Sub-Domain: Additional Proposed Instruments
CRF: Miscellaneous Sickle Cell-related CDEs
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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C10576 | Imaging in plane resolution axis 1 measurement | ImgInPlaneRsltnAxis1Measr | Axis 1 of in-plane spatial resolution used in imaging acquisition | Axis 1 of in-plane spatial resolution used in imaging acquisition | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
millimeter | |||||||||||||||||||||||||||||||||
C15910 | Assessment date and time | AssessDateTime | The date of participant's injury | The date of participant's injury | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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C56423 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid other used indicator | WASIIIExVisHearAidOthrUsedInd | The indicator relating to whether the examinee used his/her other visual or hearing aid during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The indicator relating to whether the examinee used his/her other visual or hearing aid during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Used;Not used | Used;Not used | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:58:34.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C00313 | Medical history condition SNOMED CT code | MedclHistCondSNOMEDCTCode | Systematized Nomenclature Of Medicine Clinical Terms (SNOMED CT) code for medical condition/disease reported by the participant/subject | Systematized Nomenclature Of Medicine Clinical Terms (SNOMED CT) code for medical condition/disease reported by the participant/subject | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
C13961 | Microembolic signals present indicator | MicroembolSignalPresentInd | Indicates presence of microembolic signals | Indicates presence of microembolic signals | 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 | Other |
Single Pre-Defined Value Selected |
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C52699 | Sickle cell anemia blood transfusion treatment indicator | SickleCellAnemBloodTransfInd | The indicator related to whether blood transfusions are used for treatment for sickle cell anemia | The indicator related to whether blood transfusions are used for treatment for sickle cell anemia | 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 | Other |
Single Pre-Defined Value Selected |
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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 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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C13897 | Imaging vessel angiography collateral status anatomic site | ImgVessAngioCollatStatAntSite | Indicates vessel angiography collateral status location | Indicates vessel angiography collateral status location | ECA/OA-ICA;ECA/Other-ICA;AComA-A1-MCA;AComA-A2-MCA pial;PComA-ICA;PCA-ACA pial;PCA-MCA pial;ICA to MCA/ACA Moyamoya;Other, specify;ECA/OA-ICA;ECA/Other-ICA;AComA-A1-MCA;AComA-A2-MCA pial;PComA-ICA;PCA-ACA pial;PCA-MCA pial;ICA to MCA/ACA Moyamoya;Other, specify | External carotid artery/OA-Internal Carotid Artery;External carotid artery/Other-Internal Carotid Artery;AComA-A1-Middle cerebral artery;AComA-A2-Middle cerebral artery pial;PComA-Internal Carotid Artery;PCA-Anterior cerebral artery pial;PCA-Middle cerebral artery pial;ICA to Middle cerebral artery/Anterior cerebral artery Moyamoya;Other, specify;External carotid artery/OA-Internal Carotid Artery;External carotid artery/Other-Internal Carotid Artery;AComA-A1-Middle cerebral artery;AComA-A2-Middle cerebral artery pial;PComA-Internal Carotid Artery;PCA-Anterior cerebral artery pial;PCA-Middle cerebral artery pial;ICA to Middle cerebral artery/Anterior cerebral artery Moyamoya;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C18813 | Imaging lesion found other text | ImgLesnFoundOTH | The free-text field related to 'Imaging lesion found type' specifying other text. Type of lesions found within the imaging study | The free-text field related to 'Imaging lesion found type' specifying other text. Type of lesions found within the imaging study | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
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C02301 | Adverse event end date and time | AdverseEvntEndDateTime | Date (and time, if applicable and known) on which the adverse event discontinued/stopped | Date (and time, if applicable and known) on which the adverse event discontinued/stopped | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
2189843 | DeBaun Forms | ||||||||||||||||||||||||||||||||
C14032 | Vasospasm severity grade | VasospasmSeverGrade | Indicates severity of vasospasm | Indicates severity of vasospasm | Mild;Moderate;Severe | Mild;Moderate;Severe | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C55782 | Imaging scanner software hardware update text | ImagScanSoftHardUpdateTxt | Text describing any scanner software or hardware updates during the time the study was performed. | Text describing any scanner software or hardware updates during the time the study was performed. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:43:09.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C13239 | National Institutes of Health Stroke Scale (NIHSS) - Motor leg score | NIHSSLvlConscMotLegScore | Motor ability of the leg (both left and right) assessed using the NIH Stroke Scale (NIHSS) | Motor ability of the leg (both left and right) assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;3;4;UN;0;1;2;3;4;UN | No drift: leg holds 30 degrees position for full 5 seconds.;Drift: leg falls by the end of the 5 second period but does not hit bed.;Some effort against gravity: leg falls to bed by 5 seconds, but has some effort against gravity.;No effort against gravity, leg falls to bed immediately.;No movement;Amputation or joint fusion, explain;No drift: leg holds 30 degrees position for full 5 seconds.;Drift: leg falls by the end of the 5 second period but does not hit bed.;Some effort against gravity: leg falls to bed by 5 seconds, but has some effort against gravity.;No effort against gravity, leg falls to bed immediately.;No movement;Amputation or joint fusion, explain | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C13929 | Intima media thickness (IMT) edge detection algorithm indicator | IMTEdgeDetectionAlgorithmInd | Indicates intima media thickness (IMT) edge detection algorithm use | Indicates intima media thickness (IMT) edge detection algorithm use | 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 | Other |
Single Pre-Defined Value Selected |
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C20416 | National Institutes of Health Stroke Scale (NIHSS) - Motor arm amputation text | NIHSSMotArmAmpTxt | The text field for explaining the amputation or joint fusion for question related to motor ability of the arm (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 arm (both left and right) assessed using the NIH Stroke Scale (NIHSS). | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
C13940 | Imaging minimum interadventitial diameter measurement | ImgMinInteradventlDiamtMeasr | Indicates minimum interadventitial diameter measurement (mm) | Indicates minimum interadventitial diameter measurement (mm) | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
millimeter | |||||||||||||||||||||||||||||||||
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 | Other |
Free-Form Entry |
0 | 9 | ||||||||||||||||||||||||||||||||
C12261 | Biopsy and autopsy inflammatory cell type | BpApInflamCellTyp | Type of inflammatory cells identified. | Type of inflammatory cells identified. | Lymphocytes;Neutrophils;Macrophages;Eosinophils;Microorganisms | Lymphocytes;Neutrophils;Macrophages;Eosinophils;Microorganisms | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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 | Other |
Single Pre-Defined Value Selected |
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C17738 | Informant participant relationship type | InformantPartcpntRelateTyp | The relationship of the informant to participant/subject | The relationship of the informant to participant/subject | Family member, specify;Friend;Study Investigator/Study Coordinator;Other, specify:;Family member, specify;Friend;Study Investigator/Study Coordinator;Other, specify: | Family member, specify;Friend;Study Investigator/Study Coordinator;Other, specify:;Family member, specify;Friend;Study Investigator/Study Coordinator;Other, specify: | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C01521 | Heart rate | HeartRate | The participant/subject's pulse or number of contractions (heart beats) per minute | The participant/subject's pulse or number of contractions (heart beats) per minute | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 300 | beats per minute | 2767073 | 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 | Other |
Multiple Pre-Defined Values Selected |
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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 | Other |
Free-Form Entry |
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C12502 | Imaging anterior commissure type indicator | ImgAntCmsrTypInd | The condition of the anterior commissure | The condition of the anterior commissure | Involved;Spared | Involved;Spared | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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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 | Other |
Single Pre-Defined Value Selected |
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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 | Other | 4000 |
Free-Form Entry |
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C04802 | Death date and time | DeathDateTime | Date (and time, if known) of participant's/subject's death | Date (and time, if known) of participant's/subject's death | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
2004152 | DeBaun Forms | ||||||||||||||||||||||||||||||||
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 | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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 | Other |
Free-Form Entry |
0 | |||||||||||||||||||||||||||||||||
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). | 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 | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C13750 | Imaging study ID number | ImgStudyIDNum | Unique identification number assigned to the study or assessment session. | Unique identification number assigned to the study. | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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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 | Other |
Free-Form Entry |
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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 | Other |
Free-Form Entry |
0 | 50 | ||||||||||||||||||||||||||||||||
C12481 | Imaging cortex lissencephaly (LIS type 1) indicator | ImgCortexLISInd | Indicator of whether cortex lissencephaly is found within the image studies | Indicator of whether cortex lissencephaly is found within the image studies | 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 | Other |
Single Pre-Defined Value Selected |
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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 | Other |
Single Pre-Defined Value Selected |
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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 | Other | 4000 |
Free-Form Entry |
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C02004 | Study drug dispensed date and time | StdyDrugDispnsdDateTime | Date (and time, if applicable and known) on which a participant/subject was given or applied a therapeutic agent (drug, intervention therapy) used in a clinical trial protocol | Date (and time, if applicable and known) on which a participant/subject was given or applied a therapeutic agent (drug, intervention therapy) used in a clinical trial protocol | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
3163963 | 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 | Other | 255 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
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 | Other |
Single Pre-Defined Value Selected |
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C13197 | Questionnaire for Verifying Stroke Free Status (QVSFS) - sudden vision loss status | QVSFSSussVisnLossStatus | Have you ever suddenly lost one half of your vision? | Have you ever suddenly lost one half of your vision? Questionnaire for Verifying Stroke Free Status (QVSFS) - numbness status | 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 | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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 | Other |
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 | Other |
Single Pre-Defined Value Selected |
2003746 | DeBaun Forms | ||||||||||||||||||||||||||||||||
C08240 | Imaging flip angle measurement | ImgFlipAngleMeasr | Measurement of the angle, in degrees, over which the radio frequency changes proton spin angle | Measurement of the angle, in degrees, over which the radio frequency changes proton spin angle | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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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 | Other |
Free-Form Entry |
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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 | Other |
Free-Form Entry |
20 | 80 | ||||||||||||||||||||||||||||||||
C10609 | Hospitalization reason | HospitRsn | Reason why the participant/subject was hospitalized, excluding all surgeries | Reason why the participant/subject was hospitalized, excluding all surgeries | Pneumonia or Respiratory;Dehydration;Trauma;Fracture;Cardiomyopathy/Arrhythmia;Failure to Thrive;Other, specify;Infection other than pneumonia;Seizures;Cardiovascular | Pneumonia or Respiratory;Dehydration;Trauma;Fracture;Cardiomyopathy/Arrhythmia;Failure to Thrive;Other, specify;Infection other than pneumonia;Seizures;Cardiovascular | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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 | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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 | Other |
Free-Form Entry |
40 | 160 | ||||||||||||||||||||||||||||||||
C00321 | Medical history for body system indicator | MedclHistBodySysInd | Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body system. | Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body system. | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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 | Other |
Single Pre-Defined Value Selected |