Study ID
Item
Study ID
integer
C2826693 (UMLS CUI [1])
Study site name
Item
Study site name
text
C2825164 (UMLS CUI [1])
Subject ID
Item
Subject ID
integer
C2348585 (UMLS CUI [1])
Item
1. What is the current diagnosis? (choose only one)
text
C0011900 (UMLS CUI [1])
Code List
1. What is the current diagnosis? (choose only one)
CL Item
RIS (Radiologically Isolated Syndrome) (RIS)
C3846158 (UMLS CUI-1)
(Comment:en)
CL Item
MS (Multiple Sclerosis) (Go to question 2 to specify clinical course, then skip to question 6) (MS)
C0026769 (UMLS CUI-1)
(Comment:en)
CL Item
NMO (Neuromyelitis Optica) spectrum disorder (Go to question 3 to specify clinical course, then skip to question 7) (NMO)
C0027873 (UMLS CUI-1)
(Comment:en)
CL Item
ADEM (Acute Disseminated Encephalomyelitis) (Go to question 4 to specify clinical course, then skip to question 7) (ADEM)
C0014059 (UMLS CUI-1)
(Comment:en)
CL Item
Other CNS demyelinating disorder (Go to question 5 to specify clinical course, then skip to question 7) (Other)
C0205394 (UMLS CUI-1)
C0011302 (UMLS CUI-2)
(Comment:en)
clinical exam of symptoms; MRI
Item
b. Improvement by clinical exam, MRI or both after acute event
boolean
C1456356 (UMLS CUI [1,1])
C1457887 (UMLS CUI [1,2])
C0024485 (UMLS CUI [2])
Multifocal white matter lesions
Item
b. Multifocal lesions predominantly involving white matter
boolean
C2751845 (UMLS CUI [1])
ADEM
Item
b. New event of ADEM, 3 or more months with recurrence of the initial symptoms and signs (recurrent ADEM)
boolean
C0014059 (UMLS CUI [1])
ADEM
Item
b. ADEM followed by a new clinical event also meeting criteria for ADEM, but involving anatomic areas of the CNS
boolean
C0014059 (UMLS CUI [1])
Clinical course CNS demyelinating disorder
Item
5. Clinical course – Other CNS demyelinating disorder: a. Specify disorder:
text
C0449259 (UMLS CUI [1,1])
C0011302 (UMLS CUI [1,2])
Item
b. Type:
text
C1114762 (UMLS CUI [1,1])
C0449259 (UMLS CUI [1,2])
C0011302 (UMLS CUI [1,3])
Other
Item
Other, specify:
text
C0205394 (UMLS CUI [1])
Item
a. Onset Course:
text
C0449259 (UMLS CUI [1,1])
C0026769 (UMLS CUI [1,2])
C0277793 (UMLS CUI [1,3])
Code List
a. Onset Course:
CL Item
Relapsing (1)
C0751967 (UMLS CUI-1)
(Comment:en)
CL Item
Progressive (2)
C0751964 (UMLS CUI-1)
(Comment:en)
Item
b. Current Disease Course:
text
C0449259 (UMLS CUI [1,1])
C0026769 (UMLS CUI [1,2])
C0205394 (UMLS CUI [2,1])
C0449259 (UMLS CUI [2,2])
C0026769 (UMLS CUI [2,3])
Code List
b. Current Disease Course:
CL Item
Relapsing remitting (Relapsing remitting)
CL Item
Secondary progressive (Secondary progressive)
CL Item
Progressive relapsing (Progressive relapsing)
CL Item
Primary progressive (Primary progressive)
CL Item
Uncertain (Uncertain)
Item
a. Type:
text
C0449259 (UMLS CUI [1,1])
C0027873 (UMLS CUI [1,2])
C0027873 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0449259 (UMLS CUI [2,3])
CL Item
Monophasic (Monophasic)
C4087481 (UMLS CUI-1)
(Comment:en)
CL Item
Relapsing (Relapsing)
C4087551 (UMLS CUI-1)
(Comment:en)
CL Item
Recurrent optic neuritis (Recurrent optic neuritis)
C3266324 (UMLS CUI-1)
(Comment:en)
CL Item
Recurrent myelitis (Recurrent myelitis)
C0026975 (UMLS CUI-1)
C2945760 (UMLS CUI-2)
(Comment:en)
CL Item
Unknown (Unknown)
C0449259 (UMLS CUI-1)
C0439673 (UMLS CUI-2)
C0027873 (UMLS CUI-3)
(Comment:en)
CL Item
Other (Other)
C0449259 (UMLS CUI-1)
C0205394 (UMLS CUI-2)
C0027873 (UMLS CUI-3)
(Comment:en)
Item
i. Optic neuritis, specify laterality:
text
C0029134 (UMLS CUI [1,1])
C0925205 (UMLS CUI [1,2])
Code List
i. Optic neuritis, specify laterality:
CL Item
Bilateral (Bilateral)
CL Item
Unknown (Unknown)
Acute myelitis
Item
ii. Acute myelitis, specify involvement of which segments (Cervical)
boolean
C0270626 (UMLS CUI [1,1])
C0270627 (UMLS CUI [1,2])
C0205064 (UMLS CUI [1,3])
Acute myelitis
Item
ii. Acute myelitis, specify involvement of which segments (Thoracic )
boolean
C0270626 (UMLS CUI [1,1])
C0270627 (UMLS CUI [1,2])
C0817096 (UMLS CUI [1,3])
Acute myelitis
Item
ii. Acute myelitis, specify involvement of which segments (Lumbar )
boolean
C0270626 (UMLS CUI [1,1])
C0270627 (UMLS CUI [1,2])
C0024090 (UMLS CUI [1,3])
Item
iii.
text
C0241224 (UMLS CUI [1,1])
C0024485 (UMLS CUI [1,2])
C0027873 (UMLS CUI [3])
C2919772 (UMLS CUI [4])
CL Item
Brain MRI not meeting diagnostic criteria for MS (Brain MRI not meeting diagnostic criteria for MS)
C0024485 (UMLS CUI-1)
C0332196 (UMLS CUI-2)
C0026769 (UMLS CUI-3)
(Comment:en)
CL Item
NMO-IgG seropositive (NMO-IgG seropositive)
C2919772 (UMLS CUI-1)
C0521143 (UMLS CUI-2)
(Comment:en)
CL Item
NMO-IgG seronegative (NMO-IgG seronegative)
C2919772 (UMLS CUI-1)
C0521144 (UMLS CUI-2)
(Comment:en)
CL Item
NMO-IgG sero status unknown (NMO-IgG sero status unknown)
C2919772 (UMLS CUI-1)
C0205258 (UMLS CUI-2)
(Comment:en)
CL Item
Contiguous spinal cord lesion on MRI >3 vertebral segments (Contiguous spinal cord lesion on MRI >3 vertebral segments)
C0241224 (UMLS CUI-1)
C0024485 (UMLS CUI-2)
(Comment:en)
onset time optic neuritis myelitis
Item
c. Time between onset of first optic neuritis and first myelitis:
integer
C0449244 (UMLS CUI [1,1])
C0029134 (UMLS CUI [1,2])
C0026975 (UMLS CUI [1,3])
Item
a. Type:
text
C0449259 (UMLS CUI [1,1])
C0014059 (UMLS CUI [1,2])
CL Item
Monophasic (Monophasic)
C0014059 (UMLS CUI-1)
(Comment:en)
CL Item
Recurrent (Recurrent)
C3266325 (UMLS CUI-1)
(Comment:en)
CL Item
Multiphasic (Multiphasic)
C3495016 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (Unknown)
C0449259 (UMLS CUI-1)
C0439673 (UMLS CUI-2)
(Comment:en)
CL Item
Other (Other)
C0449259 (UMLS CUI-1)
C0205394 (UMLS CUI-2)
(Comment:en)
Other
Item
Other, specify:
text
C0449259 (UMLS CUI [1,1])
C0014059 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
encephalopathy
Item
b. Presence of encephalopathy (behavioural change or alteration in consciousness)
boolean
C0085584 (UMLS CUI [1])
Other
Item
a. Specify disorder:
text
C0205394 (UMLS CUI [1,1])
C0011302 (UMLS CUI [1,2])
Item
b. Type:
text
C0449259 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0011302 (UMLS CUI [1,3])
CL Item
Monophasic (Monophasic)
C3846158 (UMLS CUI-1)
C0011302 (UMLS CUI-2)
(Comment:en)
CL Item
Recurrent (Recurrent)
C2945760 (UMLS CUI-1)
C0011302 (UMLS CUI-2)
(Comment:en)
CL Item
Multiphasic (Multiphasic)
C3846158 (UMLS CUI-1)
C0011302 (UMLS CUI-2)
(Comment:en)
CL Item
Unknown (Unknown)
C0449259 (UMLS CUI-1)
C0439673 (UMLS CUI-2)
(Comment:en)
CL Item
Other (Other)
C0449259 (UMLS CUI-1)
C0205394 (UMLS CUI-2)
(Comment:en)
Item
RRMS:
text
C0751967 (UMLS CUI [1,1])
C0679228 (UMLS CUI [1,2])
CL Item
≥ 2 attacks; objective clinical evidence of ≥ 2 lesions or objective clinical evidence of 1 lesion with reasonable historical evidence of a prior attack =reasonable historical evidence of a prior attack (1)
CL Item
≥ 2 attacks; objective clinical evidence of 1 lesion (2)
Item
Dissemination in space, demonstrated by
text
C0026769 (UMLS CUI [1,1])
C0205221 (UMLS CUI [1,2])
C1515974 (UMLS CUI [1,3])
Code List
Dissemination in space, demonstrated by
CL Item
≥ 1 T2 lesion in at least 2 of 4 MS-typical regions of the CNS (periventricular, juxtacortical, infratentorial, (1)
CL Item
or spinal cord) (or spinal cord))
CL Item
1 attack; objective clinical evidence of ≥ 2 lesions (2)
Item
Dissemination in time, demonstrated by:
text
C0026769 (UMLS CUI [1,1])
C0205221 (UMLS CUI [1,2])
C0040223 (UMLS CUI [1,3])
Code List
Dissemination in time, demonstrated by:
CL Item
Simultaneous presence of asymptomatic gadolinium-enhancing and nonenhancing lesions at any time (1)
CL Item
A new T2 and/or gadolinium-enhancing lesion(s) on follow-up MRI, irrespective of its timing with (2)
CL Item
reference to a baseline scan (reference to a baseline scan)
CL Item
1 attack; objective clinical evidence of 1 lesion (clinically isolated syndrome) (3)
Item
Dissemination in space and time, demonstrated by: For DIS: ≥ 1 T2 lesion in at least 2 of 4 MS-typical regions of the CNS (periventricular, juxtacortical, infratentorial, or spinal cord); and For DIT:
text
C0026769 (UMLS CUI [1,1])
C0205221 (UMLS CUI [1,2])
C0040223 (UMLS CUI [1,3])
C1515974 (UMLS CUI [1,4])
Code List
Dissemination in space and time, demonstrated by: For DIS: ≥ 1 T2 lesion in at least 2 of 4 MS-typical regions of the CNS (periventricular, juxtacortical, infratentorial, or spinal cord); and For DIT:
CL Item
Simultaneous presence of asymptomatic gadolinium-enhancing and nonenhancing lesions at any time (1)
CL Item
A new T2 and/or gadolinium-enhancing lesion(s) on follow-up MRI, irrespective of its timing with (2)
CL Item
reference to a baseline scan (reference to a baseline scan)
Multiple Sclerosis, Primary Progressive
Item
PPMS: 1 year of disease progression (retrospectively or prospectively determined) plus 2 of 3 of the following: Evidence for DIS in the brain based on ≥ 1 T2 lesions in the MS-characteristic (periventricular, juxtacortical, or infratentorial) regions Evidence for DIS in the spinal cord based on ≥ 2 T2 lesions in the cord Positive CSF (isoelectric focusing evidence of oligoclonal bands and/or elevated IgG index)
boolean
C0751964 (UMLS CUI [1,1])
C0679228 (UMLS CUI [1,2])
Multiple Sclerosis, Secondary Progressive
Item
SPMS: Initial RR disease course followed by progression with or without occasional relapses, minor remissions, and plateaus
boolean
C0751965 (UMLS CUI [1,1])
C0679228 (UMLS CUI [1,2])
Multiple Sclerosis, Progressive Relapsing
Item
PRMS: Progressive disease from onset, with clear acute relapses, with or without full recovery; periods between relapses characterized by continuing progression
boolean
C0393666 (UMLS CUI [1,1])
C0679228 (UMLS CUI [1,2])
year of diagnosis
Item
a. Year of first diagnosis:
partialDate
C2316983 (UMLS CUI [1])
Item
b. Did occurrence of onset clinical event occur:
text
C0574845 (UMLS CUI [1])
Code List
b. Did occurrence of onset clinical event occur:
CL Item
Within 1 month post-infection? (Within 1 month post-infection?)
CL Item
Within 1 month post-vaccination? (Within 1 month post-vaccination?)
CL Item
Neither (Neither)
Item
c. Indicate first onset was (choose only one):
text
C0449791 (UMLS CUI [1,1])
C0574845 (UMLS CUI [1,2])
Code List
c. Indicate first onset was (choose only one):
Item
d. Did the patient receive treatment for clinical event?
text
C2114510 (UMLS CUI [1])
C2114510 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C2827774 (UMLS CUI [3])
C2827774 (UMLS CUI [4,1])
C0205394 (UMLS CUI [4,2])
C0679868 (UMLS CUI [5])
C0679868 (UMLS CUI [6,1])
C0205394 (UMLS CUI [6,2])
Code List
d. Did the patient receive treatment for clinical event?
steroids; plasmapheresis; IVig
Item
i. If Yes, indicate treatment (mention all that apply: Steroids/ Plasmapheresis/ IVig ):
text
C0025815 (UMLS CUI [1])
C0032134 (UMLS CUI [2])
C1293891 (UMLS CUI [3])
C0398341 (UMLS CUI [4])
Item
e. Was the patient fully recovered from this relapse within a year?
text
C2004454 (UMLS CUI [1])
Code List
e. Was the patient fully recovered from this relapse within a year?
year symptom first
Item
f. Month/Year of first symptoms:
partialDate
C0574845 (UMLS CUI [1])
Item
g. Initial symptoms: i. Vision:
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0042789 (UMLS CUI [1,3])
Code List
g. Initial symptoms: i. Vision:
Initial symptoms vision site
Item
1. If Yes, specify (mention all that apply: Bilateral/ Right/ Left/ Unknown):
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0042789 (UMLS CUI [1,3])
C0205145 (UMLS CUI [1,4])
Item
ii. Motor:
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0026612 (UMLS CUI [1,3])
Initial symptoms motor site
Item
1. If Yes, specify (mention all that apply: Bilateral/ Right/ Left/ Unknown):
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0026612 (UMLS CUI [1,3])
C0205145 (UMLS CUI [1,4])
Item
iii. Sensory:
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0445254 (UMLS CUI [1,3])
Initial symptoms Sensory site
Item
1. If Yes, specify (mention all that apply: Bilateral/ Right/ Left/ Unknown):
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0445254 (UMLS CUI [1,3])
C0205145 (UMLS CUI [1,4])
Item
iv. Coordination:
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0242414 (UMLS CUI [1,3])
Code List
iv. Coordination:
Initial symptoms Coordination site
Item
1. If Yes, specify (mention all that apply: Bilateral/ Right/ Left/ Unknown):
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0242414 (UMLS CUI [1,3])
C0205145 (UMLS CUI [1,4])
Item
v. Bowel/Bladder:
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0021853 (UMLS CUI [1,3])
C0005682 (UMLS CUI [1,4])
Code List
v. Bowel/Bladder:
Item
vi. Fatigue:
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0015672 (UMLS CUI [1,3])
Item
vii. Cognitive:
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C1516691 (UMLS CUI [1,3])
Code List
vii. Cognitive:
Item
viii. Encephalopathy:
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0085584 (UMLS CUI [1,3])
Code List
viii. Encephalopathy:
Item
ix. Other, specify:
text
C1457887 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
Code List
ix. Other, specify:
Item
h. Localization of clinical event: i. Optic nerve:
text
C1290853 (UMLS CUI [1,1])
C0029130 (UMLS CUI [1,2])
Code List
h. Localization of clinical event: i. Optic nerve:
disease site optic nerve diagnostic procedure
Item
1. If Yes, specify observation method (mention all that apply: Exam/ MRI/ History/ Unknown):
text
C1290853 (UMLS CUI [1,1])
C0029130 (UMLS CUI [1,2])
C0430022 (UMLS CUI [1,3])
Item
ii. Cerebrum:
text
C1290853 (UMLS CUI [1,1])
C0242202 (UMLS CUI [1,2])
disease site Cerebrum diagnostic procedure
Item
1. If Yes, specify observation method (mention all that apply: Exam/ MRI/ History/ Unknown):
text
C1290853 (UMLS CUI [1,1])
C0242202 (UMLS CUI [1,2])
C0430022 (UMLS CUI [1,3])
Item
iii. Brainstem/Cerebellar:
text
C1290853 (UMLS CUI [1,1])
C0007765 (UMLS CUI [1,2])
Code List
iii. Brainstem/Cerebellar:
disease site Cerebellar diagnostic procedure
Item
1. If Yes, specify observation method (mention all that apply: Exam/ MRI/ History/ Unknown):
text
C1290853 (UMLS CUI [1,1])
C0007765 (UMLS CUI [1,2])
C0430022 (UMLS CUI [1,3])
Item
iv. Spinal cord:
text
C1290853 (UMLS CUI [1,1])
C0037925 (UMLS CUI [1,2])
Code List
iv. Spinal cord:
disease site Spinal cord diagnostic procedure
Item
1. If Yes, specify observation method (mention all that apply: Exam/ MRI/ History/ Unknown):
text
C1290853 (UMLS CUI [1,1])
C0037925 (UMLS CUI [1,2])
C0430022 (UMLS CUI [1,3])
Item
8. Do you have a family history of MS?
text
C0241889 (UMLS CUI [1,1])
C0026769 (UMLS CUI [1,2])
Code List
8. Do you have a family history of MS?