CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Additional Proposed Instruments
CRF: Miscellaneous Sickle Cell-related CDEs
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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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| C54615 | Brief Test of Executive Function Second Edition (BRIEF 2) - Organize material total raw scale score | BRIEF2OrgnzMtrlTtlRwSclScore | Total score of the raw scale for the organization of materials function, as part of the Brief Test of Executive Function Second Edition (BRIEF 2) | Total score of the raw scale for the organization of materials 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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| 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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| 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 | ||||||||||||||||||||||||||||||||
| C18902 | Vasospasm vessel anatomic other text | VasospasmVesselAntmicOTH | The free-text field related to 'Vasospasm vessel anatomic site' specifying other text. Indicates vasospasm vessel(s) | The free-text field related to 'Vasospasm vessel anatomic site' specifying other text. Indicates vasospasm 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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| 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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| 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 | |||||||||||||||||||||||||||||||
| C56396 | Conners Continuous Performance Test 3rd Edition (CPT3) - Vigilance omission inter-stimulus interval change value | ConnersCPT3VigOmiISIChngVal | The number of missed targets by inter-stimulus interval (ISI), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The number of missed targets by inter-stimulus interval (ISI), as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:47:31.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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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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| 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 |
degree | |||||||||||||||||||||||||||||||||
| C21492 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span backward subtest number series text | WAISIVDSBNumTxt | Series of numbers, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Backward subtest | Series of numbers, 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 | 50 | ||||||||||||||||||||||||||||||||
| 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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| 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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| C17931 | Imaging magnetic resonance imaging performed indicator | ImgMRIPerfInd | Indicator as to whether or not Magnetic Resonance Imaging (MRI) on the brain has been performed on the participant/subject | Indicator as to whether or not Magnetic Resonance Imaging (MRI) on the brain has been performed on the participant/subject | 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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| 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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| 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 | |||||||||||||||||||||||||||||||
| C18714 | Imaging radio frequency coil channel other text | ImgRFCoilChannelOTH | The free-text field related to 'Imaging radio frequency coil channel count' specifying other text. Number of the coil channels in the radio frequency (RF) coil used for the imaging scan | The free-text field related to 'Imaging radio frequency coil channel count' specifying other text. Number of the coil channels in the radio frequency (RF) coil used for the imaging scan | 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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| 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 | |||||||||||||||||||||||||||||||||
| C12492 | Imaging brainstem abnormal indicator | ImgBrnstmAbnrmlInd | Indicator of whether the brainstem appears normal or abnormal in the image studies | Indicator of whether the brainstem appears 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 |
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| C55775 | Imaging ictal pain intensity value | ImagIctPainIntensVal | The value related to the intensity of the subject's pain if the timing is ictal | The value related to the intensity of the subject's pain if the timing is ictal | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-05-31 12:19:15.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 10 | ||||||||||||||||||||||||||||||||
| 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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| C02306 | Adverse event start date and time | AdvrsEvntStartDateTime | Date (and time, if applicable and known) on which the adverse event was first evident | Date (and time, if applicable and known) on which the adverse event was first evident | 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 |
2744993 | DeBaun Forms | ||||||||||||||||||||||||||||||||
| C19779 | Medical history asthma pulmonary assessment indicator | MedHistAsthmaPulAssesInd | Indicator of history of asthma | Indicator of history of asthma | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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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| C56440 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale IQ 2 confidence interval lower bound value | WASIIIFullSclIQ2ConfIntLowVal | The lower bound of the subject's Full Scale IQ-2 confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The lower bound of the subject's Full Scale IQ-2 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 13:06:29.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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| C13240 | National Institutes of Health Stroke Scale (NIHSS) - Limb ataxia score | NIHSSLimbAtaxiaScore | Limb ataxia assessed using the NIH Stroke Scale (NIHSS) | Limb ataxia assessed using the NIH Stroke Scale (NIHSS) | 0;1;2;UN;0;1;2;UN | Absent;Present in one limb;Present in two limbs;Amputation or joint fusion, explain;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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| C56416 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Full Scale 4 T score sum value | WASIIIFullScale4TScoreSumVal | The sum of all four of the subject's T scores, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The sum of all four of the subject's T scores, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-12 11:40:41.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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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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| 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 | |||||||||||||||||||||||||||||||
| C21503 | Wechsler Adult Intelligence Scale IV (WAIS IV) - Digit span sequencing subtest trial score | WAISIVDSSTrialScore | Trial score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | Trial score, as part of Wechsler Adult Intelligence Scale IV (WAIS IV) Digit Span Sequencing subtest | 0;1;0;1;0;1 | 0;1;0;1;0;1 | 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 |
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| 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 | |||||||||||||||||||||||||||||||
| C01522 | Height measurement | HgtMeasr | Measurement of participant's/subject's height. | Measurement of participant's/subject's height. | 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 | 400 | centimeter | 649 | DeBaun Forms | |||||||||||||||||||||||||||||
| C18857 | Imaging brainstem abnormality other text | ImgBrnstmAbnrmlyOTH | The free-text field related to 'Imaging brainstem abnormality type' specifying other text. The type of abnormality in the brainstem on the image | The free-text field related to 'Imaging brainstem abnormality type' specifying other text. The type of abnormality in the brainstem on the image | 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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| 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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| C12503 | Imaging gray matter hyperintensity T2 fluid attenuated inversion recovery indicator | ImgGryMtrHyperT2FLAIRInd | Indicator of whether there is grey matter hyperintensity on T2/FLAIR (fluid attenuated inversion recovery) images | Indicator of whether there is grey matter hyperintensity on T2/FLAIR images | 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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| C56382 | Conners Continuous Performance Test 3rd Edition (CPT3) - Inattentiveness hit reaction time value | ConnersCPT3InaHRTVal | The value representing the subject's response speed time, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | The value representing the subject's response speed time, as part of the Conners Continuous Performance Test 3rd Edition (CPT3). | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-09 15:32:03.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Free-Form Entry |
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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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| C04804 | Hospital discharge date and time | HospitDischgDateTime | Date (and time, if applicable and known) the participant/subject was discharged from the hospital | Date (and time, if applicable and known) the participant/subject was discharged from the hospital | 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 |
DeBaun Forms | |||||||||||||||||||||||||||||||||
| C21117 | Subject name | SubjectName | Name of subject/participant. | Name of subject/participant. | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-06-12 15:16:39.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other | 255 |
Free-Form Entry |
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| 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 | ||||||||||||||||||||||||||||||||
| 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). | 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 | |||||||||||||||||||||||||||||||
| C56427 | Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II) - Verbal Comprehension confidence interval lower bound value | WASIIIVerbCompConfIntrvlLowVal | The lower bound of the subject's Verbal Comprehension confidence interval, as part of the Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II). | The lower bound of the subject's Verbal Comprehension 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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| 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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| C12467 | Imaging magnetic resonance imaging performed multiple indicator | ImgMRIPerfMultiInd | Indicator as to whether or not multiple magnetic resonance imaging (MRI) sessions have been performed on the participant/subject | Indicator as to whether or not multiple magnetic resonance imaging (MRI) sessions have been performed on the participant/subject | Yes;No,single brain MRI;Unknown | Yes;No,single brain MRI;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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| C54605 | Informant participant relationship duration unit of measure | InfrmntPrtcpntRltnshpDurUOM | Field related to 'Informant participant relationship duration' specifying the unit of measure of the duration for which the informant has known the participant | Field related to 'Informant participant relationship duration' specifying the unit of measure of the duration for which the informant has known the participant | Weeks;Months;Years | Weeks;Months;Years | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-03-22 09:46:35.0 | Miscellaneous Sickle Cell-related CDEs | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
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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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| C12482 | Imaging cortex lissencephaly (LIS type 1) thickness measurement | ImgCortexLISThickMeasr | The measurement of cortex thickness, in , of the lissencephaly (LIS type 1) site | The measurement of cortex thickness, in , of the lissencephaly (LIS type 1) site | 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 |
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| C54688 | PROMIS - Global Health quality of life scale | PROMISGlbHlthQualOfLfScl | Scale related to an individual's rating of his/her quality of life, as part of the PROMIS Global Health | Scale related to an individual's rating of his/her quality of life, as part of the PROMIS Global Health | 1;2;3;4;5;1;2;3;4;5 | Poor;Fair;Good;Very Good;Excellent;Poor;Fair;Good;Very Good;Excellent | 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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| 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 | |||||||||||||||||||||||||||||||
| C02005 | Study drug returned date and time | StdyDrugRetrnDateTime | Date (and time, if applicable and known) on which the study drug was returned | Date (and time, if applicable and known) on which the study drug was returned | 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 |
3164209 | DeBaun Forms |