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: Spinal Cord Injury
SubDisease: Spinal Cord Injury
Sub-Domain: General Health History
CRF: Prior and Concomitant Medications
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
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 patient/participant take any medications __ days before or during the study?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one. If this question is answered YES then at least one prior/concomitant medication record needs to be recorded. Do NOT record study medications taken (if study has a drug intervention) on this form. Refer to the Study Drug Dosing form to record study medications.
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
Medication prior or concomitant use indicator
 
Single Pre-Defined Value Selected
     
2220500
 
C02014
Medication prior or concomitant name
MedctnPriorConcomName
Name of the prior/concomitant agent or drug administered.
Medication Name
  
Alphanumeric
Record the verbatim name (generic or trade name) of the medication the participant/subject reports taking. See the data dictionary for additional information on coding the medication name 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
Prior and Concomitant Medications
General Health History
Participant History and Family History
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
Prior and Concomitant Medications
General Health History
Participant History and Family History
Medication prior or concomitant RXNorm code
255
Free-Form Entry
     
3162728
 
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
Prior and Concomitant Medications
General Health History
Participant History and Family History
Medication prior or concomitant indication text
4000
Free-Form Entry
     
3158920
 
C02006
Medication prior or concomitant dose
MedctnPriorConcomDose
Dose of prior/concomitant medication taken per administration.
Dose
  
Numeric Values
Record the strength and units of the medication the participant/subject is taking.
No references available
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
Medication prior or concomitant dose
 
Free-Form Entry
     
3162729
 
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 of the medication the participant/subject is taking. See the data dictionary for additional information on coding the dosage unit of measure using Unified Code for Units of Measure (UCUM).
Unified Code for Units of Measure (UCUM) - http://unitsofmeasure.org/
Adult;Pediatric
Supplemental
2.0
3/13/2018
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
 
4000
Free-Form Entry
     
3162730
 
C02022
Medication prior or concomitant dose unit of measure
MedctnPriorConcomDoseUo
Dosage unit of measure of the prior or concomitant medication administered.
Dose
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 of the medication the participant/subject is taking. See the data dictionary for additional information on coding the dosage unit of measure 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
Prior and Concomitant Medications
General Health History
Participant History and Family History
Medication prior or concomitant dose unit of measure
 
Single Pre-Defined Value Selected
     
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).
Dose Units
  
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
Prior and Concomitant Medications
General Health History
Participant History and Family History
Medication prior or concomitant dose unit of measure UCUM code
255
Free-Form Entry
       
C02011
Medication prior or concomitant dose frequency
MedctnPriorConcmtntDoseFreq
Frequency of use of a prior/concomitant medication.
Frequency
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
Record how often the medication is being taken. See the data dictionary for additional information on coding the frequency using CDISC SDTM Frequency Terminology.
CDISC SDTM Frequency Terminology (Code C71113) - http://evs.nci.nih.gov/ftp1/CDISC/SDTM/
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
Medication prior or concomitant dose frequency
 
Single Pre-Defined Value Selected
     
3162733
 
C02015
Medication prior or concomitant route type
MedctnPriorConcomRteTy
Type of access route for the administration of the prior/concomitant medication.
Route
Buccal;Inhaled;Intramuscular;Intravenous;Nasal;Oral;Rectal;By ear;Topical;Subcutaneous;Sublingual;Transdermal;Unknown;Other, specify;
Buccal;Inhaled;Intramuscular;Intravenous;Nasal;Oral;Rectal;By Ear;Topical;Subcutaneous;Sublingual;Transdermal;Unknown;Other, specify;
Alphanumeric
Record the route of administration. Acceptable responses for Route are shown below the medication table.
No references available
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
Medication prior or concomitant route type
 
Single Pre-Defined Value Selected
     
3162743
 
C18737
Medication prior or concomitant route other text
MedctnPriorConcomRteOTH
The free-text field related to 'Medication prior or concomitant route type' specifying other text. Type of access route for the administration of the prior/concomitant medication.
Other, specify
  
Alphanumeric
Record the route of administration. Acceptable responses for Route are shown below the medication table.
No references available
Adult;Pediatric
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
 
4000
Free-Form Entry
     
3162743
 
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 if applicable to the study) 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. Studies that need to collect Start Time will need to add fields for time to the form template.
No references available
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
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 if applicable to the study) 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. End Date should be recorded if Continuing Medication is answered NO. Conversely, End Date should remain blank if Continuing Medication is answered YES. Studies that need to collect End Time will need to add fields for time to the form template.
No references available
Adult;Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
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.
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
Prior and Concomitant Medications
General Health History
Participant History and Family History
Medication prior or concomitant ongoing indicator
 
Single Pre-Defined Value Selected
     
2321822
 
C19180
Steroid administration type
SteroidAdministrationTyp
Type of steroids (methylprednisone/corticosteroids) administered at any point during stay
Any steroids administered
NASCIS II (Methylprednisolone or Solumedrol run as an infusion x 23 or 24 hrs);NASCIS III (Methylprednisolone or solumedrol run as an infusion x 47 or 48 hrs);None;Other, specify;Unknown;
NASCIS II (Methylprednisolone or Solumedrol run as an infusion x 23 or 24 hrs);NASCIS III (Methylprednisolone or solumedrol run as an infusion x 47 or 48 hrs);None;Other, specify;Unknown;
Alphanumeric
Methylprednisone/Corticosteroids:
No references available
Adult;Pediatric
Exploratory
1.0
6/2/2014
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C19181
Steroid administration other text
SteroidAdministrationOTH
The free-text field related to 'Steroid administration type' specifying other text. Type of steroids (methylprednisone/corticosteroids) administered at any point during stay
Other, specify
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Exploratory
1.0
6/2/2014
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C19182
Steroid administration date
SteroidAdministrationDate
Date at which steroids (methylprednisone/corticosteroids) were administered during stay
Date and time administered
  
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
Exploratory
1.0
6/2/2014
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
  
Free-Form Entry
       
C19183
Vasopressor use indicator
VasopressorUseInd
Indicator for use of vasopressor
Any vasopressor use
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Exploratory
1.0
6/2/2014
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C22779
Vasopressor use date
VasopressUseDate
Date (and time, if applicable) when the vasopressor was administered.
Date and time administered
  
Date or Date & Time
No instructions available
No references available
Adult;Pediatric
Exploratory
1.0
10/25/2016
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
  
Free-Form Entry
       
C21670
Medication history date
MedctnHistDate
Date the medication history was taken
Date medication history taken
  
Date or Date & Time
No instructions available
No references available
Adult;Pediatric
Exploratory
3.0
8/28/2013
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
  
Free-Form Entry
     
3162753
 
C19184
Urinary tract drug use indicator
UrinaryTractDrugUseInd
Indicator for urinary tract drugs used within the last year
Any drugs for the urinary tract within the last year
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Exploratory
1.0
6/2/2014
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C06023
Urinary tract drug type
UrinTractDrgTyp
Type of drug, systemic or intravesical, for the urinary tract used
If yes, indicate type of drugs for the urinary tract used within the last year
Bladder relaxant drugs (anticholinergics, tricyclic antidepressants, etc.);Sphincter/bladder neck relaxant drugs (alpha adrenergic blockers, etc.);Antibiotics/antiseptics;Other,specify;
Bladder relaxant drugs (anticholinergics, tricyclic antidepressants, etc.);Sphincter/bladder neck relaxant drugs (alpha adrenergic blockers, etc.);Antibiotics/antiseptics;Other, specify;
Alphanumeric
Bladder relaxant drugs, i.e. drugs causing relaxation of the detrusor, include anticholinergics, tricyclic antidepressant, etc. These drugs may also be delivered intravesically. This does not include treatment with injections into the detrusor.
Sphincter and bladder neck relaxant drugs include alpha adrenergic blockers, etc. This does not include treatment with injections into the sphincter. Antibiotics and antiseptics used for treatment respective prophylaxis of urinary tract infections are coded separately. For prevention of urinary tract infections, drugs such as methenamine are included. For other possible drugs it is recommended to write them in a text-field, from which it will be possible to retrieve more detailed data when necessary.
Biering-Sørensen F, Craggs M, Kennelly M, Schick E, Wyndaele JJ. International Lower Urinary Tract Function Basic Spinal Cord Injury Data Set. Spinal Cord 2008 May;46(5):325-30.
Adult;Pediatric
Exploratory
3.0
7/17/2013
Refer to SCI CDE Annotated Form
Prior and Concomitant Medications
General Health History
Participant History and Family History
Urinary tract drug type
 
Multiple Pre-Defined Values Selected
       
C19185
Urinary tract drug use other text
UrinaryTractDrugUseOTH
The free-text field related to 'Urinary tract drug use indicator' specifying other text. Indicator for urinary tract drugs used within the last year
Yes, other, specify
  
Alphanumeric
No instructions available
Biering-Sørensen F, Craggs M, Kennelly M, Schick E, Wyndaele JJ. International Lower Urinary Tract Function Basic Spinal Cord Injury Data Set. Spinal Cord 2008 May;46(5):325-30.
Adult;Pediatric
Exploratory
1.0
6/2/2014
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C21671
Urinary tract antibiotic antiseptic use reason
UrnTrctAntibioAntisepURsn
Reason antibiotics or antiseptics were used for the urinary tract
Antibiotics/antiseptics
For treatment of urinary tract infection;For prophylactic reasons;
For treatment of urinary tract infection;For prophylactic reasons;
Alphanumeric
No instructions available
Biering-Sørensen F, Craggs M, Kennelly M, Schick E, Wyndaele JJ. International Lower Urinary Tract Function Basic Spinal Cord Injury Data Set. Spinal Cord 2008 May;46(5):325-30.
Adult;Pediatric
Exploratory
1.0
4/27/2016
Aliases for variable name not defined
Prior and Concomitant Medications
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C06195
Constipating agent fecal incontinence drug last four week indicator
ConAgFeclInconLstFourWkInd
Indicator related to whether a constipating agent or drugs against fecal incontinence were used in the last four weeks
Constipating agents/drugs against fecal incontinence
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
(within the last four weeks)
No references available
Adult;Pediatric
Exploratory
3.0
7/17/2013
Refer to SCI CDE Annotated Form
Prior and Concomitant Medications
General Health History
Participant History and Family History
Bowel function medication or constipating agent type taken within last four weeks indicator
 
Single Pre-Defined Value Selected
       
12-16-2018
Page 1 of 2