Sub-Domain: Additional Proposed Instruments
CRF: Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) - Child Version (Children Aged 2 Year and Older)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C13464 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - total score | PSOMSNETotalScore | The total score on the Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | The total score on the Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Total Scoring | Numeric Values |
The total score is out of 10 possible points. Supplemental - Highly Recommended based on study type, disease stage and disease type |
Pediatric Stroke Outcome Measure-Neuro Exam. Children's Stroke Program, Hospital for Sick Children, Toronto, Canada. G. deVeber, D. MacGregor, R. Curtis, T. Soman, R. Ichord et al. Version October 2003, format revised November 2005 | Pediatric | Proposed | 3.00 | 2013-06-21 00:00:00.0 | Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) - Child Version (Children Aged 2 Year and Older) | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 10 | DeBaun Forms | ||||||||||||||||||||||||||||
| 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 | Specify laterality | Alphanumeric |
Contains data elements collected when an imaging study is performed using angiography to examine the blood vessels of the body; there are separate sections to record arterial findings and venous findings. (Examples of CDEs included: Findings for each artery; TIMI scale individual vessel score; and Collateral grade) Supplemental - Highly Recommended based on study type, disease stage and disease type |
Pediatric Stroke Outcome Measure-Neuro Exam. Children's Stroke Program, Hospital for Sick Children, Toronto, Canada. G. deVeber, D. MacGregor, R. Curtis, T. Soman, R. Ichord et al. Version October 2003, format revised November 2005 | Adult;Pediatric | Proposed | 3.00 | 2013-08-28 16:08:00.453 | Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) - Child Version (Children Aged 2 Year and Older) | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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| C13456 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - sensorimotor deficit scale | PSOMSNESensDefScale | The scale for sensorimotor deficit (any motor or sensory abnormality including cranial nerve deficits, visual, and hearing deficits) based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | The scale for sensorimotor deficit (any motor or sensory abnormality including cranial nerve deficits, visual, and hearing deficits) based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Sensorimotor Deficit | 0;0.5;1;2;0;0.5;1;2;0;0.5;1;2 | None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function | Numeric values |
Answer for both right and left sides Supplemental - Highly Recommended based on study type, disease stage and disease type |
Pediatric Stroke Outcome Measure-Neuro Exam. Children's Stroke Program, Hospital for Sick Children, Toronto, Canada. G. deVeber, D. MacGregor, R. Curtis, T. Soman, R. Ichord et al. Version October 2003, format revised November 2005 | Pediatric | Proposed | 3.00 | 2013-06-21 00:00:00.0 | Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) - Child Version (Children Aged 2 Year and Older) | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | ||||||||||||||||||||||||||||
| C13457 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - sensorimotor deficit type | PSOMSNESensDefTyp | The type of sensorimotor deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | The type of sensorimotor deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Select the Sensorimotor Deficit You Observed | Global developmental delay;Global hypotonia or hypertonia;Hemiparesis;Hemifacial weakness;Dysarthria;Hemitaxia;Other motor deficit;Hemisensory deficit;Other sensory deficit;Difficulty with vision;Difficulty with drinking, chewing, or swallowing;Other describe | Global developmental delay;Global hypotonia or hypertonia;Hemiparesis;Hemifacial weakness;Dysarthria;Hemitaxia;Other motor deficit;Hemisensory deficit;Other sensory deficit;Difficulty with vision;Difficulty with drinking, chewing, or swallowing;Other describe | Alphanumeric |
Choose all that apply Supplemental - Highly Recommended based on study type, disease stage and disease type |
Pediatric Stroke Outcome Measure-Neuro Exam. Children's Stroke Program, Hospital for Sick Children, Toronto, Canada. G. deVeber, D. MacGregor, R. Curtis, T. Soman, R. Ichord et al. Version October 2003, format revised November 2005 | Pediatric | Proposed | 3.00 | 2013-06-21 00:00:00.0 | Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) - Child Version (Children Aged 2 Year and Older) | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
DeBaun Forms | ||||||||||||||||||||||||||||
| C13458 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - language deficit-production scale | PSOMSNELangDefProdScale | The scale for language deficit - production (including dysarthria) based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | The scale for language deficit - production (including dysarthria) based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Language Deficit - Production | 0;0.5;1;2;0;0.5;1;2;0;0.5;1;2 | None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function | Numeric values |
The Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) – Child Version (Children Aged 2 Years and Older) is a composite of clinical and radiographic information and a detailed neurologic examination for children 2 years and older. Supplemental - Highly Recommended based on study type, disease stage and disease type |
Pediatric Stroke Outcome Measure-Neuro Exam. Children's Stroke Program, Hospital for Sick Children, Toronto, Canada. G. deVeber, D. MacGregor, R. Curtis, T. Soman, R. Ichord et al. Version October 2003, format revised November 2005 | Pediatric | Proposed | 3.00 | 2013-06-21 00:00:00.0 | Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) - Child Version (Children Aged 2 Year and Older) | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | ||||||||||||||||||||||||||||
| 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). | Describe the Language Production Deficits You Observed Here | Alphanumeric |
The Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) – Child Version (Children Aged 2 Years and Older) is a composite of clinical and radiographic information and a detailed neurologic examination for children 2 years and older. Supplemental - Highly Recommended based on study type, disease stage and disease type |
Pediatric Stroke Outcome Measure-Neuro Exam. Children's Stroke Program, Hospital for Sick Children, Toronto, Canada. G. deVeber, D. MacGregor, R. Curtis, T. Soman, R. Ichord et al. Version October 2003, format revised November 2005 | Pediatric | Proposed | 3.00 | 2013-06-21 00:00:00.0 | Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) - Child Version (Children Aged 2 Year and Older) | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||
| C13460 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - language deficit-comprehension scale | PSOMSNELangDefCompScale | The scale for language deficit - comprehension based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | The scale for language deficit - comprehension based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Language Deficit - Comprehension | 0;0.5;1;2;0;0.5;1;2;0;0.5;1;2 | None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function | Numeric values |
The Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) – Infant Version (Infants Term Birth to Two Years) is a composite of clinical and radiographic information and a detailed neurologic examination for infants term birth to 2 years Supplemental - Highly Recommended based on study type, disease stage and disease type |
Pediatric Stroke Outcome Measure-Neuro Exam. Children's Stroke Program, Hospital for Sick Children, Toronto, Canada. G. deVeber, D. MacGregor, R. Curtis, T. Soman, R. Ichord et al. Version October 2003, format revised November 2005 | Pediatric | Proposed | 3.00 | 2013-06-21 00:00:00.0 | Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) - Child Version (Children Aged 2 Year and Older) | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | ||||||||||||||||||||||||||||
| C13461 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - language deficit-comprehension description text | PSOMSNELangDefCompDescTxt | Description of the language comprehension deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Description of the language comprehension deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Describe the Language Comprehension Deficits You Observed Here | Alphanumeric |
The Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) – Infant Version (Infants Term Birth to Two Years) is a composite of clinical and radiographic information and a detailed neurologic examination for infants term birth to 2 years Supplemental - Highly Recommended based on study type, disease stage and disease type |
Pediatric Stroke Outcome Measure-Neuro Exam. Children's Stroke Program, Hospital for Sick Children, Toronto, Canada. G. deVeber, D. MacGregor, R. Curtis, T. Soman, R. Ichord et al. Version October 2003, format revised November 2005. | Pediatric | Proposed | 3.00 | 2013-06-21 00:00:00.0 | Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) - Child Version (Children Aged 2 Year and Older) | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||
| C13462 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - cognitive or behavioral deficit scale | PSOMSNECogBehavDefScale | The scale for cognitive or behavioral deficit based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | The scale for cognitive or behavioral deficit based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Cognitive or Behavioral Deficit | 0;0.5;1;2;0;0.5;1;2;0;0.5;1;2 | None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function;None;Mild but no impact on function;Moderate with some impact on function;Severe or profound with missing function | Numeric values |
Specify whether the deficit is cognitive or behavioral. Supplemental - Highly Recommended based on study type, disease stage and disease type |
Pediatric Stroke Outcome Measure-Neuro Exam. Children's Stroke Program, Hospital for Sick Children, Toronto, Canada. G. deVeber, D. MacGregor, R. Curtis, T. Soman, R. Ichord et al. Version October 2003, format revised November 2005 | Pediatric | Proposed | 3.00 | 2013-06-21 00:00:00.0 | Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) - Child Version (Children Aged 2 Year and Older) | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | ||||||||||||||||||||||||||||
| C13463 | Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003) - cognitive or behavioral deficit description text | PSOMSNECogBehavDeficitDescTxt | Description of the cognitive or behavioral deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Description of the cognitive or behavioral deficits observed in the participant/subject based on Pediatric Stroke Outcomes Measure-Neuro Exam (PSOM-SNEVOct2003). | Describe the Cognitive or Behavioral Deficits You Observed Here | Alphanumeric |
The Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) – Infant Version (Infants Term Birth to Two Years) is a composite of clinical and radiographic information and a detailed neurologic examination for infants term birth to 2 years Supplemental - Highly Recommended based on study type, disease stage and disease type |
Pediatric Stroke Outcome Measure-Neuro Exam. Children's Stroke Program, Hospital for Sick Children, Toronto, Canada. G. deVeber, D. MacGregor, R. Curtis, T. Soman, R. Ichord et al. Version October 2003, format revised November 2005 | Pediatric | Proposed | 3.00 | 2013-06-21 00:00:00.0 | Pediatric Stroke Outcome Measure Short Neuro Exam (PSOM-SNE) - Child Version (Children Aged 2 Year and Older) | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
DeBaun Forms |
