CDE Detailed Report

Disease: Chiari I Malformation
Subdomain Name: General and Motor
CRF: Coordination

Displaying 1 - 13 of 13
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
C21703 Coordination Romberg maintain stance eye close assessment scale CoordinationRmbgMnStnEyClAsScl The scale related to assessment of Romberg's test of neurological function of maintaining way of standing with eyes closed The scale related to assessment of Romberg's test of neurological function of maintaining way of standing with eyes closed Romberg 1;0;2;3;4 1 = severely unsteady, needs touch or hand assist;0 = unable;2 - Moderately affected. Sometimes asked to repeat statements;3 = mildly unsteady, slighly widened base 3-6'';4 = Normal Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 13:40:14.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
C21704 Coordination finger to nose right upper extremity assessment scale CoordinationFnNsRUEAsScale The scale related to assessment of the motion finger to nose right (upper extremity) The scale related to assessment of the motion finger to nose right (upper extremity Right UE:F/N 0;1;2;3;4 unable;severely unsteady;moderately unsteady;mildly unsteady;Normal Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 13:47:55.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
C21705 Coordination finger to nose right upper extremity tap assessment scale CoordinationFngNsRUETpAsScale The scale related to assessment of the ability to complete the motion of finger to nose (right upper extremity) tap The scale related to assessment of the ability to complete the motion of finger to nose (right upper extremity) ta Right UE:Tap 0;1;2;3;4 unable;severely unsteady;moderately unsteady;mildly unsteady;Normal Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 14:16:54.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
C21706 Coordination finger to nose left upper extremity assessment scale CoordinationFgNsLUEAsScale The scale related to assessment of the ability to complete the motion of finger to nose (left upper extremity) The scale related to assessment of the ability to complete the motion of finger to nose (left upper extremity Left UE:F/N 0;1;2;3;4 unable;severely unsteady;moderately unsteady;mildly unsteady;Normal Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 14:21:23.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
C21707 Coordination finger to nose left upper extremity tap assessment scale CoordinationFgNsLUETpAsScale The scale related to assessment of the ability to complete the motion of finger to nose (left upper extremity) tap The scale related to assessment of the ability to complete the motion of finger to nose (left upper extremity) tap Left UE:Tap 0;1;2;3;4 unable;severely unsteady;moderately unsteady;mildly unsteady;Normal Numeric Values Pediatric Supplemental 1.00 2016-05-27 14:25:57.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
C21708 Coordination heel to shin right lower extremity assessment scale CoordinationHlShnRLEAsScale The scale related to assessment of the ability to complete the motion of heel to shin (right lower extremity) The scale related to assessment of the ability to complete the motion of heel to shin (right lower extremity Right LE:H/S 0;1;2;3;4 unable;severely unsteady;moderately unsteady;mildly unsteady;Normal Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 14:28:42.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
C21709 Coordination heel to shin right lower extremity tap assessment scale CoordinationHlShnRLETpAsScale The scale related to assessment of completing the motion of heel to shin (right lower extremity) tap The scale related to assessment of completing the motion of heel to shin (right lower extremity) tap Right LE:Tap 0;1;2;3;4 unable;severely unsteady;moderately unsteady;mildly unsteady;Normal Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 14:33:34.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
C21710 Coordination heel to shin left lower extremity assessment scale CoordinationHlShnLLEAsScale The scale related to assessment of the ability to complete the motion of heel to shin (lower extremity) The scale related to assessment of the ability to complete the motion of heel to shin (lower extremity) Left LE:H/S 0;1;2;3;4 unable;severely unsteady;moderately unsteady;mildly unsteady;Normal Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 14:36:34.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
C21700 Coordination gait assessment scale CoordinationGtAsmtScale The scale related to assessment of manner of person's walking The scale related to assessment of manner of person's walking Gait 0;1;2;3;4 unable;severely unsteady, needs touch or hand assist;moderately unsteady, more than base 1';mildly unsteady, slighly widened base 3-6'';Normal Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 13:13:22.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
C21711 Coordination heel to shin left lower extremity tap assessment scale CoordinationHlShnLLETpAsScale The scale related to assessment of the ability to complete the motion of heel to shin (lower level extremity) tap The scale related to assessment of the ability to complete the motion of heel to shin (lower level extremity) tap Left LE:Tap 0;1;2;3;4 unable;severely unsteady;moderately unsteady;mildly unsteady;Normal Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 14:39:53.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
C21701 Coordination gait tandem assessment scale CoordinationGtTndmAssmtScale The scale related to assessment of manner of person's walking where toes of the back foot touch the heel of the front foot at each step The scale related to assessment of manner of person's walking where toes of the back foot touch the heel of the front foot at each step Tandem Gait 0;1;2;3;4 unable;severely unsteady, unable to do at least 3 consecutive steps;moderately unsteady, steps off 3-6 per 10 steps;mildly unsteady, steps off 3 or less per 10 steps;Normal to 10 steps Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 13:32:34.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
C21712 Coordination total assessment score CoordinationTtlAsmntScore Total score of the Coordination assessment scale Total score of the Coordination assessment scale Total Score Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 14:43:39.0 Coordination General and Motor Assessments and Examinations

Free-Form Entry

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C21702 Coordination stance assessment scale CoordinationStncAssmtScale The scale related to assessment of way someone stands The scale related to assessment of way someone stands Stance 0;1;3;2;4 unable;severely unsteady, needs touch or hand assist;mildly unsteady, slighly widened base 3-6'';moderately unsteady, more than base 1';Normal, toes and heels together Numeric Values Adult;Pediatric Supplemental 1.00 2016-05-27 13:36:30.0 Coordination General and Motor Assessments and Examinations

Single Pre-Defined Value Selected
CSV