CDE Detailed Report

Disease: Sport Related Concussion
Subdomain Name: Post-Concussive %2F Mild TBI-Related Symptoms
CRF: Immediate Post-Concussion Assessment and Cognitive Testing (imPACT)

Displaying 101 - 109 of 109
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
C21443 Immediate Post-Concussion Assessment Testing (ImPACT) - Design memory delay percent correct percentage value ImPACTDesignMemDelCorrPercVal The delayed memory percent correct number on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The delayed memory percent correct number on the design memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Delayed memory pct. Correct Numeric Values Iverson GL, Lovell MR, Collins MW. Validity of ImPACT for measuring processing speed<br />following sports-related concussion. J Clin Exper Neuropsychol. 2005;27(6):683-699. Adult;Pediatric Core 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-Concussive %2F Mild TBI-Related Symptoms Outcomes and End Points

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C21454 Immediate Post-Concussion Assessment Testing (ImPACT) - Color match total correct count ImPACTColorMatchTotCorrCt The number of total correct on the color match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The number of total correct on the color match module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Total correct Numeric Values Iverson GL, Lovell MR, Collins MW. Validity of ImPACT for measuring processing speed<br />following sports-related concussion. J Clin Exper Neuropsychol. 2005;27(6):683-699. Adult;Pediatric Core 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-Concussive %2F Mild TBI-Related Symptoms Outcomes and End Points

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C21390 Immediate Post-Concussion Assessment Testing (ImPACT) - Verbal memory composite score ImPACTVerbMemoryCompScore Verbal memory composite score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Verbal memory composite score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Memory composite (verbal) Numeric Values Iverson GL, Lovell MR, Collins MW. Validity of ImPACT for measuring processing speed<br />following sports-related concussion. J Clin Exper Neuropsychol. 2005;27(6):683-699. Adult;Pediatric Core 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-Concussive %2F Mild TBI-Related Symptoms Outcomes and End Points

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C21422 Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) - Nervousness score ImPACTPCSSNervousnessScore The subject's current nervousness rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS) The subject's current nervousness rating score, as part of the Immediate Post-Concussion Assessment Testing (ImPACT), the Post -Concussion Symptom Scale (PCSS Nervousness 1;2;3;4;5;6;0 Minor;Minor;Moderate;Moderate;Severe;Severe;Not experiencing this symptom Numeric Values Iverson GL, Lovell MR, Collins MW. Validity of ImPACT for measuring processing speed<br />following sports-related concussion. J Clin Exper Neuropsychol. 2005;27(6):683-699. Adult;Pediatric Core 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-Concussive %2F Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C00004 Birth country ISO code BirthCntryISOCode Code (ISO 3166-1 alpha-2 code) for country where the participant/subject was born Code (ISO 3166-1 alpha-2 code) for country where the participant/subject was born Native country/region AF;AX;AL;DZ;AS;AD;AO;AI;AQ;AG;AR;AM;AW;AU;AT;AZ;BS;BH;BD;BB;BY;BE;BZ;BJ;BM;BT;BO;BQ;BA;BW;BV;BR;IO;BN;BG;BF;BI;KH;CM;CA;CV;KY;CF;TD;CL;CN;CX;CC;CO;KM;CG;CD;CK;CR;CI;HR;CU;CW;CY;CZ;DK;DJ;DM;DO;EC;EG;SV;GQ;ER;EE;ET;FK;FO;FJ;FI;FR;GF;PF;TF;GA;GM;GE;DE;GH;GI;GR;GL;GD;GP;GU;GT;GG;GN;GW;GY;HT;HM;VA;HN;HK;HU;IS;IN;ID;IR;IQ;IE;IM;IL;IT;JM;JP;JE;JO;KZ;KE;KI;KP;KR;KW;KG;LA;LV;LB;LS;LR;LY;LI;LT;LU;MO;MK;MG;MW;MY;MV;ML;MT;MH;MQ;MR;MU;YT;MX;FM;MD;MC;MN;ME;MS;MA;MZ;MM;NA;NR;NP;NL;NC;NZ;NI;NE;NG;NU;NF;MP;NO;OM;PK;PW;PS;PA;PG;PY;PE;PH;PN;PL;PT;PR;QA;RE;RO;RU;RW;BL;SH;KN;LC;MF;PM;VC;WS;SM;ST;SA;SN;RS;SC;SL;SG;SX;SK;SI;SB;SO;ZA;GS;SS;ES;LK;SD;SR;SJ;SZ;SE;CH;SY;TW;TJ;TZ;TH;TL;TG;TK;TO;TT;TN;TR;TM;TC;TV;UG;UA;AE;GB;US;UM;UY;UZ;VU;VE;VN;VG;VI;WF;EH;YE;ZM;ZW AFGHANISTAN;ALAND ISLANDS;ALBANIA;ALGERIA;AMERICAN SAMOA;ANDORRA;ANGOLA;ANGUILLA;ANTARCTICA;ANTIGUA AND BARBUDA;ARGENTINA;ARMENIA;ARUBA;AUSTRALIA;AUSTRIA;AZERBAIJAN;BAHAMAS;BAHRAIN;BANGLADESH;BARBADOS;BELARUS;BELGIUM;BELIZE;BENIN;BERMUDA;BHUTAN;BOLIVIA, PLURINATIONAL STATE OF;BONAIRE, SINT EUSTATIUS AND SABA;BOSNIA AND HERZEGOVINA;BOTSWANA;BOUVET ISLAND;BRAZIL;BRITISH INDIAN OCEAN TERRITORY;BRUNEI DARUSSALAM;BULGARIA;BURKINA FASO;BURUNDI;CAMBODIA;CAMEROON;CANADA;CAPE VERDE;CAYMAN ISLANDS;CENTRAL AFRICAN REPUBLIC;CHAD;CHILE;CHINA;CHRISTMAS ISLAND;COCOS (KEELING) ISLANDS;COLOMBIA;COMOROS;CONGO;CONGO, THE DEMOCRATIC REPUBLIC OF THE;COOK ISLANDS;COSTA RICA;COTE D'IVOIRE;CROATIA;CUBA;CURACAO;CYPRUS;CZECH REPUBLIC;DENMARK;DJIBOUTI;DOMINICA;DOMINICAN REPUBLIC;ECUADOR;EGYPT;EL SALVADOR;EQUATORIAL GUINEA;ER;ESTONIA;ETHIOPIA;FALKLAND ISLANDS (MALVINAS);FAROE ISLANDS;FIJI;FINLAND;FRANCE;FRENCH GUIANA;FRENCH POLYNESIA;FRENCH SOUTHERN TERRITORIES;GABON;GAMBIA;GEORGIA;GERMANY;GHANA;GIBRALTAR;GREECE;GREENLAND;GRENADA;GUADELOUPE;GUAM;GUATEMALA;GUERNSEY;GUINEA;GUINEA-BISSAU;GUYANA;HAITI;HEARD ISLAND AND MCDONALD ISLANDS;HOLY SEE (VATICAN CITY STATE);HONDURAS;HONG KONG;HUNGARY;ICELAND;INDIA;INDONESIA;IRAN, ISLAMIC REPUBLIC OF;IRAQ;IRELAND;ISLE OF MAN;ISRAEL;ITALY;JAMAICA;JAPAN;JERSEY;JORDAN;KAZAKHSTAN;KENYA;KIRIBATI;KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF;KOREA, REPUBLIC OF;KUWAIT;KYRGYZSTAN;LAO PEOPLE'S DEMOCRATIC REPUBLIC;LATVIA;LEBANON;LESOTHO;LIBERIA;LIBYA;LIECHTENSTEIN;LITHUANIA;LUXEMBOURG;MACAO;MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF;MADAGASCAR;MALAWI;MALAYSIA;MALDIVES;MALI;MALTA;MARSHALL ISLANDS;MARTINIQUE;MAURITANIA;MAURITIUS;MAYOTTE;MEXICO;MICRONESIA, FEDERATED STATES OF;MOLDOVA, REPUBLIC OF;MONACO;MONGOLIA;MONTENEGRO;MONTSERRAT;MOROCCO;MOZAMBIQUE;MYANMAR;NAMIBIA;NAURU;NEPAL;NETHERLANDS;NEW CALEDONIA;NEW ZEALAND;NICARAGUA;NIGER;NIGERIA;NIUE;NORFOLK ISLAND;NORTHERN MARIANA ISLANDS;NORWAY;OMAN;PAKISTAN;PALAU;PALESTINIAN TERRITORY, OCCUPIED;PANAMA;PAPUA NEW GUINEA;PARAGUAY;PERU;PHILIPPINES;PITCAIRN;POLAND;PORTUGAL;PUERTO RICO;QATAR;REUNION;ROMANIA;RUSSIAN FEDERATION;RWANDA;SAINT BARTHELEMY;SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA;SAINT KITTS AND NEVIS;SAINT LUCIA;SAINT MARTIN (FRENCH PART);SAINT PIERRE AND MIQUELON;SAINT VINCENT AND THE GRENADINES;SAMOA;SAN MARINO;SAO TOME AND PRINCIPE;SAUDI ARABIA;SENEGAL;SERBIA;SEYCHELLES;SIERRA LEONE;SINGAPORE;SINT MAARTEN (DUTCH PART);SLOVAKIA;SLOVENIA;SOLOMON ISLANDS;SOMALIA;SOUTH AFRICA;SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS;SOUTH SUDAN;SPAIN;SRI LANKA;SUDAN;SURINAME;SVALBARD AND JAN MAYEN;SWAZILAND;SWEDEN;SWITZERLAND;SYRIAN ARAB REPUBLIC;TAIWAN, PROVINCE OF CHINA;TAJIKISTAN;TANZANIA, UNITED REPUBLIC OF;THAILAND;TIMOR-LESTE;TOGO;TOKELAU;TONGA;TRINIDAD AND TOBAGO;TUNISIA;TURKEY;TURKMENISTAN;TURKS AND CAICOS ISLANDS;TUVALU;UGANDA;UKRAINE;UNITED ARAB EMIRATES;UNITED KINGDOM;UNITED STATES;UNITED STATES MINOR OUTLYING ISLANDS;URUGUAY;UZBEKISTAN;VANUATU;VENEZUELA, BOLIVARIAN REPUBLIC OF;VIET NAM;VIRGIN ISLANDS, BRITISH;VIRGIN ISLANDS, U.S.;WALLIS AND FUTUNA;WESTERN SAHARA;YEMEN;ZAMBIA;ZIMBABWE Alphanumeric Iverson GL, Lovell MR, Collins MW. Validity of ImPACT for measuring processing speed<br />following sports-related concussion. J Clin Exper Neuropsychol. 2005;27(6):683-699. Adult;Pediatric Core 3.00 2013-07-24 21:00:23.88 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-Concussive %2F Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21524 Language secondary text LangSecondaryTxt Text for the language the participant/subject speaks second-most often Text for the language the participant/subject speaks second-most often Secondary language eng;spa;sgn;chi;fre;ger;Other, specify English;Spanish;Sign Languages;Chinese languages;French;German;Other, specify Alphanumeric Iverson GL, Lovell MR, Collins MW. Validity of ImPACT for measuring processing speed<br />following sports-related concussion. J Clin Exper Neuropsychol. 2005;27(6):683-699. Adult;Pediatric Core 3.00 2013-07-20 10:21:25.65 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-Concussive %2F Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21401 Immediate Post-Concussion Assessment Testing (ImPACT) - Reaction time Reliable Change Index (RCI) exceeded indicator ImPACTReactTimeRCIExceedInd Indicator of whether the subject's composite score in reaction time exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Indicator of whether the subject's composite score in reaction time exceeded the Reliable Change Index (RCI), as part of the Immediate Post-Concussion Assessment Testing (ImPACT No;Yes No;Yes Alphanumeric Iverson GL, Lovell MR, Collins MW. Validity of ImPACT for measuring processing speed<br />following sports-related concussion. J Clin Exper Neuropsychol. 2005;27(6):683-699. Adult;Pediatric Core 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-Concussive %2F Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21433 Immediate Post-Concussion Assessment Testing (ImPACT) - Word memory learning correct percentage value ImPACTWordMemLearnCorrPercVal The learning percent correct number on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) The learning percent correct number on the word memory module, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Learning percent correct Numeric Values Iverson GL, Lovell MR, Collins MW. Validity of ImPACT for measuring processing speed<br />following sports-related concussion. J Clin Exper Neuropsychol. 2005;27(6):683-699. Adult;Pediatric Core 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-Concussive %2F Mild TBI-Related Symptoms Outcomes and End Points

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C21369 Immediate Post-Concussion Assessment Testing (ImPACT) - Primary position event class text ImPACTPrimPosEventClassText Primary type of position/event/class, as part of the Immediate Post-Concussion Assessment Testing (ImPACT) Primary type of position/event/class, as part of the Immediate Post-Concussion Assessment Testing (ImPACT Primary position/event/class Alphanumeric Iverson GL, Lovell MR, Collins MW. Validity of ImPACT for measuring processing speed<br />following sports-related concussion. J Clin Exper Neuropsychol. 2005;27(6):683-699. Adult;Pediatric Core 1.00 2015-07-20 11:52:01.0 Immediate Post-Concussion Assessment and Cognitive Testing (imPACT) Post-Concussive %2F Mild TBI-Related Symptoms Outcomes and End Points 400

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