CDE Detailed Report
Subdomain Name: History of Disease/Injury Event
CRF: system
Displaying 1 - 22 of 22
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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C05418 | Hospital transport type | HospTrnsprtTyp | Type of transportation from injury scene to hospital | Type of transportation from injury scene to hospital | Transport to hospital type | Ground ambulance with physician;Ground ambulance no physician;Private transportation/taxi/other from home/scene;By foot;Other, specify;Helicopter | Ground ambulance with physician;Ground ambulance no physician;Private transportation/taxi/other from home/scene;By foot;Other, specify;Helicopter | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C05408 | Hospital admission date and time | HospitlAdmissDateTime | Date (and time, if applicable and known) the participant/subject was admitted to the hospital | Date (and time, if applicable and known) the participant/subject was admitted to the hospital | Hospital admission date and 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 | 3.00 | 2013-07-25 08:54:08.2 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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C17404 | Injury elapsed time | InjElapsedTime | The elapsed time (in minutes) from the time of injury | The elapsed time (in minutes) from the time of injury | Numeric Values |
Indicate the time since injury occurred following definition provided per protocol. Note: Accurate determination of time since injury is critical for gauging patient progress and for assessing eligibility for acute phase studies. The need for TBI patients to be transferred from an initial receiving hospital to another hospital may delay definitive care and consequently impact outcome adversely, and longer transport times delay definitive treatment. |
No references available | Adult;Pediatric | Core | 1.00 | 2012-12-20 00:00:00.0 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
0 | minutes | |||||||||
C05409 | Injury presentation reason | InjPresentRsn | Reason for presentation at study facility/reason for interface with medical provider | Reason for presentation at study facility/reason for interface with medical provide | Injury presentation reason | On advice significant other;Routine screening;Repatriation;Professional referral;Self referral with complaints | On advice significant other;Routine screening;Repatriation;Professional referral;Self referral with complaints | Alphanumeric |
Choose one |
Moss NE, Wade DT. Admission after head injury: how many occur and how many are recorded? Injury. Apr 1996;27(3):159-161. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C18675 | Emergency service other text | EmrServOTH | The free-text field related to 'Emergency service type' specifying other text. Branch of service involved at the accident scene | The free-text field related to 'Emergency service type' specifying other text. Branch of service involved at the accident scene | Other, specify | Alphanumeric |
Choose all that apply. |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events | 4000 |
Free-Form Entry |
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C05410 | Injury presentation professional referral category | InjPrsnttnProfssnlRfrrlCat | Category of professional that referred the participant/subject to seek medical care | Category of professional that referred the participant/subject to seek medical care | Injury presentation professional referral category | General practitioner;Hospital staff;Other caretaker | General practitioner;Hospital staff;Other caretaker | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C18686 | Hospital transport other text | HospTrnsprtOTH | The free-text field related to 'Hospital transport type' specifying other text. Type of transportation from injury scene to hospital | The free-text field related to 'Hospital transport type' specifying other text. Type of transportation from injury scene to hospital | Other, specify | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events | 4000 |
Free-Form Entry |
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C05400 | Injury date time | InjDateTime | Date (and time, if applicable and known) of injury | Date (and time, if applicable and known) of injury | Injury date and 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 | Basic | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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C05411 | Injury immediate medical service receive indicator | InjImmdtMedclServRecvdInd | Indicator of whether initial medical services were received directly after injury | Indicator of whether initial medical services were received directly after injury | Were initial medical services received directly after injury? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one |
Berlot G, Fata CL, Bacer B, et al. Influence of prehospital treatment on the outcome of patients with severe blunt traumatic brain injury. Eur J Emerg Med. Jun 1 2009 Davis DP, Peay J, Serrano JA, et al. The impact of aeromedical response to patients with moderate to severe traumatic brain injury. Ann Emerg Med. Aug 2005;46(2):155-22. | Adult;Pediatric | Basic | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C05401 | Injury date reliability type | InjDateReliablTyp | The type of reliability of the reported injury date | The type of reliability of the reported injury date | Reliability of injury date | Verified;Estimated;Unknown | Verified;Estimated;Unknown | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Basic | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C05412 | Injury immediate medical service received type | InjImmdtMedServRecvdTyp | Type of initial medical services received directly after injury | Type of initial medical services received directly after injury | Injury immediate medical services received type | CT/MRI;Hospitalization;Specialized therapies (speech, physical, occupational therapy);Evaluations (neurological, psychological);Medication;Other;Education about course of symptoms | CT/MRI;Hospitalization;Specialized therapies (speech, physical, occupational therapy);Evaluations (neurological, psychological);Medication;Other;Education about course of symptoms | Alphanumeric |
Choose all that apply. |
Berlot G, Fata CL, Bacer B, et al. Influence of prehospital treatment on the outcome of patients with severe blunt traumatic brain injury. Eur J Emerg Med. Jun 1 2009 Davis DP, Peay J, Serrano JA, et al. The impact of aeromedical response to patients with moderate to severe traumatic brain injury. Ann Emerg Med. Aug 2005;46(2):155-22. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C05402 | Injury time reliability type | InjReliablTyp | The reliability of the reported time of injury | The reliability of The reported time of injury | Injury time reliability type | Verified;Estimated;Unknown | Verified;Estimated;Unknown | Alphanumeric |
Choose one. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C05413 | Emergency medical care provider type | EmrMedCrProvTyp | Type of provider of initial medical care directly after injury | Type of provider of initial medical care directly after injury | Emergency medical care provider type | Bystander;Trainer/coach;Paramedic/Medic;Emergency department;Physician;Other | Bystander;Trainer/coach;Paramedic/Medic;Emergency department;Physician;Other | Alphanumeric |
Choose all that apply. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C05403 | Injury date time estimation type | InjDateTimeEstTyp | The type as related to the point in time estimated as injury date and time | The type as related to the point in time estimated as injury date and time | If estimated, the point in time estimated as injury date | 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 |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C05414 | Emergency medical care provider train type | EmrgyMedclCarePrvdrTrainTyp | Type of training by Emergency medical care provider | Type of training by Emergency medical care provide | Emergency medical care provider training type | Untrained person;Military - non medic;Paramedic;Nurse;Physician;Medical rescue team;Other;None | Untrained person;Military - non medic;Paramedic;Nurse;Physician;Medical rescue team;Other;None | Alphanumeric |
Mark all that apply |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C05404 | Symptom onset date and time | SymptmOnsetDateTime | Date (and time, if applicable and known) reported for onset of participant's/subject's symptoms | Date (and time, if applicable and known) reported for onset of participant's/subject's symptoms | Symptom onset date and 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 | 3.00 | 2013-07-25 08:54:08.2 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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C05415 | Emergency service type | EmrServTyp | Branch of service involved at the accident scene | Branch of service involved at the accident scene | Emergency service type | None;Police;Firefighter;Ambulance (Core, EMT-B);Ambulance with specialized personnel (EMT-1);Helicopter medical service;Other, specify | None;Police;Firefighter;Ambulance (Core, EMT-B);Ambulance with specialized personnel (EMT-1);Helicopter medical service;Other, specify | Alphanumeric |
Choose all that apply. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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C05405 | Hospital presentation type | HospPresTyp | Whether the participant/subject was taken directly from the scene of accident to the study hospital (primary) or was first taken to a non-study hospital, and then transferred to the study hospital (secondary) | Whether the participant/subject was taken directly from the scene of accident to the study hospital (primary) or was first taken to a non-study hospital, and then transferred to the study hospital (secondary) | Hospital presentation type | Primary;Secondary | patient was taken directly from the scene of accident to the study hospital;patient was first taken to a non-study hospital, and then transferred to the study hospital. | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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C05416 | Emergency service response time duration | EmrServRespTmDur | Duration of time between injury and arrival of emergency services | Duration of time between injury and arrival of emergency service | Emergency services response time duration | Numeric Values |
Response should be recorded in the format DD:HH:MM. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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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 (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 | If first treated at a hospital prior to arriving at study center, arrival date and 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 | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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C05417 | Emergency service time injury scene duration | EmrServTmInjScnDur | Duration of time between arrival and departure of emergency services | Duration of time between arrival and departure of emergency service | Emergency services time at injury scene duration | Numeric Values |
Response should be recorded in the format HH:MM. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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C05407 | Study center arrival date time | StdyCntrArrDateTime | Date (and time, if applicable and known) of arrival to study center | Date (and time, if applicable and known) of arrival to study center | Study center arrival date and 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 | 3.00 | 2013-07-20 10:21:25.65 | Injury Presentation - Early/Late | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |