CDE Detailed Report
Disease: Sport Related Concussion
Subdomain Name: Cognitive Assessment
CRF: Acute Concussion Evaluation (ACE)
Displaying 51 - 59 of 59
Subdomain Name: 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 / 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C54358 | Acute Concussion Evaluation (ACE) - Symptom check list total symptom score | ACESymptomChkLstTotSympScore | Total score of the sum of physical, cognitive, emotional, and sleep symptoms the subject/participant has experienced since injury as related to the Acute Concussion Evaluation (ACE) | Total score of the sum of physical, cognitive, emotional, and sleep symptoms the subject/participant has experienced since injury as related to the Acute Concussion Evaluation (ACE | Total Symptom Score (0-22) | Numeric Values |
Sum total number of symptoms present per area, and sum all four areas into a Total Symptom Score (score range 0–22)(Note: most sleep symptoms are only applicable after a night has passed since the 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 20:29:51.0 | Acute Concussion Evaluation (ACE) | Cognitive Assessment | Outcomes and End Points |
Free-Form Entry |
0 | 22 | ||||||||
| 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 |
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| 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 |
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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 |
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| 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 |
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 | 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 |
Free-Form Entry |
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| 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 |
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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 |
Free-Form Entry |
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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 |
Free-Form Entry |
