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CDE Detailed Report
This report contains detailed information about the selected CDEs.
Note: If at least one CDE was selected from a copyright- or trademark-protected instrument/scale then all of the CDEs from that instrument/scale are included in this report.
Disease:
Sub-Domain: Therapies
CRF: GI Therapies
Item count: 30 (30 distinct CDEs)
CDE ID
CDE Name
Variable Name
Definition / Description
Question Text
Permissible Value
Description
Data Type
Instructions
References
Population
Classification (e.g., Core)
Version #
Version Date
Aliases for Variable Name
CRF Module / Guideline
© or TM
Sub-Domain
Domain
Previous Title
Size
Input Restrictions
Min Value
Max Value
Measurement Type
LOINC ID
SNOMED
caDSR ID
CDISC ID
C17883
Gastrointestinal therapy water flush status
GITherapyWaterFlushStatus
The status of whether water was used to flush the participant/subject's feeding tube, if applicable
 
N/A - no water flush;
N/A - no water flush;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
  
Single Pre-Defined Value Selected
       
C17884
Gastrointestinal therapy continuous feed start time value
GITherapContinFeedStrtTimeVal
The value for the time of day that the participant/subject's continuous feeding is normally begun
Continuous feeding start time
am;PM;
am;PM;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
  
Single Pre-Defined Value Selected
       
C17885
Gastrointestinal therapy other feed tube text
GITherapyOtherFeedTubeTxt
Text identification of unlisted tube type through which the participant/subject receives therapeutic tube feedings
3. Tube Type: Other, specify
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
 
255
Free-Form Entry
       
C12220
Gastrointestinal therapy estimate caloric intake value
GITherapyEstCaloricIntakeVal
Value of the participant/subject's caloric intake received through formula
Estimated caloric intake
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Estimated caloric intake value
 
Free-Form Entry
  
kilocalorie
    
C12221
Gastrointestinal therapy water flush dose
GITherapyWaterFlushDose
Dose, with unit of measurement, of water used to flush the participant/subject's feeding tube, if applicable
Amount of water flush
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Water flush amount value
255
Free-Form Entry
       
C12212
Gastrointestinal therapy feed duration
GITherapyFeedDur
Duration of feedings received by the participant/subject
9. Feeding Schedule: Table 1: Duration
  
Numeric Values
Record the duration in HH:MM
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Feeding duration
 
Free-Form Entry
       
C12210
Gastrointestinal therapy feed type
GITherapyFeedTyp
Type of feeding received by the participant/subject
9. Feeding Schedule: Table 1: Type of feeding
Bolus G tube;Continuous G tube;Oral liquid supplement intake;
Bolus G tube;Continuous G tube;Oral liquid supplement intake;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Feeding method type
 
Single Pre-Defined Value Selected
       
C12535
Gastrointestinal therapy feed schedule end date
GITherapFeedSchedEndDat
Date on which the feeding schedule for gastrointestinal therapy ended, if applicable
End of Feeding Schedule:
  
Date or Date & Time
Record the date in the format MM/DD/YYYY. If the date is unknown, record as 99/99/999.
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Feeding schedule end date
 
Free-Form Entry
       
C12223
Gastrointestinal therapy other oral intake estimate caloric value
GITherapOthrOrlIntkEstCalVal
Value of the subject/participant's caloric intake received through other oral intake
Estimated Calories
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Estimated calories for other oral intake value
 
Free-Form Entry
       
C12213
Gastrointestinal therapy continuous feed start time
GITherapContinFeedStrtTime
Time of day that the participant/subject's continuous feeding is normally begun
Continuous feeding start time
  
Date or Date & Time
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Feeding start time
 
Free-Form Entry
       
C12214
Gastrointestinal therapy continuous feed end time
GITherapContinFeedEndTime
Time of day that the participant/subject's continuous feeding is normally ended
Continuous feeding end time
  
Date or Date & Time
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Feeding end time
 
Free-Form Entry
       
C12224
Gastrointestinal therapy feed schedule start date
GITherapFeedSchedStrtDate
Date on which the feeding schedule for gastrointestinal therapy began
Start of Feeding Schedule:
  
Date or Date & Time
Record the date in the format MM/DD/YYYY. If the date is unknown, record as 99/99/999.
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Feeding schedule start date
 
Free-Form Entry
       
C17887
Gastrointestinal therapy continuous feed end time value
GITherapContinFeedEndTimeVal
The value for the time of day that the participant/subject's continuous feeding is normally ended
Continuous feeding end time
am;PM;
am;PM;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
  
Single Pre-Defined Value Selected
       
C12532
Gastrointestinal therapy feed tube first place date
GITherapFeedTube1stPlaceDate
Date on which the participant/subject's feeding tube was first placed
4. Date Feeding Tube First Placed:
  
Date or Date & Time
Record the date in the format MM/DD/YYYY. If the date is unknown, record as 99/99/999.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Feeding tube placed date
 
Free-Form Entry
       
C12533
Gastrointestinal therapy daily feed value
GITherapyDailyFeedVal
Number of times per day that the participant/subject receives feedings
# of Times per Day
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Feeding times per day value
 
Free-Form Entry
       
C12218
Gastrointestinal therapy formula name
GITherapyFormulaName
Name of the formula taken by the participant/subject for non-continuous feeding
Formula Name
  
Alphanumeric
Trade or Generic
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Formula name
255
Free-Form Entry
       
C12534
Gastrointestinal therapy formula grade
GITherapyFormulaGrade
Grade, in cal/oz, of formula taken by the participant/subject if receiving continuous feeding
Formula Type
  
Alphanumeric
cal/oz
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Formula type
255
Free-Form Entry
  
calories per ounce
    
C12202
Gastrointestinal therapy fundoplication indicator
GITherapyFundoplicationInd
Indicator whether the participant/subject has had fundoplication surgery
5. Fundoplication?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Fundoplication indicator
 
Single Pre-Defined Value Selected
       
C12203
Gastrointestinal therapy fundoplication date
GITherapyFundoplicationDate
Date on which the participant/subject had fundoplication surgery
5. Fundoplication? If Yes, a. Date:
  
Date or Date & Time
Only record the date if Yes is answered for Nissen fundoplication. Record the date in the format MM/DD/YYYY. If the date is unknown, record as 99/99/999.
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Fundoplication date
 
Free-Form Entry
       
C12216
Gastrointestinal therapy feed formula dose
GITherapyFeedFormulaDose
Dose, in mL, of formula that the participant/subject receives at each feeding for non-continuous feeding
Amount of Formula per Feed
  
Numeric Values
Include units - e.g., 240 ml
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Feeding amount measurement
 
Free-Form Entry
  
milliliter
    
C12222
Gastrointestinal therapy other oral intake text
GITherapyOthrOralIntakeTxt
Text of other nutriment taken orally, if any
Other Oral Intake
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Other oral intake type
255
Free-Form Entry
       
C12217
Gastrointestinal therapy continuous feed formula rate
GITherapContinFeedFormulRat
Rate, in mL/hr, at which the participant/subject receives formula if receiving continuous feeding
Rate
  
Numeric Values
mL/hr
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Feeding rate
 
Free-Form Entry
  
millimeter per hour
    
C12209
Gastrointestinal therapy feed schedule table number
GITherapyFeedScheduleTableNum
Number of the table used to describe the participant/subject's feeding schedule
9. Feeding schedule
Table 1;Table 2;
Table 1;Table 2;
Alphanumeric
Complete either Table 1 or Table 2, but not both, and questions 10 and 11 to capture data on the participant/subject's original feeding schedule and any changes to the feeding schedule over the course of the study.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Feeding schedule table number
 
Single Pre-Defined Value Selected
       
C12204
Gastrointestinal therapy fundoplication age value
GITherapyFundoplicationAgeVal
Value of the participant/subject's age at which s/he had fundoplication surgery
5. Fundoplication? If Yes, b. Age:
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Fundoplication age
 
Free-Form Entry
  
year
    
C12198
Gastrointestinal therapy received indicator
GITherapyRecieveInd
Indicator of whether the participant/subject is currently receiving any gastrointestinal (GI) therapies.
Is the participant/subject on any GI therapies?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
If this question is answered No then leave the rest of the form blank.
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
Gastrointestinal Therapies indicator
 
Single Pre-Defined Value Selected
       
C12200
Gastrointestinal therapy feed tube type
GITherapyFeedTubeTyp
Type of tube through which the participant/subject receives therapeutic tube feedings
3. Tube Type:
Nasogastric;Nasojejunal;Gastrostomy (G-tube);Gastrojejunal;Jejunal;Other, specify;
Nasogastric;Nasojejunal;Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression;Gastrojejunal;Jejunal;Other, specify;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
GI Therapies
Therapies
Treatment/Intervention Data
GI feeding tube type
 
Single Pre-Defined Value Selected
       
07-22-2019
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