CDE Detailed Report

Disease: Chiari I Malformation
Sub-Domain: 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 / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
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 touch. 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/Neurological 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 irritability. 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/Neurological 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 urine. 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/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22205 Cough cry laugh sneeze pain worse indicator CghCryLghSnzPnWrseInd The indicator related to pain worsened by coughing, crying, laughing, sneezing, orgasms, bowel movements. The indicator related to pain worsened by coughing, crying, laughing, sneezing, orgasms, bowel movements. Is the pain worsened by coughing, crying, laughing, sneezing, orgasms, bowel movements? Yes;No Yes;No Alphanumeric Adult;Pediatric Core 1.00 2016-06-08 13:37:46.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22740 Urination urge control difficulty indicator UrinatnUrgCntrlDiffcltyInd Indicator of whether the patient/participant has experienced difficulty controlling the urge to urinate. Indicator of whether the patient/participant has experienced difficulty controlling the urge to urinate. Do you have difficulty controlling the urge 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/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22772 Precipitating cause test type PreciptatCauseTestTyp Type of test(s) performed to identify the precipitating cause of the neurological disorder. Type of test(s) performed to identify the precipitating cause of the neurological disorder. Which of these tests have been performed to identify the precipitating cause of the disorder? MRI Brain;MRI Cervical Spine;MRI Lumbar Spine;MRI Thoracic Spine;Cine MRI;CT Head;CT Cervical Spine;CT Thoracic Spine;CT Lumbar Spine;CT Myelogram;X-ray Skull;X-ray Shunt Series;X-ray Cervical Spine;X-ray Thoracic Spine;X-ray Lumbar Spine;PET Scan: Brain;Lumbar Puncture;Stellate Ganglion Block;Other;Vestibular Function Testing;Tilt Table;Holter Monitor;Barium Swallow;Sleep Apnea Monitoring;Sleep EEG Monitoring;Pulmonary Function Tests;Pituitary Hormone Profile;Lyme Titer;Rheumatology Panel;Rheumatology Consultation;Allergist Consultation;Cardiology Consultation;Coagulation/Hematology Consultation;Endocrinology Consultation;ENT/Otolaryngology Consultation;Genetics Consultation;Neurology Consultation;Neuropsychology Consultation;Nutritional Assessment Consultation;Orthopedics Consultation;Pain Management Consultation;Urology Consultation;Other Consultation MRI Brain;MRI Cervical Spine;MRI Lumbar Spine;MRI Thoracic Spine;Cine MRI (CSF flow study);CT Head;CT Cervical Spine;CT Thoracic Spine;CT Lumbar Spine;CT Myelogram;X-ray Skull;X-ray Shunt Series;X-ray Cervical Spine;X-ray Thoracic Spine;X-ray Lumbar Spine;PET Scan: Brain;Lumbar Puncture;Stellate Ganglion Block;Other;Vestibular Function Testing;Tilt Table;Holter Monitor;Barium Swallow;Sleep Apnea Monitoring;Sleep EEG Monitoring;Pulmonary Function Tests;Pituitary Hormone Profile;Lyme Titer;Rheumatology Panel;Rheumatology Consultation;Allergist Consultation;Cardiology Consultation;Coagulation/Hematology Consultation;Endocrinology Consultation;ENT/Otolaryngology Consultation;Genetics Consultation;Neurology Consultation;Neuropsychology Consultation;Nutritional Assessment Consultation;Orthopedics Consultation;Pain Management Consultation;Urology Consultation;Other Consultation Alphanumeric

All tests/consultations are classified as Supplemental except for the following: CORE: MRI Brain, Neurology Consultation; SUPPLEMENTAL - HIGHLY RECOMMENDED: Cine MRI, MRI Cervical/Thoracic/Lumbar Spine, Genetics Consultation; EXPLORATORY: Other, Other Consultation

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

C22719 Tinnitus indicator TinnitusInd Indicator of whether the patient/participant has tinnitus or a high-pitched ringing in his or her ears. Indicator of whether the patient/participant has tinnitus or a high-pitched ringing in his or her ears. Do you have high-pitched ringing 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

C22751 Crohns disease colitis diagnosis ever indicator CrohnDzColitisDiagnosEvrInd Indicator of whether the patient/participant has ever been diagnosed with Crohn's disease or colitis. Indicator of whether the patient/participant has ever been diagnosed with Crohn's disease or colitis. Have you ever been diagnosed with Crohn's disease or colitis? 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

C22730 Pain sensitivity decrease indicator PainSensitivityDecreaseInd Indicator of whether the patient/participant has experienced a decrease in sensitivity to pain. Indicator of whether the patient/participant has experienced a decrease in sensitivity to pain. Do you have diminished sensitivity to pain? 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

C22762 Chronic fatigue indicator ChronicFatigueInd Indicator of whether the patient/participant is experiencing or exhibits chronic fatigue. Indicator of whether the patient/participant is experiencing or exhibits chronic fatigue. Do you suffer from chronic fatigue? 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

C13523 Dizziness or vertigo indicator DizzinessVertigoInd Indicator of whether the participant/subject experienced dizziness or vertigo. Indicator of whether the participant/subject experienced dizziness or vertigo. Do you have vertigo (feelings that you or the room are spinning)? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22208 Stiffness pain general indicator StiffPnGenInd The indicator related to general neck pain/stiffness. The indicator related to general neck pain/stiffness. Do you have general neck pain/stiffness? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2016-06-08 13:41:27.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22741 Urination initiation difficulty indicator UrinatnInitiatnDffcltyInd Indicator of whether the patient/participant has experienced difficulty initiating urination. Indicator of whether the patient/participant has experienced difficulty initiating urination. Do you have difficulty initiating your urine stream? 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

C22773 Precipitating cause test date PreciptatCauseTestDate Date on which the selected Precipitating Cause Test Type was performed. Date on which the selected Precipitating Cause Test Type was performed. Record date of test/image Date or Date & Time Adult;Pediatric Supplemental 1.00 2016-10-13 12:39:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Free-Form Entry

C22720 Tremor indicator TremorInd Indicator of whether the patient/participant has tremors. Indicator of whether the patient/participant has tremors. Do you have tremors? 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

C22752 Sex decreased interest indicator SexDecreasdIntrestInd Indicator of whether the patient/participant has experienced decreased interest in sex. Indicator of whether the patient/participant has experienced decreased interest in sex. Do you have a decreased interest in sex (reduced libido)? 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

C22731 Sensation loss extremities indicator SensationLossExtremitiesInd Indicator of whether the patient/participant has experienced a partial or complete loss of sensation in his or her extremities. Indicator of whether the patient/participant has experienced a partial or complete loss of sensation in his or her extremities. Do you have partial or complete loss of sensation in 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

C22763 Nipple discharge indicator NippleDischargeInd Indicator of whether the patient/participant is experiencing or exhibits discharge from one or both nipples. Indicator of whether the patient/participant is experiencing or exhibits discharge from one or both nipples. Do you have nipple discharge? No;Yes No;Yes Alphanumeric Adult;Pediatric Exploratory 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

C19833 Psychiatric depression indicator PsychDepressInd Indicator of history of depression Indicator of history of depression Do you suffer from depression? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22665 Medical history chronic constipation indicator MedHIstChrnConsInd Indicator of whether the participant/subject has/had chronic constipation Indicator of whether the participant/subject has/had chronic constipation Do you have constipation? Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:34:16.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22742 Excessive urination frequency indicator ExcessvUrinatnFreqncyInd Indicator of whether the patient/participant's urination frequency has been excessive. Indicator of whether the patient/participant's urination frequency has been excessive. Do you urinate more than 10 times per day? 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

C22721 Hearing very sensitive indicator HearingVerySensitiveInd Indicator of whether the patient/participant has very sensitive hearing. Indicator of whether the patient/participant has very sensitive hearing. Do you have very sensitive hearing? 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

C22753 Sexual arousal difficulty maintain indicator SexlArslDffcltyMntnInd Indicator of whether the patient/participant is experiencing difficulty maintaining sexual arousal. Indicator of whether the patient/participant is experiencing difficulty maintaining sexual arousal. Do you have difficulty maintaining arousal? 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

C22732 Burning pain abnormal extremity indicator BurnPainAbnormalExtremityInd Indicator of whether the patient/participant has experienced an abnormal burning pain in his or her extremeties. Indicator of whether the patient/participant has experienced an abnormal burning pain in his or her extremeties. Do you have an abnormal burning pain in 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

C22764 Joint hypermobility indicator JointHypermobilityInd Indicator of whether the patient/participant is experiencing or exhibits hypermobility of one or more joints. Indicator of whether the patient/participant is experiencing or exhibits hypermobility of one or more joints. Do you have joint hypermobility? 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

C21577 Respiration stop during sleep indicator RespStopDurSleepInd The indicator related to stopping of transport of oxygen from the outside air to the cells within tissues during sleep. The indicator related to stopping of transport of oxygen from the outside air to the cells within tissues during sleep. Do you have sleep apnea? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2015-07-28 18:24:23.0 Self - Report Testing (On Intake) Physical/Neurological Examination Assessments and Examinations

Single Pre-Defined Value Selected

C22711 Pain pressure behind eyes indicator PainPressrBehndEyesInd Indicator of whether the patient/participant feels pressure or pain behind his or her eyes. Indicator of whether the patient/participant feels pressure or pain behind his or her eyes. Do you have pain or pressure behind your 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

C22743 Inability empty bladder single attempt indicator InabltyEmptyBlddrSnglAttmptInd Indicator of whether the patient/participant is unable to empty his or her bladder in a single urination attempt. Indicator of whether the patient/participant is unable to empty his or her bladder in a single urination attempt. Do you go two or more times in succession before completely emptying your bladder? 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