CDE Detailed Report
Disease: content
Subdomain Name: Ataxia and Performance Measures
CRF: welcome
Displaying 1 - 14 of 14
Subdomain Name: Ataxia and Performance Measures
CRF: welcome
Displaying 1 - 14 of 14
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C12001 | Timed 25-Foot Walk (T25FW) - more than two attempts indicator | T25FWMoreTwoAttmptsInd | Indicator of whether more than two attempts were required to obtain two successful trials, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | Indicator of whether more than two attempts were required to obtain two successful trials, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | Did it take more than two attempts to get two successful trials? | Yes;No | Yes;No | Alphanumeric |
NO ADDITIONAL INSTRUCTIONS |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11990 | Timed 25-Foot Walk (T25FW) - ankle foot orthosis status | T25FWAFOStatus | Indicator whether the participant/subject wore an ankle-foot orthosis (AFO) during the assessment, as part of the Timed 25-Foot Walk (T25FW) | Indicator whether the participant/subject wore an ankle-foot orthosis (AFO) during the assessment, as part of the Timed 25-Foot Walk (T25FW) | Did patient wear an AFO? | Yes;No | Yes;No | Alphanumeric |
NO ADDITIONAL INSTRUCTIONS |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C12002 | Timed 25-Foot Walk (T25FW) - more than two attempts text | T25FWOver2AttmptReqdReasnTxt | Text specification of reason(s) for attempting more than two trials, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | Text specification of reason(s) for attempting more than two trials, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | If yes, please specify reason(s) for more than two attempted trials | Alphanumeric |
NO ADDITIONAL INSTRUCTIONS |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points | 255 |
Free-Form Entry |
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| C11991 | Timed 25-Foot Walk (T25FW) - assistive device status | T25FWAssistDevStatus | Indicator whether the participant/subject used an assistive device during the assessment, as part of the Timed 25-Foot Walk (T25FW) | Indicator whether the participant/subject used an assistive device during the assessment, as part of the Timed 25-Foot Walk (T25FW) | Was assistive device used? | Yes;No | Yes;No | Alphanumeric |
No additional instructions |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C17863 | Timed 25-Foot Walk (T25FW) - trial not complete reason text | T25FWTrialNotCompltRsnTxt | Text description of the indicated reason why the trial being recorded was not completed, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | Text description of the indicated reason why the trial being recorded was not completed, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | Specify | Alphanumeric | Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points | 255 |
Free-Form Entry |
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| C11992 | Timed 25-Foot Walk (T25FW) - unilateral assistance device type | T25FWUniAssistDevType | Range, in sides of the body, for which the participant/subject used an assistive device during the assessment, as part of the Timed 25-Foot Walk (T25FW) | Range, in sides of the body, for which the participant/subject used an assistive device during the assessment, as part of the Timed 25-Foot Walk (T25FW) | Assistive device used | Unilateral;Bilateral | Unilateral;Bilateral | Alphanumeric |
Mark one |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C17864 | Timed 25-Foot Walk (T25FW) - trial number | T25FWTrialNum | Number assigned for identification to the trial currently being assessed, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | Number assigned for identification to the trial currently being assessed, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | 1;2 | 1;2 | Numeric Values | Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11993 | Timed 25-Foot Walk (T25FW) - bilateral assistance device type | T25FWBilatrlAssistanceDevType | Type of assistive device used by the participant/subject during the assessment, as part of the Timed 25-Foot Walk (T25FW) | Type of assistive device used by the participant/subject during the assessment, as part of the Timed 25-Foot Walk (T25FW) | Assistive device used | Cane;Crutch;Walker/Rollator | Cane;Crutch;Walker/Rollator | Alphanumeric |
Mark one |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11995 | Timed 25-Foot Walk (T25FW) - trial 1 duration | T25FWTr1WalkDur | Duration , in seconds and to the nearest tenth of a second, of the participant/subject's walking 25 feet for the trial being recorded, as part of the Timed 25-Foot Walk (T25FW) | Duration , in seconds and to the nearest tenth of a second, of the participant/subject's walking 25 feet for the trial being recorded, as part of the Timed 25-Foot Walk (T25FW) | Time for 25-foot walk | Numeric Values |
Record time in seconds. Record for Trial 1 and Trial 2. |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points |
Free-Form Entry |
second | |||||||||
| C11996 | Timed 25-Foot Walk (T25FW) - trial 1 circumstances affecting performance text | T25FWCircmstncAfctTr1PerfTxt | Text description of any circumstances that affected the participant/subject's performance on or completion of the trial being recorded, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | Text description of any circumstances that affected the participant/subject's performance on or completion of the trial being recorded, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | For a complete trial, record any circumstances that affected the patient's performance | Alphanumeric |
Record for Trial 1 and Trial 2, only if trial was completed. |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points | 255 |
Free-Form Entry |
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| C11997 | Timed 25-Foot Walk (T25FW) - trial 1 not completed reason | T25FWTr1NotCompltRsn | Indicator of the reason why the trial being recorded was not completed, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | Indicator of the reason why the trial being recorded was not completed, as part of the Frontal Behavioral Inventory-ALS Version (FBI-ALS) | If trial was not completed | Unable to complete trial due to physical limitations;Other | Unable to complete trial due to physical limitations;Other | Alphanumeric |
Choose only one. Record for Trial 1 and Trial 2, if trial was not completed. |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C11998 | Timed 25-Foot Walk (T25FW) - trial 2 duration | T25FWTr2WalkDur | The time it takes the participant/subject to walk 25 feet, as part of the Timed 25-Foot Walk (T25FW) | The time it takes the participant/subject to walk 25 feet, as part of the Timed 25-Foot Walk (T25FW) | The time it takes the participant/subject to walk 25 feet | Numeric Values |
Record time in seconds. Record for Trial 1 and Trial 2. |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points |
Free-Form Entry |
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| C11999 | Timed 25-Foot Walk (T25FW) - trial 2 circumstances affecting performance text | T25FWCircmstncAfctTr2PerfTxt | Record in text any circumstances that affected the patient's performance for a completed Trial 2, as part of the Timed 25-Foot Walk (T25FW) | Record in text any circumstances that affected the patient's performance for a completed Trial 2, as part of the Timed 25-Foot Walk (T25FW) | For a complete trial, record any circumstances that affected the patient's performance. | Alphanumeric |
Record for Trial 1 and Trial 2, only if trial was completed. |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points | 255 |
Free-Form Entry |
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| C12000 | Timed 25-Foot Walk (T25FW) - trial 2 not completed reason | T25FWTr2NotCompltRsn | Specify the type of reason Trial 2 was not completed by the participant/subject, as part of the Timed 25-Foot Walk (T25FW) | Specify the type of reason Trial 2 was not completed by the participant/subject, as part of the Timed 25-Foot Walk (T25FW) | If trial was not completed, the reason the trial was not completed by the participant/subject | Unable to complete trial due to physical limitations;Other | Unable to complete trial due to physical limitations;Other | Alphanumeric |
Choose only one. Record for Trial 1 and Trial 2, if trial was not completed. |
Timed 25-Foot Walk (T25-FW). National Multiple Sclerosis Society. http://nationalmssociety.org/for-professionals/researchers/clinical-study-measures/t25-fw/index.aspx. Multiple sclerosis administration and scoring manual. National Multiple Sclerosis Society. 2001. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Timed 25-Foot Walk (T25-FW) | Ataxia and Performance Measures | Outcomes and End Points |
Single Pre-Defined Value Selected |
