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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
0 | 100 | percent | |||||||||||||||||||||||||||||||
C54691 | PROMIS - Global Health social satisfaction rate scale | PROMISGlbHlthSocSatisRtScl | Scale related to an individual's rating of his/her satisfaction with his/her social activities, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her satisfaction with his/her social activities, 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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C12490 | Imaging ventricle abnormal indicator | ImgVentrclAbnrmlInd | Indicator of whether the ventricles appear normal or abnormal in the image studies | Indicator of whether the ventricles appear 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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X | 4000 |
Free-Form Entry |
|||||||||||||||||||||||||||||||||
C19015 | Imaging angiography method other text | ImgAngioMethdOTH | The free-text field related to 'Imaging angiography method type' specifying other text. Type of angiography method performed | The free-text field related to 'Imaging angiography method type' specifying other text. Type of angiography method performed | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | PhenX CDEs | Additional Proposed Instruments | Phen-X | 4000 |
Free-Form Entry |
|||||||||||||||||||||||||||||||||
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C14027 | Intracranial pressure (ICP) other measurement text | ICPOtherMeasrTxt | Indicates other method of measuring intracranial pressure (ICP) | Indicates other method of measuring intracranial pressure (ICP) | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X | 255 |
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value 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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C21507 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span subtest total raw score | WAISIVDSTtlScore | Total score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span subtest | Total score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span subtest | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-07-22 11:32:44.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
0 | 48 | ||||||||||||||||||||||||||||||||
C10932 | Imaging lesion found indicator | ImgLesnFoundInd | Indicator of whether lesions are found within the imaging study | Indicator of whether lesions are found within the imaging study | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value 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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C13956 | Microembolic signal duration | MicroembolSignalDur | Indicates microembolic signal duration time (msec) | Indicates microembolic signal duration time (msec) | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
0 | 999 | millisecond | |||||||||||||||||||||||||||||||
C12501 | Imaging internal capsule type indicator | ImgIntCpslTypInd | The condition of the internal capsule. | The condition of the internal capsule. | Involved;Spared | Involved;Spared | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C14005 | Imaging brain death diagnosis result | ImgBrainDeathDiagReslt | Indicates brain death diagnosis result | Indicates brain death diagnosis result | Reversed Diastolic Flow;Systolic spike;No signals | Reversed Diastolic Flow;Systolic spike;No signals | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Multiple Pre-Defined Values Selected |
||||||||||||||||||||||||||||||||
C13237 | National Institutes of Health Stroke Scale (NIHSS) - Facial palsy score | NIHSSLvlConscFaclPlsyScore | Facial palsy assessed using the NIH Stroke Scale (NIHSS) | Facial palsy assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;3;UN;0;1;2;3;UN | Normal symmetrical movement;Minor paralysis (flattened nasolabial fold, asymmetry on smiling);Partial paralysis (total or near total paralysis of lower face);Complete paralysis of one or both sides (absence of facial movement in the upper and lower face);Unexaminable (intubated/paralyzed);Normal symmetrical movement;Minor paralysis (flattened nasolabial fold, asymmetry on smiling);Partial paralysis (total or near total paralysis of lower face);Complete paralysis of one or both sides (absence of facial movement in the upper and lower face);Unexaminable (intubated/paralyzed) | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C21486 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest trial number | WAISIVDSFTrialNum | Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | Trial number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | 1;2 | Trial 1;Trial 2 | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-07-22 11:32:44.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C02496 | Imaging scanner manufacturer name | ImgScannerManufName | Name of manufacturer of imaging scanner | Imaging scanner manufacturer name | Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify;Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify | Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify;Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C14038 | Imaging power M mode right middle cerebral artery result | ImgPowerMModeRightMCARes | Indicates power M mode for right middle cerebral artery (MCA) result | Indicates power M mode for right middle cerebral artery (MCA) result | Absent;High Resistance;Low Resistance;Absent;High Resistance;Low Resistance | Absent;High Resistance;Low Resistance;Absent;High Resistance;Low Resistance | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C54609 | Brief Test of Executive Function Second Edition (BRIEF 2) - Emotional control total raw scale score | BRIEF2EmtnlCntrlTtlRwSclScore | Total score of the raw scale for the emotional control function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the emotional control function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-03-22 09:57:02.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C12480 | Imaging cortex-pachygyria thickness measurement | ImgCortexPachygyriaThickMeasr | The measurement of cortex thickness, in , of the cortex | The measurement of cortex thickness, in , of the cortex | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X | 4000 |
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C18859 | Imaging cerebellum abnormality other text | ImgCrblmAbnrmlyOTH | The free-text field related to 'Imaging cerebellum abnormality type' specifying other text. The type of abnormality in the cerebellum on the image | The free-text field related to 'Imaging cerebellum abnormality type' specifying other text. The type of abnormality in the cerebellum on the image | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | PhenX CDEs | Additional Proposed Instruments | Phen-X | 4000 |
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C14016 | Microembolic signal start time | MicroembolSignalStartTime | Indicates microembolic signal start time | Indicates microembolic signal start time | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C13248 | National Institutes of Health Stroke Scale (NIHSS) Supplemental - Limb sensory loss status | NIHSSSupLimbSensoryLossStatus | The indicator to determine if any limbs have sensory loss | The indicator to determine if any limbs have sensory loss | 0;1;2 | 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. | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value 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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
0 | 71 | ||||||||||||||||||||||||||||||||
C21497 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest last trial correct digit score | WAISIVLDSBScore | Score for correctly recalled digits for the last trial, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Score for correctly recalled digits for the last trial, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-07-22 11:32:44.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
0 | 8 | ||||||||||||||||||||||||||||||||
C08255 | Imaging visual analysis blinded indicator | ImgVisAnlysisBlindInd | Indicator of whether the visual analysis was performed blinded to clinical data | Indicator of whether the visual analysis was performed blinded to clinical data | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C14685 | Pediatric Migraine Disability Assessment (MIDAS) - headache frequency | PedMIDASHeadFreq | Headache frequency, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. | Headache frequency, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C56440 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 confidence interval lower bound value | WASIIIFullSclIQ2ConfIntLowVal | The lower 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 lower 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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C54692 | PROMIS - Global Health carry out social role scale | PROMISGlbHlthCrryOutSocRlScl | Scale related to an individual's rating of his/her ability to carry out usual social activities and roles, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her ability to carry out usual social activities and roles, as part of the PROMIS Global Health | 1;2;3;4;5;1;2;3;4;5 | Excellent;Very good;Good;Fair;Poor;Excellent;Very good;Good;Fair;Poor | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-04-07 15:34:25.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C12491 | Imaging ventricle abnormality type | ImgVentrclAbnrmlyTyp | The type of abnormality in the ventricles on the image | The type of abnormality in the ventricles on the image | Dilation;Other, specify;Dilation;Other, specify | Dilation;Other, specify;Dilation;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Multiple Pre-Defined Values Selected |
||||||||||||||||||||||||||||||||
C55777 | Imaging inter peri ictal headache since end duration | ImagInterPeriIctHeadSincEndDur | The duration of time since the end of the subject's last inter-ictal or peri-ictal headahe. | The duration of time since the end of the subject's last inter-ictal or peri-ictal headahe. | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:23:34.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
||||||||||||||||||||||||||||||||||
C19059 | Informant participant relationship other text | InformantPartcpntRelateOTH | The free-text field related to 'Informant participant relationship type' specifying other text. The relationship of the informant to participant/subject | The free-text field related to 'Informant participant relationship type' specifying other text. The relationship of the informant to participant/subject | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | PhenX CDEs | Additional Proposed Instruments | Phen-X | 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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C00007 | Birth date | BirthDate | Date (and time, if applicable and known) the participant/subject was born | Date (and time, if applicable and known) the participant/subject was born | What is your birthdate? | Date or Date & Time | PhenX Measure: Current Age (#010100) • PhenX Protocol: Current Age (#010101) • Protocol source: https://www.phenxtoolkit.org/index.php?pageLink=browse.protocoldetails&id=10101 | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
793 | DeBaun Forms | ||||||||||||||||||||||||||||||
C14028 | Vasospasm present indicator | VasoPresInd | Indicates presence of vasospasm | Indicates presence of vasospasm | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
||||||||||||||||||||||||||||||||
C56418 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid type | WASIIIExVisHearAidTyp | The type of visual or hearing aid or aids that the examinee needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The type of visual or hearing aid or aids that the examinee needed during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Glasses;Assisted Listening Device;Other;Prescription Lenses | Glasses;Assisted Listening Device;Other;Prescription Lenses | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:43:19.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Multiple Pre-Defined Values Selected |
||||||||||||||||||||||||||||||||
C50680 | Examiner name | ExaminerName | The name of the person performing the exam. | The name of the person performing the exam. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-12-12 00:00:00.0 | PhenX CDEs | Additional Proposed Instruments | Phen-X | 255 |
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 | PhenX CDEs | Additional Proposed Instruments | Phen-X |
Multiple Pre-Defined Values Selected |