CDE Detailed Report
Disease: system
Subdomain Name: Cognitive Assessment
CRF: files
Displaying 51 - 59 of 59
Subdomain Name: Cognitive Assessment
CRF: files
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C21117 | Subject name | SubjectName | Name of subject/participant | Name of subject/participan | Patient Name | Alphanumeric | Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. | Adult;Pediatric | Supplemental | 1.00 | 2015-06-12 15:16:39.0 | Acute Concussion Evaluation (ACE) | Cognitive Assessment | Outcomes and End Points | 255 |
Free-Form Entry |
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| C54362 | Acute Concussion Evaluation (ACE) - Risk factors protracted recovery history type | ACERiskFacProtrctRecovHxTyp | Type of risk factors that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE) | Type of risk factors that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE | Risk Factors for Protracted Recovery | Concussion History;Headache History;Developmental History;Psychiatric History | Concussion History;Headache History;Developmental History;Psychiatric History | Alphanumeric |
Check all that apply |
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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| C54375 | Acute Concussion Evaluation (ACE) - Risk factors protracted recovery psychiatric history type | ACERskFacPrtrctRcvPsychHxTyp | Type psychiatric history disorder as a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE) | Type psychiatric history disorder as a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE | Psychiatric History | Anxiety;Depression;Other psychiatric disorder;Sleep disorder | Anxiety;Depression;Other psychiatric disorder;Sleep disorder | 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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| C54341 | Acute Concussion Evaluation (ACE) - Amnesia before no memory events duration | ACEAmnesiaBfNoMemEvntsDur | Duration of subject's/participant's length of amnesia before injury as related to the Acute Concussion Evaluation (ACE) | Duration of subject's/participant's length of amnesia before injury as related to the Acute Concussion Evaluation (ACE | Amnesia Before (Retrograde) Duration | Numeric Values | 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 |
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| C54352 | Acute Concussion Evaluation (ACE) - Symptom check list cognitive indicator | ACESymptomChkLstCogntvInd | Indicator of whether subject/participant has experienced cognitive symptoms since injury as related to the Acute Concussion Evaluation (ACE) | Indicator of whether subject/participant has experienced cognitive symptoms since injury as related to the Acute Concussion Evaluation (ACE | COGNITIVE (4) | 0;1 | 0=No;1=Yes | 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 |
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| C54331 | Acute Concussion Evaluation (ACE) - Person obtaining report type | ACEPersonObtRprtTyp | The type indicating who the report was obtained by, as part of the Acute Concussion Evaluation (ACE) | The type indicating who the report was obtained by, as part of the Acute Concussion Evaluation (ACE) | Reporter: | Patient;Parent;Spouse;Other | Patient;Parent;Spouse;Other | Alphanumeric | Centers for the Disease Control and Prevention. Heads Up: Brain Injury in Your Practice Tool Kit, 2006. | Adult;Pediatric | Supplemental | 1.00 | 2016-12-05 10:04:25.0 | Acute Concussion Evaluation (ACE) | Cognitive Assessment | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C54363 | Acute Concussion Evaluation (ACE) - Risk factors protracted recovery concussion history indicator | ACERiskFacProtrctRecvConcHxTyp | Indicator of whether concussion 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 concussion history is a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE | Concussion History? | No;Yes | No;Yes | Alphanumeric |
Assess the number and date(s) of prior concussions, duration of symptoms for each injury, and whether less biomechanical force resulted in re-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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| C54377 | Acute Concussion Evaluation (ACE) - Risk factors protracted recovery other psychiatric disorder other text | ACERskFacPrtrctRcvPsycDsordOTH | Text for other psychiatric disorder as a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE) | Text for other psychiatric disorder as a risk factor that may protract the subject/participant recovery process since injury as related to the Acute Concussion Evaluation (ACE | Other psychiatric disorder | Alphanumeric |
Specify other psychiatric disorder. |
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 |
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| C54342 | Acute Concussion Evaluation (ACE) - Amnesia after no memory events indicator | ACEAmnesiaAftrNoMemEvntsInd | Indicator of whether subject/participant had no memory of events after (anterograde) amnesia as related to the Acute Concussion Evaluation (ACE) | Indicator of whether subject/participant had no memory of events after (anterograde) amnesia as related to the Acute Concussion Evaluation (ACE | Amnesia After (Anterograde) Are there any events just AFTER the injury that you/ person has no memory of (even brief)? | No;Yes | No;Yes | Alphanumeric |
Even seconds to minutes of memory loss can be predictive of outcome. Recent research has indicated that amnesia may be up to 4-10 times more predictive of symptoms and cognitive deficits following concussion than is LOC (less than 1 minute). |
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 |
