CDE Detailed Report
Disease: Sport Related Concussion
Subdomain Name: Drugs
CRF: Medications
Displaying 1 - 41 of 41
Subdomain Name: 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 / 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
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| 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/participan | 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 |
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| C02016 | Medication prior or concomitant start date and time | MedctnPriorOrConcmStrtDateTime | 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 | 3.10 | 2022-08-02 16:58:56.0 | 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 |
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| 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 |
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| 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/subjec | 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 |
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| C02022 | Medication prior or concomitant dose unit of measure | MedctnPriorOrConcomDoseUOM | 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 | 3.10 | 2022-08-02 14:36:00.0 | 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 |
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| 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 |
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| 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/subjec | 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 | ||||||||||
| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 constipatio | 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 |
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| 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 week | 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 |
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| 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 |
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| 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 medication | 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 |
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| 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 ongoin | 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 |
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| 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 |
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| 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/participan | 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 |
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| C02006 | Medication prior or concomitant dose | MedctnPriorOrConcomDose | Dose of prior/concomitant medication taken per administration | Dose of prior/concomitant medication taken per administration | Dose | Numeric Values | Adult;Pediatric | Supplemental | 3.10 | 2022-08-02 14:33:32.0 | 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 week | 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 |
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| 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 |
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| 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 medication | 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 |
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| C02008 | Medication prior or concomitant end date and time | MedctnPriorOrConcomEndDateTime | 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 | 3.10 | 2022-08-02 16:59:51.0 | 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 |
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| 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 tex | Other, specify | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2014-06-02 13:19:50.0 | Medications | Drugs | Treatment/Intervention Data | 4000 |
Free-Form Entry |
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| 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/participan | 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 |
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| C02011 | Medication prior or concomitant dose frequency | MedctnPriorConcmtntDoseFreq | Frequency of use of a prior/concomitant medication | Frequency of use of a prior/concomitant medicatio | 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 type other text | MedctnPriorOrConcomRteTypOTH | 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 | 2.00 | 2022-08-02 16:52:05.0 | 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 |
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| 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/participan | 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 |
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| C02014 | Medication prior or concomitant name | MedctnPriorConcomName | Name of the prior/concomitant agent or drug administered | Name of the prior/concomitant agent or drug administere | 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 |
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| 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 |
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| 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 supplement | 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 |
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| C02015 | Medication prior or concomitant route type | MedctnPriorOrConcomRteTyp | 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 | 3.10 | 2022-08-02 14:44:16.0 | 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 |
