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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: History of Disease/Injury Event
CRF: Injury Report
Item count: 82 (82 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
C52400
Injury date
InjuryDate
The date the subject received his or her injury
Date Injury Occurred
  
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
1.0
1/18/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Free-Form Entry
       
C19197
Injury time
InjuryTime
Time of injury
Time of Injury (24 hour clock)
  
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
1.0
6/2/2014
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Free-Form Entry
       
C55462
Injury day week name
InjuryDayWeekName
Name of the day of the week on which the injury occurred
Day of week of injury
Monday;Tuesday;Wednesday;Thursday;Friday;Saturday;Sunday;
Monday;Tuesday;Wednesday;Thursday;Friday;Saturday;Sunday;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C08147
Data source
DataSource
Source of the data provided on the case report form
Source of information
Clinician;Player;Parent;Coach;Other;
Clinician;Player;Parent;Coach;Other;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
Data source
 
Multiple Pre-Defined Values Selected
       
C55463
Injury data reliability category
InjDataReliablCat
Category of reliability for the injury data being reported
Reliability of injury data
Verified;Estimated;Unknown;
Verified;Estimated;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C55464
Assessment clinical perform occupation type
AssmntClnclPrfrmOccptnTyp
Type of occupation of the person performing the clinical assessment
Who was the clinical assessment completed by?
Athletic trainer;Coach;Physician's Assistant;Medical doctor;Physical therapist;Other;
Athletic trainer;Coach;Physician's Assistant;Medical doctor;Physical therapist;Other;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C55465
Concussion determine confidence category
CncssnDtrmnCnfdncCat
Category of the clinical assessor's confidence in his or her determination that the injury was a concussion
How confident was clinician that injury was a concussion?
Not at all confident;Barely confident;Somewhat confident;Fairly confident;Very confident;
Not at all confident;Barely confident;Somewhat confident;Fairly confident;Very confident;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C05403
Injury date time estimation type
InjDateTimeEstTyp
The type as related to the point in time estimated as injury date and time
If injury data is ESTIMATED, injury data type (point in time)
Time that the participant/subject became symptomatic;Time of first trauma activation;Time of presentation to emergency department;
Time that the participant/subject became symptomatic;Time of first trauma activation;Time of presentation to emergency department;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
Injury date and time estimation type
 
Single Pre-Defined Value Selected
       
C55467
First evaluation injury elapsed hour count
FrstEvalInjElpsdHrCt
Count of hours elapsed between the injury and the first evaluation
How many hours after the injury did the first evaluation take place?
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Free-Form Entry
0
 
Hours
    
C55468
Second evaluation injury elapsed hour count
ScndEvalInjElpsdHrCt
Count of hours elapsed between the injury and the second evaluation
How many hours after the injury did the second evaluation take place?
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Free-Form Entry
0
 
Hours
    
C55469
Third evaluation injury elapsed hour count
ThrdEvalInjElpsdHrCt
Count of hours elapsed between the injury and the third evaluation
How many hours after the injury did the third evaluation take place?
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Free-Form Entry
0
 
Hours
    
C55470
Concussion assessment baseline exist indicator
CncssnAssmntBslnExstInd
Indicator of whether a baseline evaluation exists for the subject/participant to aid in concussion assessment
Does subject have a baseline?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C55472
Remove participation activity indicator
RmvPrtcptnActvtyInd
Indicator of whether subject/participant was removed from participation in the activity in which he or she incurred the condition or injury being documented
Was athlete taken out of game?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C55475
Injury report immediate indicator
InjRptImmedInd
Indicator of whether the injury was reported by the injured party immediately upon occurrence
Did athlete immediately report the injury?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C55473
Injury report delay elapsed time duration
InjRptDlyElpsdTimDur
Duration of time elapsed between occurrence of injury and initial report of injury by subject/participant if not immediately reported
How many minutes/hours after injury did athlete report it to someone?
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Free-Form Entry
0
      
C55474
Injury report delay elapsed time unit of measure
InjRptDlyElpsdTimUOM
Unit of measure related to 'Injury report delay elapsed time duration' for recording the units of the elapsed time between the occurrence and reporting of the injury that was recorded
How many minutes/hours after injury did the athlete report it to someone?
Minute;Hour;
Minute;Hour;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C55477
Participation continue activity post injury indicator
PtcptnCntnuActvtyPostInjyInd
Indicator of whether the injured party continued to participate in the activity in which he or she received the suspected injury, after the occurrence of the suspected injury.
Did athlete continue participation after suspected injury event?
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C55479
Participation continue activity post injury duration text
PrtcptnCntnActvPstInjDurtnTxt
Text specifying the duration for which the subject/participant continued to participate in the activity in which he or she incurred the suspected injury, after incurring the suspected injury.
If so, for how long?
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
 
50
Free-Form Entry
       
C55480
Participation continue activity post injury turn count
PrtcptnCntnuActvyPostInjTurnCt
Count of discrete turns for which the subject/participant continued to participate in the activity in which the suspected injury was received, after receiving the suspected injury
For how many plays?
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Free-Form Entry
0
 
Turns
    
C55481
Emergency room visit indicator
ERVisitInd
Indicator of whether the subject/participant visited an emergency room (ER) or equivalent facility.
Did athlete go to ER?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C55482
Injury treatment hospital prior study center indicator
InjTxHospPriorStyCtrInd
Indicator of whether the subject/participant received treatement for his or her suspected injury at a hospital prior to being seen at the study center.
Treated at hospital before study center?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C05406
Hospital first treat arrival date time
HospFirstTreatArrDateTime
Date (and time, if applicable and known) of arrival at the first hospital, if the participant/subject was transferred to the study center from another hospital
Date treated at hospital; Time treated at hospital
  
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
7/20/2013
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
Hospital first treated arrival date and time
 
Free-Form Entry
       
C05408
Hospital admission date and time
HospitlAdmissDateTime
Date (and time, if applicable and known) the participant/subject was admitted to the hospital
Hospital admission date; Hospital admission time
  
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
7/25/2013
SCI CDEs: ADMITDT
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
Hospital admission date and time
 
Free-Form Entry
       
C55483
Hospital admission date time not applicable status
HospAdmsnDtTmNoAplcblStatus
Status indicating that date and time of hospital admission does not apply to the subject/participant
Hospital admission date
N/A;
N/A;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/11/2017
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C05404
Symptom onset date and time
SymptmOnsetDateTime
Date (and time, if applicable and known) reported for onset of participant's/subject's symptoms
Symptom onset date; Symptom onset time
  
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
7/25/2013
Aliases for variable name not defined
Injury Report
History of Disease/Injury Event
Disease/Injury Related Events
Symptom onset date and time
 
Free-Form Entry
       
12-19-2018
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