CDE Detailed Report

Disease: Traumatic Brain Injury
Subdomain Name: Therapies
CRF: Post Discharge

Displaying 1 - 8 of 8
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
C05135 Therapy rehabilitation end date time TherpyRehabEndDateTime Date (and time, if applicable and known) on which the therapy or rehabilitation ended Date (and time, if applicable and known) on which the therapy or rehabilitation ended Date Time of Discontinuation 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.).

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Post Discharge/Outpatient Treatment Therapies Treatment/Intervention Data

Free-Form Entry

C05136 Therapy rehabilitation ongoing indicator TherpyRehabOngngInd Indicator of whether the therapy or rehabilitation is ongoing Indicator of whether the therapy or rehabilitation is ongoing Therapy or Rehabilitation Ongoing? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one. Add date and time stamp for when assessed.

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Post Discharge/Outpatient Treatment Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C18768 Therapy or rehabilitation other text TherpyRehabOTH The free-text field related to 'Therapy or rehabilitation type' specifying other text. Type of therapy or rehabilitation services received by the participant/subject The free-text field related to 'Therapy or rehabilitation type' specifying other text. Type of therapy or rehabilitation services received by the participant/subject Other, specify Alphanumeric

Choose all that apply. Response is obtained from report by the participant/subject, a reliable proxy or medical records. Add date stamp for when assessed. Recommend collection at end of initial medical care. Service provision post-TBI is important to track as it is an indicator of health care resource utilization.

International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): http://www.cdc.gov/nchs/icd/icd9cm.htm Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Post Discharge/Outpatient Treatment Therapies Treatment/Intervention Data 4000

Free-Form Entry

C21667 Therapy rehabilitation ICD 10 CM code TherpyRehabICD10CMCd ICD-10-CM code that describes the therapy or rehabilitation received by the participant/subject ICD-10-CM code that describes the therapy or rehabilitation received by the participant/subject ICD-10-CM code Alphanumeric

Add date stamp for when assessed. Recommend collection at least at end of initial medical care.

International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) for permissible values: http://www.cdc.gov/nchs/icd/icd9cm.htm Adult;Pediatric Supplemental 1.00 2013-07-20 10:21:25.65 Post Discharge/Outpatient Treatment Therapies Treatment/Intervention Data 255

Free-Form Entry

C05130 Therapy or rehabilitation type TherpyRehabTyp Type of therapy or rehabilitation services received by the participant/subject Type of therapy or rehabilitation services received by the participant/subjec Type of Therapy or Rehabilitation Unknown;Other, specify;Home health;Therapeutic recreation;Speech therapy;Occupational therapy;Physical therapy Unknown;Other, specify;Home health;Therapeutic recreation;Speech therapy;Occupational therapy;Physical therapy Alphanumeric

Choose all that apply. Response is obtained from report by the participant/subject, a reliable proxy or medical records. Add date stamp for when assessed. Recommend collection at end of initial medical care. Service provision post-TBI is important to track as it is an indicator of health care resource utilization.

International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): http://www.cdc.gov/nchs/icd/icd9cm.htm Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Post Discharge/Outpatient Treatment Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C05132 Therapy or rehabilitation frequency TherpyRehabFreq Identified describing the frequency the participant/subject received the therapy or rehabilitation Identified describing the frequency the participant/subject received the therapy or rehabilitation Therapy or Rehabilitation Frequency Numeric Values

Choose one.

CDISC SDTM Frequency Terminology (Code C71113) (http://www.cancer.gov/cancertopics/cancerlibrary/terminologyresources/cdisc) - http://evs.nci.nih.gov/ftp1/CDISC/SDTM/ Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Post Discharge/Outpatient Treatment Therapies Treatment/Intervention Data

Free-Form Entry

C05133 Therapy or rehabilitation session duration TherpyRehabSessnDur Average duration of a therapy or rehabilitation session Average duration of a therapy or rehabilitation session Avg. Duration of Therapy Session Numeric Values

Record the duration of therapy or rehabilitation session in minutes.

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Post Discharge/Outpatient Treatment Therapies Treatment/Intervention Data

Free-Form Entry

minute
C05134 Therapy rehabilitation start date time TherpyRehabStrtDateTime Date (and time, if applicable and known) on which the therapy or rehabilitation started Date (and time, if applicable and known) on which the therapy or rehabilitation started Date Time of Initiation 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.).

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Post Discharge/Outpatient Treatment Therapies Treatment/Intervention Data

Free-Form Entry

CSV