CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Additional Proposed Instruments
CRF: Miscellaneous Sickle Cell-related CDEs

491 results.
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
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
C13883 Computer tomography (CT) angiography type CTAngioTyp The type of computer tomography angiography being performed. The type of computer tomography angiography being performed. Head;Neck;Computer Tomography Venography (CTV) Head;Neck;Computer Tomography Venography (CTV) Alphanumeric Adult;Pediatric Supplemental 4.00 2017-04-11 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Multiple Pre-Defined Values Selected

C12490 Imaging ventricle abnormal indicator ImgVentrclAbnrmlInd Indicator of whether the ventricles appear normal or abnormal in the image studies Indicator of whether the ventricles appear normal or abnormal in the image studies Abnormal;Normal;Abnormal;Normal Abnormal;Normal;Abnormal;Normal 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

C54602 Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) - Form version name BRIEF2FormVersionName Name of the version of the form, as part of the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) Name of the version of the form, as part of the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF 2) Parent form;Self form;Teacher form Parent form;Self form;Teacher form Alphanumeric Adult;Pediatric Supplemental 1.00 2017-03-20 15:13:56.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C14019 Sickle cell disease present indicator SickleCellPresInd Indicates presence of sickle cell Indicates presence of sickle cell 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

DeBaun Forms
C02212 Informed consent obtained date and time InformConsntObtnDateTime Date (and time, if applicable and known) on which the participant/subject (or the legal representative on behalf of the participant/subject) agrees to participate in a protocol, treatment, or other activity by signing an informed consent document. Date (and time, if applicable and known) on which the participant/subject (or the legal representative on behalf of the participant/subject) agrees to participate in a protocol, treatment, or other activity by signing an informed consent document. Date or Date & Time Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

2435038,656 DeBaun Forms
C18854 Imaging other incidental finding other text ImgOthrIncidentalFindOTH The free-text field related to 'Imaging other incidental finding type' specifying other text. The type of other incidental findings found within the image studies The free-text field related to 'Imaging other incidental finding type' specifying other text. The type of other incidental findings found within the image studies 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

C13916 Imaging color flow angle measurement ImgColorFlowAngleMeasr Indicates color flow angle (degrees) Indicates color flow angle (degrees) Numeric Values Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

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0 360 degree of arc
C13238 National Institutes of Health Stroke Scale (NIHSS) - Motor arm score NIHSSLvlConscMotArmScore Motor ability of the arm (both left and right) assessed using the NIH Stroke Scale (NIHSS) Motor ability of the arm (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: limb holds 90 (or 45) degrees for full 10 seconds;Drift: limb holds 90 (or 45) degrees, but drifts down before full 10 seconds, does not hit bed or other support;Some effort against gravity: limb cannot get to or maintain (if cued) 90 (or 45) degrees, drifts down to bed, but has some effort against gravity.;No effort against gravity: limb falls;No movement;Amputation or joint fusion, explain;No drift: limb holds 90 (or 45) degrees for full 10 seconds;Drift: limb holds 90 (or 45) degrees, but drifts down before full 10 seconds, does not hit bed or other support;Some effort against gravity: limb cannot get to or maintain (if cued) 90 (or 45) degrees, drifts down to bed, but has some effort against gravity.;No effort against gravity: limb falls;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
C56378 Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness detectability score ConnersCPT3InaDetectScore Ability to discriminate between targets (non-X) and non-targets (X), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Ability to discriminate between targets (non-X) and non-targets (X), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:27:57.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

C14680 Pediatric Migraine Disability Assessment (MIDAS) - headache decrease school function day count PedMIDASHeadDecSchFuncDayCt Count days functioning at less than half your ability in school in the last 3 months due to headaches, as part of migraine disability assessment (MIDAS) questionnaire-pediatric form. Count days functioning at less than half your ability in school in the last 3 months due to headaches, 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

0 92
C56394 Conners Continuous Performance Test 3rd Edition (CPT3) - Sustained attention commission block count ConnersCPT3SusAtnCommBlkCt The number of incorrect responses to non-targets by block, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). The number of incorrect responses to non-targets by block, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). Numeric Values Adult;Pediatric Supplemental 1.00 2017-06-09 15:44:12.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

0
C15565 Imaging angiography time of flight method duration ImgAngioTOFMethdDur Time of flight (TOF) method duration Time of flight (TOF) method duration 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

second
C11061 Gait assessment result GaitAssmtReslt Result of the gait assessment Result of the gait assessment Normal;Abnormal;Cannot Assess;Other, specify Normal;Abnormal;Cannot Assess;Other, specify 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
C21490 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span forward subtest total raw score WAISIVDSFTtlScore Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward subtest Total raw score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Forward 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
C13959 Microembolic signal measurement MicroembolSignalMeasr Indicates actual settings measurement for all categories (mm) Indicates actual settings measurement for all categories (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
C01520 Head circumference measurement HeadCircumfMeasr Circumferential measurement of the head at the widest point - the distance from above the eyebrows and ears and around the back of the head Circumferential measurement of the head at the widest point - the distance from above the eyebrows and ears and around the back of the head 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

0 100 centimeter 3181613
C17798 Imaging contrast agent name ImgContrastAgentName Name of imaging contrast agent used Name of imaging contrast agent used Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-22 16:57:17.79 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other 4000

Free-Form Entry

C13895 Imaging vessel angiography presumed pathogenesis type ImgVesselAngioPresmPathogenTyp Indicates vessel angiography presumed pathogenesis Indicates vessel angiography presumed pathogenesis Congenital Hypoplasia;Thrombosis;Stenosis;Congenital Hypoplasia;Thrombosis;Stenosis Congenital Hypoplasia;Thrombosis;Stenosis;Congenital Hypoplasia;Thrombosis;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

C12501 Imaging internal capsule type indicator ImgIntCpslTypInd The condition of the internal capsule. The condition of the internal capsule. 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

C54613 Brief Test of Executive Function Second Edition (BRIEF 2) - Plan organize total raw scale score BRIEF2PlnOrgnzTtlRwSclScore Total score of the raw scale for the plan/organize function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) Total score of the raw scale for the plan/organize 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

C14030 Vasospasm resistive index indicator VasospasmRestistIndexInd Indicates vasospasm resistive Index (RI) Indicates vasospasm resistive Index (RI) 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

C02496 Imaging scanner manufacturer name ImgScannerManufName Name of manufacturer of imaging scanner Imaging scanner manufacturer name Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify;Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify;Agfa;Carestream;GE;Hitachi;Hologic;Konica Minolta;Philips;Siemens;Toshiba;Other, specify 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

C18900 Intracranial stenosis collateral vessel anatomic other text IntracrnStnoColltVsslAntmicOTH The free-text field related to 'Intracranial stenosis collateral vessel anatomic site' specifying other text. Indicates intracranial stenosis collateral vessel(s) The free-text field related to 'Intracranial stenosis collateral vessel anatomic site' specifying other text. Indicates intracranial stenosis collateral 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

C13927 Intima media thickness (IMT) B Mode guided M mode indicator IMTBModeGuidedMModeInd Indicates intima media thickness (IMT) B mode guided M mode Indicates intima media thickness (IMT) B mode guided M mode 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

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). 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 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
C19500 Assessment performed date AssessmentPerformedDate The date of assessment of the examination being performed. The date of assessment of the examination being performed. Date or Date & Time Adult;Pediatric Supplemental 1.00 2014-06-18 08:10:12.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

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C13938 Imaging minimum lumen diameter measurement ImgMinLumenDiameterMeasr Indicates minimum lumen diameter measurement (mm) Indicates minimum lumen 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
C13470 Stroke Adjudication Worksheet - neuroimaging type StrokeAdjudWksNeuroimagTyp Type of neuro-imaging done for the stroke event Type of neuro-imaging done for the stroke event Single brain CT;Multiple brain CTs separated in time;MRI;DWI Single brain CT;Multiple brain CTs separated in time;MRI;DWI 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
C56413 Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Similarities T score WASIIISimTScore The T score converted from the raw score that the subject received on the Similarities 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 Similarities 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
C17494 Delay language cognitive milestone indicator DelayLangCogMilestoneInd Indicator as to whether the participant/subject has or had delayed acquisition of language or cognitive milestones, as diagnosed by a pediatrician or neurologist Indicator as to whether the participant/subject has or had delayed acquisition of language or cognitive milestones, as diagnosed by a pediatrician or neurologist 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

DeBaun Forms
C12480 Imaging cortex-pachygyria thickness measurement ImgCortexPachygyriaThickMeasr The measurement of cortex thickness, in , of the cortex The measurement of cortex thickness, in , of the cortex 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

C21501 Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest item number WAISIVDSSItemNum Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest Item number, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest 1;2;3;4;5;6;7;8 Item 1;Item 2;Item 3;Item 4;Item 5;Item 6;Item 7;Item 8 Numeric Values Adult;Pediatric Supplemental 1.00 2015-07-22 11:32:44.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Single Pre-Defined Value Selected

C14008 Imaging window quality category ImgWindowQualityCat Indicates window quality category Indicates window quality category Temporal;Posterior;Orbital Temporal;Posterior;Orbital 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

C01705 Lab test name LabTestName Name representing the 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. Name representing the 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 LB LBTEST

Lab Test or Examination Name

Laboratory Test Name

What was the lab test name?

LBTEST; LBTESTCD Char Record the name of the Lab measurement or finding, if not preprinted on the CRF. If collected on the CRF, the sponsor may provide additional instructions to ensure the data is entered as intended. (LBTEST)

[Select appropriate values from the LBTEST codelist]

Prompt Radio
C18693 Imaging contrast agent method other text ImgContrastAgentMethodOTH The free-text field related to 'Imaging contrast agent method type' specifying other text. Indicates imaging contrast agent method of administration The free-text field related to 'Imaging contrast agent method type' specifying other text. Indicates imaging contrast agent method of administration 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

C13906 Imaging B-mode artery name ImgBModArtName Indicates B-mode artery name Indicates B-mode artery name CCA;ICA;ECA;CCA;ICA;ECA Common carotid artery;Internal carotid artery;External carotid artery;Common carotid artery;Internal carotid artery;External carotid 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

C13196 Questionnaire for Verifying Stroke Free Status (QVSFS) - painless vision loss status QVSFSPainlsVisnLossStatus Have you ever had sudden painless loss of vision in one or both eyes? Have you ever had sudden painless loss of vision in one or both eyes? 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
C55773 Imaging MRI scanner used count ImagMRIScanUsedCt The number of different MRI scanners that were used on the subject. The number of different MRI scanners that were used on the subject. Numeric Values Adult;Pediatric Supplemental 1.00 2017-05-31 12:11:13.0 Miscellaneous Sickle Cell-related CDEs Additional Proposed Instruments Other

Free-Form Entry

C14056 Imaging depth measurement ImgDepthMeasr The depth measurement (mm) of imaging. The depth measurement (mm) of imaging. 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

0 999 millimeter
C08239 Imaging echo duration ImgEchoDur Duration between the application of the 90 degree pulse and the peak of the echo signal, in milliseconds, during the spin echo and inversion recovery pulse sequences in imaging acquisition Duration between the application of the 90° pulse and the peak of the echo signal, in milliseconds, during the spin echo and inversion recovery pulse sequences 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

millisecond
491 results.
CSV