CDE Detailed Report
Disease: content
Subdomain Name: Physical/Neurological Examination
CRF: welcome
Displaying 1 - 11 of 11
Subdomain Name: Physical/Neurological Examination
CRF: welcome
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 | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
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 | Physical/Neurological Examination | Assessments and Examinations |
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 | Physical/Neurological Examination | Assessments and Examinations |
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 | Physical/Neurological Examination | Assessments and Examinations |
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 | Physical/Neurological Examination | Assessments and Examinations |
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 | Physical/Neurological Examination | Assessments and Examinations |
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 | Physical/Neurological Examination | Assessments and Examinations |
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 | Physical/Neurological Examination | Assessments and Examinations |
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 | Physical/Neurological Examination | Assessments and Examinations |
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 | Physical/Neurological Examination | Assessments and Examinations |
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 | Physical/Neurological Examination | Assessments and Examinations |
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 | Physical/Neurological Examination | Assessments and Examinations |
Single Pre-Defined Value Selected |