CDE Detailed Report

Disease: Traumatic Brain Injury
Subdomain Name: History of Disease%2FInjury Event
CRF: content

Displaying 1 - 22 of 22
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
C05409 Injury presentation reason InjPresentRsn Reason for presentation at study facility/reason for interface with medical provider Reason for presentation at study facility/reason for interface with medical provide Injury presentation reason On advice significant other;Routine screening;Repatriation;Professional referral;Self referral with complaints On advice significant other;Routine screening;Repatriation;Professional referral;Self referral with complaints Alphanumeric

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Moss NE, Wade DT. Admission after head injury: how many occur and how many are recorded? Injury. Apr 1996;27(3):159-161. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Single Pre-Defined Value Selected

C18675 Emergency service other text EmrServOTH The free-text field related to 'Emergency service type' specifying other text. Branch of service involved at the accident scene The free-text field related to 'Emergency service type' specifying other text. Branch of service involved at the accident scene Other, specify Alphanumeric

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No references available Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events 4000

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C05410 Injury presentation professional referral category InjPrsnttnProfssnlRfrrlCat Category of professional that referred the participant/subject to seek medical care Category of professional that referred the participant/subject to seek medical care Injury presentation professional referral category General practitioner;Hospital staff;Other caretaker General practitioner;Hospital staff;Other caretaker Alphanumeric

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No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Single Pre-Defined Value Selected

C18686 Hospital transport other text HospTrnsprtOTH The free-text field related to 'Hospital transport type' specifying other text. Type of transportation from injury scene to hospital The free-text field related to 'Hospital transport type' specifying other text. Type of transportation from injury scene to hospital Other, specify Alphanumeric

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No references available Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events 4000

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C05400 Injury date time InjDateTime Date (and time, if applicable and known) of injury Date (and time, if applicable and known) of injury Injury date and 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.).

No references available Adult;Pediatric Basic 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

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C05411 Injury immediate medical service receive indicator InjImmdtMedclServRecvdInd Indicator of whether initial medical services were received directly after injury Indicator of whether initial medical services were received directly after injury Were initial medical services received directly after injury? Yes;No;Unknown Yes;No;Unknown Alphanumeric

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Berlot G, Fata CL, Bacer B, et al. Influence of prehospital treatment on the outcome of patients with severe blunt traumatic brain injury. Eur J Emerg Med. Jun 1 2009 Davis DP, Peay J, Serrano JA, et al. The impact of aeromedical response to patients with moderate to severe traumatic brain injury. Ann Emerg Med. Aug 2005;46(2):155-22. Adult;Pediatric Basic 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Single Pre-Defined Value Selected

C05401 Injury date reliability type InjDateReliablTyp The type of reliability of the reported injury date The type of reliability of the reported injury date Reliability of injury date Verified;Estimated;Unknown Verified;Estimated;Unknown Alphanumeric

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No references available Adult;Pediatric Basic 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Single Pre-Defined Value Selected

C05412 Injury immediate medical service received type InjImmdtMedServRecvdTyp Type of initial medical services received directly after injury Type of initial medical services received directly after injury Injury immediate medical services received type CT/MRI;Hospitalization;Specialized therapies (speech, physical, occupational therapy);Evaluations (neurological, psychological);Medication;Other;Education about course of symptoms CT/MRI;Hospitalization;Specialized therapies (speech, physical, occupational therapy);Evaluations (neurological, psychological);Medication;Other;Education about course of symptoms Alphanumeric

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Berlot G, Fata CL, Bacer B, et al. Influence of prehospital treatment on the outcome of patients with severe blunt traumatic brain injury. Eur J Emerg Med. Jun 1 2009 Davis DP, Peay J, Serrano JA, et al. The impact of aeromedical response to patients with moderate to severe traumatic brain injury. Ann Emerg Med. Aug 2005;46(2):155-22. Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Multiple Pre-Defined Values Selected

C05402 Injury time reliability type InjReliablTyp The reliability of the reported time of injury The reliability of The reported time of injury Injury time reliability type Verified;Estimated;Unknown Verified;Estimated;Unknown Alphanumeric

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No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Single Pre-Defined Value Selected

C05413 Emergency medical care provider type EmrMedCrProvTyp Type of provider of initial medical care directly after injury Type of provider of initial medical care directly after injury Emergency medical care provider type Bystander;Trainer/coach;Paramedic/Medic;Emergency department;Physician;Other Bystander;Trainer/coach;Paramedic/Medic;Emergency department;Physician;Other Alphanumeric

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No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Multiple Pre-Defined Values Selected

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 estimated, the point in time estimated as injury date 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

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No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Single Pre-Defined Value Selected

C05414 Emergency medical care provider train type EmrgyMedclCarePrvdrTrainTyp Type of training by Emergency medical care provider Type of training by Emergency medical care provide Emergency medical care provider training type Untrained person;Military - non medic;Paramedic;Nurse;Physician;Medical rescue team;Other;None Untrained person;Military - non medic;Paramedic;Nurse;Physician;Medical rescue team;Other;None Alphanumeric

Mark all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Multiple Pre-Defined Values 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 and 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.).

No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

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C05415 Emergency service type EmrServTyp Branch of service involved at the accident scene Branch of service involved at the accident scene Emergency service type None;Police;Firefighter;Ambulance (Core, EMT-B);Ambulance with specialized personnel (EMT-1);Helicopter medical service;Other, specify None;Police;Firefighter;Ambulance (Core, EMT-B);Ambulance with specialized personnel (EMT-1);Helicopter medical service;Other, specify Alphanumeric

Choose all that apply.

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Multiple Pre-Defined Values Selected

C05405 Hospital presentation type HospPresTyp Whether the participant/subject was taken directly from the scene of accident to the study hospital (primary) or was first taken to a non-study hospital, and then transferred to the study hospital (secondary) Whether the participant/subject was taken directly from the scene of accident to the study hospital (primary) or was first taken to a non-study hospital, and then transferred to the study hospital (secondary) Hospital presentation type Primary;Secondary patient was taken directly from the scene of accident to the study hospital;patient was first taken to a non-study hospital, and then transferred to the study hospital. Alphanumeric

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No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Single Pre-Defined Value Selected

C05416 Emergency service response time duration EmrServRespTmDur Duration of time between injury and arrival of emergency services Duration of time between injury and arrival of emergency service Emergency services response time duration Numeric Values

Response should be recorded in the format DD:HH:MM.

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Free-Form Entry

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 If first treated at a hospital prior to arriving at study center, arrival date and 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.).

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Free-Form Entry

C05417 Emergency service time injury scene duration EmrServTmInjScnDur Duration of time between arrival and departure of emergency services Duration of time between arrival and departure of emergency service Emergency services time at injury scene duration Numeric Values

Response should be recorded in the format HH:MM.

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Free-Form Entry

C05407 Study center arrival date time StdyCntrArrDateTime Date (and time, if applicable and known) of arrival to study center Date (and time, if applicable and known) of arrival to study center Study center arrival date and 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.).

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Free-Form Entry

C05418 Hospital transport type HospTrnsprtTyp Type of transportation from injury scene to hospital Type of transportation from injury scene to hospital Transport to hospital type Ground ambulance with physician;Ground ambulance no physician;Private transportation/taxi/other from home/scene;By foot;Other, specify;Helicopter Ground ambulance with physician;Ground ambulance no physician;Private transportation/taxi/other from home/scene;By foot;Other, specify;Helicopter Alphanumeric

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No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Single Pre-Defined Value Selected

C05408 Hospital admission date and time HospitlAdmissDateTime Date (and time, if applicable and known) the participant/subject was admitted to the hospital Date (and time, if applicable and known) the participant/subject was admitted to the hospital Hospital admission date and 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.).

No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

Free-Form Entry

C17404 Injury elapsed time InjElapsedTime The elapsed time (in minutes) from the time of injury The elapsed time (in minutes) from the time of injury Numeric Values

Indicate the time since injury occurred following definition provided per protocol. Note: Accurate determination of time since injury is critical for gauging patient progress and for assessing eligibility for acute phase studies. The need for TBI patients to be transferred from an initial receiving hospital to another hospital may delay definitive care and consequently impact outcome adversely, and longer transport times delay definitive treatment.

No references available Adult;Pediatric Core 1.00 2012-12-20 00:00:00.0 Injury Presentation - Early/Late History of Disease%2FInjury Event Disease%2FInjury Related Events

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