Sub-Domain: Additional Proposed Instruments
CRF: themes
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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C54612 | Brief Test of Executive Function Second Edition (BRIEF 2) - Working memory total raw scale score | BRIEF2WrkngMmryTtlRwSclScore | Total score of the raw scale for the working memory function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the working memory 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 | sites |
Free-Form Entry |
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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 | sites |
Single Pre-Defined Value Selected |
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C02005 | Study drug returned date and time | StdyDrugRetrnDateTime | Date (and time, if applicable and known) on which the study drug was returned | Date (and time, if applicable and known) on which the study drug was returned | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
3164209 | DeBaun Forms | ||||||||||||||||||||||||||||||||
C18899 | Imaging brain death vessel anatomic other text | ImgBrainDeathVesseIAntmicOTH | The free-text field related to 'Imaging brain death vessel anatomic site' specifying other text. Indicates brain death vessel(s) | The free-text field related to 'Imaging brain death vessel anatomic site' specifying other text. Indicates brain death vessel(s) | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites | 4000 |
Free-Form Entry |
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C13198 | Questionnaire for Verifying Stroke Free Status (QVSFS) - understanding status | QVSFSUndstandStatus | Have you ever suddenly lost the ability to understand what people were saying? | Have you ever suddenly lost the ability to understand what people were saying? 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 | sites |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C14010 | Intracranial stenosis collateral vessel anatomic site | IntracrnStnoColltVsslAntmicSit | Indicates intracranial stenosis collateral vessel(s) | Indicates intracranial stenosis collateral vessel(s) | ICA;Basilar;MCA;Other, specify;ACA;VA;PCA | Internal carotid artery;Basilar;Middle cerebral artery;Other, specify;Anterior carotid artery;Vertebral artery;Posterior carotid artery | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Multiple Pre-Defined Values Selected |
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C56393 | Conners Continuous Performance Test 3rd Edition (CPT3) - Sustained attention omission block count | ConnersCPT3SusAttnOmiBlkCt | The number of missed targets by block, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The number of missed targets by block, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:42:50.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
0 | |||||||||||||||||||||||||||||||||
C08241 | Imaging field of view axis 1 measurement | ImgFieldViewAxis1Measr | Axis 1 of the image that is visible through the camera at a particular position in orientation and space in millimeters | Axis 1 of the image that is visible through the camera at a particular position in orientation and space in millimeters | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
millimeter | |||||||||||||||||||||||||||||||||
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 | sites |
Single Pre-Defined Value Selected |
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C21489 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest last trial correct digit score | WAISIVLDSFScore | Score for the digits reported correctly by the subject/participant during the last trial of the Digit Span Forward subtest, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) | Score for the digits reported correctly by the subject/participant during the last trial of the Digit Span Forward subtest, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-07-22 11:32:44.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
0 | 9 | ||||||||||||||||||||||||||||||||
C13751 | Imaging acquisition reason | ImgAcquisitionRsn | Describes why the imaging study was performed | Describes why the imaging study was performed | Diagnostic;Post-treatment;Monitoring;Other, specify;Diagnostic;Post-treatment;Monitoring;Other, specify | Diagnostic;Post-treatment;Monitoring;Other, specify;Diagnostic;Post-treatment;Monitoring;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Multiple Pre-Defined Values Selected |
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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 | sites |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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 | sites |
Free-Form Entry |
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C00322 | Medical history condition text | MedclHistCondTxt | Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history | Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites | 4000 |
Free-Form Entry |
2003874 | DeBaun Forms | |||||||||||||||||||||||||||||||
C18689 | Imaging anatomic site other text | ImgAntmicSitOTH | The free-text field related to 'Imaging anatomic site' specifying other text. Type of body part or anatomy scanned in the imaging study | The free-text field related to 'Imaging anatomic site' specifying other text. Type of body part or anatomy scanned in the imaging study | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites | 4000 |
Free-Form Entry |
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C12493 | Imaging brainstem abnormality type | ImgBrnstmAbnrmlyTyp | The type of abnormality in the brainstem on the image | The type of abnormality in the brainstem on the image | Hypoplasia;Anterior concavity;Posterior concavity;Other, specify | Hypoplasia;Anterior concavity;Posterior concavity;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Multiple Pre-Defined Values Selected |
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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 | sites |
Free-Form Entry |
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C54695 | PROMIS - Global Health fatigue rate scale | PROMISGlbHlthFtgRtScl | Scale related to an individual's rating of his/her fatigue, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her fatigue, 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 | sites |
Single Pre-Defined Value Selected |
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C02307 | Adverse event verbatim term text | AdvrsEvntVerbatimTermText | Text that describes the adverse event word for word as described by the participant/subject | Adverse event verbatim term text | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites | 4000 |
Free-Form Entry |
2188132 | DeBaun Forms | |||||||||||||||||||||||||||||||
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 | sites |
Single Pre-Defined Value Selected |
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C19358 | Lab test type | LabTstTyp | Type of lab test performed on body fluid(s) and tissues. Test names are typically comprised of the analyte name, properties (%, Ratio, etc.), the type of body fluid tested, and any special instructions. | Type of lab test performed on body fluid(s) and tissues. Test names are typically comprised of the analyte name, properties (%, Ratio, etc.), the type of body fluid tested, and any special instructions. | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Single Pre-Defined Value Selected |
2003746 | DeBaun Forms | ||||||||||||||||||||||||||||||||
C13241 | National Institutes of Health Stroke Scale (NIHSS) - Sensory score | NIHSSSensoryScore | Sensory abilities assessed using the NIH Stroke Scale (NIHSS) | Sensory abilities assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;UN;0;1;2;UN | Normal: no sensory loss.;Mild to moderate sensory loss: patient feels pinprick is less sharp or is dull on the affected side, or there is a loss of superficial pain with pinprick but patient is aware he/she is being touched.;Severe to total sensory loss: patient is not aware of being touched in the face, arm, and leg.;Unexaminable (intubated/paralyzed);Normal: no sensory loss.;Mild to moderate sensory loss: patient feels pinprick is less sharp or is dull on the affected side, or there is a loss of superficial pain with pinprick but patient is aware he/she is being touched.;Severe to total sensory loss: patient is not aware of being touched in the face, arm, and leg.;Unexaminable (intubated/paralyzed) | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
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 | sites | 255 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
C56412 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Matrix Reasoning T score | WASIIIMRTScore | The T score converted from the raw score that the subject received on the Matrix Reasoning 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 Matrix Reasoning subtest of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:23:35.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
20 | 80 | ||||||||||||||||||||||||||||||||
C10682 | Imaging anatomic site | ImgAntmicSite | Type of body part or anatomy scanned in the imaging study | Type of body part or anatomy scanned in the imaging study | Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify;Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify | Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify;Brain;Cervical spine;Thoracic spine;Lumbar spine;Calf;Thigh;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Multiple Pre-Defined Values Selected |
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C56439 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 percentile rank value | WASIIIFullScale2PrcntRankVal | The percentile rank the subject placed in with respect to Full Scale IQ for two subtests (Vocabulary and Matrix Reasoning), as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The percentile rank the subject placed in with respect to Full Scale IQ for two subtests (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 13:04:39.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
0 | 100 | percent | |||||||||||||||||||||||||||||||
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 | sites |
Single Pre-Defined Value Selected |
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C21500 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest number series text | WAISIVDSSNumTxt | Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-07-22 11:32:44.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
0 | 50 | ||||||||||||||||||||||||||||||||
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 | sites |
Single Pre-Defined Value Selected |
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C54602 | Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) - Form version name | BRIEF2FormVersionName | Name of the version of the form, as part of the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) | Name of the version of the form, as part of the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) | Parent form;Self form;Teacher form | Parent form;Self form;Teacher form | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-03-20 15:13:56.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
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 | sites |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C01535 | Respiratory rate | RespRate | Rate of the participant/subject's breathing (inhalation and exhalation). | Rate of the participant/subject's breathing (inhalation and exhalation). | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
0 | 120 | breaths per minute | 2644399 | DeBaun Forms | |||||||||||||||||||||||||||||
C18854 | Imaging other incidental finding other text | ImgOthrIncidentalFindOTH | The free-text field related to 'Imaging other incidental finding type' specifying other text. The type of other incidental findings found within the image studies | The free-text field related to 'Imaging other incidental finding type' specifying other text. The type of other incidental findings found within the image studies | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites | 4000 |
Free-Form Entry |
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C12504 | Imaging gray matter hyperintensity T2 fluid attenuated inversion recovery site | ImgGryMtrHyperT2FLAIRSiteTyp | The type of anatomical site of the grey matter hyperintensity on T2/FLAIR (fluid attenuated inversion recovery) images | The type of anatomical site of the grey matter hyperintensity on T2/FLAIR images | Putamen;Caudate;Other, specify;Cerebellar nuclei;Colliculi;Floor of the fourth ventricle;Pallidum;Periaqueductal grey;Red nucleus;Substantia nigra;Mammillary body;Subthalmic nucleus;Thalamus | Putamen;Caudate;Other, specify;Cerebellar nuclei;Colliculi;Floor of the fourth ventricle;Pallidum;Periaqueductal grey;Red nucleus;Substantia nigra;Mammillary body;Subthalmic nucleus;Thalamus | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Multiple Pre-Defined Values Selected |
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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 | sites |
Single Pre-Defined Value Selected |
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C56378 | Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness detectability score | ConnersCPT3InaDetectScore | Ability to discriminate between targets (non-X) and non-targets (X), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Ability to discriminate between targets (non-X) and non-targets (X), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:27:57.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
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C05408 | Hospital admission date and time | HospitlAdmissDateTime | Date (and time, if applicable and known) the participant/subject was admitted to the hospital | Date (and time, if applicable and known) the participant/subject was admitted to the hospital | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||||||
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 | sites |
Single Pre-Defined Value Selected |
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C20417 | National Institutes of Health Stroke Scale (NIHSS) - Motor leg amputation text | NIHSSMotLegAmpTxt | The text field for explaining the amputation or joint fusion for question related to motor ability of the leg (both left and right) assessed using the NIH Stroke Scale (NIHSS). | The text field for explaining the amputation or joint fusion for question related to motor ability of the leg (both left and right) 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 | sites | 4000 |
Free-Form Entry |
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C13459 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - language deficit-production description text | PSOMSNELangDefProdDescTxt | Description of the language production deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Description of the language production deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites | 255 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
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 | sites |
Multiple Pre-Defined Values Selected |
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C56424 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Verbal Comprehension IQ composite score | WASIIIVerbCompIQCompScore | The subject's Verbal Comprehension IQ composite score, converted from his/her Verbal Comprehension T score, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The subject's Verbal Comprehension IQ composite score, converted from his/her Verbal Comprehension T score, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:58:34.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
40 | 160 | ||||||||||||||||||||||||||||||||
C12468 | Imaging magnetic resonance imaging performed multiple count | ImgMRIPerfMultiCt | The count representing of the number of magnetic resonance imaging (MRI) sessions performed on the participant/subject | The count representing of the number of magnetic resonance imaging (MRI) sessions performed on the participant/subject | 2;3;4;5;6;>6;2;3;4;5;6;>6 | 2;3;4;5;6;>6;2;3;4;5;6;>6 | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Single Pre-Defined Value Selected |
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C17798 | Imaging contrast agent name | ImgContrastAgentName | Name of imaging contrast agent used | Name of imaging contrast agent used | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites | 4000 |
Free-Form Entry |
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C12483 | Imaging cortex-polymicrogyria indicator | ImgCortexPolymicrogyriaInd | Indicator of whether a developmental malformation of the human brain characterized by an excessive number of small convolutions (gyri) on the surface of the brain is present | Indicator of whether a developmental malformation of the human brain characterized by an excessive number of small convolutions (gyri) on the surface of the brain is present | 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 | sites |
Single Pre-Defined Value Selected |
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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 | sites |
Single Pre-Defined Value Selected |
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C54613 | Brief Test of Executive Function Second Edition (BRIEF 2) - Plan organize total raw scale score | BRIEF2PlnOrgnzTtlRwSclScore | Total score of the raw scale for the plan/organize function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the plan/organize 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 | sites |
Free-Form Entry |
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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 | sites |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C02006 | Medication prior or concomitant dose | MedctnPriorConcomDose | Dose of prior/concomitant medication taken per administration. | Dose of prior/concomitant medication taken per administration. | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites |
Free-Form Entry |
3162729 | DeBaun Forms | ||||||||||||||||||||||||||||||||
C18900 | Intracranial stenosis collateral vessel anatomic other text | IntracrnStnoColltVsslAntmicOTH | The free-text field related to 'Intracranial stenosis collateral vessel anatomic site' specifying other text. Indicates intracranial stenosis collateral vessel(s) | The free-text field related to 'Intracranial stenosis collateral vessel anatomic site' specifying other text. Indicates intracranial stenosis collateral vessel(s) | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | sites | 4000 |
Free-Form Entry |