CDE Detailed Report
Disease: Traumatic Brain Injury
Subdomain Name: Demographics
CRF: FITBIR Demographics Form
Displaying 101 - 123 of 123
Subdomain Name: Demographics
CRF: FITBIR Demographics Form
Displaying 101 - 123 of 123
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C00007 | Birth date | BirthDate | Date (and time, if applicable and known) the participant/subject was born | Date (and time, if applicable and known) the participant/subject was born | What is the subject's date of birth? | 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.). Recording date of birth will give the most detailed information required for calculation of age and is recommended as first choice. However, in some studies recording date of birth may elicit discussions on a potential violation of privacy legislation and specifically HIPAA regulations. In these cases, the calculated age should be recorded. Data Sharing Instructions: When date/time data are prepared for aggregation or sharing they should be converted to the format specified by ISO 8601, YYYY-MM-DDThh:mm:ss. |
ISO 8601 - http: //www.iso.org/iso/iso_catalogue.htm Management and prognosis of severe traumatic brain injury: Age. J Neurotrauma. 2000;17: 573-581.<br />Mushkudiani NA, Engel DC, Steyerberg EW, et al. Prognostic value of demographic characteristics in traumatic brain injury: results from the IMPACT study. J Neurotrauma. Feb 2007;24(2): 259-69. <br />Pediatric-specific reference(s): Anderson V, Catroppa C, Morse S, Haritou F, Rosenfeld J (2005) Functional plasticity or vulnerability after early brain injury. Pediatric 116: 1374-1382 | Adult;Pediatric | Core | 3.00 | 2013-07-25 08:54:08.2 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Free-Form Entry |
793 | |||||||||
| C21991 | Sport professional participation total year count | SportProfessPrimPartTtlYrsCt | Total combined years the participant/subject played primary professional sport (should be used in combination with Primary professional sport played by the participant/subject CDE) | Total combined years the participant/subject played primary professional sport (should be used in combination with Primary professional sport played by the participant/subject CDE) | What is the total number of years the subject played the primary professional sports? | Numeric Values |
Use in combination with Primary professional sport played by the participant UDE. |
Adult | Supplemental | 1.00 | 2016-06-06 18:37:01.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Free-Form Entry |
1 | 50 | |||||||||
| C15993 | Dependent children number | DpndntChildNum | Number of dependent children | Number of dependent children | What is the total number of dependents children the subject has? | Numeric Values |
Number of dependent children for a participant/subject |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Free-Form Entry |
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| C21820 | Sport junior high participation year count | JuniorHighPrimarySprtYrsCt | The number of years participant/subject played sport(s) in junior high school | The number of years participant/subject played sport(s) in junior high school | How many years did the subject play the primary sport in junior high school? | 1;2;3;4;5;6 | 1;2;3;4;5;6 | Numeric Values |
The number of years subject played sport(s) in junior high school |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-03 12:48:46.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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| C00029 | Language written fluent ISO code | LangWrtnFlntlyTxtISOCode | Code (ISO 639-2) for each language that the participant/subject writes fluently | Code (ISO 639-2) for each language that the participant/subject writes fluently | What are the ISO codes for each language the subject can write fluently? | Alphanumeric |
Enter all that apply |
ISO 639-2 language codes (http://www.loc.gov/standards/iso639-2/php/code_list.php) | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | FITBIR Demographics Form | Demographics | Participant Characteristics | 255 |
Free-Form Entry |
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| C22691 | Parent birth country ISO code | ParentBirthCntryISOCode | Code (ISO 3166-1 alpha-2 code) for country where the participant's/subject's parent, guardian, or caregiver was born | Code (ISO 3166-1 alpha-2 code) for country where the participant's/subject's parent, guardian, or caregiver was bor | What is the parent's, guardian's, or caregiver's birth country ISO code? | AU;CA;MX;GB;US | AUSTRALIA;CANADA;MEXICO;UNITED KINGDOM;UNITED STATES | Alphanumeric |
Choose one. It may be easier to record the full name of the country and code the data later using the ISO 3166-1 alpha-2 codes. Code (ISO 3166-1 alpha-2 code) for country where the participant/subject was born |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 21:00:23.88 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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| C18747 | Residence other text | ResdncOTH | The free-text field related to 'Residence type' specifying other text. Type of residence where the participant/subject is currently living | The free-text field related to 'Residence type' specifying other text. Type of residence where the participant/subject is currently living | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| C21981 | Sport college primary participation other text | SportCollegePrimarPartOTH | Other sports the participant/subject played in college. A complimentary CDE for Primary college sport played by the participant/subject | Other sports the participant/subject played in college. A complimentary CDE for Primary college sport played by the participant/subjec | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 18:26:32.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| C00222 | Job classification category | JobclassCat | Category that classifies work performed by participant/subject | Category that classifies work performed by participant/subjec | What is the subject's current job classification? | Agricultural or fishery worker;Armed forces occupation;Clerk;Craft and related trades workers;Elementary occupations;Legislator, or senior official, or manager;Plant and machine operators and assemblers;Professional;Professional referral;Service or sales worker;Technicians and associate professionals;Not applicable;Unknown;Other, specify | Agricultural or fishery worker;Armed forces occupation (officers, service personnel);Clerk;Craft and related trades workers (e.g. motor mechanic, printer, tool and die makers, electrician);Elementary occupations (laborer, porter, unskilled workers);Legislator, or senior official, or manager;Plant and machine operators and assemblers;Professional;Professional referral;Service or sales worker;Technicians and associate professionals (typically requiring a Bachelor degree or equivilent);Not applicable;Unknown;Other, specify | Alphanumeric |
For detailed definitions go to: http://www.who.int/healthinfo/survey/whsshortversionguide.pdf |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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| C22706 | Military USA rank category other text | MilUSARnkCatOTH | The free-text field related to Military rank category specifying other text. Category that describes the participant's/subject's rank in the military | The free-text field related to Military rank category specifying other text. Category that describes the participant's/subject's rank in the military | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-08-22 09:14:32.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 255 |
Free-Form Entry |
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| C21798 | Living situation juvenile patient other text | SesPrimChildOTH | Living situation of juvenile patient other text | Living situation of juvenile patient other text | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-03 08:49:58.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| C21809 | Military deployment location | MilDeploy | Region or country to where participant/subject was deployed | Region or country to where participant/subject was deployed | Where was the subject deployed? | Iraq;Afghanistan;Africa;Germany;None;Other, specify | Iraq;Afghanistan;Africa;Germany;None;Other, specify | Alphanumeric |
Region or country the military patient was deployed |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-03 11:24:57.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Multiple Pre-Defined Values Selected |
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| C00008 | Age value | AgeVal | Value for participant's age, calculated as elapsed time since the birth of the participant | Value for participant's age, calculated as elapsed time since the birth of the participant | Subject's age (recorded in years) | Numeric Values |
The subject's age is typically recorded to the nearest full year completed, e.g., 11 years and 6 months should be recorded as 11 years. For subject's which are under 1 year old, use decimal points and use the following convention: record 1 month as 0.083 (1/12), 2 months as 0.166 (2/12), 3 months as 0.25 (3/12), 4 months as 0.333 (4/12), 5 months as 0.416 (5/12), 6 months as 0.5 (6/12), 7 months as 0.583 (7/12), 8 months as 0.666 (8/12), 9 months as 0.75 (9/12), 10 months as 0.833 (10/12), 11 months as 0.916 (11/12) and 12 months as 1 year. |
Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:47:28.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Free-Form Entry |
0 | 1800 | month | ||||||||
| C21992 | Sport professional primary participation other text | SportProfessionalPartOTH | Other sports the participant played professionally. A complimentary element for Primary professional sport played by the participant | Other sports the participant played professionally. A complimentary element for Primary professional sport played by the participan | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 18:38:26.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| C15994 | Dependent children living in household number | DpndntChildLvngHshldNum | Number of dependent children living in household | Number of dependent children living in household | What is the number of dependent children living in the subject's household? | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Free-Form Entry |
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| C21821 | Sport junior high other participation text | JuniorHighSportOtherplayedTxt | The free-text field to specify which other sports participant/subject played in junior high school | The free-text field to specify which other sports participant/subject played in junior high school | Which other sports did the subject play in junior high school? | Alphanumeric |
The free-text field to specify which other sports subject played in junior high school |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-03 12:51:28.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| C00030 | Race USA category | RaceUSACat | The patient's self declared racial origination, independent of ethnic origination, using OMB approved categories | The patient's self declared racial origination, independent of ethnic origination, using OMB approved categori | What is the subject's racial background (as defined by OMB)? | American Indian or Alaska Native;Asian;Black or African-American;Native Hawaiian or Other Pacific Islander;White;Unknown;Not Reported | A person having origins in any of the original peoples of North and South America (including Central America) , and who maintains tribal affiliation or community attachment.;A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.;A person having origins in any of the black racial groups of Africa. Terms such as "Haitian" can be used in addition to "Black or African American.";A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.;A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.;Could not be determined or unsure;Not provided or unavailable | Alphanumeric |
Choose all that apply. Response is obtained by report of the participant/subject or caretaker. Collecting information on race may not be allowed in some countries for concerns related to discrimination. In other countries, however, these concerns are considered a reason for recording race in order to guarantee equal access to care. Investigators receiving funding from the US National Institutes of Health (NIH) are required to report the number of subjects enrolled on an annual basis using the racial categories listed. The NIH Guidelines on Inclusion of Women and Minorities as Subjects in Clinical Research: The Office of Management and Budget (OMB) Directive No. 15 defines the minimum standard of basic racial and ethnic categories. (http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm) |
The NIH Guidelines on Inclusion of Women and Minorities as Subjects in Clinical Research: The Office of Management and Budget (OMB) Directive No. 15 defines the minimum standard of basic racial and ethnic categories. (http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm) Collection of Race and Ethnicity Data in Clinical Trials (FDA, September 2005 - http://www.fda.gov/RegulatoryInformation/Guidances/ucm126340.htm) Jorde LB and Wooding SP. Genetic variation, classification and "race". Nature Genetics. 2004;36(11):S28-S33. Bhopal R and Donaldson L. White, European, Western, Caucasian, or What? Inappropriate labeling in Research on Race, Ethnicity, and Health. Amer J of Publ Health. 1998;88:1303-1307. | Adult;Pediatric | Core | 3.00 | 2013-07-25 08:54:08.2 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Multiple Pre-Defined Values Selected |
2192199 | |||||||
| C22692 | Parent birth country name | ParentBirthCntryName | Name for country where the parent, guardian, or caregiver was born | Name for country where the parent, guardian, or caregiver was born | What is the parent's, guardian's, or caregiver's birth country name? | Alphanumeric |
Choose one. It may be easier to record the full name of the country and code the data later using the ISO 3166-1 alpha-2 codes. Code (ISO 3166-1 alpha-2 code) for country where the participant/subject was born |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 21:00:23.88 | FITBIR Demographics Form | Demographics | Participant Characteristics | 255 |
Free-Form Entry |
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| C18821 | School placement other text | SchoolPlacementOTH | The free-text field related to 'School placement type' specifying other text. The description of the type of education the participant/subject receives with details of being with or without assistance | The free-text field related to 'School placement type' specifying other text. The description of the type of education the participant/subject receives with details of being with or without assistanc | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-11 15:03:49.2 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| C21799 | Living situation before injury type | LivingSituationPreInjTyp | Living situation of the participant/subject before injury | Living situation of the participant/subject before injur | What was the subject's living situation before injury? | Homeless/lives in shelter;Lives alone;Lives in group home/assisted living;Lives with friend(s) or roommate(s) or cohabiting;Lives with spouse and/or other family member(s);Data Missing/Refused/Unknown;Other, specify | Homeless/lives in shelter;Lives alone;Lives in group home/assisted living;Lives with friend(s) or roommate(s) or cohabiting;Lives with spouse and/or other family member(s);Data Missing/Refused/Unknown;Other, specify | Alphanumeric |
Living situation of the participant/subject before injury. |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-03 10:34:36.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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| C21982 | Sport college other participation text | SportCollegeOtherPlaydTxt | College sports played other than primary sport | College sports played other than primary sport | Which other sports did the subject play in college? | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 18:28:08.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| C04814 | Residence type | ResdncTyp | Type of residence where the participant/subject is currently living | Type of residence where the participant/subject is currently living | What type of residence does the subject currently live in? | Hospital;Nursing home;Home;N/A - patient died;Other, specify;Unknown;Rehabilitation center | Hospital;Nursing home;Home;N/A - patient died;Other, specify;Unknown;Rehabilitation center | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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| C22707 | Education level USA type other text | EduLvlUSATypOTH | The free-text field related to Education level USA type specifying other text. The highest level of education the participant/subject received | The free-text field related to Education level USA type specifying other text. The highest level of education the participant/subject receive | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-08-22 10:51:20.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 255 |
Free-Form Entry |
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