CDE Detailed Report

Disease: Sport-Related Concussion
Subdomain Name: Physical Examinations
CRF: Clinical Examination

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
C52383 Post-concussion busy environment foggy dizzy severity score PCBusyEnviroFogDizzySevScore The score of the severity of the dizziness or fatigue the subject experiences from busy environments post-concussion The score of the severity of the dizziness or fatigue the subject experiences from busy environments post-concussio Severity (0-10) Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-17 15:49:27.0 Clinical Examination Physical Examinations Assessments and Examinations

Free-Form Entry

0 10
C52394 Post-concussion negative change mood personality indicator PCNegaChangMoodPersInd The indicator relating to whether or not the subject has been experiencing negative changes in his/her mood or personality post-concussion The indicator relating to whether or not the subject has been experiencing negative changes in his/her mood or personality post-concussio Have you experienced negative changes in mood or personality? Yes;No;Unknown;Not Asked Yes;No;Unknown;Not Asked Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-17 16:05:21.0 Clinical Examination Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C52384 Post-concussion blurred fuzzy vision while read indicator PCBlurFuzzyVisWhileReadInd The indicator relating to whether or not the subject has blurred fuzzy vision while reading or difficulty reading post-concussion The indicator relating to whether or not the subject has blurred fuzzy vision while reading or difficulty reading post-concussio Do you have blurred or fuzzy vision while reading or difficulty reading? Yes;No;Unknown;Not Asked Yes;No;Unknown;Not Asked Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-17 15:51:08.0 Clinical Examination Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C52395 Post-concussion negative change mood personality severity score PCNegaChangeModdPersSevScore The score of the severity of the subject's negative changes in his/her mood or personality post-concussion The score of the severity of the subject's negative changes in his/her mood or personality post-concussio Severity (0-10) Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-17 16:06:43.0 Clinical Examination Physical Examinations Assessments and Examinations

Free-Form Entry

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C52385 Post-concussion blurred fuzzy vision while read severity score PCBlurFuzzyVisWhilReadSevScore The score of the severity of the blurred fuzzy vision the subject experiences while reading or his/her difficulty reading post-concussion The score of the severity of the blurred fuzzy vision the subject experiences while reading or his/her difficulty reading post-concussio Severity (0-10) Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-17 15:52:16.0 Clinical Examination Physical Examinations Assessments and Examinations

Free-Form Entry

0 10
C52396 Post-concussion think about symptom indicator PCThinkAbtSymptmInd The indicator relating to whether or not the subject often thinks about his/her symptoms post-concussion The indicator relating to whether or not the subject often thinks about his/her symptoms post-concussio Are you often thinking about your symptoms? Yes;No;Unknown;Not Asked Yes;No;Unknown;Not Asked Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-17 16:07:51.0 Clinical Examination Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C52386 Post-concussion fatigue end of day indicator PCFatigueEndOfDayInd The indicator relating to whether or not the subject feels more fatigued than normal at the end of the day post-concussion The indicator relating to whether or not the subject feels more fatigued than normal at the end of the day post-concussio Do you feel more fatigued than normal at the end of the day? Yes;No;Unknown;Not Asked Yes;No;Unknown;Not Asked Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-17 15:53:33.0 Clinical Examination Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C52397 Post-concussion think about symptom severity score PCThinkAbtSymptmSevScore The score relating to how often the subject thinks of his/her symptoms post-concussion The score relating to how often the subject thinks of his/her symptoms post-concussio Severity (0-10) Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-17 16:09:08.0 Clinical Examination Physical Examinations Assessments and Examinations

Free-Form Entry

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C52387 Post-concussion fatigue end of day severity score PCFatigueAtEndOfDaySevScore The score of the severity of the subject's fatigue at the end of the day, if any post-concussion The score of the severity of the subject's fatigue at the end of the day, if any post-concussio Severity (0-10) Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-17 15:54:46.0 Clinical Examination Physical Examinations Assessments and Examinations

Free-Form Entry

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C55731 Post injury day count PostInjuryDayCt The number of day post injury The number of day post injur Number of days form completed from date of injury? Numeric Values Adult;Pediatric Supplemental 1.00 2017-05-26 15:25:06.0 Clinical Examination Physical Examinations Assessments and Examinations

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C52388 Post-concussion easily distract indicator PCEasilyDistractInd The indicator relating to whether or not the subject is easily distracted post-concussion The indicator relating to whether or not the subject is easily distracted post-concussio Are you easily distracted? Yes;No;Unknown;Not Asked Yes;No;Unknown;Not Asked Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-17 15:55:34.0 Clinical Examination Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C52389 Post-concussion easily distract severity score PCEasilyDistractSevScore The score pertaining to how easily distracted the subject gets post-concussion The score pertaining to how easily distracted the subject gets post-concussio Severity (0-10) Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-17 15:56:34.0 Clinical Examination Physical Examinations Assessments and Examinations

Free-Form Entry

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C52390 Post-concussion stress increase indicator PCStressIncreaseInd The indicator relating to whether or not the subject has been experiencing more stress than normal post-concussion The indicator relating to whether or not the subject has been experiencing more stress than normal post-concussio Are you experiencing more stress than normal? Yes;No;Unknown;Not Asked Yes;No;Unknown;Not Asked Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-17 16:00:41.0 Clinical Examination Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C17402 Site name SiteName The name of the site for the study The name of the site for the study Site Name Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Clinical Examination Physical Examinations Assessments and Examinations 255

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C52391 Post-concussion stress increase severity score PCStressIncreaseSevScore The score of the severity of how much more stress the subject is experiencing more than usual post-concussion The score of the severity of how much more stress the subject is experiencing more than usual post-concussio Severity (0-10) Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-17 16:01:40.0 Clinical Examination Physical Examinations Assessments and Examinations

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C19247 Subject ID SubIDNam Subject identification ID Subject identification ID Subject ID Alphanumeric Adult;Pediatric Supplemental 1.00 2014-06-05 13:10:49.0 Clinical Examination Physical Examinations Assessments and Examinations 255

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C52392 Post-concussion difficulty turning off thought indicator PCDiffTurnOffThoughtInd The indicator relating to whether or not the subject has difficulty turning off his/her thoughts post-concussion The indicator relating to whether or not the subject has difficulty turning off his/her thoughts post-concussio Do you have difficulty turning off your thoughts? Yes;No;Unknown;Not Asked Yes;No;Unknown;Not Asked Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-17 16:02:43.0 Clinical Examination Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C52382 Post-concussion busy environment foggy dizzy indicator PCBusyEnviroFogDizzyInd The indicator relating to whether or not busy environments cause the subject to feel foggy, dizzy, fatigued, or overwhelmed post-concussion The indicator relating to whether or not busy environments cause the subject to feel foggy, dizzy, fatigued, or overwhelmed post-concussio Do busy environments cause you to feel foggy, dizzy, fatigued or overwhelmed? Yes;No;Unknown;Not Asked Yes;No;Unknown;Not Asked Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-17 15:47:12.0 Clinical Examination Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C52393 Post-concussion difficulty turning off thought severity score PCDiffTurnOffThoughtSevScore The score of how difficult is it for the subject to turn off his/her thoughts post-concussion The score of how difficult is it for the subject to turn off his/her thoughts post-concussio Severity (0-10) Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-17 16:04:17.0 Clinical Examination Physical Examinations Assessments and Examinations

Free-Form Entry

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CSV