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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: Spinal Cord Injury
SubDisease: Spinal Cord Injury
Sub-Domain: Therapies
CRF: Falls Diary
Item count: 14 (14 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
C10628
Diary day falls status
DiaryFallsStatus
Describes whether the participant/subject experienced falls on a particular day
Falls Data Collection Grid
No Falls;Near Falls;Falls;
No Falls;Near Falls;Falls;
Alphanumeric
If a near fall or falls is checked, indicate the number.
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
Diary day falls status
 
Single Pre-Defined Value Selected
       
C21634
Diary day falls date
DiaryDayFallsDate
Date in the diary when the participant/subject recorded a fall.
Date
  
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
7/22/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
  
Free-Form Entry
       
C10629
Diary day falls experienced number
DiaryNearFallDailyCt
Number of falls the participant/subject experienced on a particular day.
Falls
  
Numeric Values
Record the number of falls on days when "Falls" is checked/chosen
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
Diary day falls experienced number
 
Free-Form Entry
       
C10630
Diary day near falls experienced number
DiaryFallDailyCt
Number of near falls the participant/subject experienced on a particular day.
Near Falls
  
Numeric Values
Record the number of near falls on days when "Near Falls" is checked/chosen
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
Diary day near falls experienced number
 
Free-Form Entry
       
C21635
Fall record date and time
FallRecDatTime
Date and time for each fall recorded in the falls diary by the participant/subject.
Date; Time of Day
am;PM;
am;PM;
Alphanumeric
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
7/22/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
  
Single Pre-Defined Value Selected
       
C21636
Fall details location text
FallDetLocTxt
Location of the fall the participant/subject experienced recorded in the Falls Diary.
Location:
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
  
Free-Form Entry
       
C19144
Activity description
ActivityDescription
Description of activity
Activity:
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/29/2014
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
 
4000
Free-Form Entry
       
C21637
Fall details footwear type
FallDetFootwrTyp
Type of footwear the participant/subject was wearing when the fall recorded in the Falls Diary occurred.
If you fell while walking, were you wearing any of the following
Only socks;Socks and shoes/sneakers;Leg braces;Other, please specify;
Only socks;Socks and shoes/sneakers;Leg braces;Other, please specify;
Alphanumeric
check all that apply
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
  
Multiple Pre-Defined Values Selected
       
C21638
Fall details footwear specify text
FallDetFootwrSpecfyTxt
The free-text field to specify the type of other footwear worn when the fall recorded in the Falls Diary occurred.
Other, please describe
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/17/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
 
255
Free-Form Entry
       
C21639
Fall details assistive device type
FallDetAssistDevTyp
Type of assistive device(s) the participant/subject was using when the fall recorded in the Falls Diary occurred.
If you fell while walking, were you using an assistive device
Cane;Walker;One crutch;Two crutches;Other, please specify;
Cane;Walker;One crutch;Two crutches;Other, please specify;
Alphanumeric
check all that apply
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
  
Multiple Pre-Defined Values Selected
       
C21640
Fall details assistive device specify text
FallDetAssisDevSpecfyTxt
The free-text field to specify the other type of assistive device used when the fall recorded in the Falls Diary occurred.
Other, please specify
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/17/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
 
255
Free-Form Entry
       
C21641
Fall details injury sustained test
FallDetInjSustTxt
Description of the injuries sustained when the fall recorded in the Falls Diary occurred.
Injuries sustained:
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
  
Free-Form Entry
       
C21642
Fall details not walking type
FallDetNotWalkTyp
Details of the participant's/subject's position if fall recorded in Falls Diary occurred when not walking.
If you fell while sitting, transferring or moving in your wheelchair, please check all statements that apply:
I fell while transferring to or from my wheelchair;I fell while transferring into the shower/bath;I fell while moving my wheelchair;When I fell, I was (check all that apply);
I fell while transferring to or from my wheelchair;I fell while transferring into the shower/bath;I fell while moving my wheelchair;When I fell, I was (check all that apply);
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
  
Multiple Pre-Defined Values Selected
       
C21643
Fall details specify type
FallDetSpecTyp
Description of what the participant/subject was doing when the fall recorded in Falls Diary occurred when not walking.
When I fell, I was
Being helped by someone else;Using equipment such as a transfer board, hoyer lift, etc.;Using other equipment;
Being helped by someone else;Using equipment such as a transfer board, hoyer lift, etc.;Using other equipment;
Alphanumeric
(check all that apply)
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Falls Diary
Therapies
Treatment/Intervention Data
  
Multiple Pre-Defined Values Selected
       
12-16-2018
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