CDE Detailed Report

Disease: Chiari I Malformation
Subdomain Name: Physical/Neurological 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
C21693 Chiari I malformation position change dizzy symptom indicator CMPosChngDzySympInd The indicator related to dizziness with position changes in defining signs and symptoms for Chiari I malformation The indicator related to dizziness with position changes in defining signs and symptoms for Chiari I malformatio Do you have dizziness with position changes? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-05-27 08:49:49.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22734 Skin change indicator SkinChangeInd Indicator of whether the patient/participant has experienced a skin change Indicator of whether the patient/participant has experienced a skin chang Do you have any noticeable skin changes? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22766 Pituitary problem diagnosis ever indicator PituitryProblmDiagnosEvrInd Indicator of whether the patient/participant has ever been diagnosed with a pituitary gland problem Indicator of whether the patient/participant has ever been diagnosed with a pituitary gland proble Have you been diagnosed with any pituitary problems? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22713 Vision blurred indicator VisionBlurredInd Indicator of whether the patient/participant has blurred vision Indicator of whether the patient/participant has blurred visio Do you have blurred vision? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22745 Interstitial cystitis diagnosis ever indicator IntrsttlCystitsDiagnosEvrInd Indicator of whether the patient/participant has ever been diagnosed with interstitial cystitis Indicator of whether the patient/participant has ever been diagnosed with interstitial cystiti Have you ever been diagnosed with interstitial cystitis? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22724 Speech difficulty indicator SpeechDifficultyInd Indicator of whether the patient/participant has difficulty with speech Indicator of whether the patient/participant has difficulty with speec Do you have difficulty speaking? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22756 Genital pelvic sensation loss indicator GenitalPelvicSensatnLossInd Indicator of whether the patient/participant has experienced a loss of sensation in his or her genital or pelvic area Indicator of whether the patient/participant has experienced a loss of sensation in his or her genital or pelvic are Have you experienced a decrease or loss of sensation in your pelvic (or genital) area? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C21771 Chiari malformation screening wound prolong heal separation indicator ChiMalScrWouPeoHeaSepInd The indicator related to experiencing prolonged wound healing or separation in a screening for Chiari malformation The indicator related to experiencing prolonged wound healing or separation in a screening for Chiari malformatio Do you have wound healing problems? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-02 14:15:30.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22735 Balance difficulty absent visual cue indicator BlncDffcltyAbsntVslCueInd Indicator of whether the patient/participant has experienced difficulty with balance in the absence of visual cues Indicator of whether the patient/participant has experienced difficulty with balance in the absence of visual cue If you close your eyes or are in the dark, do you have difficulty with your balance? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22767 Bleeding clotting disorder indicator BleedClotDisorderInd Indicator of whether the patient/participant has ever had a bleeding or blood clotting disorder Indicator of whether the patient/participant has ever had a bleeding or blood clotting disorde Have you experienced any bleeding or blood clotting disorders? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22714 Vision doubled indicator VisionDoubledInd Indicator of whether the patient/participant has double vision Indicator of whether the patient/participant has double visio Do you have double vision? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22746 Urethral stricture prostate problem diagnosis ever indicator UrthrlStrctrPrstPblmDgnsEvrInd Indicator of whether the patient/participant has ever been diagnosed with a urethral stricture or prostate problem Indicator of whether the patient/participant has ever been diagnosed with a urethral stricture or prostate proble Have you ever been diagnosed with a urethral stricture or prostate problems? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22725 Vocal hoarseness increase indicator VocalHoarsenessIncreaseInd Indicator of whether the patient/participant has experienced an increase in vocal hoarseness Indicator of whether the patient/participant has experienced an increase in vocal hoarsenes Is your voice changing, becoming hoarse? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22757 Short-term memory loss indicator ShortTermMemoryLossInd Indicator of whether the patient/participant is experiencing a loss of short-term memory Indicator of whether the patient/participant is experiencing a loss of short-term memor Do you suffer from short-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/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C21873 Medical history hearing deficit indicator MedHistHeaDefInd The indicator related to personal medical history of hearing deficit or use of hearing aid The indicator related to personal medical history of hearing deficit or use of hearing ai Do you have decreased hearing? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-06 10:55:07.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
C22736 Extremity weakness indicator ExtremityWeaknessInd Indicator of whether the patient/participant has experienced weakness of his or her extremities Indicator of whether the patient/participant has experienced weakness of his or her extremitie Do you have weakness of your extremities? 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/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
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/Neurological 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/Neurological 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/Neurological 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/Neurological 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/Neurological 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/Neurological 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/Neurological 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/Neurological 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/Neurological 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/Neurological 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/Neurological 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/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected
CSV