CDE Detailed Report

Disease: Sport Related Concussion
Sub-Domain: Drugs
CRF: Medications

Displaying 1 - 41 of 41
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
C19184 Urinary tract drug use indicator UrinaryTractDrugUseInd Indicator for urinary tract drugs used within the last year Indicator for urinary tract drugs used within the last year Any drugs for the urinary tract within the last year: No;Yes;Unknown No;Yes;Unknown Alphanumeric Adult;Pediatric Exploratory 1.00 2014-06-02 10:58:55.0 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C21671 Urinary tract antibiotic antiseptic use reason UrnTrctAntibioAntisepURsn Reason antibiotics or antiseptics were used for the urinary tract Reason antibiotics or antiseptics were used for the urinary tract Antibiotics/antiseptics: For prophylactic reasons;For treatment of urinary tract infection For prophylactic reasons;For treatment of urinary tract infection Alphanumeric Adult;Pediatric Exploratory 1.00 2016-04-27 10:17:02.0 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C06023 Urinary tract drug type UrinTractDrgTyp Type of drug, systemic or intravesical, for the urinary tract used Type of drug, systemic or intravesical, for the urinary tract used If Yes, indicate type of drugs for the urinary tract used within the last year: Antibiotics/antiseptics;Bladder relaxant drugs (anticholinergics, tricyclic antidepressants, etc.);Other,specify;Sphincter/bladder neck relaxant drugs (alpha adrenergic blockers, etc.) Antibiotics/antiseptics;Bladder relaxant drugs (anticholinergics, tricyclic antidepressants, etc.);Other, specify;Sphincter/bladder neck relaxant drugs (alpha adrenergic blockers, etc.) Alphanumeric Adult;Pediatric Exploratory 3.00 2013-07-17 09:26:36.973 Medications Drugs Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C19185 Urinary tract drug use other text UrinaryTractDrugUseOTH The free-text field related to 'Urinary tract drug use indicator' specifying other text. Indicator for urinary tract drugs used within the last year The free-text field related to 'Urinary tract drug use indicator' specifying other text. Indicator for urinary tract drugs used within the last year Other, specify Alphanumeric Adult;Pediatric Exploratory 1.00 2014-06-02 11:11:36.0 Medications Drugs Treatment/Intervention Data 4000

Free-Form Entry

C53047 Oral laxative tablet capsule granulate type OrlLaxTabCapsGrnlTyp Type of tablets, capsules or granulate oral laxative, a medicine taken by mouth to encourage bowel movements to relieve constipation. Type of tablets, capsules or granulate oral laxative, a medicine taken by mouth to encourage bowel movements to relieve constipation. Yes, tablets, capsules or granulates Bulking/osmotic;Irritant;Prokinetics/chloride channel activators;Other, specify Bulking/osmotic;Irritant;Prokinetics/chloride channel activators;Other, specify Alphanumeric Adult;Pediatric Exploratory 3.00 2013-07-17 09:26:36.973 Medications Drugs Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C02002 Medication prior or concomitant use indicator MedctnPriorConcomUseInd Indicator of whether the participant/subject reported taking any medications during the time period relevant to the study protocol Indicator of whether the participant/subject reported taking any medications during the time period relevant to the study protocol Did the patient/participant take any medications: XX days before or during the study? (If "No", leave rest of form blank) Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-22 16:57:17.79 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

2220500
C06196 Oral laxative drops liquid type OrlLaxDropsLiquidTyp Type of drops or liquid oral laxative, a medicine taken by mouth to encourage bowel movements to relieve constipation taken within the last four weeks. Type of drops or liquid oral laxative, a medicine taken by mouth to encourage bowel movements to relieve constipation taken within the last four weeks. Yes, drops or liquids Bulking/osmotic;Irritant Bulking/osmotic;Irritant Alphanumeric Adult;Pediatric Exploratory 3.00 2013-07-17 09:26:36.973 Medications Drugs Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C19186 Bowel function medication indicator BowelFunctionMedicationInd Indicator for medication affecting bowel function/constipating agents (within the last four weeks) Indicator for medication affecting bowel function/constipating agents (within the last four weeks) Medication affecting bowel function / constipating agents (within the last four weeks): No;Unknown;Yes, anticholinergics;Yes, narcotics;Yes, other, specify No;Unknown;Yes, anticholinergics;Yes, narcotics;Yes, other, specify Alphanumeric Adult;Pediatric Exploratory 1.00 2014-06-02 11:14:40.0 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C54123 Medication prescription current take indicator MedPresCurrentTakeInd Indicator related to whether the participant/subject is currently taking prescription medications. Indicator related to whether the participant/subject is currently taking prescription medications. Currently Taking Prescription Medications? No;Yes;Unknown No;Yes;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2017-02-14 11:29:08.0 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C02003 Medication prior or concomitant ongoing indicator MedctPrConcomOngoingInd Indicator of or description that the prior/concomitant medication usage is ongoing. Indicator of or description that the prior/concomitant medication usage is ongoing. Ongoing? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

2321822
C06251 Medication cardiovascular function type MedctnCardioFnctnTyp Type of medication affecting cardiovascular functions. Type of medication affecting cardiovascular functions. If Yes, indicate type of medication affecting cardiovascular function: Anticholinergics;Antihypertensives;Antihypotensives;Cardiac;Other, specify Anticholinergics;Antihypertensives (beta-blocker, antiarhythmics, ACE etc);Antihypotensives;Cardiac (digitalis, anti-arrhythmics etc);Other, specify Alphanumeric Adult;Pediatric Exploratory 3.00 2013-07-17 09:26:36.973 Medications Drugs Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C19187 Medication affecting bowel function constipating agent other text MedAffBowlFxnConstAgntOTH The free-text field related to 'Bowel function medication indicator' specifying other text. Indicator for medication affecting bowel function/constipating agents (within the last four weeks) The free-text field related to 'Bowel function medication indicator' specifying other text. Indicator for medication affecting bowel function/constipating agents (within the last four weeks) Other, specify Alphanumeric Adult;Pediatric Exploratory 1.00 2014-06-02 11:24:00.0 Medications Drugs Treatment/Intervention Data 4000

Free-Form Entry

C54124 Medication prescription indication type MedicationPrescriptionIndicTyp Type of indication related to prescription medication taken by the subject/participant. Type of indication related to prescription medication taken by the subject/participant. Type of Prescription Medications (check all that apply) Anti-Depressant;Anti-Anxiety;Anti-Psychotic;Migraine;Anti-Seizure;Cardiovascular;Diabetes;Narcotic Pain Medication;Non-Narcotic Pain Medication;Sleep Aid/Sedative;Psychostimulant (ADHD);Birth Control;Allergy;Asthma;Acid Reflux/Heart Burn;Other Anti-Depressant Prescription Medication;Anti-Anxiety Prescription Medication;Anti-Psychotic Prescription Medication;Migraine Prescription Medication;Anti-Seizure Prescription Medication;Cardiovascular Prescription Medication;Diabetes Prescription Medication;Narcotic Pain Prescription Medication;Non-Narcotic Pain Prescription Medication;Sleep Aid/Sedative Prescription Medication;Psychostimulant (ADHD) Prescription Medication;Birth Control Prescription Medication;Allergy Prescription Medication;Asthma Prescription Medication;Acid Reflux/Heart Burn Prescription Medication;Other Prescription Medication Alphanumeric Adult;Pediatric Supplemental 1.00 2017-02-14 11:43:12.0 Medications Drugs Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C02006 Medication prior or concomitant dose MedctnPriorConcomDose Dose of prior/concomitant medication taken per administration. Dose of prior/concomitant medication taken per administration. Dose Numeric Values Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Medications Drugs Treatment/Intervention Data

Free-Form Entry

3162729
C06448 Spasticity spasm treat last four week indicator SpasctySpsmTrtLst4WkInd Indicator of whether the person with SCI has received any kind of treatment for spasticity/spasms within the last four weeks. Indicator of whether the person with SCI has received any kind of treatment for spasticity/spasms within the last four weeks. Any treatment for spasticity/spasms within the last four weeks: Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Exploratory 3.00 2013-07-17 09:26:36.973 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C19188 Oral laxative medication indicator OralLaxativeMedicationInd Indicator for oral laxative medication use (within the last four weeks) Indicator for oral laxative medication use (within the last four weeks) Medication affecting bowel function - oral laxatives (within the last four weeks): No;Yes;Unknown No;Yes;Unknown Alphanumeric Adult;Pediatric Exploratory 1.00 2014-06-02 11:39:57.0 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C54182 Over the counter medication current take indicator OverTheCounterMedCurntTakeInd Indicator related to whether the participant/subject is currently taking over-the-counter medications. Indicator related to whether the participant/subject is currently taking over-the-counter medications. Are you currently taking any over-the-counter medications (e.g. Advil/ibuprofen, Claritin, etc)? (Either today or on a regular basis) No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2017-02-14 11:29:08.0 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C02008 Medication prior or concomitant end date and time MedctnPriorConcomEndDateTime The date (and time, if applicable and known) the administration of the prior/concomitant medication ended. The date (and time, if applicable and known) the administration of the prior/concomitant medication ended. End Date (mm/dd/yyyy) Date or Date & Time Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Medications Drugs Treatment/Intervention Data

Free-Form Entry

3162753
C17402 Site name SiteName The name of the site for the study The name of the site for the study Site Name: Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Medications Drugs Treatment/Intervention Data 255

Free-Form Entry

C19189 Oral laxative tablets capsules granulates other text OralLaxTabCapGrnlOTH The free-text field related to 'Oral laxative tablets capsules granulates type' specifying other text. The free-text field related to 'Oral laxative tablets capsules granulates type' specifying other text. Other, specify Alphanumeric Adult;Pediatric Exploratory 1.00 2014-06-02 13:19:50.0 Medications Drugs Treatment/Intervention Data 4000

Free-Form Entry

C54186 Over the counter medicine type OverTheCounterMedicineTyp Type of over-the-counter medicine taken by the subject/participant. Type of over-the-counter medicine taken by the subject/participant. Type of over-the-counter medicine Advil/Ibuprofen;Tylenol/Acetaminophen;Claritin/Allergy medication;Other Advil/Ibuprofen;Tylenol/Acetaminophen;Claritin/Allergy medication;Other Alphanumeric Adult;Pediatric Supplemental 1.00 2017-02-14 11:43:12.0 Medications Drugs Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C02011 Medication prior or concomitant dose frequency MedctnPriorConcmtntDoseFreq Frequency of use of a prior/concomitant medication. Frequency of use of a prior/concomitant medication. Frequency BID;TID;QID;q2h;q4h;q6h;q8h;QAM;QPM;QD;alt. d.;HS;PRN;OTH;UNK;NA twice a day;three times a day;four times a day;every 2 hours;every 4 hours;every 6 hours;every 8 hours;every morning;every evening;one a day;every other day (on alternate days);at bedtime;as needed;Other, specify;unknown;Not applicable Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

3162733
C18737 Medication prior or concomitant route other text MedctnPriorConcomRteOTH The free-text field related to 'Medication prior or concomitant route type' specifying other text. Type of access route for the administration of the prior/concomitant medication. The free-text field related to 'Medication prior or concomitant route type' specifying other text. Type of access route for the administration of the prior/concomitant medication. Other/Specify Alphanumeric Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Medications Drugs Treatment/Intervention Data 4000

Free-Form Entry

3162743
C19190 Examination day cardiovascular function medication indicator ExamDayCardioFunctMedicatnInd Indicator for medication affecting cardiovascular function on the day of the examination Indicator for medication affecting cardiovascular function on the day of the examination Any medication affecting cardiovascular function on the day of examination: No;Yes;Unknown No;Yes;Unknown Alphanumeric Adult;Pediatric Exploratory 1.00 2014-06-02 13:21:03.0 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C54199 Over the counter medicine other name OverTheCounterMedOtherName Name of other over-the-counter medicine currently taken by the subject/participant. Name of other over-the-counter medicine currently taken by the subject/participant. Other OTC, what? Alphanumeric Adult;Pediatric Supplemental 1.00 2017-02-16 10:15:05.0 Medications Drugs Treatment/Intervention Data 255

Free-Form Entry

C02014 Medication prior or concomitant name MedctnPriorConcomName Name of the prior/concomitant agent or drug administered. Name of the prior/concomitant agent or drug administered. Medication Name (Trade or generic name) Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Medications Drugs Treatment/Intervention Data 4000

Free-Form Entry

3162728
C19180 Steroid administration type SteroidAdministrationTyp Type of steroids (methylprednisone/corticosteroids) administered at any point during stay Type of steroids (methylprednisone/corticosteroids) administered at any point during stay Any steroids administered: Methylprednisone/Corticosteriods: (at any point during their stay): NASCIS II (Methylprednisolone or Solumedrol run as an infusion x 23 or 24 hrs);NASCIS III (Methylprednisolone or solumedrol run as an infusion x 47 or 48 hrs);None;Other, specify;Unknown NASCIS II (Methylprednisolone or Solumedrol run as an infusion x 23 or 24 hrs);NASCIS III (Methylprednisolone or solumedrol run as an infusion x 47 or 48 hrs);None;Other, specify;Unknown Alphanumeric Adult;Pediatric Exploratory 1.00 2014-06-02 10:33:02.0 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C19191 Examination day cardiovascular function medication other text ExamDayCardioFunctMedOTH Free-text field for medication affecting cardiovascular function on the day of the examination Free-text field for medication affecting cardiovascular function on the day of the examination Other, specify Alphanumeric Adult;Pediatric Exploratory 1.00 2014-06-02 13:32:36.0 Medications Drugs Treatment/Intervention Data 4000

Free-Form Entry

C54204 Over the counter supplement current take indicator OverTheCounterSuppCurntTakeInd Indicator related to whether the participant/subject is currently taking over-the-counter supplements. Indicator related to whether the participant/subject is currently taking over-the-counter supplements. Are you currently taking any over-the-counter supplements (e.g. protein or vitamins)? (Either today or on a regular basis) No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2017-02-14 11:29:08.0 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C02015 Medication prior or concomitant route type MedctnPriorConcomRteTyp Type of access route for the administration of the prior/concomitant medication. Type of access route for the administration of the prior/concomitant medication. Route Buccal;Inhaled;Intramuscular;Intravenous;Nasal;Oral;Rectal;By ear;Topical;Subcutaneous;Sublingual;Transdermal;Unknown;Other, specify Buccal;Inhaled;Intramuscular;Intravenous;Nasal;Oral;Rectal;By Ear;Topical;Subcutaneous;Sublingual;Transdermal;Unknown;Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

3162743
C19181 Steroid administration other text SteroidAdministrationOTH The free-text field related to 'Steroid administration type' specifying other text. Type of steroids (methylprednisone/corticosteroids) administered at any point during stay The free-text field related to 'Steroid administration type' specifying other text. Type of steroids (methylprednisone/corticosteroids) administered at any point during stay Other, specify Alphanumeric Adult;Pediatric Exploratory 1.00 2014-06-02 10:36:14.0 Medications Drugs Treatment/Intervention Data 4000

Free-Form Entry

C19247 Subject ID SubIDNam Subject identification ID Subject identification ID Subject ID: Alphanumeric Adult;Pediatric Supplemental 1.00 2014-06-05 13:10:49.0 Medications Drugs Treatment/Intervention Data 255

Free-Form Entry

C54205 Over the counter supplement type OverTheCounterSupplementTyp Type of over-the-counter supplement taken by the subject/participant. Type of over-the-counter supplement taken by the subject/participant. Type of over-the-counter supplement Protein;Creatine;DHEA;Chromium;Androstenedione;Vitamins;Weight Loss;Other Protein;Creatine;DHEA;Chromium;Androstenedione;Vitamins;Weight Loss over-the-counter supplement;Other over-the-counter supplement Alphanumeric Adult;Pediatric Supplemental 1.00 2017-02-14 11:43:12.0 Medications Drugs Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C02016 Medication prior or concomitant start date and time MedctnPriorConcomStrtDateTime The date (and time, if applicable and known) on which the prior/concomitant medication usage began. The date (and time, if applicable and known) on which the prior/concomitant medication usage began. Start Date (mm/dd/yyyy) Date or Date & Time Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Medications Drugs Treatment/Intervention Data

Free-Form Entry

3162752
C19182 Steroid administration date SteroidAdministrationDate Date at which steroids (methylprednisone/corticosteroids) were administered during stay Date at which steroids (methylprednisone/corticosteroids) were administered during stay Date administered: YYYYMMDD Date or Date & Time Adult;Pediatric Exploratory 1.00 2014-06-02 10:38:23.0 Medications Drugs Treatment/Intervention Data

Free-Form Entry

C19256 Study protocol name StudyProtocolName Name of study protocol Name of study protocol Study Name/ID pre-filled Alphanumeric Adult;Pediatric Supplemental 1.00 2014-06-05 16:38:14.0 Medications Drugs Treatment/Intervention Data 4000

Free-Form Entry

C55382 Medication prescription type text MedicationPrescriptionTypTxt The free-text field related to type of prescription medication participant/subject. The free-text field related to type of prescription medication participant/subject. If checked, indicate type: Alphanumeric Adult;Pediatric Supplemental 1.00 2017-05-02 09:31:44.0 Medications Drugs Treatment/Intervention Data 255

Free-Form Entry

C02022 Medication prior or concomitant dose unit of measure MedctnPriorConcomDoseUOM Dosage unit of measure of the prior or concomitant medication administered. Dosage unit of measure of the prior or concomitant medication administered. Dose Units g;mcg;mcL;mg;mL;oz;Other, specify;Unknown;NA gram;microgram;microliter;milligram;milliliter;ounce;Other, specify;Unknown;Not applicable Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

3162730
C19183 Vasopressor use indicator VasopressorUseInd Indicator for use of vasopressor Indicator for use of vasopressor Any vasopressor use No;Yes;Unknown No;Yes;Unknown Alphanumeric Adult;Pediatric Exploratory 1.00 2014-06-02 10:40:47.0 Medications Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C19500 Assessment performed date AssessmentPerformedDate The date of assessment of the examination being performed. The date of assessment of the examination being performed. Assessment date: YYYYMMDD Date or Date & Time Adult;Pediatric Exploratory 1.00 2014-06-18 08:10:12.0 Medications Drugs Treatment/Intervention Data

Free-Form Entry

C02024 Medication prior or concomitant indication text MedctnPriorConcomIndTxt Text describing reason for administration of a prior/concomitant (nonstudy) agent or measure. This is not the pharmacologic classification of an agent (antibiotic, analgesic, etc.), but the reason for its administration to the participant/subject. Text describing reason for administration of a prior/concomitant (nonstudy) agent or measure. This is not the pharmacologic classification of an agent (antibiotic, analgesic, etc.), but the reason for its administration to the participant/subject. Indication (If given for AE, enter exact term from AE CRF) Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Medications Drugs Treatment/Intervention Data 4000

Free-Form Entry

3158920
CSV