CDE Detailed Report

Disease: Chiari I Malformation
Subdomain Name: Physical%2FNeurological Examination
CRF: Self - Report Testing (On Intake)

Displaying 51 - 78 of 78
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
C22768 Irregular menstrual period indicator IrreglrMenstrlPeriodInd Indicator of whether the patient/participant has irregular menstrual periods Indicator of whether the patient/participant has irregular menstrual period Women: Do you have irregular periods? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22715 Visual field reduced look straight ahead indicator VisFldReducLookStrghtAhdInd Indicator of whether the patient/participant's visual field is reduced or missing a portion when looking straight ahead with either or both eyes Indicator of whether the patient/participant's visual field is reduced or missing a portion when looking straight ahead with either or both eye Are you missing a portion of your visual field when looking straight ahead (Field Cuts) with either or both eyes? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22747 Current diarrhea indicator CurrentDiarrheaInd Indicator of whether the patient/participant currently experiences diarrhea Indicator of whether the patient/participant currently experiences diarrhea Do you suffer from diarrhea? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22726 Palpitations indicator PalpitationsInd Indicator of whether the patient/participant has experienced palpitations Indicator of whether the patient/participant has experienced palpitation Do you have palpitations? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22758 Long-term memory loss indicator LongTermMemoryLossInd Indicator of whether the patient/participant is experiencing a decline in long-term memory Indicator of whether the patient/participant is experiencing a decline in long-term memor Do you suffer from long-term memory loss? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22195 Base head pressure indicator BasHdPrsInd The indicator related to pressure at the base of head The indicator related to pressure at the base of hea Do you have pressure at the base of your head? Yes;No Yes;No Alphanumeric Adult;Pediatric Core 1.00 2016-06-08 13:20:31.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22737 Muscle tone loss indicator MuscleToneLossInd Indicator of whether the patient/participant has experienced a loss of muscle tone Indicator of whether the patient/participant has experienced a loss of muscle ton Do you have loss of muscle tone? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22769 Unexpected breast milk production indicator UnexpectBrstMlkProdInd Indicator of whether the patient/participant is experiencing unexpected breast milk production Indicator of whether the patient/participant is experiencing unexpected breast milk productio Women: Do you have unexpected milk production at the breast? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22716 Ear pressure indicator EarPressureInd Indicator of whether the patient/participant has pressure in his or her ears Indicator of whether the patient/participant has pressure in his or her ear Do you have pressure in your ears? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22748 Occasional bowel incontinence current indicator OccasnlBowlIncontncCurrInd Indicator of whether the patient/participant currently experiences occasional bowel incontinence Indicator of whether the patient/participant currently experiences occasional bowel incontinenc Have you had occasional incontinence for stools (fecal soiling)? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22727 Breath shortness indicator BreathShortnessInd Indicator of whether the patient/participant has experienced shortness of breath Indicator of whether the patient/participant has experienced shortness of breat Do you ever have shortness of breath? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22759 Indecisiveness indicator IndecisivenessInd Indicator of whether the patient/participant is experiencing or exhibits difficulty making decisions Indicator of whether the patient/participant is experiencing or exhibits difficulty making decision Do you have difficulty making decisions? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22198 Behind eye pain radiate indicator BhndEyePnRadInd The indicator related to pain radiating behind your eyes The indicator related to pain radiating behind your eye Does your pain radiate behind your eyes? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2016-06-08 13:28:30.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22738 Precision grip difficulty indicator PrecisionGripDifficultyInd Indicator of whether the patient/participant has experienced difficulty with his or her precision grip Indicator of whether the patient/participant has experienced difficulty with his or her precision gri Do you have difficulty picking up small objects with your fingers? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22770 Need urinate multiple times while sleep indicator NdUrinatMultplTimeWhilSlpInd Indicator of whether the patient/participant experiences the need to urinate more than once while sleeping Indicator of whether the patient/participant experiences the need to urinate more than once while sleepin Do you awaken from sleep two or more times to urinate? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22717 Stand unsteady indicator StandUnsteadyInd Indicator of whether the patient/participant feels unsteady when standing Indicator of whether the patient/participant feels unsteady when standin Do you have feelings of unsteadiness when standing? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22749 Irritable bowel syndrome diagnosis ever indicator IrritblBowelSyndrmDiagnsEvrInd Indicator of whether the patient/participant has ever been diagnosed with Irritable Bowel Syndrome (IBS) Indicator of whether the patient/participant has ever been diagnosed with Irritable Bowel Syndrome (IBS Have you ever been diagnosed with irritable bowel syndrome (IBS)? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22728 Frequent nausea indicator FrequentNauseaInd Indicator of whether the patient/participant has experienced frequent nausea Indicator of whether the patient/participant has experienced frequent nause Do you have frequent nausea? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22760 Word selection anomia indicator WordSelectnAnomiaInd Indicator of whether the patient/participant is experiencing or exhibits problems with recalling words Indicator of whether the patient/participant is experiencing or exhibits problems with recalling word Do you have word finding problems? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C01052 Loss of consciousness indicator LOCInd The indicator for whether the participant/subject experienced any period of loss of consciousness (LOC) The indicator for whether the participant/subject experienced any period of loss of consciousness (LOC Have you ever "passed out"? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 3.00 2013-07-20 10:21:25.65 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22200 Neck shoulder pain radiate indicator NckShldrPnRdInd The indicator related to pain radiating to the neck or shoulders The indicator related to pain radiating to the neck or shoulder Does your pain radiate to your neck or shoulders? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2016-06-08 13:33:42.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22739 Extremity stiffness indicator ExtremityStiffnessInd Indicator of whether the patient/participant has experienced stiffness in his or her extremities Indicator of whether the patient/participant has experienced stiffness in his or her extremitie Do you have stiffness of your arms or legs? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22771 Snoring indicator SnoringInd Indicator of whether the patient/participant snores during sleep Indicator of whether the patient/participant snores during slee Do you snore? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22718 Walk unsteady indicator WalkUnsteadyInd Indicator of whether the patient/participant feels unsteady when walking Indicator of whether the patient/participant feels unsteady when walkin Do you have feelings of unsteadiness when walking? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22750 Celiac disease gluten sensitivity diagnosis ever indicator ClcDzGltnSnstvtyDiagnosEvrInd Indicator of whether the patient/participant has ever been diagnosed with celiac disease or gluten sensitivity Indicator of whether the patient/participant has ever been diagnosed with celiac disease or gluten sensitivit Have you ever been diagnosed with celiac disease or gluten sensitivity? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22729 Pain touch sensitivity increase indicator PainTouchSensitivityIncreasInd Indicator of whether the patient/participant has experienced an increase in sensitivity to pain or touch Indicator of whether the patient/participant has experienced an increase in sensitivity to pain or touc Do you have increased sensitivity to pain or touch? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22761 Irritability indicator IrritabilityInd Indicator of whether the patient/participant is experiencing or exhibits irritability Indicator of whether the patient/participant is experiencing or exhibits irritabilit Do you suffer from irritability? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C06020 Urinary incontinence past three months indicator UrinIncntPstThreeMoInd Indicator of involuntary urine leakage (incontinence) within the last three months. Urinary incontinence is defined by International Continence Society (Abrams et al. 2002) as the complaint of any involuntary leakage of urine Indicator of involuntary urine leakage (incontinence) within the last three months. Urinary incontinence is defined by International Continence Society (Abrams et al. 2002) as the complaint of any involuntary leakage of urin Do you have urinary incontinence (Have you accidentally leaked urine)? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-17 09:26:36.973 Self - Report Testing (On Intake) Physical%2FNeurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

CSV