CDE Detailed Report

Disease: Traumatic Brain Injury
Subdomain Name: Demographics
CRF: FITBIR Demographics Form

Displaying 51 - 100 of 123
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
C22691 Parent birth country ISO code ParentBirthCntryISOCode Code (ISO 3166-1 alpha-2 code) for country where the participant's/subject's parent, guardian, or caregiver was born Code (ISO 3166-1 alpha-2 code) for country where the participant's/subject's parent, guardian, or caregiver was bor What is the parent's, guardian's, or caregiver's birth country ISO code? AU;CA;MX;GB;US AUSTRALIA;CANADA;MEXICO;UNITED KINGDOM;UNITED STATES Alphanumeric

Choose one. It may be easier to record the full name of the country and code the data later using the ISO 3166-1 alpha-2 codes.

Code (ISO 3166-1 alpha-2 code) for country where the participant/subject was born

Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C18747 Residence other text ResdncOTH The free-text field related to 'Residence type' specifying other text. Type of residence where the participant/subject is currently living The free-text field related to 'Residence type' specifying other text. Type of residence where the participant/subject is currently living Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

C21820 Sport junior high participation year count JuniorHighPrimarySprtYrsCt The number of years participant/subject played sport(s) in junior high school The number of years participant/subject played sport(s) in junior high school How many years did the subject play the primary sport in junior high school? 1;2;3;4;5;6 1;2;3;4;5;6 Numeric Values

The number of years subject played sport(s) in junior high school

Adult;Pediatric Supplemental 1.00 2016-06-03 12:48:46.0 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C00029 Language written fluent ISO code LangWrtnFlntlyTxtISOCode Code (ISO 639-2) for each language that the participant/subject writes fluently Code (ISO 639-2) for each language that the participant/subject writes fluently What are the ISO codes for each language the subject can write fluently? Alphanumeric

Enter all that apply

ISO 639-2 language codes (http://www.loc.gov/standards/iso639-2/php/code_list.php) Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 FITBIR Demographics Form Demographics Participant Characteristics 255

Free-Form Entry

C00222 Job classification category JobclassCat Category that classifies work performed by participant/subject Category that classifies work performed by participant/subjec What is the subject's current job classification? Agricultural or fishery worker;Armed forces occupation;Clerk;Craft and related trades workers;Elementary occupations;Legislator, or senior official, or manager;Plant and machine operators and assemblers;Professional;Professional referral;Service or sales worker;Technicians and associate professionals;Not applicable;Unknown;Other, specify Agricultural or fishery worker;Armed forces occupation (officers, service personnel);Clerk;Craft and related trades workers (e.g. motor mechanic, printer, tool and die makers, electrician);Elementary occupations (laborer, porter, unskilled workers);Legislator, or senior official, or manager;Plant and machine operators and assemblers;Professional;Professional referral;Service or sales worker;Technicians and associate professionals (typically requiring a Bachelor degree or equivilent);Not applicable;Unknown;Other, specify Alphanumeric

For detailed definitions go to: http://www.who.int/healthinfo/survey/whsshortversionguide.pdf

Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C22706 Military USA rank category other text MilUSARnkCatOTH The free-text field related to Military rank category specifying other text. Category that describes the participant's/subject's rank in the military The free-text field related to Military rank category specifying other text. Category that describes the participant's/subject's rank in the military Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2016-08-22 09:14:32.0 FITBIR Demographics Form Demographics Participant Characteristics 255

Free-Form Entry

C21798 Living situation juvenile patient other text SesPrimChildOTH Living situation of juvenile patient other text Living situation of juvenile patient other text Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-03 08:49:58.0 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

C21981 Sport college primary participation other text SportCollegePrimarPartOTH Other sports the participant/subject played in college. A complimentary CDE for Primary college sport played by the participant/subject Other sports the participant/subject played in college. A complimentary CDE for Primary college sport played by the participant/subjec Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-06 18:26:32.0 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

C15994 Dependent children living in household number DpndntChildLvngHshldNum Number of dependent children living in household Number of dependent children living in household What is the number of dependent children living in the subject's household? Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 FITBIR Demographics Form Demographics Participant Characteristics

Free-Form Entry

C21809 Military deployment location MilDeploy Region or country to where participant/subject was deployed Region or country to where participant/subject was deployed Where was the subject deployed? Iraq;Afghanistan;Africa;Germany;None;Other, specify Iraq;Afghanistan;Africa;Germany;None;Other, specify Alphanumeric

Region or country the military patient was deployed

Adult;Pediatric Supplemental 1.00 2016-06-03 11:24:57.0 FITBIR Demographics Form Demographics Participant Characteristics

Multiple Pre-Defined Values Selected

C00008 Age value AgeVal Value for participant's age, calculated as elapsed time since the birth of the participant Value for participant's age, calculated as elapsed time since the birth of the participant Subject's age (recorded in years) Numeric Values

The subject's age is typically recorded to the nearest full year completed, e.g., 11 years and 6 months should be recorded as 11 years. For subject's which are under 1 year old, use decimal points and use the following convention: record 1 month as 0.083 (1/12), 2 months as 0.166 (2/12), 3 months as 0.25 (3/12), 4 months as 0.333 (4/12), 5 months as 0.416 (5/12), 6 months as 0.5 (6/12), 7 months as 0.583 (7/12), 8 months as 0.666 (8/12), 9 months as 0.75 (9/12), 10 months as 0.833 (10/12), 11 months as 0.916 (11/12) and 12 months as 1 year.

Adult;Pediatric Supplemental 3.10 2024-02-29 15:47:28.0 FITBIR Demographics Form Demographics Participant Characteristics

Free-Form Entry

0 1800 month
C21992 Sport professional primary participation other text SportProfessionalPartOTH Other sports the participant played professionally. A complimentary element for Primary professional sport played by the participant Other sports the participant played professionally. A complimentary element for Primary professional sport played by the participan Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-06 18:38:26.0 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

C22692 Parent birth country name ParentBirthCntryName Name for country where the parent, guardian, or caregiver was born Name for country where the parent, guardian, or caregiver was born What is the parent's, guardian's, or caregiver's birth country name? Alphanumeric

Choose one. It may be easier to record the full name of the country and code the data later using the ISO 3166-1 alpha-2 codes.

Code (ISO 3166-1 alpha-2 code) for country where the participant/subject was born

Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 FITBIR Demographics Form Demographics Participant Characteristics 255

Free-Form Entry

C18821 School placement other text SchoolPlacementOTH The free-text field related to 'School placement type' specifying other text. The description of the type of education the participant/subject receives with details of being with or without assistance The free-text field related to 'School placement type' specifying other text. The description of the type of education the participant/subject receives with details of being with or without assistanc Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-11 15:03:49.2 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

C21821 Sport junior high other participation text JuniorHighSportOtherplayedTxt The free-text field to specify which other sports participant/subject played in junior high school The free-text field to specify which other sports participant/subject played in junior high school Which other sports did the subject play in junior high school? Alphanumeric

The free-text field to specify which other sports subject played in junior high school

Adult;Pediatric Supplemental 1.00 2016-06-03 12:51:28.0 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

C00030 Race USA category RaceUSACat The patient's self declared racial origination, independent of ethnic origination, using OMB approved categories The patient's self declared racial origination, independent of ethnic origination, using OMB approved categori What is the subject's racial background (as defined by OMB)? American Indian or Alaska Native;Asian;Black or African-American;Native Hawaiian or Other Pacific Islander;White;Unknown;Not Reported A person having origins in any of the original peoples of North and South America (including Central America) , and who maintains tribal affiliation or community attachment.;A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.;A person having origins in any of the black racial groups of Africa. Terms such as "Haitian" can be used in addition to "Black or African American.";A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.;A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.;Could not be determined or unsure;Not provided or unavailable Alphanumeric

Choose all that apply. Response is obtained by report of the participant/subject or caretaker. Collecting information on race may not be allowed in some countries for concerns related to discrimination. In other countries, however, these concerns are considered a reason for recording race in order to guarantee equal access to care. Investigators receiving funding from the US National Institutes of Health (NIH) are required to report the number of subjects enrolled on an annual basis using the racial categories listed.

The NIH Guidelines on Inclusion of Women and Minorities as Subjects in Clinical Research: The Office of Management and Budget (OMB) Directive No. 15 defines the minimum standard of basic racial and ethnic categories. (http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm)

The NIH Guidelines on Inclusion of Women and Minorities as Subjects in Clinical Research: The Office of Management and Budget (OMB) Directive No. 15 defines the minimum standard of basic racial and ethnic categories. (http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm) Collection of Race and Ethnicity Data in Clinical Trials (FDA, September 2005 - http://www.fda.gov/RegulatoryInformation/Guidances/ucm126340.htm) Jorde LB and Wooding SP. Genetic variation, classification and "race". Nature Genetics. 2004;36(11):S28-S33. Bhopal R and Donaldson L. White, European, Western, Caucasian, or What? Inappropriate labeling in Research on Race, Ethnicity, and Health. Amer J of Publ Health. 1998;88:1303-1307. Adult;Pediatric Core 3.00 2013-07-25 08:54:08.2 FITBIR Demographics Form Demographics Participant Characteristics

Multiple Pre-Defined Values Selected

2192199
C04814 Residence type ResdncTyp Type of residence where the participant/subject is currently living Type of residence where the participant/subject is currently living What type of residence does the subject currently live in? Hospital;Nursing home;Home;N/A - patient died;Other, specify;Unknown;Rehabilitation center Hospital;Nursing home;Home;N/A - patient died;Other, specify;Unknown;Rehabilitation center Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C22707 Education level USA type other text EduLvlUSATypOTH The free-text field related to Education level USA type specifying other text. The highest level of education the participant/subject received The free-text field related to Education level USA type specifying other text. The highest level of education the participant/subject receive Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2016-08-22 10:51:20.0 FITBIR Demographics Form Demographics Participant Characteristics 255

Free-Form Entry

C21799 Living situation before injury type LivingSituationPreInjTyp Living situation of the participant/subject before injury Living situation of the participant/subject before injur What was the subject's living situation before injury? Homeless/lives in shelter;Lives alone;Lives in group home/assisted living;Lives with friend(s) or roommate(s) or cohabiting;Lives with spouse and/or other family member(s);Data Missing/Refused/Unknown;Other, specify Homeless/lives in shelter;Lives alone;Lives in group home/assisted living;Lives with friend(s) or roommate(s) or cohabiting;Lives with spouse and/or other family member(s);Data Missing/Refused/Unknown;Other, specify Alphanumeric

Living situation of the participant/subject before injury.

Adult;Pediatric Supplemental 1.00 2016-06-03 10:34:36.0 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C21982 Sport college other participation text SportCollegeOtherPlaydTxt College sports played other than primary sport College sports played other than primary sport Which other sports did the subject play in college? Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-06 18:28:08.0 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

C15995 Household wage earners number HshldWgeEarnNum Number of wage earners in household Number of wage earners in household How many wage earners live in the subject's household? Numeric Values

Refer to Household and Income.

Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 FITBIR Demographics Form Demographics Participant Characteristics

Free-Form Entry

C21810 Military deployment location other text MilDeployOTH Region or country to where participant/subject was deployed other text Region or country to where participant/subject was deployed other text Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-03 11:26:09.0 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

C00012 Education level USA type EduLvlUSATyp Highest grade or level of school participant/subject has completed or the highest degree received Highest grade or level of school participant/subject has completed or the highest degree received What best describes the highest level the subject completed in school? Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational/technical/vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational/technical/vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Alphanumeric

Choose the highest level attained by the participant/subject.

National Health and Nutrition Examination Survey (NHANES); National Health Interview Survey (NHIS); PhenX Toolkit Current Educational Attainment #011001 (https: //www.phenxtoolkit.org) Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

3134878
C21993 Sport professional other participation text SportProfessionlOtherPartTxt Professional sports played other than primary sport Professional sports played other than primary sport Which other professional sports did the subject play? Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-06 18:39:11.0 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

C22693 Parent marital or partner status ParentMartlPartnerStatus Status of participant's/subject's parent, guardian, or caregiver's current domestic relationship, whether marital or partnered Status of participant's/subject's parent, guardian, or caregiver's current domestic relationship, whether marital or partnered What is the parent's, guardian's, or caregiver's marital status? Never married;Married;Domestic partnership;Divorced;Separated;Widowed Never married;Married;Domestic partnership;Divorced;Separated;Widowed Alphanumeric

STROKE: Johnson NJ, Backlund E, Sorlie PD, Loveless CA. Marital status and mortality: the national longitudinal mortality study. Ann Epidemiol. 2000;10:224-238. NCI CDE Browser Public ID = 2188083

Status of participant/subjects current domestic relationship, whether marital or partnered

Johnson NJ, Backlund E, Sorlie PD, Loveless CA. Marital status and mortality: the national longitudinal mortality study. Ann Epidemiol. 2000;10: 224-238. Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

2188083
C19036 Education other text EduOTH The free-text field related to 'Education type' specifying other text. The type of education the participant/subject received The free-text field related to 'Education type' specifying other text. The type of education the participant/subject receive Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

C21822 Sport junior high other participation year count JuniorHighSportOtherYrsCt Total combined number of years participant/subject played sport(s) junior high school Total combined number of years participant/subject played sport(s) junior high school How many total combined years did the subject play other sports in junior high school? Numeric Values

Total combined number of years subject played sport(s) junior high school

Adult;Pediatric Supplemental 1.00 2016-06-03 12:52:39.0 FITBIR Demographics Form Demographics Participant Characteristics

Free-Form Entry

0 100
C00031 Race expanded category RaceCat Category of race(s) or region(s) the participant/subject most closely identifies with Category of race(s) or region(s) the participant/subject most closely identifies with What is the subject's racial background (expanded categories)? Not reported;Other;Unknown;Black African American;Black African;Black Afro Caribbean;South/Central American Indian;North American Indian;Alaskan Native;Inuit;South Asian;Far Eastern Asian;Western Asian;White North American;White South American;White European;White Middle Eastern;White African;White Australian;Hawaiian;Pacific Islander;American Indian or Alaska Native;Caucasian;Asian-West;Asian-East;African-North Not reported;Other;Unknown;Black African American (for OMB purposes, this value is considered to be part of Black or African-American);Black African (for OMB purposes, this value is considered to be part of Black or African-American);Black Afro Caribbean (for OMB purposes, this value is considered to be part of Black or African-American);South/Central American Indian (for OMB purposes, this value is considered to be part of American Indian or Alaska Native);North American Indian (for OMB purposes, this value is considered to be part of American Indian or Alaska Native);Alaskan Native (for OMB purposes, this value is considered to be part of American Indian or Alaska Native);Inuit (for OMB purposes, this value is considered to be part of American Indian or Alaska Native);South Asian (Indian subcontinent) (for OMB purposes, this value is considered to be part of Asian);Far Eastern Asian (e.g., China, Japan, Korea, etc.) (for OMB purposes, this value is considered to be part of Asian);Western Asian (e.g., Pakistan, Iraq, Iran) (for OMB purposes, this value is considered to be part of Asian);White North American (for OMB purposes, this value is considered to be part of White);White South American (for OMB purposes, this value is considered to be part of White);White European (for OMB purposes, this value is considered to be part of White);White Middle Eastern (for OMB purposes, this value is considered to be part of White);White African (for OMB purposes, this value is considered to be part of White);White Australian (for OMB purposes, this value is considered to be part of White);Hawaiian (for OMB purposes, this value is considered to be part of Native Hawaiian or Other Pacific Islander);Pacific Islander (for OMB purposes, this value is considered to be part of Native Hawaiian or Other Pacific Islander);A person having origins in any of the original peoples of North and South America (including Central America) , and who maintains tribal affiliation or community attachment.;Caucasian;Asian-West;Asian-East;African-North Alphanumeric

Choose all that apply. Response is obtained by report of the participant/subject or caretaker. Collecting information on race may not be allowed in some countries for concerns related to discrimination. In other countries, however, these concerns are considered a reason for recording race in order to guarantee equal access to care. Investigators receiving funding from the US National Institutes of Health (NIH) are required to report the number of subject's enrolled on an annual basis using the racial categories listed.

The NIH Guidelines on Inclusion of Women and Minorities as Subjects in Clinical Research: The Office of Management and Budget (OMB) Directive No. 15 defines the minimum standard of basic racial and ethnic categories. (http: //grants.nih.gov/grants/funding/women_min/guidelines_update.htm) Collection of Race and Ethnicity Data in Clinical Trials (FDA, September 2005 - http: //www.fda.gov/RegulatoryInformation/Guidances/ucm126340.htm) <br />Jorde LB and Wooding SP. Genetic variation, classification and race . Nature Genetics. 2004;36(11): S28-S33. Bhopal R and Donaldson L. White, European, Western, Caucasian, or What? Inappropriate labeling in Research on Race, Ethnicity, and Health. Amer J of Publ Health. 1998;88: 1303-1307. Adult;Pediatric Core 3.00 2013-07-22 16:57:17.79 FITBIR Demographics Form Demographics Participant Characteristics

Multiple Pre-Defined Values Selected

C08147 Data source DataSource Source of the data provided on the case report form Source of the data provided on the case report form Who is the source of this information in relation to the subject? Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Other, specify;Unknown;Spouse Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Other, specify;Unknown;Spouse Alphanumeric

Choose all that apply

Adult;Pediatric Supplemental 3.00 2013-07-20 10:46:24.96 FITBIR Demographics Form Demographics Participant Characteristics

Multiple Pre-Defined Values Selected

C22708 Parent ethnicity USA category other text ParentEthnUSACatOTH The free-text field describing the category of ethnicity the participant's/subject's parent/guardian most closely identifies with The free-text field describing the category of ethnicity the participant's/subject's parent/guardian most closely identifies wit Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2016-08-22 11:45:27.0 FITBIR Demographics Form Demographics Participant Characteristics 255

Free-Form Entry

C21800 Living situation before injury other text LivingSituationPreInjTypOTH Living situation of the participant/subject before injury other text Living situation of the participant/subject before injury other tex Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-03 10:38:50.0 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

C21983 Sport college other participation total year count SportCollegeOtherYrsCt Total combined years the participant/subject played other college sport(s) (should be used in combination with Other sport(s) the participant played in college) Total combined years the participant/subject played other college sport(s) (should be used in combination with Other sport(s) the participant played in college How many total combined years did the subject play other sports in college? Numeric Values

Use in combination with Other sport(s) the participant played in college UDE

Adult Supplemental 1.00 2016-06-06 18:29:02.0 FITBIR Demographics Form Demographics Participant Characteristics

Free-Form Entry

1 50
C17396 Sex genotype type SexGenotypTyp The difference between male and female, based upon the interactions between genes and between the genotype and the environment. Genotype is identified based on the individual's reproductive organs and functions assigned by chromosomal complement Sex chromosomes of the participant/subject based upon genotyping What is the subject's sex or genotype? XX;XY;XXX;XYY;XXY;Other, specify;Unknown;Unspecified XX;XY;XXX;XYY;XXY;Other, specify;Unknown;Undifferentiated/Indeterminant/Intersex Alphanumeric

Choose only one

Added to TBI per meeting with FITBIR on 12/18/13.

Adult;Pediatric Core 3.10 2018-07-26 00:00:00.0 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C21812 Sport head neck injury indicator TBISportInd The indicator related to having a injury of head or neck in sports The indicator related to having a injury of head or neck in sport Was the subject's traumatic brain injury sports related? Yes;No;Unknown Yes;No;Unknown Alphanumeric

The indicator related to having a injury of head or neck in sports.

Adult;Pediatric Supplemental 1.00 2016-06-03 11:54:50.0 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C00013 Education level primary caregiver USA type EduLvlPrimCaregiverUSATyp Highest grade or level of school the participant's/subject's primary caregiver has completed or the highest degree he/she has received Highest grade or level of school the participant's/subject's primary caregiver has completed or the highest degree he/she has received What is the parent's, guardian's, or caregiver's highest grade or level of school completed? Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational, technical, or vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational, technical, or vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Alphanumeric

Choose the highest level attained by the participant/subject's primary caregiver. This element is recommended for Pediatric stroke studies. Choose highest level attained.

Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C21994 Sport professional participation other total year count SportProfessionPartOthTtlYrsCt Total combined years the participant/subject played other professional sport(s) (should be used in combination with Other professional sports played by the participant/subject Total combined years the participant/subject played other professional sport(s) (should be used in combination with Other professional sports played by the participant/subjec What is the total number of years the subject played other professional sports? Numeric Values

Use in combination with Other professional sports played by the participant UDE

Adult Supplemental 1.00 2016-06-06 18:40:17.0 FITBIR Demographics Form Demographics Participant Characteristics

Free-Form Entry

1 50
C22694 Parent dependent children liviing in household number ParentDpndntChildLvngHshldNum Number of dependent children living in parent's, guardian's or caregiver's household Number of dependent children living in parent's, guardian's or caregiver's household What is the number of dependent children living in the parent, guardian, or caregiver's household? Numeric Values

Refer to Household and Income.

Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 FITBIR Demographics Form Demographics Participant Characteristics

Free-Form Entry

C19247 Subject ID SubIDNam Subject identification ID Subject identification ID Subject ID Number Alphanumeric

The participant or subject identifiers or IDs should be assigned by the study.

SCI Variable: SUBJECT

Alexander MS, Biering-Saarensen F, Elliott S, Kreuter M, Saanksen J. International Spinal Cord Injury Female Sexual and Reproductive Function Basic Data Set. Spinal Cord. 2011 Jul;49(7):787-90. Alexander MS, Biering-S&Oslash;rensen F, Elliott S, Kreuter M, S&Oslash;nksen J. International spinal cord injury male sexual function basic data set. Spinal Cord. 2011 Jul;49(7):795-8.<br />Bauman WA, Biering-Saarensen F, Krassioukov A. International spinal cord injury endocrine and metabolic function basic data set. Spinal Cord. 2011 Oct;49(10):1068-72.<br />Biering-Saarensen F, Craggs M, Kennelly M, Schick E, Wyndaele JJ. International Lower Urinary Tract Function Basic Spinal Cord Injury Data Set. Spinal Cord 2008 May;46(5):325-30.<br />Krogh K, Perkash I, Stiens SA, Biering-Saarensen F. International bowel function extended spinal cord injury data set. Spinal Cord. 2009 Mar;47(3):235-41.<br />Widerstraam-Noga E, Biering-Saarensen F, Bryce T, Cardenas DD, Finnerup NB, Jensen MP, Richards JS, Siddall PJ. The international spinal cord injury pain basic data set. Spinal Cord. 2008 Dec;46(12):818-23. Adult;Pediatric Supplemental 1.00 2014-06-05 13:10:49.0 FITBIR Demographics Form Demographics Participant Characteristics 255

Free-Form Entry

C21973 Sport high school participation indicator SportHighSchoolInd Whether participant/subject played sports in high school Whether participant/subject played sports in high school Did the subject participate in sports in high school? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-06 18:07:34.0 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C00035 Gender type GenderTyp Self-reported gender of the participant/subject Self-reported gender of the participant/subjec What is the subject's gender? Alphanumeric

Choose one. Response is obtained by report of the participant/subject or caretaker.

The NIH Guidelines on Inclusion of Women and Minorities as Subjects in Clinical Research: The Office of Management and Budget Directive No. 15 (http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm)

The NIH Guidelines on Inclusion of Women and Minorities as Subjects in Clinical Research: The Office of Management and Budget Directive No. 15 (http: //grants.nih.gov/grants/funding/women_min/guidelines_update.htm) Adult;Pediatric Core 3.00 2013-08-28 16:08:00.453 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

2200604
C10467 Risk Factor Questionnaire (RFQ) - military service current active status RFQMilSrvcCurrActStatus The status whether the participant/subject is currently active in the military as part of the Risk Factor Questionnaire (RFQ) - Occupation The status whether the participant/subject is currently active in the military as part of the Risk Factor Questionnaire (RFQ) - Occupatio Is the subject active military? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Whether participant currently has active military status

Adult;Pediatric Supplemental 3.00 2013-07-18 09:11:50.26 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C21801 Education highest level before injury type HighestLvlEduPreInj Highest level education pre-injury Highest level education pre-injury What is the highest level of education the subject received pre-injury? None/basic primary = 0 - 4 years;Primary/Intermediate Primary = 5 - 8 years;Secondary = 12 years;Tertiary = 13 - 15 years (e.g., Teachers, Technicians);University = 16 - 17 years;Post Graduate = 18-19 years (e.g., Masters, Doctoral);Unknown None/basic primary = 0 - 4 years;Primary/Intermediate Primary = 5 - 8 years;Secondary = 12 years;Tertiary = 13 - 15 years (e.g., Teachers, Technicians);University = 16 - 17 years;Post Graduate = 18-19 years (e.g., Masters, Doctoral);Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-03 10:54:09.0 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C21984 Sport recreational participation indicator SportRecreationlPartInd Whether the participant/subject played recreational sports Whether the participant/subject played recreational sports Did the subject participate in recreational sports? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-06 18:30:14.0 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C17399 Global unique identifier number GlobalUniqueIdNum Number representing the Global Unique ID (GUID) which uniquely identifies a participant Number representing the Global Unique ID (GUID) which uniquely identifies a participant GUID Alphanumeric Johnson SB, Whitney G, McAuliffe M, Wang H, McCreedy E, Rozenblit L, Evans CC. Using global unique identifiers to link autism collections. J Am Med Inform Assoc. 2010;17(6):689-95. doi: 10.1136/jamia.2009.002063. Adult;Pediatric Supplemental 3.10 2024-02-29 15:54:17.0 FITBIR Demographics Form Demographics Participant Characteristics 255

Free-Form Entry

C21813 Sport elementary school participation indicator ElementarySchoolSprtInd The indicator related to whether participant/subject participated in sport(s) in elementary school The indicator related to whether participant/subject participated in sport(s) in elementary school Did the subject participate in sports in elementary school? No;Yes No;Yes Alphanumeric

The indicator related to whether subject participated in sport(s) in elementary school

Adult;Pediatric Supplemental 1.00 2016-06-03 11:56:15.0 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C00015 Education year count EduYrCt Number of years of education completed (age 5 and beyond) Number of years of education completed (age 5 and beyond) How many years of education does the subject have? Numeric Values

Choose the highest level attained by the participant/subject caBIG CDE Public ID = 3134878 For years completed, code the number of years attained (0-30 years), normed to someone moving full time at the usual pace, i.e. a year that was repeated counts as only 1 year and the usual single-year full-time load completed over several years counts as 1 year. Certificate and technical programs do NOT count no matter how specialized. The number of years of typical completion of the relevant program is counted. If the subject obtained their education outside the United States, ask about their educational system to estimate the correct coding - Internship, Residency, and Fellowship years are experiential training and do not count. Recommend collection at least on date of TBI.

Adult;Pediatric Supplemental 3.00 2013-07-22 16:57:17.79 FITBIR Demographics Form Demographics Participant Characteristics

Free-Form Entry

0 30 year 3134878
C22682 Case Control Indicator CaseContrlInd The response related to whether subject is in the case or control arm of the study Indicator of whether subject is in the case or control arm of the study Is the subject in the case or control arm of the study? Case;Control;Unknown Case;Control;Unknown Alphanumeric

Indicate whether subject is (was) in the case or control arm of the study

Adult;Pediatric Supplemental 1.00 2016-07-27 13:36:42.0 FITBIR Demographics Form Demographics Participant Characteristics

Multiple Pre-Defined Values Selected

C22695 Parent dependent children number ParentDpndntChildNum Number of dependent children the participant's/subject's parent, guardian, or caregiver has Number of dependent children the participant's/subject's parent, guardian, or caregiver has What is the total number of dependent children the parent, guardian, or caregiver's has? Include both living in the household and living elsewhere. Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 FITBIR Demographics Form Demographics Participant Characteristics

Free-Form Entry

C19257 Residence area type ResidenceAreaTyp Type describing the participant's/subject's current location of residence Type describing the participant's/subject's current location of residence How would you describe the subject's current location of residence? A big city (population >= 250,000) including suburbs/outskirts;A small town/ small city (population 500-10,000);Rural area (population =< 500);Unknown A big city (population >= 250,000) including suburbs/outskirts;A small town/ small city (population 500-10,000);Rural area (population =< 500);Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2014-06-05 17:27:45.0 FITBIR Demographics Form Demographics Participant Characteristics

Single Pre-Defined Value Selected

C21974 Sport high school primary participation indicator SportHighSchoolPrimryPartInd The primary sport the participant/subject played in high school The primary sport the participant/subject played in high school What was the primary sport the subject played in high school? Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-06 18:09:32.0 FITBIR Demographics Form Demographics Participant Characteristics 4000

Free-Form Entry

CSV