASIIIPercRsngPrcntRankVal | The percentile rank the subject placed into with respect to the Perceptual Reasoning subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The percentile rank the subject placed into with respect to the Perceptual Reasoning subtests, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 12:05:57.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
0 | 100 | percent | |||||||||||||||||||||||||||||||
C14027 | Intracranial pressure (ICP) other measurement text | ICPOtherMeasrTxt | Indicates other method of measuring intracranial pressure (ICP) | Indicates other method of measuring intracranial pressure (ICP) | 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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C10609 | Hospitalization reason | HospitRsn | Reason why the participant/subject was hospitalized, excluding all surgeries | Reason why the participant/subject was hospitalized, excluding all surgeries | Pneumonia or Respiratory;Dehydration;Trauma;Fracture;Cardiomyopathy/Arrhythmia;Failure to Thrive;Other, specify;Infection other than pneumonia;Seizures;Cardiovascular | Pneumonia or Respiratory;Dehydration;Trauma;Fracture;Cardiomyopathy/Arrhythmia;Failure to Thrive;Other, specify;Infection other than pneumonia;Seizures;Cardiovascular | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Multiple Pre-Defined Values Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C54608 | Brief Test of Executive Function Second Edition (BRIEF 2) - Shift total raw scale score | BRIEF2ShftTtlRwSclScore | Total score of the raw scale for the shift function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the shift 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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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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C00321 | Medical history for body system indicator | MedclHistBodySysInd | Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body system. | Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body system. | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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 | |||||||||||||||||||||||||||||||||
C01522 | Height measurement | HgtMeasr | Measurement of participant's/subject's height. | Measurement of participant's/subject's height. | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
0 | 400 | centimeter | 649 | DeBaun Forms | |||||||||||||||||||||||||||||
C19059 | Informant participant relationship other text | InformantPartcpntRelateOTH | The free-text field related to 'Informant participant relationship type' specifying other text. The relationship of the informant to participant/subject | The free-text field related to 'Informant participant relationship type' specifying other text. The relationship of the informant to participant/subject | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy | 4000 |
Free-Form Entry |
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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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C12503 | Imaging gray matter hyperintensity T2 fluid attenuated inversion recovery indicator | ImgGryMtrHyperT2FLAIRInd | Indicator of whether there is grey matter hyperintensity on T2/FLAIR (fluid attenuated inversion recovery) images | Indicator of whether there is grey matter hyperintensity on T2/FLAIR images | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C56408 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Matrix Reasoning raw score | WASIIIMRRawScore | The raw score that the subject received on the Matrix Reasoning subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) . | The raw score that the subject received on the Matrix Reasoning subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:23:35.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
0 | 30 | ||||||||||||||||||||||||||||||||
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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C04804 | Hospital discharge date and time | HospitDischgDateTime | Date (and time, if applicable and known) the participant/subject was discharged from the hospital | Date (and time, if applicable and known) the participant/subject was discharged from the hospital | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||||||
C21496 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest item score | WAISIVDSBItemScore | Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | 0;1;2 | 0;1;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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C13458 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - language deficit-production scale | PSOMSNELangDefProdScale | The scale for language deficit - production (including dysarthria) based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | The scale for language deficit - production (including dysarthria) based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | 0;0.5;1;2;0;0.5;1;2;0;0.5;1;2 | None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function | Numeric values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | 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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C18493 | Screening visit eligibility status | ScreenVisitEligibilityStatus | The status determined from screening criteria that indicates whether a participant/subject may be eligible for a study. | Screening visit eligibility status | Eligible;Eligible but declined;Not eligible;Other, specify;Eligible;Eligible but declined;Not eligible;Other, specify | Eligible;Eligible but declined;Not eligible;Other, specify;Eligible;Eligible but declined;Not eligible;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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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C12467 | Imaging magnetic resonance imaging performed multiple indicator | ImgMRIPerfMultiInd | Indicator as to whether or not multiple magnetic resonance imaging (MRI) sessions have been performed on the participant/subject | Indicator as to whether or not multiple magnetic resonance imaging (MRI) sessions have been performed on the participant/subject | Yes;No,single brain MRI;Unknown | Yes;No,single brain MRI;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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C54691 | PROMIS - Global Health social satisfaction rate scale | PROMISGlbHlthSocSatisRtScl | Scale related to an individual's rating of his/her satisfaction with his/her social activities, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her satisfaction with his/her social activities, 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 | cookie-policy |
Single Pre-Defined Value Selected |
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C55779 | Imaging automated evaluation vascular MRI data indicator | ImagAutoEvalVasMRIDataInd | The indicator relating to whether or not an automated evaluation of vascular magnetic resonance imaging (MRI) data has been given. | The indicator relating to whether or not an automated evaluation of vascular magnetic resonance imaging (MRI) data has been given. | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:26:23.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
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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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C02005 | Study drug returned date and time | StdyDrugRetrnDateTime | Date (and time, if applicable and known) on which the study drug was returned | Date (and time, if applicable and known) on which the study drug was returned | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Free-Form Entry |
3164209 | DeBaun Forms | ||||||||||||||||||||||||||||||||
C19840 | Medical history medication change since last visit indicator | MedHistMedctnChngeSLVInd | Indicator of medication changes since last study visit | Indicator of medication changes since last study visit | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-06 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | cookie-policy |
Single Pre-Defined Value Selected |
DeBaun Forms |