CDE Detailed Report | NINDS Common Data Elements

Disease: Sport Related Concussion
Subdomain Name: History of Disease/Injury Event
CRF: Injury Report

Displaying 51 - 82 of 82

CDE ID	CDE Name	Variable Name	Definition	Short Description	Question Text	Permissible Values	Description	Data Type	Disease Specific Instructions	Population	Classification (e.g., Core)	Version Number	Version Date	CRF Name (CRF Module / Guideline)	Subdomain Name	Domain Name	Size	Input Restrictions	Min Value	Max Value	External Id caDSR
C55485	Injury activity circumstance type	InjActvtyCrcmstncTyp	Type of circumstances of the activity during which the suspected injury was incurred	Type of circumstances of the activity during which the suspected injury was incurred	Injury occurred during	Training;Other;Game;Practice;Dryland/fitness	Training;Other;Game;Practice;Dryland/fitness	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-11 16:53:27.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55569	Educational assistance supplemental formal indicator	EduAsstncSupplFormlInd	Indicator of whether the subject/participant has ever received formal supplemental educational assistance, such as an Individualized Education Program (IEP)	Indicator of whether the subject/participant has ever received formal supplemental educational assistance, such as an Individualized Education Program (IEP)	Have you ever had an IEP (Individualized Education Program) or extra support for studies?	Yes;No;Unknown	Yes;No;Unknown	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-12 16:08:25.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C13523	Dizziness or vertigo indicator	DizzinessVertigoInd	Indicator of whether the participant/subject experienced dizziness or vertigo	Indicator of whether the participant/subject experienced dizziness or vertig	Dizziness	Yes;No	Yes;No	Alphanumeric		Adult;Pediatric	Supplemental	3.00	2013-06-21 00:00:00.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55508	Amnesia retrograde duration range	AmnsiaRtrogrdDuratnRng	Range of time within which the duration of the subject/participant's retrograde amnesia falls	Range of time within which the duration of the subject/participant's retrograde amnesia falls	Retrograde amnesia duration	Less than 1 hour;1-24 hours;>24 hours	Less than 1 hour;1-24 hours;>24 hours	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-12 12:17:20.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C54338	Acute Concussion Evaluation (ACE) - Injury cause type sports text	ACEInjuryCauseTypSportsTxt	Text specifying the cause of the impact injury as related to the Acute Concussion Evaluation (ACE)	Text specifying the cause of the impact injury as related to the Acute Concussion Evaluation (ACE	Sport at time of injury			Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-02-27 20:29:51.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events	255	Free-Form Entry
C55541	Concussion prior current year text	ConcusnPriorCurrYrTxt	The free-text field for documenting prior concussions suffered by the subject/participant during the current year	The free-text field for documenting prior concussions suffered by the subject/participant during the current year	Repeat concussion this year			Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-12 13:35:06.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events	4000	Free-Form Entry
C04813	Return work school status	RtrnWrkSchlStatus	Status of participant's/subject's return to work and/or school	Status of participant's/subject's return to work and/or school	Return to work/school	Returned to previous level;Same work or school, reduced level;Different work or school;Only in sheltered environment;Did not return to work or school;N/A;Unknown	Returned to previous level;Same work or school, reduced level;Different work or school;Only in sheltered environment;Did not return to work or school;N/A;Unknown	Alphanumeric		Adult;Pediatric	Supplemental	3.00	2013-07-20 10:21:25.65	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55473	Injury report delay elapsed time duration	InjRptDlyElpsdTimDur	Duration of time elapsed between occurrence of injury and initial report of injury by subject/participant if not immediately reported	Duration of time elapsed between occurrence of injury and initial report of injury by subject/participant if not immediately reported	How many minutes/hours after injury did athlete report it to someone?			Numeric Values		Adult;Pediatric	Supplemental	1.00	2017-05-11 14:50:06.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Free-Form Entry	0
C55486	Equipment protective worn injury incur type	EqpmntPrtctvWrnInjryIncrTyp	Type of protective equipment being worn by the subject/participant when he or she incurred the suspected injury	Type of protective equipment being worn by the subject/participant when he or she incurred the suspected injury	At the time of injury, was any protective equipment worn?	Helmet;Mouthguard;Brace;Tape;Other	Helmet;Mouthguard;Brace;Tape;Other	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-11 16:57:20.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Multiple Pre-Defined Values Selected
C55570	Educational assistance supplemental formal subject type	EduAsstncSupplFormlSbjTyp	Type of academic subject(s) for which the subjec/participant received formal supplemental educational assistance, such as an Individualized Education Program (IEP)	Type of academic subject(s) for which the subjec/participant received formal supplemental educational assistance, such as an Individualized Education Program (IEP)	What did you have an IEP in?	Reading;Writing;Math;Other	Reading;Writing;Math;Other	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-12 16:11:30.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Multiple Pre-Defined Values Selected
C17499	Special education indicator	SpecialEduInd	Indicator as to whether the participant/subject has or had special education	Indicator as to whether the participant/subject has or had special education	Does your child have a history of Special Education? For example, have you had any special classes or accommodations in school?	Yes;No;Unknown	Yes;No;Unknown	Alphanumeric		Adult;Pediatric	Supplemental	3.00	2013-07-15 16:08:48.687	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55511	Amnesia event lacuna indicator	AmnsiaEvntLacunaInd	Indicator of whether the subject/participant experienced lacunar amnesia of the suspected injury event	Indicator of whether the subject/participant experienced lacunar amnesia of the suspected injury event	Amnesia of event	No;Yes	No;Yes	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-12 12:20:44.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C54340	Acute Concussion Evaluation (ACE) - Amnesia before no memory events indicator	ACEAmnesiaBfNoMemEvntsInd	Indicator of whether subject/participant had no memory of events before (retrograde) amnesia as related to the Acute Concussion Evaluation (ACE)	Indicator of whether subject/participant had no memory of events before (retrograde) amnesia as related to the Acute Concussion Evaluation (ACE	Retrograde amnesia	No;Yes	No;Yes	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-02-27 20:29:51.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55542	Injury external cause ICD-10 code	InjExtrnlCausICD10Code	Code from the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) for the external cause of the suspected injury	Code from the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) for the external cause of the suspected injury	Injury ICD external cause code			Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-12 13:42:56.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events	10	Free-Form Entry
C05403	Injury date time estimation type	InjDateTimeEstTyp	The type as related to the point in time estimated as injury date and time	The type as related to the point in time estimated as injury date and time	If injury data is ESTIMATED, injury data type (point in time)	Time that the participant/subject became symptomatic;Time of first trauma activation;Time of presentation to emergency department	Time that the participant/subject became symptomatic;Time of first trauma activation;Time of presentation to emergency department	Alphanumeric		Adult;Pediatric	Supplemental	3.00	2013-07-20 10:21:25.65	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55474	Injury report delay elapsed time unit of measure	InjRptDlyElpsdTimUOM	Unit of measure related to 'Injury report delay elapsed time duration' for recording the units of the elapsed time between the occurrence and reporting of the injury that was recorded	Unit of measure related to 'Injury report delay elapsed time duration' for recording the units of the elapsed time between the occurrence and reporting of the injury that was recorded	How many minutes/hours after injury did the athlete report it to someone?	Hour;Minute	Hour;Minute	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-11 14:55:12.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55487	Injury incur activity role text	InjryIncurActvtyRolTxt	The free-text field for specifying the subject/participant's role in the activity in which he or she incurred the suspected injury	The free-text field for specifying the subject/participant's role in the activity in which he or she incurred the suspected injury	Position at time of injury			Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-11 17:08:21.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events	255	Free-Form Entry
C55571	Academic performance high school category	AcadPerfrmncHiSchlCat	Category of the subject/participant's overall academic performance in high school	Category of the subject/participant's overall academic performance in high school	What type of student were/are you in high school?	Below Average;Average;Above Average	Below Average;Average;Above Average	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-12 16:17:04.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C18397	Influence alcohol likelihood type	InfAlcLkhdTyp	Indicator for the likelihood the subject was under the influence of alcohol	Indicator for the likelihood the subject was under the influence of alcoho	Likelihood participant under influence of alcohol	None;Suspected;Confrimed;Unknown	None;Suspected;Confrimed;Unknown	Alphanumeric		Adult;Pediatric	Supplemental	3.00	2013-07-20 10:21:25.65	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55512	Amnesia event lacuna duration range	AmnsiaEvntLacunaDuratnRng	Range of time within which the duration of the subject/participant's lacunar amnesia of the suspected injury event falls	Range of time within which the duration of the subject/participant's lacunar amnesia of the suspected injury event falls	Amnesia of event: duration	Less than 1 hour;1-24 hours;>24 hours	Less than 1 hour;1-24 hours;>24 hours	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-12 12:17:20.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55462	Injury day week name	InjuryDayWeekName	Name of the day of the week on which the injury occurred	Name of the day of the week on which the injury occurred	Day of week of injury	Monday;Friday;Wednesday;Tuesday;Thursday;Sunday;Saturday	Monday;Friday;Wednesday;Tuesday;Thursday;Sunday;Saturday	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-11 11:55:34.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55543	Days school missed count range	DaysSchoolMissedCtRng	Range in which the count of days of school missed by the subject/participant falls	Range in which the count of days of school missed by the subject/participant falls	Approximately how many days of school has the child missed?	1-2 days;0 days;3–6 days;7 or more days	1-2 days;0 days;3–6 days;7 or more days	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-12 13:48:24.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C05404	Symptom onset date and time	SymptmOnsetDateTime	Date (and time, if applicable and known) reported for onset of participant's/subject's symptoms	Date (and time, if applicable and known) reported for onset of participant's/subject's symptoms	Symptom onset date; Symptom onset time			Date or Date & Time	Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).	Adult;Pediatric	Supplemental	3.00	2013-07-25 08:54:08.2	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Free-Form Entry
C55475	Injury report immediate indicator	InjRptImmedInd	Indicator of whether the injury was reported by the injured party immediately upon occurrence	Indicator of whether the injury was reported by the injured party immediately upon occurrence	Did athlete immediately report the injury?	No;Yes	No;Yes	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-11 16:05:32.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55496	Injury onset participant involvment category	InjOnstPtcptInvlvmntCat	Category of onset speed of the suspected injury and involvment of other participants in the activity in which the subject/participant incurred the suspected injury	Category of onset speed of the suspected injury and involvment of other participants in the activity in which the subject/participant incurred the suspected injury	Injury involved:	Gradual onset/overuse;Sudden onset and contact with another participant;Sudden onset and no contact with another participant;Unknown	Gradual onset/overuse;Sudden onset and contact with another participant;Sudden onset and no contact with another participant;Unknown	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-12 10:36:03.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55573	Pain intensity visual analogue scale value	PainIntnstyVslAnalogSclVal	Value indicated by the subject/participant for his or her pain intensity using a visual analogue scale	Value indicated by the subject/participant for his or her pain intensity using a visual analogue scale	Pain assessment			Numeric Values		Adult;Pediatric	Supplemental	1.00	2017-05-12 16:23:04.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Free-Form Entry	0	10
C19197	Injury time	InjuryTime	Time of injury	Time of injury	Time of Injury (24 hour clock)			Date or Date & Time	Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).	Adult;Pediatric	Supplemental	1.00	2014-06-02 16:13:18.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Free-Form Entry
C55517	Symptom duration value	SymptmDuratnVal	Value for the duration of the symptom(s) being documented	Value for the duration of the symptom(s) being documented	How long did symptoms last after injury/impact?			Numeric Values		Adult;Pediatric	Supplemental	1.00	2017-05-12 12:33:35.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Free-Form Entry	0
C55463	Injury data reliability category	InjDataReliablCat	Category of reliability for the injury data being reported	Category of reliability for the injury data being reported	Reliability of injury data	Verified;Estimated;Unknown	Verified;Estimated;Unknown	Alphanumeric		Adult;Pediatric	Supplemental	3.00	2013-07-20 10:21:25.65	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected
C55558	Education current level USA type	EduCurrLvlUSATyp	Current grade or level of school in which participant/subject is enrolled	Current grade or level of school in which participant/subject is enrolled	Please indicate the grade that your child is currently enrolled in:	1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade;Kindergarten;Not currently enrolled;Other, specify	1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade;Kindergarten;Not currently enrolled;Other, specify	Alphanumeric		Pediatric	Supplemental	3.00	2013-07-25 08:54:08.2	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected			3134878
C05406	Hospital first treat arrival date time	HospFirstTreatArrDateTime	Date (and time, if applicable and known) of arrival at the first hospital, if the participant/subject was transferred to the study center from another hospital	Date (and time, if applicable and known) of arrival at the first hospital, if the participant/subject was transferred to the study center from another hospital	Date treated at hospital; Time treated at hospital			Date or Date & Time	Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).	Adult;Pediatric	Supplemental	3.00	2013-07-20 10:21:25.65	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Free-Form Entry
C55477	Participation continue activity post injury indicator	PtcptnCntnuActvtyPostInjyInd	Indicator of whether the injured party continued to participate in the activity in which he or she received the suspected injury, after the occurrence of the suspected injury	Indicator of whether the injured party continued to participate in the activity in which he or she received the suspected injury, after the occurrence of the suspected injur	Did athlete continue participation after suspected injury event?	No;Yes	No;Yes	Alphanumeric		Adult;Pediatric	Supplemental	1.00	2017-05-11 16:08:03.0	Injury Report	History of Disease/Injury Event	Disease/Injury Related Events		Single Pre-Defined Value Selected