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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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 | Other |
Single Pre-Defined Value Selected |
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C19500 | Assessment performed date | AssessmentPerformedDate | The date of assessment of the examination being performed. | The date of assessment of the examination being performed. | Date or Date & Time | Adult;Pediatric | Supplemental | 1.00 | 2014-06-18 08:10:12.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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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 |
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C02310 | Adverse event CTCAE low level term name | AdvrsEvntCTCAELowLvlTermName | Text that represents the Common Terminology Criteria for Adverse Events (CTCAE) low level term name for an adverse event. | Text that represents the Common Terminology Criteria for Adverse Events (CTCAE) low level term name for an adverse event. | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
3125302 | DeBaun Forms | |||||||||||||||||||||||||||||||
C56413 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Similarities T score | WASIIISimTScore | The T score converted from the raw score that the subject received on the Similarities subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) . | The T score converted from the raw score that the subject received on the 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 |
20 | 80 | ||||||||||||||||||||||||||||||||
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 |
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C13244 | National Institutes of Health Stroke Scale (NIHSS) - Extinction and inattention score | NIHSSExtinctInattentScore | Extinction and inattention assessed using the NIH Stroke Scale (NIHSS) | Extinction and inattention assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;UN;0;1;2;UN | No abnormality.;Visual, tactile, auditory, spatial, or personal inattention or extinction to bilateral simultaneous stimulation in one of the sensory modalities.;Profound hemi-inattention or extinction to more than one modality. Does not recognize own hand or orients to only one side of space.;Unexaminable (intubated/paralyzed;No abnormality.;Visual, tactile, auditory, spatial, or personal inattention or extinction to bilateral simultaneous stimulation in one of the sensory modalities.;Profound hemi-inattention or extinction to more than one modality. Does not recognize own hand or orients to only one side of space.;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 | |||||||||||||||||||||||||||||||
C21501 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest item number | WAISIVDSSItemNum | Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing 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 |
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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 | |||||||||||||||||||||||||||||||
C54603 | Informant participant familiar grade | InfrmntPrtcpntFmlrGrade | Grade denoting the degree to which the informant knows the subject/participant | Grade denoting the degree to which the informant knows the subject/participant | Very well;Moderately well;Not well | Very well;Moderately well;Not well | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-03-22 09:39:15.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C17503 | Hemoglobin electrophoresis type | HemoglbnElectrophoresisType | Type of hemoglobin that was identified by the electrophoresis test being reported | Type of hemoglobin that was identified by the electrophoresis test being reported | HbSS;HbSA;HBAA;HbFF;HbAF | HbSS;HbSA;HBAA;HbFF;HbAF | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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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C18855 | Imaging other cortical abnormality other text | ImgOthrCorticalAbnrmlyOTH | The free-text field related to 'Imaging other cortical abnormality type' specifying other text. The type of other cortical abnormality | The free-text field related to 'Imaging other cortical abnormality type' specifying other text. The type of other cortical abnormality | 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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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 |
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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 | ||||||||||||||||||||||||||||||
C56380 | Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness omission count | ConnersCPT3InaOmmCt | The number of missed targets, as part of the Conners Continuous Performance Test 3rd Edition (CPT3) | The number of missed targets, as part of the Conners Continuous Performance Test 3rd Edition (CPT3) | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:29:58.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | |||||||||||||||||||||||||||||||||
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 |
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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 | |||||||||||||||||||||||||||||||
C20419 | National Institutes of Health Stroke Scale (NIHSS) - Limb ataxia amputation text | NIHSSLimbAtaxiaAmputTxt | The text field for explaining the amputation or joint fusion for question related to Limb ataxia assessed using the NIH Stroke Scale (NIHSS). | The text field for explaining the amputation or joint fusion for question related to Limb ataxia assessed using the NIH Stroke Scale (NIHSS). | Alphanumeric | Adult;Pediatric | Supplemental | 4.00 | 2015-04-27 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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 | |||||||||||||||||||||||||||||||
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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C56425 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Verbal Comprehension percentile rank value | WASIIIVerbCompPrcntRankVal | The percentile rank the subject placed into with respect to the Verbal Comprehension 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 Verbal Comprehension 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 | Other |
Free-Form Entry |
0 | 100 | percent | |||||||||||||||||||||||||||||||
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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C13941 | Imaging insonation plane type | ImgInsonPlaneTyp | Indicates insonation plane | Indicates insonation plane | Free;Coronal;Axial mesencephalic | Free;Coronal;Axial mesencephalic | 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 | |||||||||||||||||||||||||||||||
C17925 | Imaging contrast agent dose | ImgContrastAgentDose | Dosage of the contrast agent used | Dosage of the contrast agent used | 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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C13952 | Consensus on Grading Intracranial Flow Obstruction (COGIF) - score | COGIFScore | The score related to the consensus on grading intracranial flow obstruction (COGIF) | The score related to the consensus on grading intracranial flow obstruction (COGIF) | No flow;Low flow/No diastolic flow;Low flow/diastolic flow;Established perfusion | No flow;Low flow/No diastolic flow;Low flow/diastolic flow;Established 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 |
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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 | Other |
Free-Form Entry |
0 | 1800 | month | DeBaun Forms | ||||||||||||||||||||||||||||||
C54614 | Brief Test of Executive Function Second Edition (BRIEF 2) - Task monitor total raw scale score | BRIEF2TskMntrTtlRwSclScore | Total score of the raw scale for the task-monitor function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the task-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 | Other |
Free-Form Entry |
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C13887 | Imaging vessel angiography symptomology type | ImgVesselAngioSympTyp | Indicates vessel imaging angiography symptomology | Indicates vessel imaging angiography symptomology | Symptomatic;Asymptomatic;Indeterminate | Symptomatic;Asymptomatic;Indeterminate | 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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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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C18901 | Sickle cell disease vessel anatomic other text | SickleCellDisVesselAntmicOTH | The free-text field related to 'Sickle cell disease vessel anatomic site' specifying other text. Indicates sickle cell vessel | The free-text field related to 'Sickle cell disease vessel anatomic site' specifying other text. Indicates sickle cell vessel | 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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C14023 | Sickle cell disease diagnosis result | SickleCellDiagnosReslt | Indicates sickle cell diagnosis result | Indicates sickle cell diagnosis result | Abnormal;Normal;Conditional;Abnormal;Normal;Conditional | Abnormal;Normal;Conditional;Abnormal;Normal;Conditional | 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 | |||||||||||||||||||||||||||||||
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 | ||||||||||||||||||||||||||||||||
C56395 | Conners Continuous Performance Test 3rd Edition (CPT3) - Vigilance hit reaction time inter-stimulus interval change value | ConnersCPT3VigHRTISIChngVal | The change in response speed at various inter-stimulus intervals (ISIs), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The change in response speed at various inter-stimulus intervals (ISIs), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:46:09.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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C13920 | Imaging volume flow rate measurement | ImgVolFlowRateMeasr | Indicates volume flow rate | Indicates volume flow rate | 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 | milliliter per minute | |||||||||||||||||||||||||||||||
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 | |||||||||||||||||||||||||||||||
C21491 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subset response text | WAISIVDSBRespnsTxt | Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Participant response, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward 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 |
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C14684 | Pediatric Migraine Disability Assessment (MIDAS) - total score | PedMIDASTotalScore | The total score as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. | The total score 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 |
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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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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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C18708 | Imaging pulse sequence other text | ImgPulseSeqOTH | The free-text field related to 'Imaging pulse sequence type' specifying other text. Type of imaging pulse sequence used | The free-text field related to 'Imaging pulse sequence type' specifying other text. Type of imaging pulse sequence used | 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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C14001 | Extracranial stenosis type | ExtracranStenosisTyp | Indicates extracranial stenosis type | Indicates extracranial stenosis type | Collateral;Reduced upstroke;Reduced pulsatility index (Pi);VMR;Reduced velocity;Collateral;Reduced upstroke;Reduced pulsatility index (Pi);VMR;Reduced velocity | Collateral;Reduced upstroke;Reduced pulsatility index (Pi);VMR;Reduced velocity;Collateral;Reduced upstroke;Reduced pulsatility index (Pi);VMR;Reduced velocity | 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 |
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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 | Other | 255 |
Free-Form Entry |
2201880 | DeBaun Forms | |||||||||||||||||||||||||||||||
C55774 | Imaging headache relation time type | ImagHeadacheRelTimeTyp | The type of timing of the imaging in relation to headache. | The type of timing of the imaging in relation to headache. | Inter-Ictal;Ictal;Peri-Ictal | Inter-Ictal;Ictal;Peri-Ictal | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:14:56.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C13899 | Imaging probe type text | ImgProbeTypTxt | The text describing the type of imaging probe | Describes imaging probe type | 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 |
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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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C19526 | Military Acute Concussion Evaluation (MACE) - Incident cause other text | MACEIncdntCauseOth | The free-text field related to Military Acute Concussion Evaluation (MACE) - Incident cause indicator specifying other text, as part of Military Acute Concussion Evaluation (MACE). | The free-text field related to Military Acute Concussion Evaluation (MACE) - Incident cause indicator specifying other text, as part of Military Acute Concussion Evaluation (MACE).` | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
C14034 | Vasomotor response (VMR) vessel anatomic site | VMRVesselAntmicSite | Indicates vasomotor response (VMR) vessel type | Indicates vasomotor response (VMR) vessel type | M1;A1;P1;Siphon;Ophthalmic;Vert;Basilar;MCA;Other, specify | M1;A1;P1;Siphon;Ophthalmic;Vert;Basilar;Middle cerebral artery;Other, specify | 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 |
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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 |