Sub-Domain: Assessments and Examinations
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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C15529 | Imaging quality assurance/quality control (QA/QC) implemented techniques text | ImgQAQCImplentTxt | Free text field to describe the quality assurance techniques implemented. | Free text field to describe the quality assurance techniques implemented. | What measures of quality assurance scans were used? | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics | 4000 |
Free-Form Entry |
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C56599 | Imaging functional scan patient task other text | ImagFucScanPtTaskOthrTxt | Text describing another patient task performed during the evoked functional scan, if applicable. | Text describing another patient task performed during the evoked functional scan, if applicable. | Other, specify | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 1.00 | 2017-06-19 10:07:43.0 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics | 255 |
Free-Form Entry |
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C15609 | Imaging rest duration | ImgRestDur | The rest duration between multiple evoked functional acquisitions | The rest duration between multiple evoked functional acquisitions | If there are multiple evoked functional acquisitions, what is the rest duration in between acquisitions? | Numeric Values |
Record in seconds. Report the duration of time between each functional acquisition. |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Free-Form Entry |
second | ||||||||||||||||||||||||||||||
C15643 | Imaging statistical group analysis test text | ImgStatGrpAnalTstTxt | Statistical tests used for group analysis | Statistical tests used for group analysis | What were the statistical tests used for group analysis? | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics | 255 |
Free-Form Entry |
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C56610 | Imaging data denoised indicator | ImagDataDenInd | The indicator relating to whether the data was denoised during preprocessing. | The indicator relating to whether the data was denoised during preprocessing. | Was the data denoised? | No;Yes | No;Yes | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 1.00 | 2017-06-19 11:15:07.0 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Single Pre-Defined Value Selected |
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C08244 | Imaging slice thickness value | ImgSliceThicknessVal | Value of the thickness of the slice measured in millimeters (mm) | Value of the thickness of the optical slice measured in millimeters (mm) | Slice thickness (mm) | Numeric Values |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-25 08:54:08.2 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Free-Form Entry |
0 | 99 | millimeter | ||||||||||||||||||||||||||||
C19330 | Sensory evoked potential stimulation count | SEPStimulationCt | The number of stimulations in sensory evoked potential. | The number of stimulations in sensory evoked potential. | Total number of stimulations? | Numeric Values |
Report the total number of times that the patient ewas stimulated during the study. |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 1.00 | 2014-06-09 16:27:34.0 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Free-Form Entry |
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C15536 | Imaging paradigm approach type | ImgPardgmApprochTyp | The types of approach of imaging paradigm | The types of approach of imaging paradigm | Approach | Evoked Functional Scan with Stimulation;Evoked Functional Scan with Patient Task;Resting State Functional Imaging;Perfusion Imaging;Other | Evoked Functional Scan with Stimulation;Evoked Functional Scan with Patient Task;Resting State Functional Imaging;Perfusion Imaging;Other | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Multiple Pre-Defined Values Selected |
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C56600 | Imaging functional scan performed task count | ImagFuncScanPerfTaskCt | The total number of performed tasks during the patient's functional scan. | The total number of performed tasks during the patient's functional scan. | Total number of performed tasks? | Numeric Values |
Report the total number of times that the patient performed a task during the study |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 1.00 | 2017-06-19 10:09:08.0 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Free-Form Entry |
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C15611 | Imaging standard average brain text | ImgStandrdAvgBrnTxt | Text representing the standard average brain used | Text representing the standard average brain used | Report standard average brain used | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics | 255 |
Free-Form Entry |
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C18011 | Imaging motion correction technique pass criteria text | ImgMotCorrTechPasCritTxt | Text of correction technique and pass criteria text | Type of correction technique and pass criteria text | Describe motion correction technique and the pass criteria text | Alphanumeric | No references available | Adult | Supplemental ? Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics | 255 |
Free-Form Entry |
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C56611 | Imaging high low pass filter approach used indicator | ImagHighLowPassFiltAppUsedInd | The indicator relating to whether the High/Low Pass filter approach was used during preprocessing. | The indicator relating to whether the High/Low Pass filter approach was used during preprocessing. | Was High/Low Pass filter approach used? | No;Yes | No;Yes | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 1.00 | 2017-06-19 11:16:06.0 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Single Pre-Defined Value Selected |
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C08245 | Imaging slice count | ImgSliceCt | Count representing the total number of single image planes captured during imaging acquisition | Count representing the total number of single image planes captured during imaging acquisition | Number of slices | Numeric Values |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-25 08:54:08.2 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Free-Form Entry |
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C55773 | Imaging MRI scanner used count | ImagMRIScanUsedCt | The number of different MRI scanners that were used on the subject. | The number of different MRI scanners that were used on the subject. | Number of differenet MRI scanners used | Numeric Values |
Report the number of different MRI scanners that were used for imaging participants during the study |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 1.00 | 2017-05-31 12:11:13.0 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Free-Form Entry |
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C15580 | Imaging acquisition type | ImgAcquisitionTyp | Type of imaging acquisition | Type of imaging acquisition | Acquisition type | EPI;SSFSP;Spiral;Other,specify;EPI;SSFSP;Spiral;Other,specify | Echo Planar Imaging (EPI);Steady State Free Precession (SSFSP);Spiral;Other, specify;Echo Planar Imaging (EPI);Steady State Free Precession (SSFSP);Spiral;Other, specify | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Multiple Pre-Defined Values Selected |
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C15623 | Imaging nonstimulation fixation landmark indicator | ImgNonstimFixLandInd | Type of fixation landmark | Type of fixation landmark | Was a fixation landmark used? | Yes;No | Yes;No | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Single Pre-Defined Value Selected |
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C56601 | Imaging preprocessing method performed text | ImagProcMethdPerfmdTxt | Text specifying the details of any imaging preprocessing methods that were performed. | Text specifying the details of any imaging preprocessing methods that were performed. | If one of the above is selected, specify details | Alphanumeric | No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 1.00 | 2017-06-19 10:14:53.0 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics | 255 |
Free-Form Entry |
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C02494 | Imaging study date and time | ImgStdyDateTime | Date (and time, if applicable and known) the radiologic study was obtained. | Date (and time, if applicable and known) the radiologic study was obtained. | Date of scan | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-08-28 16:08:00.453 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Free-Form Entry |
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C18013 | Imaging spatial normalization name | ImgSpatNormName | Name of spatial normalization approach transformation from functional space to a standard brain space | Name of spatial normalization approach transformation from functional space to a standard brain space | Describe the spatial normalization approach transformation from functional space to a standard brain space | Alphanumeric | No references available | Adult | Supplemental ? Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics | 255 |
Free-Form Entry |
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C08264 | Imaging raw data reconstruction method type | ImgRawDataReconstructMthdTyp | The type of method used for reconstruction of raw data from the imaging scan | The type of method used for reconstruction of raw data from the imaging scan | Reconstruction method used | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-22 09:34:41.527 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Single Pre-Defined Value Selected |
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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. | Timing of imaging in relation to headache | Inter-Ictal;Ictal;Peri-Ictal | Inter-Ictal;Ictal;Peri-Ictal | Alphanumeric |
Report the timing of imaging in relation to the headache. The precise time windows for peri-ictal and inter-ictal vary with headache type. For episodic migraine, an interval of at least 72h from the last and before the next attack is generally accepted for "inter-ictal". |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 1.00 | 2017-05-31 12:14:56.0 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Single Pre-Defined Value Selected |
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C15585 | Imaging stimulation type | ImgStimlTyp | Type of stimulation | Type of stimulation | Type of stimulation | Visual;Sensorial;Other, specify: | Visual;Sensorial;Other, specify: | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Multiple Pre-Defined Values Selected |
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C15626 | Imaging nonstimulation eye assessment indicator | ImgNonstimEyeAssmtInd | Participant's/subject's eyes status | Participant's/subject's eyes indicator | Were the participant's/subject's eyes open or closed | Eyes Open;Eyes Closed;Eyes Open;Eyes Closed | Eyes Open;Eyes Closed;Eyes Open;Eyes Closed | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Single Pre-Defined Value Selected |
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C56602 | Imaging analysis approach type | ImagAnalysisAppTyp | The analysis approach that was made for imaging. | The analysis approach that was made for imaging. | Analysis Type | Region of interest;Whole brain;Independent Components Analysis;Other, specify | Region of interest;Whole brain;Independent Components Analysis;Other, specify | Alphanumeric |
No additional instructions |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 1.00 | 2017-06-19 10:16:40.0 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Single Pre-Defined Value Selected |
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C02495 | Imaging scanner strength value | ImgScannerStrgthVal | Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | Value, in Tesla (T), of the scanner's magnetic field strength used for the scan being reported | Magnet Strength | 1.5T;3.0T;4.0T;7.0T;Other, specify;1.5T;3.0T;4.0T;7.0T;Other, specify | 1.5T;3.0T;4.0T;7.0T;Other, specify;1.5T;3.0T;4.0T;7.0T;Other, specify | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental ? Highly Recommended | 3.00 | 2013-08-28 16:08:00.453 | Functional Magnetic Resonance Imaging (fMRI) | Assessments and Examinations | Imaging Diagnostics |
Single Pre-Defined Value Selected |
Tesla |