CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Additional Proposed Instruments
CRF: Miscellaneous Sickle Cell-related CDEs

Displaying 51 - 100 of 491
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type Source Form Set Form Field Domain CDASH Variable CDASH Definition CDASH Label Controlled Terminology Prompt Essentiality Question Text CDASH imp guidance SDTM IG target csDSR PhenX Data Type CRF Completion Inst SDTMIG Target Var SDTMIG Target Map Codelist Name PVs Pre Pop Value Query Display List Style
C13908 Imaging echo pattern result ImgEchoPattReslt Indicates echo pattern Indicates echo pattern Homogeneous;Heterogeneous Homogeneous;Heterogeneous 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

C02203 Off study reason OffStdyRsn Primary reason participant/ subject is no longer participating in study (i.e., is not being followed and will not receive intervention/treatment). Primary reason participant/ subject is no longer participating in study (i.e., is not being followed and will not receive intervention/treatment). Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died;Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died;Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-18 16:35:19.49 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

2979313 DeBaun Forms
C14424 Epilepsy etiology specific classification type EpilepsyEtioSpecClassTyp The specific etiologies preceeding the development of epilepsy in the participant/subject, as described by the International League Against Epilepsy (ILAE). The specific etiologies preceding the development of epilepsy in the participant/subject. Viral, bacterial and parasitic infections;Traumatic brain injury;Stroke;Intraventricular hemorrhage;Hypoxic-ischemic encephalopathy;Other metabolic or toxic insults;Neurocutaneous syndromes;Inborn errors of metabolism;Genetic and chromosomal development encephalopathies;Malformations of cortical or other brain development with or without known genetic determinants;Neoplasia;Dementia;Other degenerative neurologic diseases;Genetic or presumed genetic;Epilepsy of unknown cause, without relevant abnormalities on examination, cognition, history, or imaging;Other, specify;Developmental encephalopathy of unknown cause;Mesial Temporal Sclerosis Viral, bacterial and parasitic infections;Traumatic brain injury;Stroke;Intraventricular hemorrhage;Hypoxic-ischemic encephalopathy;Other metabolic or toxic insults;Neurocutaneous syndromes;Inborn errors of metabolism;Genetic and chromosomal development encephalopathies;Malformations of cortical or other brain development with or without known genetic determinants;Neoplasia;Dementia;Other degenerative neurologic diseases;Genetic or presumed genetic;Epilepsy of unknown cause, without relevant abnormalities on examination, cognition, history, or imaging;Other, specify;Developmental encephalopathy of unknown cause as evidenced by the presence of mental retardation, cerebral palsy, or autism with no evidence of a specific insult or disorder to which cause can be attributed preceding the onset of epilepsy;Mesial Temporal Sclerosis Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C21493 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest item number WAISIVDSBItemNum Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward 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 Other

Single Pre-Defined Value Selected

C13236 National Institutes of Health Stroke Scale (NIHSS) - Visual field score NIHSSLvlConscVisuFldScore Visual fields assessed using the NIH Stroke Scale (NIHSS) Visual fields assessed using the NIH Stroke Scale (NIHSS) 0;1;2;3;UN;0;1;2;3;UN No visual loss;Partial hemianopia;Complete hemianopia;Bilateral hemianopia (blind including cortical blindness);Unexaminable (intubated/paralyzed);No visual loss;Partial hemianopia;Complete hemianopia;Bilateral hemianopia (blind including cortical blindness);Unexaminable (intubated/paralyzed) Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C13940 Imaging minimum interadventitial diameter measurement ImgMinInteradventlDiamtMeasr Indicates minimum interadventitial diameter measurement (mm) Indicates minimum interadventitial diameter measurement (mm) Numeric Values Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

millimeter
C17972 Medication prior concomitant dose frequency Clinical Data Interchange Standards Consortium Standard Data Tabulation Model code MedPriConDoseFreqCDISCSDTMCode Code that represents the frequency of the dosage of the prior or concomitant medication administered. Clinical Data Interchange Standards Consortium Standard Data Tabulation Model (CDISC SDTM) Code that represents the frequency of the dosage of the prior or concomitant medication administered. Clinical Data Interchange Standards Consortium Standard Data Tabulation Model (CDISC SDTM) Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:36:20.083 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

Free-Form Entry

DeBaun Forms
C10567 Imaging radio frequency coil type ImgRFCoilTyp Type of radio frequency (RF) coil(s) used for the body part scanned Type of RF coil(s) used for the body part scanned Head coil;Neck coil;Spine array;Body coil (transmit);Double-cone;Circular;Figure 8;Other, specify Head coil;Neck coil;Spine array;Body coil (transmit);Double-cone;Circular;Figure 8;Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Multiple Pre-Defined Values Selected

C17499 Special education indicator SpecialEduInd Indicator as to whether the participant/subject has or had special education Indicator as to whether the participant/subject has or had special education Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C54688 PROMIS - Global Health quality of life scale PROMISGlbHlthQualOfLfScl Scale related to an individual's rating of his/her quality of life, as part of the PROMIS Global Health Scale related to an individual's rating of his/her quality of life, 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 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

C00023 Hand preference type HandPrefTyp Hand which the participant/subject uses predominantly, not necessarily the hand he/she writes with exclusively. Hand which the participant/subject uses predominantly, not necessarily the hand he/she writes with exclusively. Left hand;Right hand;Both hands;Unknown;Forced right Left hand;Right hand;Both hands;Unknown;Forced right 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

2180147 DeBaun Forms
C01052 Loss of consciousness indicator LOCInd The indicator for whether the participant/subject experienced any period of loss of consciousness (LOC). The indicator for whether the participant/subject experienced any period of loss of consciousness (LOC). Yes;No;Suspected;Unknown Yes;No;Suspected;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C14022 Sickle cell disease criterion result text SickleCellCriterResltTxt Indicates sickle cell criterion result Indicates sickle cell criterion result Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 255

Free-Form Entry

DeBaun Forms
C19805 Medical history endocrine osteoporosis indicator MedHistEndcrnOstprsisInd Indicator of history of osteoporosis Indicator of history of osteoporosis 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 Other

Single Pre-Defined Value Selected

DeBaun Forms
C56437 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 4 confidence interval upper bound value WASIIIFullSclIQ4ConfIntUppVal The upper bound of the subject's Full Scale IQ-4 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-4 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

C12499 Imaging T2 weighted white matter abnormality site type ImgT2WWMAbnrmlySiteTyp The type of anatomical site of the white matter abnormality on T2 weighted images The type of anatomical site of the white matter abnormality on T2 weighted images Frontal;Parietal;Temporal;Cerebellar WM;Deep WM;Diffuse;Occipital;Periventricular Frontal;Parietal;Temporal;Cerebellar WM;Deep WM;Diffuse;Occipital;Periventricular Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

C56417 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale 2 T score sum value WASIIIFullScale2TScoreSumVal The sum of two of the subject's T scores (Vocabulary and Matrix Reasoning), as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The sum of two of the subject's T scores (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 11:40:41.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

C13919 Imaging percent stenosis criterion type ImgPercentStenosisCriterionTyp The criteria used to find indicate stenosis. The criteria used to find indicate stenosis. PSV;PSV/EDV;Other, specify Peak systolic velocity;Peak systolic velocity/end diastolic velocity;Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C02494 Imaging study date and time ImgStdyDateTime Date (and time, if applicable and known) the radiologic study was obtained. Date (and time, if applicable and known) the radiologic study was obtained. 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

C14683 Pediatric Migraine Disability Assessment (MIDAS) - headache decrease other activity function day count PedMIDASHeadDecOActFuncDayCt Count the days you participate in these activities, but functioned at less than half your ability, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. Count the days you participate in these activities, but functioned at less than half your ability, 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

C21504 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest item score WAISIVDSSSubtestItemScore Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Item score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest 0;1;2 0;1;2 Numeric Values Adult;Pediatric Supplemental 1.10 2018-07-30 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C13247 National Institutes of Health Stroke Scale (NIHSS) Supplemental - Limb ataxia status NIHSSSupLimbAtaxiaStatus The indicator to determine if ataxia is present in the limbs The indicator to determine if ataxia is present in the limbs 0;1;2;UN 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 Other

Single Pre-Defined Value Selected

C13951 Imaging spectrum end diastolic ratio value ImgSpectrumEndDiastlRatioVal Indicates spectrum end diastolic ratio result Indicates spectrum end diastolic ratio result 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

C18715 Imaging radio frequency coil other text ImgRFCoilOTH The free-text field related to 'Imaging radio frequency coil type' specifying other text. Type of radio frequency (RF) coil(s) used for the body part scanned The free-text field related to 'Imaging radio frequency coil type' specifying other text. Type of radio frequency (RF) coil(s) used for the body part scanned 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

C10933 Imaging lesion found type ImgLesnFoundTyp Type of lesions found within the imaging study Type of lesions found within the imaging study Grey matter hyperintensity;Infarct;Malformation;Other, specify;WM hyperintensity Grey matter hyperintensity;Infarct;Malformation;Other, specify;WM hyperintensity 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

C55776 Imaging ictal headache since onset duration ImagIctHeadSinceOnsetDur The duration of time since the onset of the subject's headache if it was ictal. The duration of time since the onset of the subject's headache if it was ictal. Numeric Values Adult;Pediatric Supplemental 1.00 2017-05-31 12:21:21.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

C13886 Imaging vessel angiography cause type ImgVesselAngioCauseTyp Indicates vessel imaging angiography cause Indicates vessel imaging angiography cause Atherosclerotic;Embolic;Other;Unknown;Vasospasm Atherosclerotic;Embolic;Other;Unknown;Vasospasm 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

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 Other

Free-Form Entry

C13898 Imaging vessel angiography collateral grade ImgVesselAngioCollateralGrad Indicates vessel angiography collateral grade Indicates vessel angiography collateral grade Grade 0;Grade 1;Grade 2;Grade 3;Grade 4 No collaterals visible to the ischemic site;Slow collaterals to the periphery of the ischemic site with persistence of some of the defect;Rapid collaterals to the periphery of ischemic site with persistence of some of the defect and to only a portion of the ischemic territory;Collaterals with slow but complete angiographic blood flow of the ischemic bed by the late venous phase;Complete and rapid collateral blood flow to the vascular bed in the entire ischemic territory by retrograde perfusion. 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

C01701 Lab specimen collection date and time LabSpecmnCollDateTime Date (and time if applicable and known) when the specimen was collected Date (and time if applicable and known) when the specimen was collected Date or Date & Time Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

2004004 DeBaun Forms LB LBDTC

Specimen Collection Date

Collection Date

What was the date of the lab specimen collection?

LBDTC Char Record the date when specimen collection was done using this format (DD-MON-YYYY). Prompt
C14033 Vasospasm vessel anatomic site VasospasmVesselAntmicSite Indicates vasospasm vessel(s) Indicates vasospasm vessel(s) ICA;Basilar;MCA;Other, specify;ACA;VA Internal carotid artery;Basilar;Middle cerebral artery;Other, specify;Anterior cerebral artery;Vertebral artery Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

C21483 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest response text WAISIVDSFRespnsTxt Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest Alphanumeric Adult;Pediatric Supplemental 1.00 2015-07-22 11:32:44.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 50

Free-Form Entry

C13194 Questionnaire for Verifying Stroke Free Status (QVSFS) - painless weakness status QVSFSPainlsWeaknsStatus Have you ever had sudden painless weakness on one side of your body? Have you ever had sudden painless weakness on one side of your body? Questionnaire for Verifying Stroke Free Status (QVSFS) No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C56428 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Verbal Comprehension confidence interval upper bound value WASIIIVerbCompConfIntrvlUppVal The upper bound of the subject's Verbal Comprehension confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). The upper bound of the subject's Verbal Comprehension 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

C13930 Intima media thickness (IMT) timing type IMTTimingTyp Indicates intima media thickness (IMT) timing type Indicates intima media thickness (IMT) timing type ECG Gating;End Diastolic;Peak Systolic;ECG Gating;End Diastolic;Peak Systolic ECG Gating;End Diastolic;Peak Systolic;ECG Gating;End Diastolic;Peak Systolic 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

C08177 Hemorrhage indicator HemrrhgInd Indicator of the presence of cerebral hemorrhages, regardless of size in any region of the brain Indicator of the presence of cerebral hemorrhages, regardless of size in any region of the brain Yes;No;Unknown;Not assessed Yes;No;Unknown;Not assessed 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

DeBaun Forms
C16100 Symptoms new or worsening neurologic indicator SymptmNewWrseNeuroInd Indicates whether the participant/subject has new neurologic symptoms or an acute worsening of preexisting neurologic symptoms Indicates whether the participant/subject has new neurologic symptoms or an acute worsening of preexisting neurologic symptoms Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C54606 Brief Test of Executive Function Second Edition (BRIEF 2) - Inhibit total raw scale score BRIEF2InhbtTtlRwSclScore Total score of the raw scale for the inhibit function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Total score of the raw scale for the inhibit 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

C13468 Stroke Adjudication Worksheet - symptom duration StrokeAdjudWksSymDur How long the symptom(s) experienced around the time of the stroke event lasted How long the symptom(s) experienced around the time of the stroke event lasted Confirmed to be greater than or equal to 24 hours;Confirmed to be less than 24 hours;Duration of symptoms could not be confirmed;Confirmed to be greater than or equal to 24 hours;Confirmed to be less than 24 hours;Duration of symptoms could not be confirmed Confirmed to be greater than or equal to 24 hours;Confirmed to be less than 24 hours;Duration of symptoms could not be confirmed;Confirmed to be greater than or equal to 24 hours;Confirmed to be less than 24 hours;Duration of symptoms could not be confirmed Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
C14000 Extracranial stenosis present indicator ExtracranStenPresInd Indicates presence of extracranial stenosis Indicates presence of extracranial stenosis 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

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 Other 4000

Free-Form Entry

C12478 Imaging cortex-pachygyria indicator ImgCortexPachygyriaInd Indicator of whether cortex-pachygyria are found within the image studies Indicator of whether cortex-pachygyria are 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 Other

Single Pre-Defined Value Selected

C14011 Intracranial stenosis present indicator IntracranStenosisPresentInd Indicates presence of intracranial stenosis Indicates presence of intracranial stenosis 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

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 Other 4000

Free-Form Entry

DeBaun Forms
C12489 Imaging subcortical cysts site type ImgSubCorticalCystSiteTyp The anatomical site(s) of the subcortical cysts The anatomical site(s) of the subcortical cysts Temporal;Frontoparietal;Occipital Temporal;Frontoparietal;Occipital Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

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 Other

Free-Form Entry

0 71
C13909 Imaging plaque surface type ImgPlaqSurfaceTyp Indicates plaque surface type Indicates plaque surface type Irregular;Smooth Irregular;Smooth 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

C02209 Informed consent obtained indicator InfConsntObtInd Indicator of whether informed consent was obtained for the participant/subject to participate in the clinical research study. Indicator of whether informed consent was obtained for the participant/subject to participate in the clinical research study Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-18 16:35:19.49 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

2186028 DeBaun Forms
C14443 Muscle tone assessment anatomic site MuscToneAssmtAntmicSite Anatomic location of the muscle tone as part of the motor examination. Anatomic location of the muscle tone as part of the motor examination. Right upper extremity;Left upper extremity;Right lower extremity;Left lower extremity;Truncal tone Right upper extremity (RUE);Left upper extremity (LUE);Right lower extremity (RLE);Left lower extremity (LLE);Truncal tone Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

DeBaun Forms
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 Other

Single Pre-Defined Value Selected

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CSV