CDE Detailed Report
Disease: general-data-protection-regulation-gdpr
Sub-Domain: Additional Proposed Instruments
CRF:

Displaying 301 - 350 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
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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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3133353 DeBaun Forms
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