CDE Detailed Report

Disease: Chiari I Malformation
Subdomain Name: History of Disease/Injury Event
CRF: CMI - Tethered Cord Screening

Displaying 1 - 19 of 19
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
C22374 Chiari malformation tethered spinal cord urinary dribble incontinence indicator ChiariMlfTethSpCdUrinDrbIncInd The indicator related to dribbling (in the context of urinary incontinence) The indicator related to dribbling (in the context of urinary incontinence Dribbling? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 16:13:34.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22387 Chiari malformation tethered spinal cord sole numbness indicator ChiariMlfTethSpCdSleNmbInd The indicator related to numbness in the soles of an individual's feet The indicator related to numbness in the soles of an individual's fee Do you have numbness in the soles of your feet? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-10 09:16:26.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22375 Chiari malformation tethered spinal cord urinary drench incontinence indicator ChiariMlTethSpCdUrinDrnIncnInd The indicator related to urinary drenching (in context of urinary incontinence) The indicator related to urinary drenching (in context of urinary incontinence Drenching? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 16:17:35.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22388 Chiari malformation tethered spinal cord knee bent sleep back pain indicator ChiariMlfTethSpCdKnBnSlBkPnInd The indicator related to knees bent at night to relieve back or leg discomfort The indicator related to knees bent at night to relieve back or leg discomfor Do you keep your knees bent at night to relieve back or leg discomfort? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-10 09:19:05.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22378 Chiari malformation tethered spinal cord urinate incomplete indicator ChiariMlfTethSpCdUrinIncomInd The indicator related to incomplete urination The indicator related to incomplete urinatio Do you go two or more times in succession before completely emptying your bladder? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 16:21:27.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22389 Chiari malformation tethered spinal cord low back leg pain urinary symptom stair walk indicator ChiariMlfThSpCdBkLPUSyStWkInd The indicator related to low back pain, leg pain, or urinary symptoms while walking up stairs The indicator related to low back pain, leg pain, or urinary symptoms while walking up stair Do you have low back pain, leg pain, or urinary symptoms while walking up stairs? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-10 09:22:03.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22379 Chiari malformation tethered spinal cord reoccur bladder kidney indicator ChiariMlfTethSpCdRocBlKdInd The indicator related to recurring urinary bladder or kidney infection The indicator related to recurring urinary bladder or kidney infectio Do you have a history of recurring urinary bladder or kidney infections? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 17:07:43.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22391 Chiari malformation tethered spinal cord history severe growing pain indicator ChiariMlfTethSpCdHsSvGrPnInd The indicator related to a history of growing pains during childhood and adolescence The indicator related to a history of growing pains during childhood and adolescenc Did you have a history of severe growing pains during childhood and adolescence? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-10 09:26:19.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22380 Chiari malformation tethered spinal cord past urodynamic test indicator ChiariMlfTethSpnCdPstUroTstInd The indicator related to past urodynamic testing The indicator related to past urodynamic testin Have you had urodynamic testing in the past? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 17:13:35.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22381 Chiari malformation tethered spinal cord occasional fecal incontinence indicator ChiariMlfTethSpCdOcFclInconInd The indicator related to the occasional incontinence (in context of stool) The indicator related to the occasional incontinence (in context of stool Have you had occasional incontinence for stools (fecal soiling)? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 17:21:44.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22382 Chiari malformation tethered spinal cord decrease pelvic sensation indicator ChiariMlfTethSpCdDecPlvSenInd The indicator related to a decrease of sensation in the pelvic region The indicator related to a decrease of sensation in the pelvic regio Have you experienced a decrease or loss of sensation in your pelvic (or genital) area? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 17:27:57.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
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 Date or Date & Time Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Free-Form Entry
C22383 Chiari malformation tethered spinal cord loss sexual intercourse ability indicator ChiariMlfTethSpCdLsSxlInsAbInd The indicator related to the loss of ability to perform physiological sexual functions The indicator related to the loss of ability to perform physiological sexual function Have you lost the ability to reach an orgasm, sustain an erection, or ejaculate properly? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 17:35:34.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22366 Chiari malformation tethered spinal cord urine hold trouble indicator ChiariMlfTethSpCrdUrHlTroubInd The indicator related to trouble holding your urine The indicator related to trouble holding your urin Do you have trouble holding your urine more than 10-15 minutes after the 1st urge to go? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 15:33:46.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22384 Chiari malformation tethered spinal cord persistent low back pain indicator ChiariMlfTethSpCdPrsLwBckPnInd The indicator related to persistent or unexplained low back pain The indicator related to persistent or unexplained low back pai Do you have persistent or unexplained low back pain? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 17:45:41.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22369 Chiari malformation tethered spinal cord frequent urinate indicator ChiariMlfTethSpinCdFrqUrinInd Indicator related to frequency of urination Indicator related to frequency of urinatio Do you urinate more than 10 times per day? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 15:41:20.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22385 Chiari malformation tethered spinal cord leg pain indicator ChiariMlfTethSpCdLgPnInd The indicator related to leg pain The indicator related to leg pai Do you have leg pains? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-10 09:12:15.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22371 Chiari malformation tethered spinal cord urinary incontinence indicator CMTethSpiCrdUrnyIncontInd The indicator related to urinary incontinence The indicator related to urinary incontinenc Do you have urinary incontinence (Have you accidentally leaked urine)? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-09 16:10:13.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
C22386 Chiari malformation tethered spinal cord restless leg syndrome indicator ChiariMlfTethSpCdRstLgSynInd The indicator related to restless leg syndrome The indicator related to restless leg syndrom Do you have restless leg syndrome? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-10 09:14:22.0 CMI - Tethered Cord Screening History of Disease/Injury Event Disease/Injury Related Events

Single Pre-Defined Value Selected
CSV