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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: Friedreich's Ataxia
Sub-Domain: Activities of Daily Living/Performance
CRF: Activities of Daily Living and Gait
Item count: 35 (35 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
C10692
Speech level status
SpeechLvlStatus
Status that reflects the participant's/subject's current level of speech ability
Indicate the description that reflects the participant’s/ subject’s current level of speech.
Normal;Mildly affected, no difficulty being understood;Moderately affected, sometimes asked to repeat statements;Severely affected, frequently asked to repeat statements;Unintelligible most of the time;
Normal;Mildly affected, no difficulty being understood;Moderately affected, sometimes asked to repeat statements;Severely affected, frequently asked to repeat statements;Unintelligible most of the time;
Alphanumeric
Choose only one.
No references available.
Adult;Pediatric
Supplemental–Highly Recommended
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Speech level status
 
Single Pre-Defined Value Selected
       
C10693
Swallowing level status
SwallowingLvlStatus
Status that reflects the participant's/subject's current level of swallowing ability
Indicate the description that reflects the participant’s/ subject’s current level of swallowing.
Normal;Rare choking;Frequent choking;Requires modified food or chokes multiple times a week or avoids certain foods;Requires NG tube or gastrostomy feedings;
Normal;Rare choking (less than once a month);Frequent choking (less than once a week, greater than once a month);Requires modified food or chokes multiple times a week or avoids certain foods;Requires NG tube or gastrostomy feedings;
Alphanumeric
Choose only one.
No references available.
Adult;Pediatric
Supplemental–Highly Recommended
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Swallowing level status
 
Single Pre-Defined Value Selected
       
C10694
Cutting food or use of items functioning level status
CutUseFunctionLvlStatus
Status that reflects the participant's/subject's current level of functioning for cutting food or use of items
Indicate the description that reflects the participant's/ subject's current level of functioning for cutting food/use of items.
Normal;Somewhat slow and clumsy, but no help needed;Clumsy and slow, but can cut most foods with some help needed or needs assistance when in a hurry;Food must still be cut by someone, but can still feed self slowly;Needs to be fed;
Normal;Somewhat slow and clumsy, but no help needed;Clumsy and slow, but can cut most foods with some help needed or needs assistance when in a hurry;Food must still be cut by someone, but can still feed self slowly;Needs to be fed;
Alphanumeric
Choose only one.
No references available.
Adult;Pediatric
Supplemental–Highly Recommended
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Cutting food or use of items functioning level status
 
Single Pre-Defined Value Selected
       
C10695
Dressing level status
DressingLvlStatus
Status that reflects the participant's/subject's current level of dressing ability
Indicate the description that reflects the participant's/subject's current level of dressing.
Normal;Somewhat slow, but no help needed;Occasional assistance with buttoning, getting arms in sleeves, etc. or has to modify activity in some way;Considerable help required but can do some things alone;Helpless;
Normal;Somewhat slow, but no help needed;Occasional assistance with buttoning, getting arms in sleeves, etc. or has to modify activity in some way (e.g. having to sit to get dressed, use Velcro for shoes, stop wearing ties, etc.);Considerable help required but can do some things alone;Helpless;
Alphanumeric
Choose only one.
No references available.
Adult;Pediatric
Supplemental–Highly Recommended
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Dressing level status
 
Single Pre-Defined Value Selected
       
C10696
Personal hygiene level status
PrsnalHygieneLvlStatus
Status that reflects the participant's/subject's current level of personal hygiene
Indicate the description that reflects the participant's/subject's current level of personal hygiene.
Normal;Somewhat slow, but no help needed;Very slow hygiene care or has need for devices such as special grab bars, tub bench, shower chair, etc.;Requires personal help with washing, brushing teeth, combing hair or using toilet;Fully dependent;
Normal;Somewhat slow, but no help needed;Very slow hygiene care or has need for devices such as special grab bars, tub bench, shower chair, etc.;Requires personal help with washing, brushing teeth, combing hair or using toilet;Fully dependent (bed-bound);
Alphanumeric
Choose only one.
No references available.
Adult;Pediatric
Supplemental–Highly Recommended
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Personal hygiene level status
 
Single Pre-Defined Value Selected
       
C10697
Fall rate
FallRate
Rate that reflects the participant's/subject's current frequency of falling
Indicate the description that reflects the participant's/subject's current rate of falls.
Normal;Rare falling;Occasional falls;Falls multiple times a week or requires device to prevent falls;Unable to stand;
Normal;Rare falling (less than once a month);Occasional falls (once a week to once a month);Falls multiple times a week or requires device to prevent falls;Unable to stand;
Alphanumeric
Choose only one.
No references available.
Adult;Pediatric
Supplemental–Highly Recommended
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Fall rate
 
Single Pre-Defined Value Selected
       
C10698
Walking ability status
WalkingAbilityStatus
Status that reflects the participant's/subject's current ability to walk
Indicate the description that reflects the participant's/subject's current ability to walk.
Normal;Mild difficulty, perception of imbalance;Moderate difficulty, but requires little or no assistance;Severe disturbance of walking, requires assistance or walking aids;Cannot walk at all even with assistance;
Normal;Mild difficulty, perception of imbalance;Moderate difficulty, but requires little or no assistance;Severe disturbance of walking, requires assistance or walking aids;Cannot walk at all even with assistance (wheelchair bound);
Alphanumeric
Choose only one.
No references available.
Adult;Pediatric
Core
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking ability status
 
Single Pre-Defined Value Selected
       
C10699
Sitting ability status
SittingAbilityStatus
Status that reflects the participant's/subject's current ability to sit
Indicate the description that reflects the participant's/subject's current ability to sit.
Normal;Slight imbalance of the trunk, but needs no back support;Unable to sit without back support;Can sit only with extensive support;Unable to sit;
Normal;Slight imbalance of the trunk, but needs no back support;Unable to sit without back support;Can sit only with extensive support (geriatric chair, posy, etc.);Unable to sit;
Alphanumeric
Choose only one.
No references available.
Adult;Pediatric
Supplemental–Highly Recommended
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Siting ability status
 
Single Pre-Defined Value Selected
       
C10700
Bladder control status
BladderControlStatus
Status that reflects the participant's/subject's current level of bladder control
Indicate the description that reflects the participant's/subject's current level of bladder control.
Normal;Mild urinary hesitance, urgency or retention;Moderate hesitance, urgency, rate retention/incontinence;Frequent urinary incontinence;Loss of bladder function requiring intermittent catheterization/indwelling catheter;
Normal;Mild urinary hesitance, urgency or retention (less than once a month);Moderate hesitance, urgency, rate retention/incontinence (greater than once a month, but less than once a week);Frequent urinary incontinence (greater than once a week);Loss of bladder function requiring intermittent catheterization/indwelling catheter;
Alphanumeric
Choose only one.
No references available.
Adult;Pediatric
Supplemental–Highly Recommended
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Bladder control status
 
Single Pre-Defined Value Selected
       
C10701
Walking difficulty level status
WalkingDifficultyLvlStatus
Status that reflects the participant's/subject's current level of walking difficulty
Indicate the description that reflects the participant's/subject's current level of difficulty walking.
Without any difficulty;With some difficulties walking or getting around;With difficulty, difficulty walking interfered with activities of daily living;Participant unable to walk on their own;
Without any difficulty;With some difficulties walking or getting around;With difficulty, difficulty walking interfered with activities of daily living;Participant unable to walk on their own;
Alphanumeric
If answer is "Without any difficulty" stop here and do not complete the rest of the form. If answer is "With some difficulties walking or getting around" or "With difficulty, difficulty walking interfered with activities of daily living" skip to "Walking difficulty age started value" question.
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking difficulty level status
 
Single Pre-Defined Value Selected
       
C10702
Walking own unable reason
WalkingOwnUnableRsn
Reason why the participant/subject is unable to walk on his/her own
If participant/subject is unable to walk on their own, indicate reason why.
  
Alphanumeric
After answering this question skip to "Wheelchair bound age value", “if participant is permanently bound to the wheelchair, indicate age of participant when first permanently bound to wheelchair.”
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking unable on own reason
255
Free-Form Entry
       
C10703
Walking difficulty age started value
WalkingDifficultyStrtAgeVal
Age when participant/subject first noticed problems with walking
If participant/subject walks with some difficulties or with difficulty, indicate age when participant first noticed problems with walking.
  
Numeric Values
Answer should be recorded in years.
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking difficulty age started value
 
Free-Form Entry
       
C10704
Walking difficulty age others noticed value
WalkDfficltyAgeOthersNoticeVal
Age when other people first noticed the participant's/subject's gait disturbances
If participant/subject walks with some difficulties or with difficulty, indicate age when other people noticed gait disturbances.
  
Numeric Values
Answer should be recorded in years.
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking difficulty age others noticed value
 
Free-Form Entry
       
C10705
Walking difficulty age interfered with activities value
WalkDffcltyAgeIntrfereActivVal
Age of participant/subject when difficulty with walking interfered with activities
If participant/subject walks with difficulty, indicate age when difficulty with walking interfered with activities.
  
Numeric Values
Answer should be recorded in years.
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking difficulty age interfered with activities value
 
Free-Form Entry
       
C10706
Walking difficulty age support first needed value
WlkDffcltyAgeNdIntrmitSuprtVal
Age of participant/subject when intermittent support first needed for walking
If participant/subject needs intermittent support for walking, indicate age of participant when support first needed.
  
Numeric Values
Answer should be recorded in years.
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking difficulty age support first needed value
 
Free-Form Entry
       
C17511
Walking difficulty age need intermittent support indicator
WlkDfcltyAgeNdIntrmtSuprtInd
Indicator used when participant/subject age when needing intermittent support for walking
If participant/subject needs intermittent support for walking, indicate age of participant when support first needed.
Unknown;
Unknown;
Alphanumeric
Leave age blank is unknown and check Unknown.
No references available.
Adult;Pediatric
Supplemental
3.0
7/15/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C17512
Walking difficulty age need permanent support indicator
WlkDffcltyAgeNeedPrmSuprtInd
Indicator related to age of participant/subject needing permanent support for walking
If participant/subject needs permanent support for walking, indicate age of participant when support first needed.
Unknown;
Unknown;
Alphanumeric
Leave age blank and check Unknown.
No references available.
Adult;Pediatric
Supplemental
3.0
7/15/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C10707
Walking difficulty age permanent support started value
WlkDffcltyAgeNeedPermSuportVal
Age of participant/subject when permanent support first needed walking
If participant/subject needs permanent support for walking, indicate age of participant when support first needed.
  
Numeric Values
Answer should be recorded in years.
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking difficulty age permanent support started value
 
Free-Form Entry
       
C17517
Wheelchair bound age indicator
WheelchairBoundAgeInd
Indicator used related to age of participant/subject permanently bound to a wheelchair
If participant/subject is permanently bound to the wheelchair, indicate age of participant when first permanently bound to wheelchair.
Unknown;
Unknown;
Alphanumeric
Check Unknown if age is not known.
No references available.
Adult;Pediatric
Supplemental
3.0
7/15/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C10708
Wheelchair bound age value
WheelchairBoundAgeVal
Age of participant/subject when first permanently bound to wheelchair
If participant/subject is permanently bound to the wheelchair, indicate age of participant when first permanently bound to wheelchair.
  
Numeric Values
Answer should be recorded in years.
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Wheelchair bound age value
 
Free-Form Entry
       
C10709
Walking assistive device indicator
WalkAssistiveDeviceInd
Indicator of whether the participant/subject uses an assistive device for walking
Indicate if the participant/subject uses an assistive device.
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one. History can also be obtained from a family member, friend, or chart/ medical record. If the informant is unable to answer the question or is deemed unreliable (e.g., the participant/ subject has dementia) the history should be obtained from the medical record. Unknown includes the scenario where information is not documented in the medical record. Choose one. If answer is "No" or "Unknown" stop here and do not complete the rest of the form.
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking assistive device indicator
 
Single Pre-Defined Value Selected
       
C10710
Walking 1 cane use indicator
Walk1CaneUseInd
Indicator whether the participant/subject uses one cane for walking
Indicate if the participant/subject uses a cane.
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
If "No" or "Unknown" skip to "Walking cane or crutches pair use indicator."
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking cane use indicator
 
Single Pre-Defined Value Selected
       
C10711
Walking cane use age started value
WalkCaneUseStrtAgeVal
Age of the participant/subject when he/she began using a cane for walking
If yes to cane, indicate age participant/subject began using a cane.
  
Numeric Values
Answer should be recorded in years.
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking cane use age started value
 
Free-Form Entry
       
C10712
Walking use 2 cane crutch indicator
WalkUse2CaneCrutchInd
Indicator whether the participant/subject uses two canes or crutches for walking
Indicate if the participant/subject uses two canes/crutches.
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
If "No" or "Unknown" skip to "Walker use indicator."
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking cane or crutches pair use indicator
 
Single Pre-Defined Value Selected
       
C10713
Walking cane or crutches pair use age started value
WalkUse2CaneCrutchStrtAgeVal
Age of the participant/subject when he/she began using two canes or crutches for walking
If yes to canes/ crutches, indicate age participant/subject began using two canes/crutches.
  
Numeric Values
Answer should be recorded in years.
No references available.
Adult;Pediatric
Supplemental
4.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walking cane or crutches pair use age started value
 
Free-Form Entry
       
C10714
Walker use indicator
WalkerUseInd
Indicator whether the participant/subject uses a walker
Indicate if participant/subject uses a walker.
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
If "No" or "Unknown" skip to "Canine assistance use indicator"
No references available.
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Activities of Daily Living and Gait
Activities of Daily Living/Performance
Outcomes and End Points
Walker use indicator
 
Single Pre-Defined Value Selected
       
07-15-2019
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