CDE Detailed Report

Disease: Chiari I Malformation
Sub-Domain: History of Disease/Injury Event
CRF: Chiari Symptom Onset

Displaying 1 - 33 of 33
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (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
C22356 Imaging diagnostic method type other text ImgDiagMethodTypeOthTxt The free text field related to the imaging method utilized for diagnosis. The free text field related to the imaging method utilized for diagnosis. Other,specify Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:49:18.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events 255

Free-Form Entry

C22302 Chiari malformation headache onset important symptom scale ChiariHdacheOnstImptSympScale The scale as related to headache at onset importance in Chiari malformation symptoms. The scale as related to headache at onset importance in Chiari malformation symptoms. Initial Symptom: Headache 1;0;2;3;4;5 1;Least important;2;3;4;Worst Symptom Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 12:50:11.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22333 Chiari malformation neck pain onset symptom severity scale ChiariMlfNckPnOnstSymSevScale The scale as related to neck pain at onset severity in Chiari malformation symptoms. The scale as related to neck pain at onset severity in Chiari malformation symptoms. Initial Symptom Severity: Neck pain 0;1;2;3;4;5;6;7;8;9;10 0;1;2;3;4;5;6;7;8;9;Worst possible pain Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:08:24.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22357 Chiari malformation identify speciality diagnosis type ChiariMlfIdSpDiagType The type of specialty of the individual responsible for diagnosis. The type of specialty of the individual responsible for diagnosis. Diagnosing Service (medical specialty) Neurosurgeon;Neurologist;Primary Care Physician;Self Neurosurgeon;Neurologist;Primary Care Physician;Self Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:51:45.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22307 Chiari malformation Neck pain onset important symptom scale ChiariMlfNckPnOnstImptSymScale The scale as related to neck pain at onset importance in Chiari malformation symptoms. The scale as related to neck pain at onset importance in Chiari malformation symptoms. Initial Symptom: Neck pain 1;0;2;3;4;5 1;Least important;2;3;4;Worst Symptom Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 13:21:38.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22334 Chiari malformation numbness tingling onset symptom severity scale ChiariMlfNmbTngOnstSymSevScale The scale as related to numbness/tingling at onset severity in Chiari malformation symptoms. The scale as related to numbness/tingling at onset severity in Chiari malformation symptoms. Initial Symptom Severity: Numbness/Tingling 0;1;2;3;4;5;6;7;8;9;10 0;1;2;3;4;5;6;7;8;9;Worst possible pain Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:12:54.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22358 Chiari malformation identify specialty diagnosis type text ChiariMlfIdSpDiagTypTxt The free text field related to identifying the specialty of the individual responsible for diagnosis. The free text field related to identifying the specialty of the individual responsible for diagnosis. Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:59:15.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events 255

Free-Form Entry

C00007 Birth date BirthDate Date (and time, if applicable and known) the participant/subject was born Date (and time, if applicable and known) the participant/subject was born Date of Birth Date or Date & Time Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Free-Form Entry

793
C22309 Chiari malformation numbness tingling onset important symptom scale ChiariMlfNmbTngOnstImpSymScale The scale as related to numbness/tingling at onset importance in Chiari malformation symptoms. The scale as related to numbness/tingling at onset importance in Chiari malformation symptoms. Initial Symptoms: Numbness/Tingling 1;0;2;3;4;5 1;Least important;2;3;4;Worst Symptom Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 13:24:55.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22335 Chiari malformation imbalance dizziness onset symptom severity scale ChiariMlfImbDzzOnstSymSevScale The scale as related to imbalance/dizziness at onset severity in Chiari malformation symptoms. The scale as related to imbalance/dizziness at onset severity in Chiari malformation symptoms. Initial Symptom Severity: Imbalance/Dizziness 0;1;2;3;4;5;6;7;8;9;10 0;1;2;3;4;5;6;7;8;9;Worst possible pain Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:16:39.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C01522 Height measurement HgtMeasr Measurement of participant's/subject's height. Measurement of participant's/subject's height. Height at Onset Numeric Values Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Free-Form Entry

0 400 centimeter 649
C22311 Chiari malformation imbalance dizziness onset important symptom scale ChiariMlfImbDzOnstImpSympScale The scale as related to imbalance/dizziness at onset importance in Chiari malformation symptoms. The scale as related to imbalance/dizziness at onset importance in Chiari malformation symptoms. Initial Symptoms: Imbalance/Dizziness 1;0;2;3;4;5 1;Least important;2;3;4;Worst Symptom Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 13:29:35.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22337 Chiari malformation visual symptoms onset symptom severity scale ChiariMlfVisSymOnstSymSevScale The scale as related to visual symptoms at onset severity in Chiari malformation symptoms. The scale as related to visual symptoms at onset severity in Chiari malformation symptoms. Initial Symptom Severity: Visual Symptoms 0;1;2;3;4;5;6;7;8;9;10 0;1;2;3;4;5;6;7;8;9;Worst possible pain Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:19:54.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C01541 Weight measurement WgtMeasr Measurement of participant's/subject's weight Measurement of participant's/subject's weight Weight at Onset Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Free-Form Entry

0 500 kilogram 2179689
C22313 Chiari malformation visual symptoms onset important symptom scale ChiariMlfVslSymOnstImpSymScale The scale as related to visual symptoms at onset importance in Chiari malformation symptoms. The scale as related to visual symptoms at onset importance in Chiari malformation symptoms. Initial Symptoms:Visual Symptoms 1;0;2;3;4;5 1;Least important;2;3;4;Worst Symptom Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 13:33:03.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22340 Chiari malformation auditory symptoms onset symptom severity scale ChiariMlfAudSymOnstSymSevScale The scale as related to auditory symptoms at onset severity in Chiari malformation symptoms. The scale as related to auditory symptoms at onset severity in Chiari malformation symptoms. Initial Symptom Severity: Auditory Symptoms 0;1;2;3;4;5;6;7;8;9;10 0;1;2;3;4;5;6;7;8;9;Worst possible pain Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:23:34.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C01581 Weight unit of measure WgtUoM Unit of measure for the weight numerical value Unit of measure for the weight numerical value Weight at Onset (unit of measurement) Pounds Pounds Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

2630200
C22315 Chiari malformation auditory symptoms onset important symptom scale ChiariMlfAudSymOnstImpSymScale The scale as related to auditory symptoms at onset importance in Chiari malformation symptoms. The scale as related to auditory symptoms at onset importance in Chiari malformation symptoms. Initial Symptoms: Auditory Symptoms 1;0;2;3;4;5 1;Least important;2;3;4;Worst Symptom Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 13:36:53.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22343 Chiari malformation fatigue onset symptom severity scale ChiariMlfFtgOnstSymSevScale The scale as related to fatigue at onset severity in Chiari malformation symptoms. The scale as related to fatigue at onset severity in Chiari malformation symptoms. Initial Symptom Severity: Fatigue 0;1;2;3;4;5;6;7;8;9;10 0;1;2;3;4;5;6;7;8;9;Worst possible pain Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:28:26.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C01582 Height unit of measure HgtUOM Unit of measure for the height numerical value for subject/participant Unit of measure for the height numerical value for subject/participant Height at Onset (unit of measure) Inches Inches Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

2538920
C22317 Chiari malformation fatigue onset important symptom scale ChiariMlfFtgOnstImpSymScale The scale as related to fatigue at onset importance in Chiari malformation symptoms. The scale as related to fatigue at onset importance in Chiari malformation symptoms. Initial Symptoms: Fatigue 1;0;2;3;4;5 1;Least important;2;3;4;Worst Symptom Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 13:39:43.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22345 Chiari malformation brain fog onset symptom severity scale ChiariMlfBFOnstSymSevScale The scale as related to brain fog at onset severity in Chiari malformation symptoms. The scale as related to brain fog at onset severity in Chiari malformation symptoms. Initial Symptom Severity: Brain Fog 0;1;2;3;4;5;6;7;8;9;10 0;1;2;3;4;5;6;7;8;9;Worst possible pain Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:31:57.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

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 Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Free-Form Entry

C22320 Chiari malformation brain fog onset important symptom scale ChiariMlfBnFgOnstImpSymScale The scale as related to brain fog at onset importance in Chiari malformation symptoms. The scale as related to brain fog at onset importance in Chiari malformation symptoms. Initial Symptoms: Brain Fog 1;0;2;3;4;5 1;Least important;2;3;4;Worst Symptom Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 13:46:02.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22347 Chiari malformation cardiac onset symptom severity scale ChiariMlfCardOnstSymSevScale The scale as related to cardiac at onset severity in Chiari malformation symptoms. The scale as related to cardiac at onset severity in Chiari malformation symptoms. Initial Symptom Severity: Cardiac 0;1;2;3;4;5;6;7;8;9;10 0;1;2;3;4;5;6;7;8;9;Worst possible pain Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:34:49.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22290 Chiari malformation information source CMInfoSource The source that provided information about Chiari Malformation to the patient. The source that provided information about Chiari Malformation to the patient. Informational source Self;Friend, spouse, or partner;Other family member;Other caregiver;Parent Self;Friend, spouse, or partner;Other family member;Other caregiver;Parent Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 12:22:53.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Multiple Pre-Defined Values Selected

C22323 Chiari malformation cardiac onset important symptom scale ChiariMlfCardOnstImpSymScale The scale as related to cardiac at onset importance in Chiari malformation symptoms. The scale as related to cardiac at onset importance in Chiari malformation symptoms. Initial Symptoms: Cardiac 1;0;2;3;4;5 1;Least important;2;3;4;Worst Symptom Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 13:50:51.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22351 Chiari malformation bowel bladder onset symptom severity scale ChiariMlfBwlBldOnstSymSevScale The scale as related to bowel/bladder at onset severity in Chiari malformation symptoms. The scale as related to bowel/bladder at onset severity in Chiari malformation symptoms. Initial Symptom Severity: Bowel/Bladder 0;1;2;3;4;5;6;7;8;9;10 0;1;2;3;4;5;6;7;8;9;Worst possible pain Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:39:20.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22292 Chiari malformation associate problem diagnosis type ChiAssocPronDiagnosTyp The type related to any associated problems found at the patient's diagnosis of Chiari Malformation. The type related to any associated problems found at the patient's diagnosis of Chiari Malformation. Associated problems at diagnosis Hydrocephalus;Scoliosis;Syringomyelia;Basilar Impression;Pseudotumor cerebri;Papilledema;Spina bifida;Tethered cord syndrome;Cervical disc disease;Lumbar disc disease;Joint hypermobility (EDS);POTS/Fainting/Arrythmia;Sleep disorder;Arachnoid cyst Hydrocephalus;Scoliosis;Syringomyelia;Basilar Impression;Pseudotumor cerebri;Papilledema;Spina bifida;Tethered cord syndrome;Cervical disc disease;Lumbar disc disease;Joint hypermobility (EDS);POTS/Fainting/Arrythmia;Sleep disorder;Arachnoid cyst Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 12:29:08.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Multiple Pre-Defined Values Selected

C22324 Chiari malformation bowel bladder onset important symptom scale ChiariMlfBwlBldOnstImpSymScale The scale as related to bowel/bladder at onset importance in Chiari malformation symptoms. The scale as related to bowel/bladder at onset importance in Chiari malformation symptoms. Initial Symptoms: Bowel/Bladder 1;0;2;3;4;5 1;Least important;2;3;4;Worst Symptom Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 13:54:37.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22354 Imaging diagnostic method type ImgDiagMethodType The type of imaging method utilized for diagnosis. The type of imaging method utilized for diagnosis. Initial Diagnostic Test MRI;CT MRI;CT Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 14:44:44.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

C22295 Chiari malformation precipitate factor type CMPrecipFacTyp The type related to any precipitating factors that may have contributed to the patient's Chiari Malformation. The type related to any precipitating factors that may have contributed to the patient's Chiari Malformation. Precipitating Factors Other trauma;Motor vehicle accident;Childbirth;Diagnosis in other family member;Other medical illness;Chiropractic manipulation;Dental procedure/Sedation Other trauma;Motor vehicle accident;Childbirth;Diagnosis in other family member;Other medical illness;Chiropractic manipulation;Dental procedure/Sedation Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 12:38:43.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Multiple Pre-Defined Values Selected

C22328 Chiari malformation headache onset symptom severity scale ChiariMlfHdacheOnstSymSevScale The scale as related to headache at onset severity in Chiari malformation symptoms. The scale as related to headache at onset severity in Chiari malformation symptoms. Initial Symptom Severity: Headache 0;1;2;3;4;5;6;7;8;9;10 0;1;2;3;4;5;6;7;8;9;Worst possible pain Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 13:58:45.0 Chiari Symptom Onset History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected

CSV