CDE Detailed Report

Disease: Epilepsy
Subdomain Name: Drugs
CRF: Non Anti Epileptic Medication Log

Displaying 1 - 15 of 15
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
C02025 Medication prior or concomitant RXNorm code MedctnPriorConcomRxNormCode Code for name of the prior/concomitant agent or drug administered Code for name of the prior/concomitant agent or drug administere Generic Name of Medication Alphanumeric

Code the verbatim name of the medication using RXNorm. Core for all prospective intervention and observation studies

RXNorm (http://www.nlm.nih.gov/research/umls/rxnorm/) Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data 255

Free-Form Entry

3162728
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 participant/subject take any medications _ days before or during the study Yes;No Yes;No Alphanumeric

Indicate whether the participant/subject took any non-study anti epileptic drugs (AEDs) during the study. Core for all prospective intervention and observation studies

No references available Adult;Pediatric Supplemental 3.00 2013-07-22 16:57:17.79 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

2220500
C10636 Medication prior or concomitant PRN average monthly frequency MedctnPriorConTknPRNAvMnthFreq Average frequency per month for medications that are taken on an as needed basis (PRN) Average frequency per month for the non-anti-epileptic drugs (NAED) that are taken on an as needed basis (PRN) Average frequency Numeric Values

Record the average number of times per month the PRN medication is taken

No references available Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data

Free-Form Entry

1 99
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 N/A - Ongoing? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one. Answer YES if the participant/subject is still taking the medication or NO if the participant/subject has stopped taking the medication. Core for all prospective intervention and observation studies

No references available Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

2321822
C18552 Medication non-anti-epileptic drug log line number MedctnNAEDLogLineNum The referenced line number of an entry on the non-anti-epileptic drug (NAED) plasma concentration log The referenced line number of an entry on the non-anti-epileptic drug (NAED) plasma concentration lo Line number Numeric Values No references available Adult;Pediatric Supplemental 3.00 2013-07-30 14:29:49.047 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data

Free-Form Entry

0 20
C02006 Medication prior or concomitant dose MedctnPriorOrConcomDose Dose of prior/concomitant medication taken per administration Dose of prior/concomitant medication taken per administration Total Daily Dose or PRN Dose Numeric Values

Record the dose of AED the participant/subject was prescribed to take. Core for all prospective intervention and observation studies. The following abbreviations are recommended to capture dose units: g = gram;gr = grain;gtt = drop;mcg = microgram;mcL = microliter;mg = milligram;mL = milliliter;oz = ounce;SPY = spray/squirt;supp = suppository;TBSP = tablespoon;Sp = teaspoon;OTH = other, specify;UNK= Unknown

No references available Adult;Pediatric Supplemental 3.10 2022-08-02 14:33:32.0 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data

Free-Form Entry

3162729
C18553 Medication non-anti-epileptic drug prior or concomitant use day count MedNAEDPriorOrConcomUseDayCt The numeric count of days a non-anti-epileptic drug (NAED) was taken before or during a study The numeric count of days a non-anti-epileptic drug (NAED) was taken before or during a stud Number of days before or during the study Numeric Values No references available Adult;Pediatric Supplemental 3.00 2013-07-30 14:29:49.047 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data

Free-Form Entry

0 200 day
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 Date or Date & Time

Record the date (and time) the participant/subject stopped taking the medication. 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.) and in the format acceptable to the study database. Stop Date should be recorded if Ongoing Medication is answered No. Conversely, Stop Date should remain blank if Ongoing Medication is answered Yes. Core for all prospective intervention and observation studies

No references available Adult;Pediatric Supplemental 3.10 2022-08-02 16:59:51.0 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data

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3162753
C18736 Medication prior or concomitant dose unit of measure other text MedctnPriorOrConcomDoseUoMOTH The free-text field related to 'Medication prior or concomitant dose unit of measure', specifying other text. Dosage unit of measure of the prior or concomitant medication administered The free-text field related to 'Medication prior or concomitant dose unit of measure', specifying other text. Dosage unit of measure of the prior or concomitant medication administere Other, specify Alphanumeric

Record the unit for dose of AED the participant/subject was prescribed to take. Core for all prospective intervention and observacation studies. Examples of dose units include: g = gram; gr = grain; gtt = drop; mcg = microgram; mcL = microliter; mg = milligram; mL = milliliter; oz = ounce; SPY = spray/squirt; supp = suppository; TBSP = Tablespoon; tsp = teaspoon; OTH = other, specify; UNK = unknown

Unified Code for Units of Measure (UCUM) - http://unitsofmeasure.org/ Adult;Pediatric Supplemental 2.10 2022-08-02 14:27:44.0 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data 4000

Free-Form Entry

3162730
C02011 Medication prior or concomitant dose frequency MedctnPriorConcmtntDoseFreq Frequency of use of a prior/concomitant medication Frequency of use of a prior/concomitant medicatio Dose 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

Record the frequency based on the dosing schedule recorded on the CRF

CDISC SDTM Frequency Terminology (Code C71113) - http://evs.nci.nih.gov/ftp1/CDISC/SDTM/ Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

3162733
C02013 Medication prior or concomitant dose unit of measure UCUM code MedctnPriorOrConDseUOMUCUMCode Code that represents the dosage unit of measure of the prior or concomitant medication administered. Unified Code for Units of Measure (UCUM) Code that represents the dosage unit of measure of the prior or concomitant medication administered. Unified Code for Units of Measure (UCUM) Alphanumeric

Code the unit of measure of the medication dosage using Unified Code for Units of Measure (UCUM). Core for all prospective intervention and observation studies

Unified Code for Units of Measure (UCUM) - http://unitsofmeasure.org/ Adult;Pediatric Supplemental 3.10 2022-08-02 14:42:09.0 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data 255

Free-Form Entry

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 Generic Name of Medication Alphanumeric

Record the generic or brand name of the anti epileptic drug. Core for all prospective intervention and observation studies

RXNorm (http://www.nlm.nih.gov/research/umls/rxnorm/) Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data 4000

Free-Form Entry

3162728
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 Date or Date & Time

Record the date (and time) the participant/subject started taking the medication. Start Date can be used to distinguish between prior medications and concomitant medications. Core for all prospective intervention and observation studies. 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 3.10 2022-08-02 16:58:56.0 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data

Free-Form Entry

3162752
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 Units g;mcg;mcL;mg;mL;oz;Other, specify;Unknown;NA gram;microgram;microliter;milligram;milliliter;ounce;Other, specify;Unknown;Not applicable Alphanumeric

Record the unit for dose of AED the participant/subject was prescribed to take. Core for all prospective intervention and observacation studies. Examples of dose units include: g = gram; gr = grain; gtt = drop; mcg = microgram; mcL = microliter; mg = milligram; mL = milliliter; oz = ounce; SPY = spray/squirt; supp = suppository; TBSP = Tablespoon; tsp = teaspoon; OTH = other, specify; UNK = unknown

Unified Code for Units of Measure (UCUM) - http://unitsofmeasure.org/ Adult;Pediatric Supplemental 3.10 2022-08-02 14:36:00.0 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

3162730
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 Alphanumeric

Record the reason the participant/subject gives for taking the medication. If given for an Adverse Event (AE), enter exact term from Adverse Event CRF. The indication for the AED medication should be recorded in the database as "epileptic seizure control" to distinguish the AEDs from other prior or concomitant medications taken during the study. The indication does NOT need to be recorded on the CRF. Core for all prospective intervention and observation studies

No references available Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Non Anti Epileptic Medication Log Drugs Treatment/Intervention Data 4000

Free-Form Entry

3158920
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