CDE Detailed Report | NINDS Common Data Elements

Disease: Epilepsy
Subdomain Name: Assessing Comorbidities
CRF: Post-Traumatic Epilepsy Screening Form

Displaying 1 - 11 of 11

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	Input Restrictions
C19508	Source of information queried type	SourceOfInformationQueriedTyp	Type of source of information queried	Type of source of information queried	Which of the following sources of information were queried?	Caregiver;Medical record;Patient	Caregiver;Medical record;Patient	Alphanumeric	Check all that apply		Adult;Pediatric	Supplemental	1.00	2014-06-30 11:20:53.0	Post-Traumatic Epilepsy Screening Form	Assessing Comorbidities	Outcomes and End Points	Multiple Pre-Defined Values Selected
C19509	Pre traumatic brain injury seizure or epilepsy indicator	PreTBISeizureEpilepsyInd	Indicator for seizures or epilepsy that the patient had prior to the traumatic brain injury	Indicator for seizures or epilepsy that the patient had prior to the traumatic brain injury	Has the participant had seizures or epilepsy prior to the traumatic brain injury?	No;Yes;Unknown	No;Yes;Unknown	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2014-06-30 11:28:11.0	Post-Traumatic Epilepsy Screening Form	Assessing Comorbidities	Outcomes and End Points	Single Pre-Defined Value Selected
C19510	Post traumatic brain injury diagnosis epilepsy seizure diagnosis indicator	PstTBIDiagEpilpSeizDiagInd	Indicator for the diagnosis of the participant with epilepsy, a seizure disorder, or a single seizure after the date of the traumatic brain injury diagnosis	Indicator for the diagnosis of the participant with epilepsy, a seizure disorder, or a single seizure after the date of the traumatic brain injury diagnosis	Hast the participant been diagnosed with epilepsy, a seizure disorder, or a single seizure after the date of the traumatic brain injury diagnosis?	No;Yes;Unknown	No;Yes;Unknown	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2014-06-30 11:33:00.0	Post-Traumatic Epilepsy Screening Form	Assessing Comorbidities	Outcomes and End Points	Single Pre-Defined Value Selected
C19511	Seven days post traumatic brain injury seizure occurrence indicator	SevnDaysPstTBISeizOccurncInd	Indicator for the occurrence of seizure(s) later than seven days after the date of the traumatic brain injury	Indicator for the occurrence of seizure(s) later than seven days after the date of the traumatic brain injury	Did seizure(s) occur later than seven days after the date of the traumatic brain injury?	No;Yes;Unknown	No;Yes;Unknown	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2014-06-30 11:38:13.0	Post-Traumatic Epilepsy Screening Form	Assessing Comorbidities	Outcomes and End Points	Single Pre-Defined Value Selected
C19512	Diagnosis giver type	DiagnosisGiverTyp	Type of professional who gave the diagnosis	Type of professional who gave the diagnosis	Who gave this diagnosis?	Neurologist;Neurosurgeon;Nurse Practitioner;Pediatric Neurologist;Pediatrician;Primary Care Physician;Psychiatrist;Psychologist	Neurologist;Neurosurgeon;Nurse Practitioner;Pediatric Neurologist;Pediatrician;Primary Care Physician;Psychiatrist;Psychologist	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2014-06-30 11:41:47.0	Post-Traumatic Epilepsy Screening Form	Assessing Comorbidities	Outcomes and End Points	Single Pre-Defined Value Selected
C19513	Seizure or epilepsy medication patient reception indicator	SeizEpilepMedicaPatntReceptInd	Indicator for the patient's reception of medication for seizures or epilepsy	Indicator for the patient's reception of medication for seizures or epilepsy	Has the patient received medication for seizures or epilepsy?	No;Yes;Unknown	No;Yes;Unknown	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2014-06-30 11:51:50.0	Post-Traumatic Epilepsy Screening Form	Assessing Comorbidities	Outcomes and End Points	Single Pre-Defined Value Selected
C08007	Diagnosis first given date and time	DiagnosFirstGivnDateTime	Date (and time if applicable and known) the participant/subject was initially diagnosed with the disease or disorder	Date (and time if applicable and known) the participant/subject was initially diagnosed with the disease or disorder	Date of diagnosis			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	2013-07-24 11:38:01.2	Post-Traumatic Epilepsy Screening Form	Assessing Comorbidities	Outcomes and End Points	Free-Form Entry
C19504	Family member body uncontrolled movement indicator	FamMmberBodyUncntrlldMovmntInd	Indicator for uncontrolled movements of part or all of the body such as twitching, jerking, shaking, or going limp, lasting about 5 minutes or less, that a family member has had or told you that you/they had	Indicator for uncontrolled movements of part or all of the body such as twitching, jerking, shaking, or going limp, lasting about 5 minutes or less, that a family member has had or told you that you/they had	Uncontrolled movements of part or all of the body such as twitching, jerking, shaking or going limp, lasting about 5 minutes or less?	No;Yes;Unknown	No;Yes;Unknown	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2014-06-30 10:35:45.0	Post-Traumatic Epilepsy Screening Form	Assessing Comorbidities	Outcomes and End Points	Single Pre-Defined Value Selected
C19505	Family member mental state awareness level unexplained change indicator	FamMmbrMentlSteAwrnsLvlChngInd	Indicator for an unexplained change in mental state or level of awareness; or an episode of "spacing out which you/your family member could not control, lasting about 5 minutes or less, that a family member has had or told you that you/they had	Indicator for an unexplained change in mental state or level of awareness; or an episode of "spacing out which you/your family member could not control, lasting about 5 minutes or less, that a family member has had or told you that you/they had	An unexplained change in mental state or level of awareness; or an episode of "spacing out" which you/your family member could not control, lasting about 5 minutes or less?	No;Yes;Unknown	No;Yes;Unknown	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2014-06-30 10:35:45.0	Post-Traumatic Epilepsy Screening Form	Assessing Comorbidities	Outcomes and End Points	Single Pre-Defined Value Selected
C19506	Family member repeated unusual attack or convulsion other type indicator	FamMemRepUnuslAtkCnvlOthTypInd	Indicator for any other type of repeated unusual attacks or convulsions lasting about 5 minutes or less that a family member has had or told you that you/they had	Indicator for any other type of repeated unusual attacks or convulsions lasting about 5 minutes or less that a family member has had or told you that you/they had	Any other type of repeated unusual attacks or convulsions lasting about 5 minutes or less?	No;Yes;Unknown	No;Yes;Unknown	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2014-06-30 10:35:45.0	Post-Traumatic Epilepsy Screening Form	Assessing Comorbidities	Outcomes and End Points	Single Pre-Defined Value Selected
C19507	Family member seizures or epilepsy indicator	FamMembrSeizureEpilepsyInd	Indicator for someone having told you that you/your family member have seizures or epilepsy	Indicator for someone having told you that you/your family member have seizures or epilepsy	Has anyone ever told you that you/your family member have seizure(s) or epilepsy?	No;Yes;Unknown	No;Yes;Unknown	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2014-06-30 11:14:02.0	Post-Traumatic Epilepsy Screening Form	Assessing Comorbidities	Outcomes and End Points	Single Pre-Defined Value Selected