CDE Detailed Report
Disease: Chiari I Malformation
Subdomain Name: Other Non-Motor
CRF: Assessment of Shunt Function
Displaying 1 - 23 of 23
Subdomain Name: 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 / 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 performe | 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
