CDE Detailed Report
Subdomain Name: History of Disease/Injury Event
CRF: welcome
Displaying 1 - 7 of 7
| 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 |
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| C12658 | Clinical event or milestone achieved age value | ClinEvntMilstnAchvAgeVal | Age when the participant/subject achieved the clinical event or milestone | Age when the participant/subject achieved the clinical event or milestone | Numeric Values |
For each milestone achieved, record the age in months when it was achieved. "Maintained seated position unsupported" and "Walked independently (without braces)" are Core while all other milestones are Supplemental. |
No references available | Adult;Pediatric | Core | 3.00 | 2013-07-25 08:54:08.2 | Motor Milestones and Current Level of Function - SMA | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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| C12659 | Milestone lost age value | MilstnLostAgeVal | Age when the participant/subject lost the ability to achieve or perform the milestone | Age when the participant/subject lost the ability to achieve or perform the milestone | Numeric Values |
For each milestone the participant/subject is no longer able to perform, record the age in months when it was lost. "Maintained seated position unsupported" and "Walked independently (without braces)" are Core while all other milestones are Supplemental. |
No references available | Adult;Pediatric | Core | 3.00 | 2013-07-25 08:54:08.2 | Motor Milestones and Current Level of Function - SMA | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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| C12660 | Milestone currently able indicator | MilstnCurrntlyAbleInd | Whether the participant/subject is currently able to complete or perform the milestone | Whether the participant/subject is currently able to complete or perform the milestone | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Record for each milestone that the participant/subject had achieved. Choose one response for each. "Maintained seated position unsupported" and "Walked independently (without braces)" are Core while all other milestones are Supplemental. |
No references available | Adult;Pediatric | Core | 3.00 | 2013-07-25 08:54:08.2 | Motor Milestones and Current Level of Function - SMA | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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| C12661 | Certainty of response topic type | MilestnCertainResponsTpicTyp | Topic for the certainty of response (i.e., element the 'certainty of response type' describes) | Topic for the certainty of response (i.e., element the 'certainty of response type' describes) | Milestone achieved;Milestone achieved age;Milestone currently able;Milestone lost age | Milestone achieved;Milestone achieved age;Milestone currently able;Milestone lost age | Alphanumeric |
This element is meant to be recorded with 'certainty of response type' to differentiate the four instances it is asked |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Motor Milestones and Current Level of Function - SMA | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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| C12665 | Certainty of response type | CertainResponsTyp | Certainty of recollection of the response or information | Certainty of recollection of the response or information | Certain/Definite;Best recollection;Unknown/Uncertain | Certain/Definite;Best recollection;Unknown/Uncertain | Alphanumeric |
This element is meant to be recorded with 'certainty of response topic type' to differentiate the four instances 'certainty of response' is asked. For 'milestone currently able,' only the 'certain/definite' and 'unknown/uncertain' permissible values should be used. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Motor Milestones and Current Level of Function - SMA | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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| C10615 | Clinical event or milestone type | ClinEvntMilestoneTyp | Type of clinical event or milestone pertinent to the disease or disorder | Type of clinical event or milestone pertinent to the disease or disorder | Milestone | Noninvasive ventilation (NIV) utilized;Loss of speech;Loss of ambulation;Percutaneous endoscopic gastrostomy (PEG)/feeding tube placement;Tracheostomy performed;Death;Walk by 17 months old;Speak his/her first words by 12 months;Speak in two word combinations by 2 years;Speak in complete sentences by 3 years;Have a cognitive/learning disability;Attend a day care group (with > 5 other children);Head control;Raise both arms above head simultaneously;Roll completely;Maintain seated position supported;Maintain seated position unsupported;Crawl- combat style;Crawl- four point;Stand with support;Cruise along furniture;Stand without support;Walk with support (hand, braces);Walk independently (without braces);Climb stairs | Noninvasive ventilation (NIV) utilized;Loss of speech;Loss of ambulation;Percutaneous endoscopic gastrostomy (PEG)/feeding tube placement;Tracheostomy performed;Death;Walk by 17 months old;Speak his/her first words by 12 months;Speak in two word combinations by 2 years;Speak in complete sentences by 3 years;Have a cognitive/learning disability;Attend a day care group (with > 5 other children);Head control;Raise both arms above head simultaneously;Roll completely;Maintain seated position supported;Maintain seated position unsupported;Crawl- combat style;Crawl- four point;Stand with support;Cruise along furniture;Stand without support;Walk with support (hand, braces);Walk independently (without braces);Climb stairs | Alphanumeric |
For each milestone record whether the participant/subject achieved it, age achieved in months (if applicable), whether the participant/subject is currently able to do it, and age skill lost in months (if applicable). "Maintained seated position unsupported" and "Walked independently (without braces)" are Core while all other milestones are Supplemental. |
No references available | Adult;Pediatric | Core | 3.00 | 2013-07-25 08:54:08.2 | Motor Milestones and Current Level of Function - SMA | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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| C10616 | Clinical event or milestone achieved indicator | ClinEvntMilestoneAchvInd | Indicator whether the participant/subject achieved or experienced the specific clinical event or milestone pertinent to the disease or disorder | Indicator whether the participant/subject achieved or experienced the specific clinical event or milestone pertinent to the disease or disorder | Achieved? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one for each milestone. "Maintained seated position unsupported" and "Walked independently (without braces)" are Core while all other milestones are Supplemental. |
No references available | Adult;Pediatric | Core | 3.00 | 2013-07-25 08:54:08.2 | Motor Milestones and Current Level of Function - SMA | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
