CDE Detailed Report
Disease: Sport Related Concussion
Subdomain Name: History of Disease/Injury Event
CRF: Return to Play
Displaying 1 - 14 of 14
Subdomain Name: History of Disease/Injury Event
CRF: Return to Play
Displaying 1 - 14 of 14
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C55629 | Same sport indicator | SameSportInd | Indicator if the participant/subject returned to the same sport, as part of the Return to Play case report form | Indicator if the participant/subject returned to the same sport, as part of the Return to Play case report form | Did participant return to same sport? | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-18 10:02:09.0 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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| C55630 | Same level of activity indicator | SameLvlActiveInd | The indicator specificying if the participant/subject returned to the same level of activity as part of the Return to Play case report form | The indicator specificying if the participant/subject returned to the same level of activity as part of the Return to Play case report form | Did participant teturn to same level of activity | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-18 10:06:25.0 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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| C55631 | No activity rehabilitation completed date | NoActiveRehabStageCompDate | The date the participant/subject completed the no activity (symptom limited physical and cognitive rest) rehabilitation stage as part of the Return to Play case report form | The date the participant/subject completed the no activity (symptom limited physical and cognitive rest) rehabilitation stage as part of the Return to Play case report form | No activity (symptom limited physical and cognitive rest) | Date or Date & Time | Adult;Pediatric | Supplemental | 1.00 | 2017-05-18 10:15:47.0 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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| C55632 | Light aerobic exercise reahbilitation stage completed date | LghtAeroExercRehabStagCompDate | The date the participant/subject completed the light aerobic exercise (walking, swimming or stationary cycling keeping intensity <70% maximum permitted heart rate; no resistance training) rehabilitation stage as part of the Return to Play case report form | The date the participant/subject completed the light aerobic exercise (walking, swimming or stationary cycling keeping intensity <70% maximum permitted heart rate; no resistance training) rehabilitation stage as part of the Return to Play case report form | Light aerobic exercise (walking, swimming or stationary cycling keeping intensity <70% maximum permitted heart rate; no resistance training) | Date or Date & Time | Adult;Pediatric | Supplemental | 1.00 | 2017-05-18 10:15:47.0 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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| C55633 | Sport-specific excercise rehabilitation stage completed date | SprtSpecExerRehabStagCompDate | The date the participant/subject completed the sport-specific exercise (skating drills in ice hockey, running drills in soccer; no head impact activities) rehabilitation stage as part of the Return to Play case report form | The date the participant/subject completed the sport-specific exercise (skating drills in ice hockey, running drills in soccer; no head impact activities) rehabilitation stage as part of the Return to Play case report form | Sport-specific exercise (skating drills in ice hockey, running drills in soccer; no head impact activities) | Date or Date & Time | Adult;Pediatric | Supplemental | 1.00 | 2017-05-18 10:15:47.0 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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| C05400 | Injury date time | InjDateTime | Date (and time, if applicable and known) of injury | Date (and time, if applicable and known) of injury | Injury Date/Time | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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| C55634 | Full-contact practice completed date | FullContactCompDate | The date the participant/subject completed the full contact (following medical clearance participate in normal training activities) rehabilitation stage as part of the Return to Play case report form | The date the participant/subject completed the full contact (following medical clearance participate in normal training activities) rehabilitation stage as part of the Return to Play case report form | Full-contact practice (following medical clearance participate in normal training activities) | Date or Date & Time | Adult;Pediatric | Supplemental | 1.00 | 2017-05-18 10:15:47.0 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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| C15910 | Assessment date and time | AssessDateTime | The date of participant's injury | The date of participant's injury | Assessment Date/Time | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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| C55635 | Non-contact rehabilitation stage complete date | NonContactRehabStageCompDate | The date the participant/subject completed the Non-contact (progression to more complex training drills, eg passing drills in football and ice hockey; may start progressive resistance training) rehabilitation stage as part of the Return to play CRF | The date the participant/subject completed the Non-contact (progression to more complex training drills, eg passing drills in football and ice hockey; may start progressive resistance training) rehabilitation stage as part of the Return to play CRF | Non-contact training drills (progression to more complex training drills, eg passing drills in football and ice hockey; may start progressive resistance training) | Date or Date & Time | Adult;Pediatric | Supplemental | 1.00 | 2017-05-18 10:15:47.0 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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| 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 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events | 255 |
Free-Form Entry |
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| C55636 | Return to play rehabilitation stage complete date | RetrnPlaytRehabStageCompDate | The date the participant/subject completed the return to play (normal game play) rehabilitation stage as part of the Return to play CRF | The date the participant/subject completed the return to play (normal game play) rehabilitation stage as part of the Return to play CRF | Return to play (normal game play) | Date or Date & Time | Adult;Pediatric | Supplemental | 1.00 | 2017-05-18 10:15:47.0 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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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 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events | 255 |
Free-Form Entry |
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| C19256 | Study protocol name | StudyProtocolName | Name of study protocol | Name of study protocol | Study Name/ID pre-filled | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2014-06-05 16:38:14.0 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events | 4000 |
Free-Form Entry |
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| C55628 | Return to sport indicator | ReturnSportInd | The indicator if the participant/subject return to play sport as part of the Return to Play case report form | The indicator if the participant/subject return to play sport as part of the Return to Play case report form | Did participant return to sport | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-18 08:50:23.0 | Return to Play | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
