of0
Export
 
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: Parkinson's Disease
Sub-Domain: Drugs
CRF: Non-Parkinson's Disease Medication Log
Item count: 16 (16 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
C02002
Medication prior or concomitant use indicator
MedctnPriorConcomUseInd
Indicator of whether the participant/subject reported taking any medications during the time period relevant to the study protocol
Did the subject take any medications days before or during the study?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
If YES is answered then at least one medication should be recorded.
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant use indicator
 
Single Pre-Defined Value Selected
     
2220500
 
C17402
Site name
SiteName
The name of the site for the study
Site Name
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
6/21/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Site name
255
Free-Form Entry
       
C19247
Subject ID
SubIDNam
Subject identification ID
SubjectID
  
Alphanumeric
No instructions available
No references available
Adult
Supplemental
1.0
6/5/2014
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
 
255
Free-Form Entry
       
C02014
Medication prior or concomitant name
MedctnPriorConcomName
Name of the prior/concomitant agent or drug administered.
Medication Name (Trade or generic name)
  
Alphanumeric
Record the verbatim name (generic or trade name) of the medication the participant/subject reports taking.
RXNorm (http://www.nlm.nih.gov/research/umls/rxnorm/)
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant name
4000
Free-Form Entry
     
3162728
 
C02025
Medication prior or concomitant RXNorm code
MedctnPriorConcomRxNormCode
Code for name of the prior/concomitant agent or drug administered.
Medication Name
  
Alphanumeric
Code the verbatim name (generic or trade name) of the medication using RXNorm.
RXNorm (http://www.nlm.nih.gov/research/umls/rxnorm/)
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant RXNorm code
255
Free-Form Entry
     
3162728
 
C08216
Medication prior total daily as needed dose measure
MedctnPrrTotDalyPRNDosMeasr
Total daily dose or PRN (as needed) dose of the non-Parkinson's disease (PD) medication taken by the participant/subject
Total Daily Dose or PRN Dose (with units)
  
Numeric Values
Record the total strength of the medication the participant/subject is taking or was taking on a daily basis or on an as needed basis.
RXNorm (http://www.nlm.nih.gov/research/umls/rxnorm/)
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant total daily or PRN dose
 
Free-Form Entry
     
3162729
 
C02022
Medication prior or concomitant dose unit of measure
MedctnPriorConcomDoseUo
Dosage unit of measure of the prior or concomitant medication administered.
Unit of Measure
g;mcg;mcL;mg;mL;oz;Other, specify;Unknown;NA;
gram;microgram;microliter;milligram;milliliter;ounce;Other, specify;Unknown;Not applicable;
Alphanumeric
Record the units for the dosage of medication the participant/subject is taking.
Unified Code for Units of Measure (UCUM): http://unitsofmeasure.org/
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant dose unit of measure
 
Single Pre-Defined Value Selected
     
3162730
 
C18736
Medication prior or concomitant dose unit of measure other text
MedctnPriorConcomDoseUoMOTH
The free-text field related to 'Medication prior or concomitant dose unit of measure' specifying other text. Dosage unit of measure of the prior or concomitant medication administered.
Other, specify
  
Alphanumeric
Record the units for the dosage of medication the participant/subject is taking.
Unified Code for Units of Measure (UCUM): http://unitsofmeasure.org/
Adult;Pediatric
Supplemental
2.0
3/13/2018
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
 
4000
Free-Form Entry
     
3162730
 
C02013
Medication prior or concomitant dose unit of measure UCUM code
MedctnPriorConcomDoseUOMUCUMCd
Code that represents the dosage unit of measure of the prior or concomitant medication administered. Unified Code for Units of Measure (UCUM).
   
Alphanumeric
Code the unit of measure of the medication dosage using Unified Code for Units of Measure (UCUM).
Unified Code for Units of Measure (UCUM): http://unitsofmeasure.org/
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant dose unit of measure UCUM code
255
Free-Form Entry
       
C02016
Medication prior or concomitant start date and time
MedctnPriorConcomStrtDateTime
The date (and time, if applicable and known) on which the prior/concomitant medication usage began.
Start Date
  
Date or Date & Time
Record the date (and time) the participant/subject started taking the medication. 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.) and in the format acceptable to the study database. Start Date can be used to distinguish between prior medications and concomitant medications.
ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant start date and time
 
Free-Form Entry
     
3162752
 
C02008
Medication prior or concomitant end date and time
MedctnPriorConcomEndDateTime
The date (and time, if applicable and known) the administration of the prior/concomitant medication ended.
End Date
  
Date or Date & Time
Record the date (and time) the participant/subject stopped taking the medication. 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.) and in the format acceptable to the study database. Stop Date should be recorded if Continuing Medication is answered No. Conversely, Stop Date should remain blank if Continuing Medication is answered Yes.
ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant end date and time
 
Free-Form Entry
     
3162753
 
C02003
Medication prior or concomitant ongoing indicator
MedctPrConcomOngoingInd
Indicator of or description that the prior/concomitant medication usage is ongoing.
Medication Use Ongoing?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one. Answer YES if the participant/subject is still taking the medication or NO if the participant/subject has stopped taking the medication.
No references available
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant ongoing indicator
 
Single Pre-Defined Value Selected
     
2321822
 
C08217
Medication prior taken as needed indicator
MedctnPrrTknPRNInd
Indicator of whether the medication is being taken PRN (as needed)
PRN Med?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No should be answered for chronic medications that are taken on a regular basis
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant taken PRN indicator
 
Single Pre-Defined Value Selected
       
C02011
Medication prior or concomitant dose frequency
MedctnPriorConcmtntDoseFreq
Frequency of use of a prior/concomitant medication.
If PRN, Average Frequency (with units e.g., times per month)
BID;TID;QID;q2h;q4h;q6h;q8h;QAM;QPM;QD;AD;HS;PRN;OTH;UNK;NA;
twice daily;three times a day;four times a day;every 2 hours;every 4 hours;every 6 hours;every 8 hours;one dose in morning;one dose in evening;once daily;alternating day (every other day);at bedtime;as needed;Other, specify;unknown;Not applicable;
Alphanumeric
Only answer if the medication is taken PRN.
CDISC SDTM Frequency Terminology (Code C71113) (http://www.cancer.gov/cancertopics/cancerlibrary/terminologyresources/cdisc) - http://evs.nci.nih.gov/ftp1/CDISC/SDTM/
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant dose frequency
 
Single Pre-Defined Value Selected
     
3162733
 
C02024
Medication prior or concomitant indication text
MedctnPriorConcomIndTxt
Text describing reason for administration of a prior/concomitant (nonstudy) agent or measure. This is not the pharmacologic classification of an agent (antibiotic, analgesic, etc.), but the reason for its administration to the participant/subject.
Indication
  
Alphanumeric
Record the reason the participant/subject gives for taking the medication. If given for an AE, enter exact term from Adverse Event CRF.
No references available
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
Medication prior or concomitant indication text
4000
Free-Form Entry
     
3158920
 
C18035
Medication prior name
MedctnPrrNm
Name of the prior/concomitant agent or drug administered
Medication Name
  
Alphanumeric
No instructions available
RXNorm (http://www.nlm.nih.gov/research/umls/rxnorm/)
Adult
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Non-Parkinson's Disease Medication Log
Drugs
Treatment/Intervention Data
 
255
Free-Form Entry
     
3162728
 
07-22-2019
Page 1 of 1