CDE Detailed Report

Disease: Multiple Sclerosis
Subdomain Name: Performance Measures
CRF: Timed 25-Foot Walk (T25-FW)

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) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

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) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

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) Performance Measures Outcomes and End Points 255

Free-Form Entry

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) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

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) Performance Measures Outcomes and End Points 255

Free-Form Entry

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) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

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) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

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) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

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) 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) Performance Measures Outcomes and End Points 255

Free-Form Entry

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) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

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) Performance Measures Outcomes and End Points

Free-Form Entry

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) Performance Measures Outcomes and End Points 255

Free-Form Entry

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) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

CSV