CDE Detailed Report

Disease: Sport Related Concussion
Sub-Domain: Post-Concussive / Mild TBI-Related Symptoms
CRF: Post Concussion Symptom Scale

Displaying 1 - 28 of 28
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
C05400 Injury date time InjDateTime Date (and time, if applicable and known) of injury Date (and time, if applicable and known) of injury Date of Injury: Date or Date & Time Adult;Pediatric Core 3.00 2013-07-20 10:21:25.65 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

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C55268 Post Concussion Symptom Scale (PCSS) - Sleep loss symptom score PCSSDSleepLossSympScore The score for loss of sleep symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for loss of sleep symptoms as part of the Post Concussion Symptom Scale (PCSS) Loss of sleep 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55279 Post Concussion Symptom Scale (PCSS) - Difficulty concentrating symptom score PCSSDifficltyConcentrSympScore The score for symptoms of having difficulty concentrating as part of the Post Concussion Symptom Scale (PCSS) The score for symptoms of having difficulty concentrating as part of the Post Concussion Symptom Scale (PCSS) Difficulty concentrating 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C21117 Subject name SubjectName Name of subject/participant. Name of subject/participant. Name: Alphanumeric Adult;Pediatric Core 1.00 2015-06-12 15:16:39.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points 255

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C55269 Post Concussion Symptom Scale (PCSS) - Drowsiness symptom score PCSSDDrowsinessSympScore The score for drowsiness symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for drowsiness symptoms as part of the Post Concussion Symptom Scale (PCSS) Drowsiness 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55280 Post Concussion Symptom Scale (PCSS) - Difficulty remembering symptom score PCSSDifficltyRememberSympScore The score for symptoms of having difficulty remembering as part of the Post Concussion Symptom Scale (PCSS) The score for symptoms of having difficulty remembering as part of the Post Concussion Symptom Scale (PCSS) Difficulty remembering 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55259 Post Concussion Symptom Scale (PCSS) - Time after concussion count PCSSTimeAfterConcussCount The number of days or hours following concussion as part of the Post Concussion Symptom Scale (PCSS) The number of days or hours following concussion as part of the Post Concussion Symptom Scale (PCSS) Days/Hrs Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

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C55270 Post Concussion Symptom Scale (PCSS) - Light sensitivity symptom score PCSSDLightSensSympScore The score for light sensitivity symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for light sensitivity symptoms as part of the Post Concussion Symptom Scale (PCSS) Light sensitivity 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55281 Post Concussion Symptom Scale (PCSS) - Visual problem symptom score PCSSVisualProbSympScore The score for visual problem symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for visual problem symptoms as part of the Post Concussion Symptom Scale (PCSS) Visual problems 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55260 Post Concussion Symptom Scale (PCSS) - Headache symptom score PCSSHeadacheSympScore The score for headache symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for headache symptoms as part of the Post Concussion Symptom Scale (PCSS) Headache 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55271 Post Concussion Symptom Scale (PCSS) - Noise sensitivity symptom score PCSSDNoiseSensSympScore The score for noise sensitivity symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for noise sensitivity symptoms as part of the Post Concussion Symptom Scale (PCSS) Noise sensitivity 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55282 Post Concussion Symptom Scale (PCSS) - Total score PCSSTotalScore The total score as part of the Post Concussion Symptom Scale (PCSS) The total score as part of the Post Concussion Symptom Scale (PCSS) Total score Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

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0 132
C55261 Post Concussion Symptom Scale (PCSS) - Nausea symptom score PCSSNauseaSympScore The score for nausea symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for nausea symptoms as part of the Post Concussion Symptom Scale (PCSS) Nausea 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55272 Post Concussion Symptom Scale (PCSS) - Irritability symptom score PCSSDIrritabSympScore The score for irritability symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for irritability symptoms as part of the Post Concussion Symptom Scale (PCSS) Irritability 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55262 Post Concussion Symptom Scale (PCSS) - Vomiting symptom score PCSSVomitingSympScore The score for vomiting symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for vomiting symptoms as part of the Post Concussion Symptom Scale (PCSS) Vomiting 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55273 Post Concussion Symptom Scale (PCSS) - Sadness symptom score PCSSDSadnessSympScore The score for sadness symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for sadness symptoms as part of the Post Concussion Symptom Scale (PCSS) Sadness 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55263 Post Concussion Symptom Scale (PCSS) - Balance problem symptom score PCSSBalanceProbSympScore The score for balance problems symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for balance problems symptoms as part of the Post Concussion Symptom Scale (PCSS) Balance problems 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55274 Post Concussion Symptom Scale (PCSS) - Nervousness symptom score PCSSDNervousnessSympScore The score for nervousness symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for nervousness symptoms as part of the Post Concussion Symptom Scale (PCSS) Nervousness 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55264 Post Concussion Symptom Scale (PCSS) - Dizziness symptom score PCSSDizzinessSympScore The score for dizziness symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for dizziness symptoms as part of the Post Concussion Symptom Scale (PCSS) Dizziness 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55275 Post Concussion Symptom Scale (PCSS) - More emotional symptom score PCSSMoreEmotionalSympScore The score for having more emotional symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for having more emotional symptoms as part of the Post Concussion Symptom Scale (PCSS) More emotional 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55265 Post Concussion Symptom Scale (PCSS) - Fatigue symptom score PCSSDFatigueSympScore The score for fatigue symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for fatigue symptoms as part of the Post Concussion Symptom Scale (PCSS) Fatigue 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55276 Post Concussion Symptom Scale (PCSS) - Numbness symptom score PCSSNumbnessSympScore The score for numbness symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for numbness symptoms as part of the Post Concussion Symptom Scale (PCSS) Numbness 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C00007 Birth date BirthDate Date (and time, if applicable and known) the participant/subject was born Date (and time, if applicable and known) the participant/subject was born Age/DOB: Date or Date & Time Adult;Pediatric Core 3.00 2013-07-25 08:54:08.2 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

793
C55266 Post Concussion Symptom Scale (PCSS) - Trouble fall asleep symptom score PCSSDTrblFallAsleepSympScore The score for having trouble asleep symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for having trouble asleep symptoms as part of the Post Concussion Symptom Scale (PCSS) Trouble falling to sleep 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55277 Post Concussion Symptom Scale (PCSS) - Feel slow symptom score PCSSFeelSlowSympScore The score for symptoms of feeling "slow" as part of the Post Concussion Symptom Scale (PCSS) The score for symptoms of feeling "slow" as part of the Post Concussion Symptom Scale (PCSS) Feeling "slow" 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C00008 Age value AgeVal Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject. Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject. Age/DOB: Numeric Values Adult;Pediatric Core 3.00 2013-08-28 16:08:00.453 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Free-Form Entry

0 1800 month
C55267 Post Concussion Symptom Scale (PCSS) - Excessive sleep symptom score PCSSDExcessSleepSympScore The score for excessive sleep symptoms as part of the Post Concussion Symptom Scale (PCSS) The score for excessive sleep symptoms as part of the Post Concussion Symptom Scale (PCSS) Excessive sleep 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

C55278 Post Concussion Symptom Scale (PCSS) - Feel foggy symptom score PCSSFeelFoggySympScore The score for symptoms of feeling "foggy" as part of the Post Concussion Symptom Scale (PCSS) The score for symptoms of feeling "foggy" as part of the Post Concussion Symptom Scale (PCSS) Feeling "foggy" 1;2;4;5;0;3;6 1;2;4;5;No symptoms at all;Moderate;Severe Numeric Values Adult;Pediatric Core 1.00 2017-04-26 15:07:24.0 Post Concussion Symptom Scale Post-Concussive / Mild TBI-Related Symptoms Outcomes and End Points

Single Pre-Defined Value Selected

CSV