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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C01565 | Blood pressure systolic measurement | BldPressrSystMeasr | Measurement of pressure of the participant's/subject's blood against the artery walls during systole (the contraction phase) in millimeters of mercury (mmHg) | Measurement of pressure of the participant's/subject's blood against the artery walls during systole (the contraction phase) in millimeters of mercury (mmHg) | 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 |
0 | 300 | millimeter of mercury | 2004289 | DeBaun Forms | |||||||||||||||||||||||||||||
C55780 | Imaging vessel studied text | ImagVessStudTxt | Text describing any and all of the subject's vessels that were studied. | Text describing any and all of the subject's vessels that were studied. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:30:51.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C13888 | Thrombolysis In Myocardial Infarction (TIMI) scale - individual vessel score | TIMIScaleIndVesselScore | The score related to the Thrombolysis In Myocardial Infarction (TIMI) scale individual vessel. | The score related to the Thrombolysis In Myocardial Infarction (TIMI) scale individual vessel. | 0;1;2;3;0;1;2;3;0;1;2;3 | No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches;No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches;No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches | Numeric values | 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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C13192 | Questionnaire for Verifying Stroke Free Status (QVSFS) - stroke status | QVSFSStrokeStatus | Were you ever told by a physician that you had a stroke? | Were you ever told by a physician that you had a stroke? 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 | |||||||||||||||||||||||||||||||
C19904 | Symptom disease lab data known disease other text | SymptSignDisLabDataOTH | Text of other symptoms, signs, known diseases, and lab data | Text of other symptoms, signs, known diseases, and lab data | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-09 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
DeBaun Forms | ||||||||||||||||||||||||||||||||
C14024 | Vasospasm criterion value | VasoCriterionVal | Indicates vasospasm criterion value | Indicates vasospasm criterion value | 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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C08173 | Ischemic hemorrhagic or vascular pathology indicator | IschHemVasclPathInd | Indicator of the presence of ischemic, hemorrhagic, or vascular pathology | Indicator of the presence of ischemic, hemorrhagic, or vascular pathology | Yes;No;Unknown;Not assessed | Yes;No;Unknown;Not assessed | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C56421 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Examinee visual hearing aid prescription lens used indicator | WASIIIExVisHeaAidPreLensUseInd | The indicator relating to the examine used his/her prescription lenses during testing, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The indicator relating to the examine used his/her prescription lenses 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 11:54:51.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C13921 | Imaging other carotid ultrasound result | ImgOthrCarotidUltrasoundReslt | Indicates other carotid ultrasound findings | Indicates other carotid ultrasound findings | Turbulence;Spectral broadening | Turbulence;Spectral broadening | 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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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). | 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 |
0 | 10 | DeBaun Forms | |||||||||||||||||||||||||||||||
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 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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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 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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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 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 100 | percent | |||||||||||||||||||||||||||||||
C12477 | Imaging other incidental finding type | ImgOthrIncidentalFindTyp | The type of other incidental findings found within the image studies | The type of other incidental findings found within the image studies | PVL;Other white matter intensities;Venous malformations;Vascular malformations;Other, specify | PVL;Other white matter intensities;Venous malformations;Vascular malformations;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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C18720 | Imaging visual analysis location performed other text | ImgVisAnlysisLocPerfOTH | The free-text field related to 'Imaging visual analysis location performed type' specifying other text. Location where visual analysis of the imaging data are performed | The free-text field related to 'Imaging visual analysis location performed type' specifying other text. Location where visual analysis of the imaging data are performed | 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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C13953 | Consensus on Grading Intracranial Flow Obstruction (COGIF) - follow-up indicator | COGIFFollowupInd | Indicates the consensus on grading intracranial flow obstruction (COGIF) follow-up | Indicates the consensus on grading intracranial flow obstruction (COGIF) follow-up | 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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C18891 | Imaging vessel angiography collateral status anatomic other text | ImgVessAngioCollatStatAntOTH | The free-text field related to 'Imaging vessel angiography collateral status anatomic site' specifying other text. Indicates vessel angiography collateral status location | The free-text field related to 'Imaging vessel angiography collateral status anatomic site' specifying other text. Indicates vessel angiography collateral status location | 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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C14002 | Extracranial stenosis collateral artery anatomic site | ExtracranStenCollArtAntmicSite | The site of parallel arteries having extracranial stenosis. | The site of parallel arteries having extracranial stenosis. | OA;ACA;VA | Ophthalmic artery;Anterior cerebral artery;Vertebral artery | 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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C02203 | Off study reason | OffStdyRsn | Primary reason participant/ subject is no longer participating in study (i.e., is not being followed and will not receive intervention/treatment). | Primary reason participant/ subject is no longer participating in study (i.e., is not being followed and will not receive intervention/treatment). | Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died;Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died | Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died;Completed study;Refused further participation (or withdrew consent);Lost to follow-up (or cannot be located);Died | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
2979313 | DeBaun Forms | ||||||||||||||||||||||||||||||
C56390 | Conners Continuous Performance Test 3rd Edition (CPT3) - Impulsivity perseveration count | ConnersCPT3ImpPersCt | The number of random or anticipatory responses, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The number of random or anticipatory responses, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:39:31.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | |||||||||||||||||||||||||||||||||
C13900 | Imaging probe frequency | ImgProbeFreq | Indicates imaging probe frequency (Hz) | Indicates imaging probe frequency (Hz) | 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 |
Hertz | |||||||||||||||||||||||||||||||||
C13236 | National Institutes of Health Stroke Scale (NIHSS) - Visual field score | NIHSSLvlConscVisuFldScore | Visual fields assessed using the NIH Stroke Scale (NIHSS) | Visual fields assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;3;UN;0;1;2;3;UN | No visual loss;Partial hemianopia;Complete hemianopia;Bilateral hemianopia (blind including cortical blindness);Unexaminable (intubated/paralyzed);No visual loss;Partial hemianopia;Complete hemianopia;Bilateral hemianopia (blind including cortical blindness);Unexaminable (intubated/paralyzed) | 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 | |||||||||||||||||||||||||||||||
C21487 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest trial score | WAISIVDSFTrlScore | Score for the digit span forward subtest, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | Score for the digit span forward subtest, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest | 0;1;0;1;0;1 | 0;1;0;1;0;1 | Numeric Values | Adult;Pediatric | Supplemental | 2.00 | 2018-07-30 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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C14035 | VMR response result | VMRResponseReslt | Indicates vasomotor response (VMR) response result | Indicates vasomotor response (VMR) response result | Abnormal;Normal;Abnormal;Normal | Abnormal;Normal;Abnormal;Normal | 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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C10567 | Imaging radio frequency coil type | ImgRFCoilTyp | Type of radio frequency (RF) coil(s) used for the body part scanned | Type of RF coil(s) used for the body part scanned | Head coil;Neck coil;Spine array;Body coil (transmit);Double-cone;Circular;Figure 8;Other, specify | Head coil;Neck coil;Spine array;Body coil (transmit);Double-cone;Circular;Figure 8;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 4000 |
Multiple Pre-Defined Values Selected |
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C56433 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Perceptual Reasoning confidence interval upper bound value | WASIIIPercRsngConfIntrvlUppVal | The upper bound of the subject's Perceptual Reasoning confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The upper bound of the subject's Perceptual Reasoning 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 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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C13932 | Intima media thickness (IMT) mean near-wall measurement | IMTMeanNearWallMeasr | Indicates mean intima media thickness (IMT) near-wall measurement (mm) | Indicates mean intima media thickness (IMT) near-wall 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 | |||||||||||||||||||||||||||||||||
C00023 | Hand preference type | HandPrefTyp | Hand which the participant/subject uses predominantly, not necessarily the hand he/she writes with exclusively. | Hand which the participant/subject uses predominantly, not necessarily the hand he/she writes with exclusively. | Left hand;Right hand;Both hands;Unknown;Forced right | Left hand;Right hand;Both hands;Unknown;Forced right | 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 |
2180147 | DeBaun Forms | ||||||||||||||||||||||||||||||
C54610 | Brief Test of Executive Function Second Edition (BRIEF 2) - Task completion total raw scale score | BRIEF2TskCmpltnTtlRwSclScore | Total score of the raw scale for the task completion function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the task completion 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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C16188 | Vaccine received indicator | VaccRcvdInd | Indicates whether participant/subject received the vaccine | Indicates whether participant/subject received the vaccine | Yes;No;Unknown;Not Asked | Yes;No;Unknown;Not Asked | 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 | |||||||||||||||||||||||||||||||
C12488 | Imaging subcortical cyst indicator | ImgSubCorticalCystInd | Indicator of whether subcortical cysts are found in the image studies | Indicator of whether subcortical cysts are found in 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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C12499 | Imaging T2 weighted white matter abnormality site type | ImgT2WWMAbnrmlySiteTyp | The type of anatomical site of the white matter abnormality on T2 weighted images | The type of anatomical site of the white matter abnormality on T2 weighted images | Frontal;Parietal;Temporal;Cerebellar WM;Deep WM;Diffuse;Occipital;Periventricular | Frontal;Parietal;Temporal;Cerebellar WM;Deep WM;Diffuse;Occipital;Periventricular | 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 |
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C19166 | Special care unit admittance indicator | SCUAddmittanceInd | Indicator for the admittance of participant to special care unit, including any Intensive Care or Step-Down Unit | Indicator for the admittance of participant to special care unit, including any Intensive Care or Step-Down Unit | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2014-05-29 13:03:57.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C14013 | Intracranial stenosis mean velocity criterion value | IntracranStenoMnVlctyCriterVal | Indicates intracranial stenosis mean velocity criterion | Indicates intracranial stenosis mean velocity criterion | 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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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 or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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C56410 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Block Design T score | WASIIIBDTScore | The T score converted from the raw score that the subject received on the Block Design 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 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 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
20 | 80 | ||||||||||||||||||||||||||||||||
C13911 | Imaging plaque texture text | ImgPlaqTextureTxt | Indicates plaque texture | Indicates plaque texture | 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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C13247 | National Institutes of Health Stroke Scale (NIHSS) Supplemental - Limb ataxia status | NIHSSSupLimbAtaxiaStatus | The indicator to determine if ataxia is present in the limbs | The indicator to determine if ataxia is present in the limbs | 0;1;2;UN | Absent;Present in one limb;Present in two limbs;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 |
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C21498 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest total raw score | WAISIVDSBTtlScore | Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Total raw score, 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 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 16 | ||||||||||||||||||||||||||||||||
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 | Flexor;Extensor;Equivocal;Cannot Assess;Other, specify | Flexor;Extensor;Equivocal;Cannot Assess;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2012-10-05 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
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 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Multiple Pre-Defined Values Selected |
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C18611 | Imaging field of view axis 2 measurement | ImgFieldViewAxis2Measr | Axis 2 of the image that is visible through the camera at a particular position in orientation and space in millimeters | Axis 2 of the image that is visible through the camera at a particular position in orientation and space in millimeters | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2013-09-12 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
millimeter | |||||||||||||||||||||||||||||||||
C13943 | Imaging B-mode result | ImgBModReslt | Indicates B mode | Indicates B mode | Normal;Occlusion;Stenosis | Normal;Occlusion;Stenosis | 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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C01052 | Loss of consciousness indicator | LOCInd | The indicator for whether the participant/subject experienced any period of loss of consciousness (LOC). | The indicator for whether the participant/subject experienced any period of loss of consciousness (LOC). | Yes;No;Suspected;Unknown | Yes;No;Suspected;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
DeBaun Forms | |||||||||||||||||||||||||||||||
C54693 | PROMIS - Global Health carry out physical activity scale | PROMISGlbHlthCrryOutPHysActScl | Scale related to an individual's rating of his/her ability to carry out everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her ability to carry out everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair, 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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C17524 | Friedreich's Ataxia Rating Scale (FARS) - neurological exam peripheral deep tendon reflex ankle jerk right score | FARSPNSNeuExDTenRAnkJRtScore | Score for right-side ankle jerk in the peripheral nervous system section of the neurological exam, as part of the Friedreich's Ataxia Rating Scale (FARS). | Score for right-side ankle jerk in the peripheral nervous system section of the neurological exam, as part of the Friedreich's Ataxia Rating Scale (FARS). | 0;1;2;3;4;0;1;2;3;4;0;1;2;3;4 | 0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia;0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia;0 - absent;1 - hyporeflexia;2 - normal;3 - hyperreflexia;4 - pathologic hyperreflexia | Numeric Values | 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 |
DeBaun Forms | |||||||||||||||||||||||||||||||
C01701 | Lab specimen collection date and time | LabSpecmnCollDateTime | Date (and time if applicable and known) when the specimen was collected | Date (and time if applicable and known) when the specimen was collected | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
2004004 | DeBaun Forms | LB | LBDTC |
Specimen Collection Date |
Collection Date |
What was the date of the lab specimen collection? |
LBDTC | Char | Record the date when specimen collection was done using this format (DD-MON-YYYY). | Prompt | |||||||||||||||||||||||
C55781 | Imaging statistical test significance level outline text | ImagStatTestSigLevOutTxt | Text outlining the statistical test(s) and significance levels for comparison between the test and control groups of the imaging study. | Text outlining the statistical test(s) and significance levels for comparison between the test and control groups of the imaging study. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:39:11.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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C13889 | Thrombolysis In Myocardial Infarction (TIMI) scale - global score | TIMIScaleGlobalScore | Indicates TIMI perfusion scale global score | Indicates TIMI perfusion scale global score | 0;1;2;3;0;1;2;3;0;1;2;3 | No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches;No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches;No perfusion;Perfusion past the initial occlusion, but no distal branch filling;Perfusion with incomplete or slow distal branch filling;Full perfusion with filling of all distal branches | Numeric values | 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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C13194 | Questionnaire for Verifying Stroke Free Status (QVSFS) - painless weakness status | QVSFSPainlsWeaknsStatus | Have you ever had sudden painless weakness on one side of your body? | Have you ever had sudden painless weakness on one side of your body? Questionnaire for Verifying Stroke Free Status (QVSFS) | 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 |