CDE Detailed Report

Disease: Sport Related Concussion
Sub-Domain: Cognitive Assessment
CRF: Acute Concussion Evaluation (ACE)

Displaying 51 - 59 of 59
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 / 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
C00008 Age value AgeVal Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject. Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject. Age Numeric Values Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Acute Concussion Evaluation (ACE) Cognitive Assessment Outcomes and End Points

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0 1800 month
C54337 Acute Concussion Evaluation (ACE) ? Injury cause type ACEInjuryCauseTyp Type of injury cause as related to the Acute Concussion Evaluation (ACE). Type of injury cause as related to the Acute Concussion Evaluation (ACE). Cause Assault;Fall;MVC;Other;Pedestrian-MVC;Sports Assault;Fall;Motor Vehicle Crash;Other;Pedestrian-Motor Vehicle Crash;Sports Alphanumeric

Greater forces associated with the trauma are likely to result in more severe presentation of symtoms.

Indicate cause of injury.

Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. Adult;Pediatric Supplemental 1.00 2017-02-27 20:22:56.0 Acute Concussion Evaluation (ACE) Cognitive Assessment Outcomes and End Points

Multiple Pre-Defined Values Selected

C54369 Acute Concussion Evaluation (ACE) ? Risk factors protracted recovery migraine headache type ACERskFcPrtrctRcvMigrneHeadTyp Type of migraine headache as a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE). Type of migraine headache as a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE). History of migraine headache Family;Personal Family;Personal Alphanumeric Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. Adult;Pediatric Supplemental 1.00 2017-02-27 20:22:56.0 Acute Concussion Evaluation (ACE) Cognitive Assessment Outcomes and End Points

Single Pre-Defined Value Selected

C54348 Acute Concussion Evaluation (ACE) ? Seizure detail text ACESeizureDetailTxt Text describing subject/participant seizures as related to the Acute Concussion Evaluation (ACE). Text describing subject/participant seizures as related to the Acute Concussion Evaluation (ACE). Observed seizure detail Alphanumeric Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. Adult;Pediatric Supplemental 1.00 2017-02-27 20:29:51.0 Acute Concussion Evaluation (ACE) Cognitive Assessment Outcomes and End Points 255

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C54393 Acute Concussion Evaluation (ACE) ? Follow-up action plan referral type ACEFollowupActPlanReferralTyp Type follow-up plan of action referral for subject/participant as related to the Acute Concussion Evaluation (ACE). Type follow-up plan of action referral for subject/participant as related to the Acute Concussion Evaluation (ACE). Referral: Emergency department;Neuropsychological Testing;Physician Emergency department;Neuropsychological Testing;Physician Alphanumeric Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. Adult;Pediatric Supplemental 1.00 2017-02-27 20:22:56.0 Acute Concussion Evaluation (ACE) Cognitive Assessment Outcomes and End Points

Multiple Pre-Defined Values Selected

C54359 Acute Concussion Evaluation (ACE) ? Symptom check list exertion physical activity indicator ACESymptomChkLstExrtPhysActInd Indicator of whether subject/participant symptoms worsen with physical activity since injury as related to the Acute Concussion Evaluation (ACE). Indicator of whether subject/participant symptoms worsen with physical activity since injury as related to the Acute Concussion Evaluation (ACE). Exertion: Do these symptoms worsen with physical activity? Yes;No;N/A Yes;No;N/A Alphanumeric Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. Adult;Pediatric Supplemental 1.00 2017-02-27 20:29:51.0 Acute Concussion Evaluation (ACE) Cognitive Assessment Outcomes and End Points

Single Pre-Defined Value Selected

C05400 Injury date time InjDateTime Date (and time, if applicable and known) of injury Date (and time, if applicable and known) of injury Date/Time of Injury Date or Date & Time Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Acute Concussion Evaluation (ACE) Cognitive Assessment Outcomes and End Points

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C54338 Acute Concussion Evaluation (ACE) ? Injury cause type sports text ACEInjuryCauseTypSportsTxt Text specifying the cause of the impact injury as related to the Acute Concussion Evaluation (ACE). Text specifying the cause of the impact injury as related to the Acute Concussion Evaluation (ACE). Sports (specify) Alphanumeric Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. Adult;Pediatric Supplemental 1.00 2017-02-27 20:29:51.0 Acute Concussion Evaluation (ACE) Cognitive Assessment Outcomes and End Points 255

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C54370 Acute Concussion Evaluation (ACE) - Risk factors protracted recovery migraine headache family text ACERskFcPtrctRcvMgrnHeadFamTxt Text describing which family member(s) had/have migraine headache as a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE). Text describing which family member(s) had/have migraine headache as a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE). Provide detail of family members with history of migraine Alphanumeric

Provide detail of family members with history of migraine

Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. Adult;Pediatric Supplemental 1.00 2017-02-27 20:22:56.0 Acute Concussion Evaluation (ACE) Cognitive Assessment Outcomes and End Points 100

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CSV