CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Additional Proposed Instruments
CRF: Miscellaneous Sickle Cell-related CDEs
Sub-Domain: Additional Proposed Instruments
CRF: Miscellaneous Sickle Cell-related CDEs
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C54609 | Brief Test of Executive Function Second Edition (BRIEF 2) - Emotional control total raw scale score | BRIEF2EmtnlCntrlTtlRwSclScore | Total score of the raw scale for the emotional control function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the emotional control function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-03-22 09:57:02.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| 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 | Other |
Single Pre-Defined Value Selected |
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| 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 | Other |
Single Pre-Defined Value Selected |
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| 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 | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
| C18888 | Imaging acquisition reason other text | ImgAcquisitionRsnOTH | The free-text field related to 'Imaging acquisition reason' specifying other text. Describes why the imaging study was performed | The free-text field related to 'Imaging acquisition reason' specifying other text. Describes why the imaging study was performed | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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| 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 | Other |
Single Pre-Defined Value Selected |
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| C56388 | Conners Continuous Performance Test 3rd Edition (CPT3) - Impulsivity commission count | ConnersCPT3ImpCommCt | The number of incorrect responses to non-targets, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The number of incorrect responses to non-targets, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:38:27.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | |||||||||||||||||||||||||||||||||
| 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 | Other | 4000 |
Free-Form Entry |
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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 | Other |
Single Pre-Defined Value Selected |
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| C21486 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest trial number | WAISIVDSFTrialNum | Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | 1;2 | Trial 1;Trial 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 |
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| 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 | Other |
Free-Form Entry |
0 | 100 | percent | DeBaun Forms | ||||||||||||||||||||||||||||||
| C15558 | Imaging angiography method type | ImgAngioMethdTyp | Type of angiography method performed | Type of angiography method performed | Contrast enhanced;Time of flight;Other, specify;Contrast enhanced;Time of flight;Other, specify | Contrast enhanced;Time of flight;Other, specify;Contrast enhanced;Time of flight;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| C56431 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Perceptual Reasoning confidence interval lower bound value | WASIIIPercRsngConfIntrvlLowVal | The lower bound of the subject's Perceptual Reasoning confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The lower bound of the subject's Perceptual Reasoning confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 12:55:22.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| 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 | Other |
Free-Form Entry |
0 | 24 | DeBaun Forms | |||||||||||||||||||||||||||||||
| 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 | Other |
Free-Form Entry |
decibel | |||||||||||||||||||||||||||||||||
| C56441 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 confidence interval upper bound value | WASIIIFullSclIQ2ConfIntUppVal | The upper bound of the subject's Full Scale IQ-2 confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The upper bound of the subject's Full Scale IQ-2 confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 13:06:29.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C14006 | Imaging stenosis percentage value | ImgStenosisPercentageVal | Indicates stenosis percentage value | Indicates stenosis percentage value | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 99 | percent | |||||||||||||||||||||||||||||||
| C54692 | PROMIS - Global Health carry out social role scale | PROMISGlbHlthCrryOutSocRlScl | Scale related to an individual's rating of his/her ability to carry out usual social activities and roles, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her ability to carry out usual social activities and roles, as part of the PROMIS Global Health | 1;2;3;4;5;1;2;3;4;5 | Excellent;Very good;Good;Fair;Poor;Excellent;Very good;Good;Fair;Poor | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-04-07 15:34:25.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| 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 | Other |
Single Pre-Defined Value Selected |
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| C13904 | Imaging interpretation offsite media type | ImgInterpretOffsiteMediaTyp | Indicates imaging offsite media type | Indicates imaging offsite media type | Video;Print;Digital | Video;Print;Digital | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| C19151 | Discontinuation date | DiscontinuationDate | The date of discontinuation | The date of discontinuation | Date or Date & Time | Adult;Pediatric | Supplemental | 1.00 | 2014-05-29 11:10:46.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||||||
| 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 | Other |
Free-Form Entry |
0 | 1800 | month | DeBaun Forms | ||||||||||||||||||||||||||||||
| C14051 | Microembolic signal end time | MicroembolSignalEndTime | Indicates microembolic signal end time | Indicates microembolic signal end 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 | Other |
Free-Form Entry |
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| C56409 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Similarities raw score | WASIIISimRawScore | The raw score that the subject received on the Similarities subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) . | The raw score that the subject received on the Similarities subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:23:35.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 45 | ||||||||||||||||||||||||||||||||
| 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 | Other |
Multiple Pre-Defined Values Selected |
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| C13936 | Intima media thickness (IMT) artery type | IMTArteryTyp | Indicates intima media thickness (IMT) artery for diameter | Indicates intima media thickness (IMT) artery for diameter | CCA - right;CCA - left;CCA - right;CCA - left | Common carotid artery - right;Common carotid artery - left;Common carotid artery - right;Common carotid artery - left | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| C21497 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest last trial correct digit score | WAISIVLDSBScore | Score for correctly recalled digits for the last trial, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Score for correctly recalled digits for the last trial, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-07-22 11:32:44.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 8 | ||||||||||||||||||||||||||||||||
| 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 | Other |
Free-Form Entry |
3162752 | DeBaun Forms | ||||||||||||||||||||||||||||||||
| C17409 | Visit date | VisitDate | Date of interview or visit (actually the date when data in the form were captured) | Date of interview or visit | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
DeBaun Forms | LB | VISDAT |
Visit Date |
Visit Date |
What [is/was] the date of the visit? |
N/A | Char | Record the [date/start date] of the visit using DD-MON-YYYY format. | Prompt | ||||||||||||||||||||||||
| 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 | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
| C18610 | Imaging in plane resolution axis 2 measurement | ImgInPlaneRsltnAxis2Measr | Axis 2 of in-plane spatial resolution used in imaging acquisition | Axis 2 of in-plane spatial resolution used in imaging acquisition | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2013-09-12 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
millimeter | |||||||||||||||||||||||||||||||||
| C13245 | National Institutes of Health Stroke Scale (NIHSS) - Severity total score | NIHSSSevTotalScore | The level of stroke severity as measured by the NIH Stroke Scale (NIHSS) scoring system (i.e., total of the subscale item scores). | The level of stroke severity as measured by the NIH Stroke Scale (NIHSS) scoring system (i.e., total of the subscale item scores). | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 42 | ||||||||||||||||||||||||||||||||
| C18720 | Imaging visual analysis location performed other text | ImgVisAnlysisLocPerfOTH | The free-text field related to 'Imaging visual analysis location performed type' specifying other text. Location where visual analysis of the imaging data are performed | The free-text field related to 'Imaging visual analysis location performed type' specifying other text. Location where visual analysis of the imaging data are performed | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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| C14017 | Microembolic signal unidirectional indicator | MicroembolSignalUnidirectInd | Indicates unidirectional microembolic signal | Indicates unidirectional microembolic signal | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| C55780 | Imaging vessel studied text | ImagVessStudTxt | Text describing any and all of the subject's vessels that were studied. | Text describing any and all of the subject's vessels that were studied. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:30:51.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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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 | Other |
Single Pre-Defined Value Selected |
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| C13915 | Imaging plaque thickness measurement | ImgPlaqThicknessMeasr | Indicates plaque thickness | Indicates plaque thickness | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C19904 | Symptom disease lab data known disease other text | SymptSignDisLabDataOTH | Text of other symptoms, signs, known diseases, and lab data | Text of other symptoms, signs, known diseases, and lab data | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-09 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
| C01013 | Physical exam description text | PhysExamDescripTxt | Free text field to describe the abnormality in a specific body system or an explanation of why the body system was not examined | Free text field to describe the abnormality in a specific body system or an explanation of why the body system was not examined | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
2201880 | DeBaun Forms | |||||||||||||||||||||||||||||||
| C14679 | Pediatric Migraine Disability Assessment (MIDAS) - headache school partial absence day count | PedMIDASHeadSchPrtlAbseDayCt | Count missed partial school days in the last 3 months due to headaches, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. | Count missed partial 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 | Other |
Free-Form Entry |
0 | 92 | ||||||||||||||||||||||||||||||||
| C56421 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid prescription lens used indicator | WASIIIExVisHeaAidPreLensUseInd | The indicator relating to the examine used his/her prescription lenses during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The indicator relating to the examine used his/her prescription lenses during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Used;Not used | Used;Not used | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:54:51.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| C12497 | Imaging cerebellum abnormality type | ImgCrblmAbnrmlyTyp | The type of abnormality in the cerebellum on the image | The type of abnormality in the cerebellum on the image | Other, specify;Cleft;Vermal hypoplasia;Hemispheric hypoplasia;Vermal dysplasia;Hemispheric dysplasia;Cysts | Other, specify;Cleft;Vermal hypoplasia;Hemispheric hypoplasia;Vermal dysplasia;Hemispheric dysplasia;Cysts | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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| C13947 | Imaging peak velocity measurement | ImgPeakVelocityMeasr | Indicates peak velocity measurement (cm/sec) | Indicates peak velocity measurement (cm/sec) | 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 | |||||||||||||||||||||||||||||||
| C50680 | Examiner name | ExaminerName | The name of the person performing the exam. | The name of the person performing the exam. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-12-12 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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| C02311 | Adverse event MedDRA lower level term code | AdvsEvntMedDRALowerLvlTermCode | Code that corresponds to the Medical Dictionary for Regulatory Activities (MedDRA) Lower Level Term (LLT) for an adverse event | Code that corresponds to the Medical Dictionary for Regulatory Activities (MedDRA) Lower Level Term (LLT) for an adverse event | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
3133353 | DeBaun Forms | |||||||||||||||||||||||||||||||
| C17528 | Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex brachioradialis jerk right score | FARSPNSNeuExDTenRefBrJRtScore | Score for right-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 right-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 | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
| C13882 | Magnetic resonance angiography type | MRAngioTyp | The type as related to magnetic resonance angiography (MRA) | The type as related to magnetic resonance angiography (MRA) | TOF;Head;Neck;Contrast enhanced Head and Neck;Magnetic resonance venography (MRV) with contrast;Magnetic resonance venography (MRV) without contrast;Computer Tomography Venography (CTV) | Time of Flight;Head;Neck;Contrast enhanced Head and Neck;Magnetic resonance venography (MRV) with contrast;Magnetic resonance venography (MRV) without contrast;Computer Tomography Venography (CTV) | Alphanumeric | Adult;Pediatric | Supplemental | 4.00 | 2017-04-11 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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| C54610 | Brief Test of Executive Function Second Edition (BRIEF 2) - Task completion total raw scale score | BRIEF2TskCmpltnTtlRwSclScore | Total score of the raw scale for the task completion function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the task completion function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-03-22 09:57:02.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C08147 | Data source | DataSource | Source of the data provided on the case report form | Source of the data provided on the case report form | Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Other, specify;Unknown;Spouse | Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Other, specify;Unknown;Spouse | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:46:24.96 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
| C13894 | Imaging vessel angiography overall assessment type | ImgVesselAngioOverallAssmTyp | Indicates vessel angiography overall assessment | Indicates vessel angiography overall assessment | Normal;Small Caliber;Impaired flow | Normal;Small Caliber;Impaired flow | 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 |