CDE Detailed Report
Disease: content
Subdomain Name: Cognitive Assessment
CRF: welcome
Displaying 51 - 59 of 59
Subdomain Name: Cognitive Assessment
CRF: welcome
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C54356 | Acute Concussion Evaluation (ACE) - Symptom check list sleep indicator | ACESymptomChkLstSleepInd | Indicator of whether subject/participant has experienced sleep symptoms since injury as related to the Acute Concussion Evaluation (ACE) | Indicator of whether subject/participant has experienced sleep symptoms since injury as related to the Acute Concussion Evaluation (ACE | SLEEP (4) | 0;1;N/A | 0=No;1=Yes;N/A | Alphanumeric |
Indicate presence of each symptom (0=No 1=Yes). |
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 |
||||||||
| C54335 | Acute Concussion Evaluation (ACE) - Evidence intracranial injury skull fracture indicator | ACEEvidnceIntraCrnSkulFrctrInd | Indicator whether injury is due to an intracranial skull fracture as related to f the Acute Concussion Evaluation (ACE) | Indicator whether injury is due to an intracranial skull fracture as related to f the Acute Concussion Evaluation (ACE | Is there eveidence of intracranial injury or skull fracture? | No;Yes;Unknown | No;Yes;Unknown | 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 20:02:13.0 | Acute Concussion Evaluation (ACE) | Cognitive Assessment | Outcomes and End Points |
Single Pre-Defined Value Selected |
|||||||||
| C54367 | Acute Concussion Evaluation (ACE) - Risk factors protracted recovery headache history indicator | ACERiskFacProtrctRecvHeadHxTyp | Indicator of whether headache history is a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE) | Indicator of whether headache history is a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE | Headache History? | No;Yes | No;Yes | 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 |
|||||||||
| C54346 | Acute Concussion Evaluation (ACE) - Early signs type | ACEEarlySignsTyp | Type of early signs that may have been observed after subject/patient injury as related to the Acute Concussion Evaluation (ACE) | Type of early signs that may have been observed after subject/patient injury as related to the Acute Concussion Evaluation (ACE | EARLY SIGNS: | Appears dazed or confused;Is confused about events;Answers questions slowly;Repeats questions;Forgetful (recent info) | Appears dazed or confused;Is confused about events;Answers questions slowly;Repeats questions;Forgetful (recent info) | 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 |
|||||||||
| C54391 | Acute Concussion Evaluation (ACE) - Follow-up action plan type | ACEFollowupActionPlanTyp | Type of follow-up plan of action for subject/participant as related to the Acute Concussion Evaluation (ACE) | Type of follow-up plan of action for subject/participant as related to the Acute Concussion Evaluation (ACE | Follow-Up Action Plan | No Follow-Up Needed;Physician/Clinician Office Monitoring;Referral | No Follow-Up Needed;Physician/Clinician Office Monitoring;Referral | 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 |
|||||||||
| C54357 | Acute Concussion Evaluation (ACE) - Symptom check list sleep total count | ACESymptomChkLstSleepTotCt | Total count of sleep symptoms subject/participant has experienced since injury as related to the Acute Concussion Evaluation (ACE) | Total count of sleep symptoms subject/participant has experienced since injury as related to the Acute Concussion Evaluation (ACE | SLEEP Total(0-4) | 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 | 4 | ||||||||
| C00007 | Birth date | BirthDate | Date (and time, if applicable and known) the participant/subject was born | Date (and time, if applicable and known) the participant/subject was born | DOB: | 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 | 2013-07-25 08:54:08.2 | Acute Concussion Evaluation (ACE) | Cognitive Assessment | Outcomes and End Points |
Free-Form Entry |
793 | ||||||||||
| C54336 | Acute Concussion Evaluation (ACE) - Impact location anatomic site | ACEImpactLocationAnatSite | Anatomic site of impact injury as related to the Acute Concussion Evaluation (ACE) | Anatomic site of impact injury as related to the Acute Concussion Evaluation (ACE | Location of Impact: | Frontal;Indirect Force;Left Parietal;Left Temporal;Neck;Occipital;Right Parietal;Right Temporal | Frontal;Indirect Force;Left Parietal;Left Temporal;Neck;Occipital;Right Parietal;Right Temporal | 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 20:16:54.0 | Acute Concussion Evaluation (ACE) | Cognitive Assessment | Outcomes and End Points |
Multiple Pre-Defined Values Selected |
|||||||||
| C54368 | Acute Concussion Evaluation (ACE) - Risk factors protracted recovery headache history prior treatment status | ACERskFcPrtrctRcvHedHxPrRxStat | Status of whether prior treatment for headaches is a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE) | Status of whether prior treatment for headaches is a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE | Prior treatment for headache | 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 | 255 |
Free-Form Entry |
