Sub-Domain: Additional Proposed Instruments
CRF: Neurological Exam
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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C14445 | Muscle tone assessment abnormality type | MuscToneAbnrmlyAssmtTyp | The muscle tone abnormality type | The muscle tone abnormality type | If abnormal, indicate type | Abnormal - Decreased;Abnormal - Increased;Other, specify | Abnormal - Decreased;Abnormal - Increased;Other, specify | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C18939 | Muscle weakness neurological anatomic other text | MuscWeakNeuroAntmicOTH | The free-text field related to 'Muscle weakness neurological anatomic site' specifying other text. Anatomic location of neurological muscle weakness. | The free-text field related to 'Muscle weakness neurological anatomic site' specifying other text. Anatomic location of neurological muscle weakness. | Other, specify | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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C14459 | Reflex exam global assessment result | RflxExmGlobAssmtReslt | The global assessment of the ability and condition of reflexes | The global assessment of the ability and condition of reflexes | Reflexes - global assessment | Abnormal;Normal;Cannot Assess;Other, specify;Abnormal;Normal;Cannot Assess;Other, specify | Abnormal;Normal;Cannot Assess;Other, specify;Abnormal;Normal;Cannot Assess;Other, specify | Alphanumeric |
Choose one. If abnormal answer questions A and B. |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C18504 | Cranial nerves abnormality present text | CranlNerveAbnrmlyPresTxt | The free-text field to explain the abnormality of the cranial nerve identified. | The free-text field to explain the abnormality of the cranial nerve identified. | Explain Abnormality | Alphanumeric |
Indicate which of the following cranial nerves are abnormal |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C21106 | Gait assessment result other text | GaitAssmtResltOTH | The free-text field to specify the other result of the gait assessment | The free-text field to specify the other result of the gait assessment | Other, specify | Alphanumeric | Adult;Pediatric | Proposed | 1.00 | 2015-06-02 16:57:18.0 | Neurological Exam | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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C14435 | Nystagmus indicator | NystagmusInd | Involuntary movements of the eyeballs; its presence or absence is used to diagnose a variety of neurological and visual disorders | Involuntary movements of the eyeballs; its presence or absence is used to diagnose a variety of neurological and visual disorders | Nystagmus | Yes;No;Cannot Assess | Yes;No;Cannot Assess | Alphanumeric |
Specify type, if yes |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C18516 | Sensory system abnormality stocking glove present text | SensySysAbnrmlyStckGlvPresTxt | The free-text field to describe the stocking sensory abnormality, a generalised and gradual loss of peripheral nerve function results in a receding glove and stocking pattern. | The free-text field to describe the stocking sensory abnormality, a generalised and gradual loss of peripheral nerve function results in a receding glove and stocking pattern. | Stocking/Glove, explain | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C14446 | Muscle strength assessment anatomic site | MuscStrAssmtAntmicSite | Anatomic location of the muscle strength as part of the motor examination. | Anatomic location of the muscle strength as part of the motor examination. | Muscle strength - global assessment | Right upper extremity;Left upper extremity;Right lower extremity;Left lower extremity | Right upper extremity (RUE);Left upper extremity (LUE);Right lower extremity (RLE);Left lower extremity (LLE) | Alphanumeric |
Evaluate all extremities. |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C18940 | Tremor assessment other text | TremAssessOTH | The free-text field related to 'Tremor assessment status' specifying other text. The status indicating whether tremors could be detected during the exam | The free-text field related to 'Tremor assessment status' specifying other text. The status indicating whether tremors could be detected during the exam | Other, specify | Alphanumeric |
Choose only one |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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C14460 | Reflex assessment anatomic site | RflxAntmicSite | The location or category for reflex assessment of limbs | The location or category for reflex assessment of limbs | Assessment of Limbs | Right Arm;Left Arm;Right Leg;Left Leg | Right Arm;Left Arm;Right Leg;Left Leg | Alphanumeric |
If reflexes abnormal record the results for each limb |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C18506 | Muscle weakness myopathic weakness present text | MuscWeakMyopathWeakPresTxt | The free-text field to describethe myopathic weakness present resultling in muscle weakness. | The free-text field to describethe myopathic weakness present resultling in muscle weakness. | Myopathic Weakness, describe | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C21107 | Gait abnormality assessment other text | GaitAbnrmlyAssmtOTH | The free-text field for other type of abnormal gait | The free-text field for other type of abnormal gait | Other Gait Abnormalities, specify | Alphanumeric |
Choose best response |
No references available | Adult;Pediatric | Proposed | 1.00 | 2015-06-02 16:08:00.0 | Neurological Exam | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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C14436 | Nystagmus type | NystagmusTyp | Type of involuntary movement of the eyeballs; its presence or absence is used to diagnose a variety of neurological and visual disorders | Type of involuntary movement of the eyeballs; its presence or absence is used to diagnose a variety of neurological and visual disorders | Type of nystagmus | Physiologic;Abnormal;Other, specify | Physiologic;Abnormal;Other, specify | Alphanumeric |
Enter type of nystagmus; physiological nystagmus is normal nystagmus (i.e. a few beats at end gaze) |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C18517 | Sensory system abnormality stocking present text | SensySysAbnrmlyStockPresTxt | The free-text field to describe the stocking sensory abnormality, a generalised and gradual loss of peripheral nerve function results in a receding stocking pattern. | The free-text field to describe the stocking sensory abnormality, a generalised and gradual loss of peripheral nerve function results in a receding stocking pattern. | Stocking, explain | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C14447 | Muscle strength abnormality assessment indicator | MuscStrAbnrmlyAssmtInd | Whether the muscle strength assessment found any abnormalities | Whether the muscle strength assessment found any abnormalities | Abnormality present? | Yes;No;Not assessed;Unknown | Yes;No;Not assessed;Unknown | Alphanumeric |
Choose one for each anatomic site |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C18941 | Tremor other text | TremOTH | The free-text field related to 'Tremor type' specifying other text. The type of tremor detected during the exam | The free-text field related to 'Tremor type' specifying other text. The type of tremor detected during the exam | Other, specify | Alphanumeric |
Choose only one |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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C02411 | Laterality type | LatTyp | Laterality type relative to the anatomic site of the body examined or affected | Laterality type relative to the anatomic site of the body examined or affected | Laterality | Alphanumeric |
Record which of the cranial nerves are abnormal and the side. Choose only one. |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C14461 | Reflex assessment limb result | RflxQual | The results from reflex limb assessment | The results from reflex limb assessment | Assessment of Limbs | Increased with clonus;Increased without clonus;Hypoactive;Absent | Increased with clonus;Increased without clonus;Hypoactive;Absent | Alphanumeric |
Choose one for each limb |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C18507 | Muscle weakness neuropathic weakness present text | MuscWeakNeuropathWeakPresTxt | The free-text field to describe the neuropathic weakness present resultling in muscle weakness. | The free-text field to describe the neuropathic weakness present resultling in muscle weakness. | Neuropathic Weakness, describe | Alphanumeric | No references available | Adult;Pediatric | Proposed | 3.00 | 2013-07-30 14:29:49.047 | Neurological Exam | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C14437 | Motor exam global assessment type | MotorExamGloblAssmtTyp | Type of global assessment for the motor exam | Type of global assessment for the motor exam | Motor assessments | Muscle bulk;Muscle tone;Muscle strength | Muscle bulk;Muscle tone;Muscle strength | Alphanumeric |
For each global assessment type record whether an abnormality is present and if so the type of abnormality |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C18931 | Global change since prior examination other text | GlobalChangeSincPriorExamOTH | The free-text field related to 'Global change since prior examination result' specifying other text. Global assessment of the difference between the prior and follow-up examinations | The free-text field related to 'Global change since prior examination result' specifying other text. Global assessment of the difference between the prior and follow-up examinations | Other, specify | Alphanumeric |
Record change from prior exam if follow-up exam |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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C14448 | Muscle strength abnormality assessment type | MuscStrAbnrmlyAssmtTyp | The muscle strength abnormality type | The muscle strength abnormality type | If abnormal, indicate type | Abnormal - Decreased;Abnormal - Increased;Other, specify | Abnormal - Decreased;Abnormal - Increased;Other, specify | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C18942 | Cerebellar or coordination assessment abnormality present other text | CerbllCoordAssmtAbnrmlyPrsOTH | The free-text field related to 'Cerebellar or coordination assessment abnormality present status' specifying other text. Whether the cerebellar/coordination assessment found abnormalities | The free-text field related to 'Cerebellar or coordination assessment abnormality present status' specifying other text. Whether the cerebellar/coordination assessment found abnormalities | Other, specify | Alphanumeric |
Choose one for each assessment type. Cannot Assess means the examiner does not know if the patient is normal or not; i.e. an uncooperative patient. |
No references available | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Neurological Exam | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||
C06005 | Data collected date and time | DataCollDateTime | Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. | Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. | Date form completed | 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.). |
EPILEPSY: Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia. 2010 Apr;51(4):676-85. http://www.ilae-epilepsy.org/Visitors/Centre/ctf/ctfoverview.cfm | Adult;Pediatric | Proposed | 3.00 | 2013-07-24 21:00:23.88 | Neurological Exam | Additional Proposed Instruments | Other |
Free-Form Entry |
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C14462 | Reflex plantar right response result | RflxPlntrRtRespnsReslt | The results from reflex plantar response on the right side | The results from reflex plantar response on the right side | Plantar Response Right | Flexor;Extensor;Equivocal;Cannot Assess;Other, specify | Flexor;Extensor;Equivocal;Cannot Assess;Other, specify | Alphanumeric |
Choose all that apply. If other, explain. |
No references available | Adult;Pediatric | Proposed | 1.00 | 2012-10-05 00:00:00.0 | Neurological Exam | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
DeBaun Forms |