CDE Detailed Report

Disease: Chiari I Malformation
Subdomain Name: Physical/Neurological Examination
CRF: Self - Report Testing (On Intake)

Displaying 51 - 78 of 78
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
C22665 Medical history chronic constipation indicator MedHIstChrnConsInd Indicator of whether the participant/subject has/had chronic constipation Indicator of whether the participant/subject has/had chronic constipation Do you have constipation? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:34:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22742 Excessive urination frequency indicator ExcessvUrinatnFreqncyInd Indicator of whether the patient/participant's urination frequency has been excessive Indicator of whether the patient/participant's urination frequency has been excessiv Do you urinate more than 10 times per day? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22753 Sexual arousal difficulty maintain indicator SexlArslDffcltyMntnInd Indicator of whether the patient/participant is experiencing difficulty maintaining sexual arousal Indicator of whether the patient/participant is experiencing difficulty maintaining sexual arousa Do you have difficulty maintaining arousal? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22721 Hearing very sensitive indicator HearingVerySensitiveInd Indicator of whether the patient/participant has very sensitive hearing Indicator of whether the patient/participant has very sensitive hearin Do you have very sensitive hearing? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22764 Joint hypermobility indicator JointHypermobilityInd Indicator of whether the patient/participant is experiencing or exhibits hypermobility of one or more joints Indicator of whether the patient/participant is experiencing or exhibits hypermobility of one or more joint Do you have joint hypermobility? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C21577 Respiration stop during sleep indicator RespStopDurSleepInd The indicator related to stopping of transport of oxygen from the outside air to the cells within tissues during sleep The indicator related to stopping of transport of oxygen from the outside air to the cells within tissues during slee Do you have sleep apnea? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2015-07-28 18:24:23.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22732 Burning pain abnormal extremity indicator BurnPainAbnormalExtremityInd Indicator of whether the patient/participant has experienced an abnormal burning pain in his or her extremeties Indicator of whether the patient/participant has experienced an abnormal burning pain in his or her extremetie Do you have an abnormal burning pain in your extremities? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22711 Pain pressure behind eyes indicator PainPressrBehndEyesInd Indicator of whether the patient/participant feels pressure or pain behind his or her eyes Indicator of whether the patient/participant feels pressure or pain behind his or her eye Do you have pain or pressure behind your eyes? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22743 Inability empty bladder single attempt indicator InabltyEmptyBlddrSnglAttmptInd Indicator of whether the patient/participant is unable to empty his or her bladder in a single urination attempt Indicator of whether the patient/participant is unable to empty his or her bladder in a single urination attemp Do you go two or more times in succession before completely emptying your bladder? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22754 Attain orgasm difficulty indicator AttainOrgsmDffcltyInd Indicator of whether the patient/participant experiences difficulty attaining orgasm Indicator of whether the patient/participant experiences difficulty attaining orgas Do you have difficulty reaching orgasm? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22722 Swallow difficulty indicator SwallowDifficultyInd Indicator of whether the patient/participant has difficulty swallowing Indicator of whether the patient/participant has difficulty swallowin Do you have difficulty swallowing? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22765 Thyroid problem diagnosis ever indicator ThyroidProblmDiagnosEvrInd Indicator of whether the patient/participant has ever been diagnosed with a thyroid problem Indicator of whether the patient/participant has ever been diagnosed with a thyroid proble Have you been diagnosed with thyroid problems? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C21692 Chiari I malformation prickle tingle numb arm leg frequent occurrence symptom indicator CMPrkTngNmbArmLgFrqOcSymInd The indicator related to frequent prickling, tingling or numbness in your arms/legs in defining signs and symptoms for Chiari I malformation The indicator related to frequent prickling, tingling or numbness in your arms/legs in defining signs and symptoms for Chiari I malformatio Do you suffer from prickling, tingling or numbness of your extremities? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-05-26 17:58:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22733 Extremity specific area pain decreased sensation indicator ExtmtySpcfcAreaPnDcrsdSnstnInd Indicator of whether the patient/participant has experienced pain or decreased sensation in a specific area of his or her extremities Indicator of whether the patient/participant has experienced pain or decreased sensation in a specific area of his or her extremitie Do you have pain or decreased sensation over a specific portion of your extremities? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22744 Recurrent urinary tract infection indicator RecurrUrinryTractInfctnInd Indicator of whether the patient/participant has a history of recurring urinary tract infections Indicator of whether the patient/participant has a history of recurring urinary tract infection Do you have a history of recurring urinary bladder or kidney infections? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22712 Light sensitivity indicator LightSensitivityInd Indicator of whether the patient/participant is sensitive to light Indicator of whether the patient/participant is sensitive to ligh Are you sensitive to light? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22755 Sexual dysfunction indicator SexualDysfunctionInd Indicator of whether the patient/participant experiences sexual dysfunction such as inability to attain orgasm, erectile dysfunction, inability to ejaculate Indicator of whether the patient/participant experiences sexual dysfunction such as inability to attain orgasm, erectile dysfunction, inability to ejaculat Have you lost the ability to reach an orgasm, sustain an erection, or ejaculate properly? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22723 Throat tight indicator ThroatTightInd Indicator of whether the patient/participant has throat tightness Indicator of whether the patient/participant has throat tightnes Do you have throat tightness? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22766 Pituitary problem diagnosis ever indicator PituitryProblmDiagnosEvrInd Indicator of whether the patient/participant has ever been diagnosed with a pituitary gland problem Indicator of whether the patient/participant has ever been diagnosed with a pituitary gland proble Have you been diagnosed with any pituitary problems? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C21693 Chiari I malformation position change dizzy symptom indicator CMPosChngDzySympInd The indicator related to dizziness with position changes in defining signs and symptoms for Chiari I malformation The indicator related to dizziness with position changes in defining signs and symptoms for Chiari I malformatio Do you have dizziness with position changes? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-05-27 08:49:49.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22734 Skin change indicator SkinChangeInd Indicator of whether the patient/participant has experienced a skin change Indicator of whether the patient/participant has experienced a skin chang Do you have any noticeable skin changes? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22745 Interstitial cystitis diagnosis ever indicator IntrsttlCystitsDiagnosEvrInd Indicator of whether the patient/participant has ever been diagnosed with interstitial cystitis Indicator of whether the patient/participant has ever been diagnosed with interstitial cystiti Have you ever been diagnosed with interstitial cystitis? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22713 Vision blurred indicator VisionBlurredInd Indicator of whether the patient/participant has blurred vision Indicator of whether the patient/participant has blurred visio Do you have blurred vision? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22756 Genital pelvic sensation loss indicator GenitalPelvicSensatnLossInd Indicator of whether the patient/participant has experienced a loss of sensation in his or her genital or pelvic area Indicator of whether the patient/participant has experienced a loss of sensation in his or her genital or pelvic are Have you experienced a decrease or loss of sensation in your pelvic (or genital) area? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22724 Speech difficulty indicator SpeechDifficultyInd Indicator of whether the patient/participant has difficulty with speech Indicator of whether the patient/participant has difficulty with speec Do you have difficulty speaking? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22767 Bleeding clotting disorder indicator BleedClotDisorderInd Indicator of whether the patient/participant has ever had a bleeding or blood clotting disorder Indicator of whether the patient/participant has ever had a bleeding or blood clotting disorde Have you experienced any bleeding or blood clotting disorders? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C21771 Chiari malformation screening wound prolong heal separation indicator ChiMalScrWouPeoHeaSepInd The indicator related to experiencing prolonged wound healing or separation in a screening for Chiari malformation The indicator related to experiencing prolonged wound healing or separation in a screening for Chiari malformatio Do you have wound healing problems? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-02 14:15:30.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22735 Balance difficulty absent visual cue indicator BlncDffcltyAbsntVslCueInd Indicator of whether the patient/participant has experienced difficulty with balance in the absence of visual cues Indicator of whether the patient/participant has experienced difficulty with balance in the absence of visual cue If you close your eyes or are in the dark, do you have difficulty with your balance? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
CSV