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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: Sport Related Concussion
SubDisease: Comprehensive
Sub-Domain: Cognitive Assessment
CRF: Acute Concussion Evaluation (ACE)
Item count: 59 (59 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
C21117
Subject name
SubjectName
Name of subject/participant.
Patient Name
  
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
6/12/2015
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
 
255
Free-Form Entry
       
C00007
Birth date
BirthDate
Date (and time, if applicable and known) the participant/subject was born
DOB:
  
Date or Date & Time
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
3.0
7/25/2013
caBIG: PER_BIR_DT; SCI CDEs: BIRTHDT
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
Birth date
 
Free-Form Entry
     
793
 
C00008
Age value
AgeVal
Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject.
Age
  
Numeric Values
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Pediatric
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
Age value
 
Free-Form Entry
0
1800
month
    
C17409
Visit date
VisitDate
Date of interview or visit (actually the date when data in the form were captured)
Date:
  
Date or Date & Time
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
3.0
6/21/2013
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
Visit date
 
Free-Form Entry
       
C19247
Subject ID
SubIDNam
Subject identification ID
ID/MR#
  
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
6/5/2014
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
 
255
Free-Form Entry
       
C05400
Injury date time
InjDateTime
Date (and time, if applicable and known) of injury
Date/Time of Injury
  
Date or Date & Time
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
3.0
7/20/2013
SCI CDEs: INJURYDT
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
Injury date and time
 
Free-Form Entry
       
C54331
Acute Concussion Evaluation (ACE) - Person obtaining report type
ACEPersonObtRprtTyp
The type indicating who the report was obtained by, as part of the Acute Concussion Evaluation (ACE)
Reporter:
Patient;Parent;Spouse;Other;
Patient;Parent;Spouse;Other;
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
12/5/2016
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C54332
Person obtaining report other text
PersonObtRprtOtherText
Text specifying another means of obtaining the report
Other
  
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
12/5/2016
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
 
255
Free-Form Entry
       
C54333
Acute Concussion Evaluation (ACE) – Injury description text
ACEInjuryDescriptnTxt
Text of injury description as related to the Acute Concussion Evaluation (ACE)
Injury Description
  
Alphanumeric
Obtain description of the injury.
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
 
255
Free-Form Entry
       
C54334
Acute Concussion Evaluation (ACE) – Evidence direct blow head indicator
ACEEvidnceDirctBlowHeadInd
Indicator whether injury is due to a blow to the head as related to the Acute Concussion Evaluation (ACE).
Is there evidence of a forcible blow to the head (direct or indirect)?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C54335
Acute Concussion Evaluation (ACE) – Evidence intracranial injury skull fracture indicator
ACEEvidnceIntraCrnSkulFrctrInd
Indicator whether injury is due to an intracranial skull fracture as related to f the Acute Concussion Evaluation (ACE).
Is there eveidence of intracranial injury or skull fracture?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C54336
Acute Concussion Evaluation (ACE) – Impact location anatomic site
ACEImpactLocationAnatSite
Anatomic site of impact injury as related to the Acute Concussion Evaluation (ACE).
Location of Impact:
Frontal;Indirect Force;Left Parietal;Left Temporal;Neck;Occipital;Right Parietal;Right Temporal;
Frontal;Indirect Force;Left Parietal;Left Temporal;Neck;Occipital;Right Parietal;Right Temporal;
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Multiple Pre-Defined Values Selected
       
C54337
Acute Concussion Evaluation (ACE) – Injury cause type
ACEInjuryCauseTyp
Type of injury cause as related to the Acute Concussion Evaluation (ACE).
Cause
Assault;Fall;MVC;Other;Pedestrian-MVC;Sports;
Assault;Fall;Motor Vehicle Crash;Other;Pedestrian-Motor Vehicle Crash;Sports;
Alphanumeric
Greater forces associated with the trauma are likely to result in more severe presentation of symtoms.

Indicate cause of injury.
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Multiple Pre-Defined Values Selected
       
C54338
Acute Concussion Evaluation (ACE) – Injury cause type sports text
ACEInjuryCauseTypSportsTxt
Text specifying the cause of the impact injury as related to the Acute Concussion Evaluation (ACE).
Sports (specify)
  
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
 
255
Free-Form Entry
       
C54339
Acute Concussion Evaluation (ACE) – Injury cause type other text
ACEInjuryCauseTypOthrTxt
Text specifying another cause of the impact injury as related to the Acute Concussion Evaluation (ACE).
Other
  
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
 
255
Free-Form Entry
       
C54340
Acute Concussion Evaluation (ACE) – Amnesia before no memory events indicator
ACEAmnesiaBfNoMemEvntsInd
Indicator of whether subject/participant had no memory of events before (retrograde) amnesia as related to the Acute Concussion Evaluation (ACE).
Amnesia Before (Retrograde) Are there any events just BEFORE th einjury that you/person has no memory of (even brief)?
Yes;No;
Yes;No;
Alphanumeric
Even seconds to minutes of memory loss can be predictive of outcome. Recent research has indicated that amnesia may be up to 4-10 times more predictive of symptoms and cognitive deficits following concussion than is LOC (less than 1 minute).
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C54341
Acute Concussion Evaluation (ACE) – Amnesia before no memory events duration
ACEAmnesiaBfNoMemEvntsDur
Duration of subject's/participant's length of amnesia before injury as related to the Acute Concussion Evaluation (ACE).
Amnesia Before (Retrograde) Duration
  
Numeric Values
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Free-Form Entry
       
C54342
Acute Concussion Evaluation (ACE) – Amnesia after no memory events indicator
ACEAmnesiaAftrNoMemEvntsInd
Indicator of whether subject/participant had no memory of events after (anterograde) amnesia as related to the Acute Concussion Evaluation (ACE).
Amnesia After (Anterograde) Are there any events just AFTER the injury that you/ person has no memory of (even brief)?
Yes;No;
Yes;No;
Alphanumeric
Even seconds to minutes of memory loss can be predictive of outcome. Recent research has indicated that amnesia may be up to 4-10 times more predictive of symptoms and cognitive deficits following concussion than is LOC (less than 1 minute).
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C54343
Acute Concussion Evaluation (ACE) – Amnesia after no memory events duration
ACEAmnesiaAftrNoMemEvntsDur
Duration of subject's/participant's length of amnesia after (anterograde) injury as related to the Acute Concussion Evaluation (ACE).
Amnesia After (Anterograde) Duration
  
Numeric Values
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Free-Form Entry
       
C54344
Acute Concussion Evaluation (ACE) – Loss of consciousness indicator
ACELossConsciousnessInd
Indicator of whether subject/participant had loss of consciousness as related to the Acute Concussion Evaluation (ACE).
Loss of consciousness: Did you/ person lose consciousness?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C54345
Acute Concussion Evaluation (ACE) – Loss of consciousness duration
ACELossConsciousnessDur
Duration of the subject/participant's loss of consciousness as related to the Acute Concussion Evaluation (ACE).
Loss of consciousness duration
  
Numeric Values
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Free-Form Entry
       
C54346
Acute Concussion Evaluation (ACE) – Early signs type
ACEEarlySignsTyp
Type of early signs that may have been observed after subject/patient injury as related to the Acute Concussion Evaluation (ACE).
EARLY SIGNS:
Appears dazed or confused;Is confused about events;Answers questions slowly;Repeats questions;Forgetful (recent info);
Appears dazed or confused;Is confused about events;Answers questions slowly;Repeats questions;Forgetful (recent info);
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Multiple Pre-Defined Values Selected
       
C54347
Acute Concussion Evaluation (ACE) – Seizure indicator
ACESeizureInd
Indicator of whether subject/participant had seizures as related to the Acute Concussion Evaluation (ACE).
Seizures: Were seizures observed?
Yes;No;
Yes;No;
Alphanumeric
Indicate whether seizures were observed or not.
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C54348
Acute Concussion Evaluation (ACE) – Seizure detail text
ACESeizureDetailTxt
Text describing subject/participant seizures as related to the Acute Concussion Evaluation (ACE).
Observed seizure detail
  
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
 
255
Free-Form Entry
       
C54349
Acute Concussion Evaluation (ACE) – Symptom check list type
ACESymptomChkLstTyp
Type of symptoms subject/participant has experienced since injury as related to the Acute Concussion Evaluation (ACE).
Since the injury, has the person experienced any of these symptoms any more than jusual today or in the past day?
Balance problems;Difficulty concentrating;Difficulty remembering;Dizziness;Drowsiness;Fatigue;Feeling mentally foggy;Feeling slowed down;Headache;Irritability;More emotional;Nausea;Nervousness;Numbness/tingling;Sadness;Sensitivity to light;Sensitivity to noise;Sleeping less than usual;Sleeping more than usual;Trouble falling asleep;Visual problems;Vomiting;
Balance problems;Difficulty concentrating;Difficulty remembering;Dizziness;Drowsiness;Fatigue;Feeling mentally foggy;Feeling slowed down;Headache;Irritability;More emotional;Nausea;Nervousness;Numbness/tingling;Sadness;Sensitivity to light;Sensitivity to noise;Sleeping less than usual;Sleeping more than usual;Trouble falling asleep;Visual problems;Vomiting;
Alphanumeric
No instructions available
Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. Lovell MR, Collins MW. Neuropsychological assessment of the college football player. J Head Trauma Rehabil. 1998;13(2):9-26.
Adult;Pediatric
Supplemental
1.0
2/27/2017
Aliases for variable name not defined
Acute Concussion Evaluation (ACE)
Cognitive Assessment
Outcomes and End Points
  
Multiple Pre-Defined Values Selected
       
12-15-2018
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