CDE Detailed Report

Disease: Chiari I Malformation
Sub-Domain: Other Non-Motor
CRF: Assessment of Shunt Function

Displaying 1 - 23 of 23
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 / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C22541 Shunt valve reservoir refill lying duration ShuntValveReservRefillLyDur Time to refill after compression, with the subject/participant lying down Time to refill after compression, with the subject/participant lying down Reservoir refill time (lying down) Numeric Values

Time to refill after compression

Adult;Pediatric Supplemental 1.00 2016-06-13 13:39:02.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Free-Form Entry

Minutes/seconds
C22527 Shunt valve other text ShuntValveOth The free-text related to shunt valve; specifying other text The free-text related to shunt valve; specifying other text Valve type other text Alphanumeric

The free-text related to shunt valve type; specifying other text

Adult;Pediatric Supplemental 1.00 2016-06-13 16:07:52.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points 255

Free-Form Entry

C22542 Shunt valve manometric pressure type ShuntValveManometPressrTyp Provide the shunt value for the manometric pressure Provide the shunt value for the manometric pressure Manometric pressure on needle access (supine) N/A;n/t;Free flow on pressure to distal cath;Free flow on ventricular aspiration;mm H2O N/A;Not tested;Free flow on pressure to distal catheter;Free flow on ventricular aspiration;mm H2O Alphanumeric Adult;Pediatric Exploratory 1.00 2016-06-13 18:08:27.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C22529 Shunt valve surgical implantation date ShuntValveSurgImplantDt Date of surgical implantation Date of surgical implantation Date placed Date or Date & Time

Indicate date of surgical implantation

Adult;Pediatric Supplemental 1.00 2016-06-13 16:10:56.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Free-Form Entry

C22543 Shunt valve functional assessment type ShuntValveFuncAssmtTyp Shunt valve functional assessment type Shunt valve functional assessment type Functional assessment Unknown;Functioning;Proximal obstruction;Distal obstruction;Unable to reset;Non-functioning;Tied off surgically Unknown;Functioning;Proximal obstruction;Distal obstruction;Unable to reset;Non-functioning;Tied off surgically Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-13 18:15:00.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C22531 Shunt valve surgical site status ShuntValveSurgSiteStat Shunt valve surgical site status Shunt valve surgical site status Surgical site status Normal;Redness;Swelling;Tenderness Normal;Redness;Swelling;Tenderness Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-13 16:14:17.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Multiple Pre-Defined Values Selected

C22544 Shunt valve scan type ShuntValveScanTyp Shunt valve scan type Shunt valve scan type Shunt scan imaging Intact path;Discontinuity;Malposition proximal;Malposition distal;Other Intact path;Discontinuity;Malposition proximal;Malposition distal;Other Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-13 18:21:27.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C02411 Laterality type LatTyp Laterality type relative to the anatomic site of the body examined or affected Laterality type relative to the anatomic site of the body examined or affected R or L Left;Right Left;Right Alphanumeric

Choose one.

Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C22532 Shunt valve removal date ShuntValveRemovalDt Date shunt valve was removed Date shunt valve was removed Date Removed Date or Date & Time

Indicate date of removal or N/A.

Adult;Pediatric Supplemental 1.00 2016-06-13 16:19:08.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Free-Form Entry

C22545 Shunt valve scan date ShuntValveScanDt Date of shunt valve scan Date of shunt valve scan Date of shunt valve scan Date or Date & Time Adult;Pediatric Supplemental 1.00 2016-06-13 18:27:05.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Free-Form Entry

C06005 Data collected date and time DataCollDateTime Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. Date of shunt function assessment Date or Date & Time

Date of assessment

Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Free-Form Entry

C22535 Shunt valve in place indicator ShuntValvePlaceInd Shunt valve currenting in place Shunt valve currenting in place Currenting in place? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-13 16:23:52.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C22509 Shunt type ShuntType Shunt type Shunt type Shunt type Ventriculo-peritoneal;Ventriculo-pleural;Ventriculo-atrial;Syringo-pleural;Syringo-subarachnoid;Syringo-subarachnoid-peritoneal;Syringo-subarachnoid-pleural;Subarachnoid-subarachnoid Ventriculo-peritoneal;Ventriculo-pleural;Ventriculo-atrial;Syringo-pleural;Syringo-subarachnoid;Syringo-subarachnoid-peritoneal;Syringo-subarachnoid-pleural;Subarachnoid-subarachnoid Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-13 13:31:33.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C22536 Shunt valve set type ShuntValveSettingTyp setting type (confirmation, mechanical, electronic) setting type (confirmation, mechanical, electronic) Current setting? Alphanumeric

Provide the shunt valve setting ( for example; confirmation, mechanical, electronic)

Adult;Pediatric Supplemental 1.00 2016-06-13 16:26:31.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points 255

Free-Form Entry

C22510 Shunt valve present indicator ShuntValvePresentInd Valve present Valve present Valve present? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-13 13:39:02.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C22537 Shunt valve reservoir refill sit not collect reason ShntVlvRsrvrReflSitNotCllctRsn Reason the time to refill after compression with the subject/participant sitting down was not collected Reason the time to refill after compression with the subject/participant sitting down was not collected Reservoir refill (sitting) N/A;n/t N/A;Not tested Alphanumeric

Time to refill after compression

Adult;Pediatric Supplemental 1.00 2016-06-13 16:29:22.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C22511 Shunt valve manufacturer type ShuntValveManufTyp Manufacturer of valve Manufacturer of valve Valve manufacturer Medtronic;Other, specify;Codman;Certus;Integra;N/A Medtronic;Other;Codman;Certus;Integra;N/A Alphanumeric Adult;Pediatric Exploratory 1.00 2016-06-13 13:42:59.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C22538 Shunt valve reservoir refill sit time ShuntValveReservRefillSitTime Shunt valve reservoir refill sitting time Shunt valve reservoir refill sitting time Reservoir refill time (sitting) Numeric Values

The free-text related to reservoir refill time (sitting); specifying other text

Adult;Pediatric Supplemental 1.00 2016-06-13 13:39:02.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Free-Form Entry

Minutes/seconds
C22512 Shunt function valve anatomic site type ShuntFunctionValveAntmcSiteTyp Site/location Site/location Valve Location Frontal;Parietal;Occipital;Lumbar;N/A Frontal;Parietal;Occipital;Lumbar;N/A Alphanumeric

Site/location

Adult;Pediatric Supplemental 1.00 2016-06-13 14:32:29.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C22539 Shunt valve reservoir refill lying not collect reason ShntVlvRsrvrRefilLyNoCllctRsn Reason the time to refill after compression with the subject/participant lying down was not collected Reason the time to refill after compression with the subject/participant lying down was not collected Reservoir refill (lying down) N/A;n/t N/A;Not tested Alphanumeric

Time to refill after compression

Adult;Pediatric Supplemental 1.00 2016-06-13 13:39:02.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C22523 Shunt valve manufacturer other text ShuntValveManufOth The free-text related to shunt valve manufacturer; specifying other text The free-text related to shunt valve manufacturer; specifying other text Shunt valve manufacturer other text Alphanumeric

The free-text related to shunt valve manufacturer; specifying other text

Adult;Pediatric Exploratory 1.00 2016-06-13 15:47:59.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points 255

Free-Form Entry

C22540 Shunt valve reservoir resistance type ShuntValveReservResistTyp Resistance to reservoir compression Resistance to reservoir compression Resistance to reservoir compression Distal (normal);Distal (resistant);Proximal (Normal);Proximal (resistant);N/A Distal (normal);Distal (resistant);Proximal (Normal);Proximal (resistant);N/A Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-13 16:29:22.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

C22526 Shunt valve type ShuntValveTyp Type of Shunt Valve Type of Shunt Valve Valve type Strata;Non-programmable;Hakim;Other, specify;N/A Strata;Non-programmable;Hakim;Other;N/A Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-13 15:59:20.0 Assessment of Shunt Function Other Non-Motor Outcomes and End Points

Single Pre-Defined Value Selected

CSV