CDE Detailed Report

Disease: Traumatic Brain Injury
Subdomain Name: Physical Function
CRF: Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain

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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
C55379 Quality of Life - Mobility stand one hour scale QolMobltyStndOneHrScl The scale which represents the extent the participant was able to stand for one hour, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant was able to stand for one hour, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to stand for one hour? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2017-05-01 13:38:14.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55380 Quality of Life - Mobility stand up tiptoes scale QolMobltyStndUpTptsScl The scale which represents the extent the participant was able to stand up on their tiptoes, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant was able to stand up on their tiptoes, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to stand up on tiptoes? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2017-05-01 13:49:39.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55381 Quality of Life - Mobility stand unsupported 30 minutes scale QolMbltyStndUnspprtd30MinsScl The scale which represents the extent the participant was able to stand unsupported for 30 minutes, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant was able to stand unsupported for 30 minutes, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to stand unsupported for 30 minutes? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2017-05-01 13:53:38.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C21323 Quality of Life - Movement without assistance floor stand ability scale QolMoveWthoutAsstnFlrAbltyScl The scale which represents the extent to which the participant was able to get up off the floor from lying on their back without help, as part of Neuro-QOL Lower Extremity Function and Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent to which the participant was able to get up off the floor from lying on their back without help, as part of Neuro-QOL Lower Extremity Function and Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to get up from the floor from lying on your back without help? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2015-07-17 09:23:23.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55383 Quality of Life - Mobility armless straight chair stand up scale QoLMobArmlssStrghtChrAbltyScl The scale which represents the amount of difficulty the participant currently has in standing up from an armless straight chair (e.g., dining room chair), as part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the amount of difficulty the participant currently has in standing up from an armless straight chair (e.g., dining room chair), as part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to stand up from an armless straight chair? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2015-07-17 09:23:23.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C21324 Quality of Life - Movement walk fifteen minute duration ability scale QolMoveWlkFftnMinDurAbltyScl The scale which represents the extent to which the participant was able to go for a walk of at least 15 minutes, as part of Neuro-QOL Lower Extremity Function and Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent to which the participant was able to go for a walk of at least 15 minutes, as part of Neuro-QOL Lower Extremity Function and Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to go for a walk of at least 15 minutes? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2015-07-17 09:23:23.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55384 Quality of Life - Mobility health limit going for short walk scale QolMobHlthLmtGngShrtWlkScl The scale which represents the extent the participant is able to go for a short walk (less than 15 minutes), as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant is able to go for a short walk (less than 15 minutes), as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Does your health now limit you in going for a short walk (less than 15 minutes)? 5;4;3;2;1 Not at all;Very little;Somewhat;Quite a lot;Cannot do Numeric Values

Part of PROMIS Mobility Domain.

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2017-05-02 12:39:38.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55373 Quality of Life - Mobility walk normal speed scale QolMobWlkNrmlSpdScl The scale which represents the extent the participant was able to walk at a normal speed, as a part of Patient Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant was able to walk at a normal speed, as a part of Patient Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to walk at a normal speed? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2017-04-28 16:28:17.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55385 Quality of Life - Mobility health limited climbing one flight of stairs scale QolMobHlthLmtClmb1FlghtStrScl The scale which represents the extent the participant's health limited he or she in climbing one flight of stairs, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant's health limited he or she in climbing one flight of stairs, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Does your health now limit you in climbing one flight of stairs? 5;4;3;2;1 Not at all;Very little;Somewhat;Quite a lot;Cannot do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 3.00 2013-07-22 12:47:20.623 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55374 Quality of Life - Mobility up and down stairs normal pace scale QolMobUpDwnStrsNmlPceScl The scale which represents the extent the participant was able to go up and down stairs at a normal pace, as a part of Patient Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant was able to go up and down stairs at a normal pace, as a part of Patient Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to go up and down stairs at a normal pace? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2017-04-28 16:40:45.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55386 Quality of Life - Mobility health limit climb several flights of stairs scale QolMobHlthLmtClmSvrlFltsStrScl The scale which represents the extent the participant' s health limited he or she in climbing several flights of stairs, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant' s health limited he or she in climbing several flights of stairs, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Does your health now limit you in climbing several flights of stairs? 5;4;3;2;1 Not at all;Very little;Somewhat;Quite a lot;Cannot do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2017-05-02 13:12:05.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55375 Quality of Life - Mobility jump up and down scale QolMobJmpUpDwnScl The scale which represents the extent the participant was able to jump up and down, as a part of Patient Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant was able to jump up and down, as a part of Patient Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to jump up and down? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2017-04-28 16:44:18.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55376 Quality of Life - Mobility climb up five steps scale QolMobiClmbUp5StpsScl The scale which represents the extent the participant was able to climb up five steps, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant was able to climb up five steps, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to climb up five steps? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2017-05-01 13:10:42.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55377 Quality of Life - Mobility run short distance scale QolMobltyRnShrtDistScl The scale which represents the extent the participant was able to run a short distance, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant was able to run a short distance, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to run a short distance, such as to catch a bus? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2017-05-01 13:16:28.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

C55378 Quality of Life - Mobility stand unsupported 10 minutes scale QolMobltyStndUnsprtd10MinScl The scale which represents the extent the participant was able to stand unsupported for ten minutes, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobility The scale which represents the extent the participant was able to stand unsupported for ten minutes, as a part of Patient-Reported Outcome Measurement Information System (PROMIS) Mobilit Are you able to stand unsupported for 10 minutes? 5;4;3;2;1 Without any Difficulty;With a Little Difficulty;With Some Difficulty;With Much Difficulty;Unable to Do Numeric Values

Part of PROMIS Mobility Domain

2008-2016 PROMIS Health Organization and PROMIS Cooperative Group Adult Supplemental 1.00 2017-05-01 13:30:32.0 Patient-Reported Outcome Measurement Information System (PROMIS), Mobility Domain Physical Function Outcomes and End Points

Single Pre-Defined Value Selected

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