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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: Traumatic Brain Injury
SubDisease: Comprehensive
Sub-Domain: General Health History
CRF: Behavioral History
Item count: 15 (15 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
C00731
Alcohol use last month days drank number
AlcoholUseLastMoDayDrnkNum
During the past 30 days, how many days per month did you have at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?
During the past 30 days, how many days per month did you have at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?
  
Numeric Values
The suggested range is 0 - 30.
Please refer the Behavioral Risk Factor Surveillance System (BRFSS) instrument for capturing alcohol consumption http://www.cdc.gov/brfss/
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Alcohol use last month days drank number
 
Free-Form Entry
0
30
     
C00732
Alcohol use last month drinking day average drinks number
AlchlUseLstMoDrnkDyAvgDrnksNum
During the past 30 days, on the days when you drank, about how many drinks did you drink on the average? NOTE: One drink is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a drink with one shot of liquor. A 40 ounce beer would count as 3 drinks, or a cocktail drink with 2 shots would count as 2 drinks.
During the past 30 days, on the days when you drank, about how many drinks did you drink on the average?
  
Numeric Values
Response is obtained from report by participant/subject or proxy. Recommend collection as soon as possible after visit/admission.
Please refer the Behavioral Risk Factor Surveillance System (BRFSS) instrument for capturing alcohol consumption http://www.cdc.gov/brfss/
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Alcohol use last month drinking day average drinks number
 
Free-Form Entry
0
30
     
C00733
Alcohol use last month consumed more than four or five drinks days number
AlcohlLstMoConsmOvr5DrnkDayNum
Considering all types of alcoholic beverages, how many times during the past 30 days did you have X [X = 5 for men, X = 4 for women] or more drinks on an occasion?
Considering all types of alcoholic beverages, how many times during the past 30 days did you have X [X = 5 for men, X = 4 for women] or more drinks on an occasion?
  
Numeric Values
The suggested range is 0 - 30.
Please refer the Behavioral Risk Factor Surveillance System (BRFSS) instrument for capturing alcohol consumption http://www.cdc.gov/brfss/
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Alcohol use last month consumed more than four or five drinks days number
 
Free-Form Entry
0
30
     
C00706
Alcohol prior use indicator
AlcPriorUseInd
Indicator of the participant's/subject's alcohol consumption prior to the past 12 months
Indicates alcohol use prior to the last 12 months
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one. Document when the behavioral history was collected so as to determine whether this information was obtained prior to study enrollment or later. Response is obtained by report of the participant/subject or proxy as soon as possible after visit/admission. Substance abuse directly before injury may have contributed to the incident causing injury. In general, substance abuse may indicate increased risk taking behavior.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Alcohol prior use indicator
 
Single Pre-Defined Value Selected
     
3171578
 
C00715
Alcohol use duration
AlcoholUseDuratn
Duration in years participant/subject has used alcohol (ingesting of alcoholic beverages, including social drinking)
Alcohol use duration in years
  
Numeric Values
Response is obtained by report of the participant/subject or proxy as soon as possible after visit/admission. Document when the behavioral history was collected so as to determine whether this information was obtained prior to study enrollment or later.
Substance abuse directly before injury may have contributed to the incident causing injury. In general, substance abuse may indicate increased risk taking behavior.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Alcohol use duration
 
Free-Form Entry
0
99
     
C00710
Tobacco current use indicator
TobcoUseCurntInd
Indicator for whether the participant/subject regularly uses tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) at the present time.
Current tobacco use?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one. Response is obtained from participant/ subject, family member, friend, or chart/ medical record. Add date stamp for when assessed.Recommend collection at least on date of TBI.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Tobacco current use indicator
 
Single Pre-Defined Value Selected
     
3170060
 
C00711
Tobacco prior use indicator
TobcoPriorUseInd
Indicator of the participant's/subject's past regular tobacco (e.g., cigarettes, cigars, chewing tobacco or pipe) use prior to the past 12 months
Past tobacco use?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one. Response is obtained by report of the participant/subject or proxy as soon as possible after visit/admission. Document when the behavioral history was collected so as to determine whether this information was obtained prior to study enrollment or later. Substance abuse directly before injury may have contributed to the incident causing injury. In general, substance abuse may indicate increased risk taking behavior.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Tobacco prior use indicator
 
Single Pre-Defined Value Selected
     
3170080
 
C00718
Tobacco use duration
TobcoUseDur
Duration in years participant/subject has used tobacco products (e.g. cigarettes, cigars, chewing tobacco or pipe)
Tobacco use duration in years
  
Numeric Values
Response is obtained by report of the participant/subject or proxy as soon as possible after visit/admission. Document when the behavioral history was collected so as to determine whether this information was obtained prior to study enrollment or later.
Substance abuse directly before injury may have contributed to the incident causing injury. In general, substance abuse may indicate increased risk taking behavior.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
3.0
7/20/2013
SCI CDEs: SMKNOYRS
Behavioral History
General Health History
Participant History and Family History
Tobacco use duration
 
Free-Form Entry
0
99
year
    
C00719
Tobacco product used type
TobcoProdctUsedTyp
Type of tobacco product (e.g., cigarettes, cigars, chewing tobacco or pipe) used by the participant/subject
Type(s) of tobacco used
Filtered cigarettes;Non-filtered cigarettes;Low tar cigarettes;Cigars;Pipes;Chewing tobacco;Other, specify;
Filtered cigarettes;Non-filtered cigarettes;Low tar cigarettes;Cigars;Pipes;Chewing tobacco;Other, specify;
Alphanumeric
Choose all that apply. Response is obtained from report by participant/subject or proxy. Document whether this information was obtained prior to study enrollment or later. Recommend collection as soon as possible after visit/admission.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Tobacco product used type
 
Multiple Pre-Defined Values Selected
     
3179449v1
 
C18770
Tobacco product used other text
TobcoProdctUsedOTH
The free-text field related to 'Tobacco product used type' specifying other text. Type of tobacco product (e.g. cigarettes, cigars, chewing tobacco or pipe) used by the participant/subject
Other, specify
  
Alphanumeric
Choose all that apply. Response is obtained from report by participant/subject or proxy. Document whether this information was obtained prior to study enrollment or later. Recommend collection as soon as possible after visit/admission.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
 
4000
Free-Form Entry
     
3170860
 
C00713
Drug or substance current illicit use indicator
DrgSubstCurrntIllicitUseInd
Indicator of participant's/subject's use of illegal drugs, prescription or over-the-counter drugs in the past year for purposes other than those for which they are meant to be used, or in large amounts
Indicates illicit drug use in the past year
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one. Response is obtained by report of the participant/subject or proxy as soon as possible after visit/admission. Document when the behavioral history was collected so as to determine whether this information was obtained prior to study enrollment or later. Do not record medications that are prescribed for medical purposes (these should be entered in the element 'medical history'.) Collect information on substances and medications taken for reasons other than prescription, or taken more frequently or at higher doses than prescribed. Assure participant/subject that information on such use will be treated as strictly confidential. Recommend collection as soon as possible after visit/admission. Substance abuse directly before injury may have contributed to the incident causing injury. In general, substance abuse may indicate increased risk taking behavior.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Drug or substance current illicit use indicator
 
Single Pre-Defined Value Selected
     
3171724
 
C00717
Drug or substance prior illicit use indicator
DrugSubstncPriorIllictUseInd
Indicator of participant's/subjects use of illegal drugs, prescription or over-the-counter drugs prior to the past 12 months for purposes other than those for which they are meant to be used, or in large amounts
Indicates illicit drug use prior to the past 12 months
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one. Response is obtained by report of the participant/subject or proxy as soon as possible after visit/admission. Document when the behavioral history was collected so as to determine whether this information was obtained prior to study enrollment or later. Do not record medications that are prescribed for medical purposes (these should be entered in the element 'medical history'.) Collect information on substances and medications taken for reasons other than prescription, or taken more frequently or at higher doses than prescribed. Assure participant/subject that information on such use will be treated as strictly confidential. Recommend collection as soon as possible after visit/admission. Substance abuse directly before injury may have contributed to the incident causing injury. In general, substance abuse may indicate increased risk taking behavior.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Drug or substance prior illicit use indicator
 
Single Pre-Defined Value Selected
       
C00716
Drug or substance illicit use duration
DrgSubsIllctUseDur
Duration, in years, the participant/subject has used unprescribed, controlled psychoactive drugs or substances.
Duration in years of illicit drug use
  
Numeric Values
Response is obtained by report of the participant/subject or proxy as soon as possible after visit/admission. Document when the behavioral history was collected so as to determine whether this information was obtained prior to study enrollment or later. Do not record medications that are prescribed for medical purposes (these should be entered in the element 'medical history'.) Collect information on substances and medications taken for reasons other than prescription, or taken more frequently or at higher doses than prescribed. Assure participant/subject that information on such use will be treated as strictly confidential. Recommend collection as soon as possible after visit/admission.
Substance abuse directly before injury may have contributed to the incident causing injury. In general, substance abuse may indicate increased risk taking behavior.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Drug or substance illicit use duration
 
Free-Form Entry
0
99
Year
  
2004152
 
C00712
Subscribed drug or substance illicitly used category
SbscrbdDrgSubIllctUseCat
Category of illegal drugs, prescription, or over-the-counter drugs subscribed by the participant/subject, and used for purposes other than those for which they are meant to be used, or in large amounts
If YES, specify illicit drug type(s) used
Sedatives (e.g., sleeping pills, barbiturates, Seconal, Quaaludes, or Chloral Hydrate);Tranquilizers or anti-anxiety drugs (e.g., Valium, Librium, muscle relaxants, or Zanax);Painkillers (e.g., Codeine, Darvon, Percodan, Dilaudid, or Demerol);Stimulants (e.g., Preludin, Benzedrine, Methadrine, uppers, or speed);Marijuana, hash, THC, or grass;Cocaine or crack;Hallucinogens (e.g., Ecstasy, LSD, mescaline, psilocybin, PCP, angel dust, or peyote);Inhalants or Solvents (e.g., amyl nitrate, nitrous oxide, glue, toluene, or gasoline;Heroin;Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol);
Sedatives (e.g., sleeping pills, barbiturates, Seconal, Quaaludes, or Chloral Hydrate);Tranquilizers or anti-anxiety drugs (e.g., Valium, Librium, muscle relaxants, or Zanax);Painkillers (e.g., Codeine, Darvon, Percodan, Dilaudid, or Demerol);Stimulants (e.g., Preludin, Benzedrine, Methadrine, uppers, or speed);Marijuana, hash, THC, or grass;Cocaine or crack;Hallucinogens (e.g., Ecstasy, LSD, mescaline, psilocybin, PCP, angel dust, or peyote);Inhalants or Solvents (e.g., amyl nitrate, nitrous oxide, glue, toluene, or gasoline;Heroin;Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol);
Alphanumeric
Choose all that apply. Response is obtained from report by participant/subject or proxy. Document whether this information was obtained prior to study enrollment or later. Recommend collection as soon as possible after visit/admission.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Drug or substance illicitly used category
 
Multiple Pre-Defined Values Selected
     
3171797
 
C18670
Subscribed drug or substance illicitly used other text
SbscrbdDrgSubIllctUseOTH
The free-text field related to 'Drug or substance illicitly used category' specifying other text. Category of illegal drugs, prescription, or over-the-counter drugs the participant/subject used for purposes other than those for which they are meant to be used, or in large amounts
Other, specify
  
Alphanumeric
Choose all that apply. Response is obtained from report by participant/subject or proxy. Document whether this information was obtained prior to study enrollment or later. Recommend collection as soon as possible after visit/admission.
Corrigan JD, Bogner J, Holloman C. Lifetime history of traumatic brain injury among persons with substance use disorders. Brain Inj. 2012;26(2):139-50.
Adult;Pediatric
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
 
4000
Free-Form Entry
     
3171797
 
12-14-2018
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