ID

8651

Description

Brain Cancer - Neurologic Evaluation Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DE951920-1FCC-25F8-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DE951920-1FCC-25F8-E034-0003BA12F5E7

Keywords

Versions (3)
  1. 12/18/14 12/18/14 - Martin Dugas
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 1/9/15 1/9/15 - Martin Dugas
Uploaded on

January 9, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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Treatment - Brain Cancer - Neurologic Evaluation Form - 2286577v3.0

English

No Instruction available.

1 forms  
  1. StudyEvent: Brain Cancer - Neurologic Evaluation Form
    1. No Instruction available.
Crf Header
Description

Crf Header

Coordinating Group Protocol No.
Description

Protocol ID Coordinating Group

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1711341
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Coordinating Group Code
Description

Coordinating Group Code

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS CUI-1
C1711341
NCI Thesaurus ObjectClass
C17005
UMLS CUI-2
C0805701
NCI Thesaurus ObjectClass-2
C25462
NCI Thesaurus Property
C25364
Protocol Title
Description

Protocol Title

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986303
NCI Thesaurus ObjectClass
C25320
NCI Thesaurus Property
C42774
Patient Study ID
Description

Patient Study ID

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Institution/Affiliate
Description

Institution Name

Data type

text

Alias
NCI Thesaurus ObjectClass
C25454
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass-2
C21541
NCI Thesaurus Property
C25364
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ValueDomain-2
C21541
Other Patient ID
Description

Trial subject ID Participating Group

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C2347449
NCI Thesaurus Property
C25608
NCI Thesaurus Property-2
C25364
Participating Group Code
Description

ParticipatingGroupIdentifierCode

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C25608
UMLS 2011AA ObjectClass
C0679823
NCI Thesaurus ObjectClass-2
C17005
UMLS 2011AA ObjectClass-2
C1257890
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Name (initials acceptable)
Description

Patient Name

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1299487
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25364
Brain: Form Administration
Description

Brain: Form Administration

Person Completing Form
Description

Person Completing Form

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass
C25657
NCI Thesaurus Property
C25364
Are data amended (If data are amended, please circle in red when using paper form)
Description

Data amended

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Brain: Neurologic Evaluation
Description

Brain: Neurologic Evaluation

Headache
Description

NeurologicalEvaluationHeadacheSymptomType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Thesaurus Property-2
C34661
UMLS 2011AA Property-2
C0018681
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Visual Disturbance
Description

NeurologicalEvaluationVisualDeficitType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C37940
UMLS 2011AA Property
C0011155
NCI Thesaurus Property-2
C38059
UMLS 2011AA Property-2
C0234621
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Speech Impairment
Description

NeurologicalEvaluationSpeechDeficitType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C38025
UMLS 2011AA Property
C0037817
NCI Thesaurus Property-2
C37940
UMLS 2011AA Property-2
C0011155
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Sensory Symptoms
Description

NeurologicalEvaluationSensorySymptomType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Thesaurus Property-2
C28259
UMLS 2011AA Property-2
C0445254
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Motor Symptoms
Description

NeurologicalEvaluationMotorSymptomType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Thesaurus Property-2
C28367
UMLS 2011AA Property-2
C1513492
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Memory Symptoms
Description

NeurologicalEvaluationMemorySymptomType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Thesaurus Property-2
C37992
UMLS 2011AA Property-2
C0025260
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Personality Changes
Description

NeurologicalEvaluationPersonalityChangeType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C25446
UMLS 2011AA Property
C0392747
NCI Thesaurus Property-2
C38002
UMLS 2011AA Property-2
C0031208
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Seizures
Description

NeurologicalEvaluationSeizureSymptomType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C2962
UMLS 2011AA Property
C0036572
NCI Thesaurus Property-2
C4876
UMLS 2011AA Property-2
C1457887
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Other Neurologic Symptoms
Description

NeurologicEvaluationOtherSymptomType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C17649
UMLS 2011AA Property
C0205394
NCI Thesaurus Property-2
C4876
UMLS 2011AA Property-2
C1457887
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Severe, specify
Description

NeurologicalEvaluationSeveritySymptomSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Thesaurus Property-2
C25676
UMLS 2011AA Property-2
C0439793
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Mental Status (Neurologic exam)
Description

NeurologicalEvaluationCognitiveStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C37926
UMLS 2011AA Property
C1516691
NCI Thesaurus Property-2
C25365
UMLS 2011AA Property-2
C0678257
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Somnolence
Description

NeurologicalEvaluationHypersomniaSymptomType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Metathesaurus Property
C0917799
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Papilledema
Description

NerveNeurologicalExamType

Data type

text

Alias
NCI Thesaurus Property
C25262
UMLS 2011AA Property
C0205494
NCI Thesaurus ObjectClass
C12466
UMLS 2011AA ObjectClass
C0027740
NCI Thesaurus Property-2
C25305
UMLS 2011AA Property-2
C0582103
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Motor Deficit
Description

NeurologicalEvaluationMotorDeficitType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C37940
UMLS 2011AA Property
C0011155
NCI Thesaurus Property-2
C28367
UMLS 2011AA Property-2
C1513492
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Complete paralysis, specify area
Description

NeurologicalFunctionMotorDeficitSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C25262
UMLS 2011AA ObjectClass
C0205494
NCI Thesaurus ObjectClass-2
C25518
UMLS 2011AA ObjectClass-2
C0542341
NCI Thesaurus Property
C37940
UMLS 2011AA Property
C0011155
NCI Thesaurus Property-2
C28367
UMLS 2011AA Property-2
C1513492
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Cranial Nerve Deficit
Description

CranialNerveDeficitType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C37940
UMLS 2011AA Property
C0011155
NCI Metathesaurus ObjectClass
C0010268
Severe, specify nerves involved
Description

CranialNerveInvolvementSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C25548
UMLS 2011AA Property
C1314939
NCI Metathesaurus ObjectClass
C0010268
Sensory Deficit
Description

NeurologicalEvaluationSensoryDeficitType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C37940
UMLS 2011AA Property
C0011155
NCI Thesaurus Property-2
C28259
UMLS 2011AA Property-2
C0445254
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Severe, specify areas
Description

NeurologicalEvaluationSensoryDeficitSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C37940
UMLS 2011AA Property
C0011155
NCI Thesaurus Property-2
C28259
UMLS 2011AA Property-2
C0445254
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Visual Test
Description

NeurologicalEvaluationVisualStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
NCI Thesaurus Property-2
C38059
UMLS 2011AA Property-2
C0234621
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Cerebral Deficit
Description

NeurologicalFunctionBrainDeficitType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25262
UMLS 2011AA ObjectClass
C0205494
NCI Thesaurus ObjectClass-2
C25518
UMLS 2011AA ObjectClass-2
C0542341
NCI Thesaurus Property
C12439
UMLS 2011AA Property
C0006104
NCI Thesaurus Property-2
C37940
UMLS 2011AA Property-2
C0011155
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Reflex Function
Description

NeurologicalEvaluationReflexFunctionStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus Property
C25518
UMLS 2011AA Property
C0542341
NCI Metathesaurus Property
C0034929
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
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1 forms
  1. StudyEvent: Brain Cancer - Neurologic Evaluation Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Crf Header
Protocol ID Coordinating Group
Item
Coordinating Group Protocol No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1711341 (UMLS CUI-2)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Coordinating Group Code
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C1711341 (UMLS CUI-1)
C17005 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25462 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
Protocol Title
Item
Protocol Title
text
C25191 (NCI Thesaurus ValueDomain)
C2986303 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C42774 (NCI Thesaurus Property)
Patient Study ID
Item
Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
Trial subject ID Participating Group
Item
Other Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
ParticipatingGroupIdentifierCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25608 (NCI Thesaurus ObjectClass)
C0679823 (UMLS 2011AA ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C1257890 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Patient Name
Item
Patient Name (initials acceptable)
text
C25191 (NCI Thesaurus ValueDomain)
C1299487 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Item Group
Brain: Form Administration
Person Completing Form
Item
Person Completing Form
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Data amended
Item
Are data amended (If data are amended, please circle in red when using paper form)
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item Group
Brain: Neurologic Evaluation
Item
Headache
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C34661 (NCI Thesaurus Property-2)
C0018681 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.2
Code List
Headache
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Minor And Intermittent (Minor and intermittent)
CL Item
Requires Non-narcotic Analgesics (Requires non-narcotic analgesics)
CL Item
Requires Narcotic Preparations (Requires narcotic preparations)
CL Item
Incapacitating And Continuous Despite Medication (Incapacitating and continuous despite medication)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Visual Disturbance
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37940 (NCI Thesaurus Property)
C0011155 (UMLS 2011AA Property)
C38059 (NCI Thesaurus Property-2)
C0234621 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.3
Code List
Visual Disturbance
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Acuity Decreases (Acuity decreases)
CL Item
Field Defect (Field defect)
CL Item
Diplopia (Diplopia)
C37941 (NCI Thesaurus)
C0012569 (UMLS 2011AA)
CL Item
Blind/unilaterally (Blind/unilaterally)
CL Item
Blind/bilaterally (Blind/bilaterally)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Speech Impairment
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C38025 (NCI Thesaurus Property)
C0037817 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property-2)
C0011155 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.4
Code List
Speech Impairment
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Minor, Intermittent (Minor, intermittent)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Sensory Symptoms
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C28259 (NCI Thesaurus Property-2)
C0445254 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.5
Code List
Sensory Symptoms
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Minor, Intermittent (Minor, intermittent)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Motor Symptoms
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C28367 (NCI Thesaurus Property-2)
C1513492 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.6
Code List
Motor Symptoms
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Minor, Intermittent (Minor, intermittent)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Memory Symptoms
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C37992 (NCI Thesaurus Property-2)
C0025260 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.7
Code List
Memory Symptoms
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Recent Event (Recent event)
CL Item
Remote Event (Remote event)
CL Item
Both Recent And Remote (Both recent and remote)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Personality Changes
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C25446 (NCI Thesaurus Property)
C0392747 (UMLS 2011AA Property)
C38002 (NCI Thesaurus Property-2)
C0031208 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.8
Code List
Personality Changes
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Minor, Intermittent (Minor, intermittent)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Seizures
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C2962 (NCI Thesaurus Property)
C0036572 (UMLS 2011AA Property)
C4876 (NCI Thesaurus Property-2)
C1457887 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.9
Code List
Seizures
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Occasional Seizure (<1 Per Week) Occurring Without Anticonvulsants (occasional seizure (<1 per week) occurring without anticonvulsants)
CL Item
Occasional Seizure With Patient Taking Anticonvulsants (Occasional seizure with patient taking anticonvulsants)
CL Item
Frequent (>1 Per Week) Seizures With Patient Taking Anticonvulsants (Frequent (>1 per week) seizures with patient taking anticonvulsants)
CL Item
Uncontrollable Status Epilepticus (Uncontrollable status epilepticus)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Other Neurologic Symptoms
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C4876 (NCI Thesaurus Property-2)
C1457887 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.10
Code List
Other Neurologic Symptoms
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Minimal (Minimal)
C0547039 (NCI Metathesaurus)
CL Item
Moderate (Moderate)
CL Item
Severe, Specify (Severe, specify)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
NeurologicalEvaluationSeveritySymptomSpecify
Item
Severe, specify
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C25676 (NCI Thesaurus Property-2)
C0439793 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
Item
Mental Status (Neurologic exam)
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus Property)
C1516691 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property-2)
C0678257 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.11
Code List
Mental Status (Neurologic exam)
CL Item
Normal Function (Normal function)
CL Item
Minor Mental Confusion (Minor mental confusion)
CL Item
Gross Confusion But Awake (Gross confusion but awake)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Somnolence
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C0917799 (NCI Metathesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.12
Code List
Somnolence
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Lethargy (Lethargy)
CL Item
Rousable With Difficulty (Rousable with difficulty)
CL Item
Coma (Coma)
C34497 (NCI Thesaurus)
C0009421 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Papilledema
text
C25262 (NCI Thesaurus Property)
C0205494 (UMLS 2011AA Property)
C12466 (NCI Thesaurus ObjectClass)
C0027740 (UMLS 2011AA ObjectClass)
C25305 (NCI Thesaurus Property-2)
C0582103 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.13
Code List
Papilledema
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Suggestive Changes Only (Suggestive changes only)
CL Item
Definite Papilledema Or Exudate (Definite papilledema or exudate)
CL Item
Definitive Hemorrhage Atrophy (definitive hemorrhage atrophy)
CL Item
Post Papilledema (Post papilledema)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Motor Deficit
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37940 (NCI Thesaurus Property)
C0011155 (UMLS 2011AA Property)
C28367 (NCI Thesaurus Property-2)
C1513492 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.14
Code List
Motor Deficit
CL Item
Normal Function (Normal function)
CL Item
Symptomatic Weakness Only (Symptomatic weakness only)
CL Item
<50% Decrease In Function (<50% decrease in function)
CL Item
>50% Decrease In Function (>50% decrease in function)
CL Item
Complete Paralysis, Specify Area (Complete paralysis, specify area)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
NeurologicalFunctionMotorDeficitSpecify
Item
Complete paralysis, specify area
text
C25262 (NCI Thesaurus ObjectClass)
C0205494 (UMLS 2011AA ObjectClass)
C25518 (NCI Thesaurus ObjectClass-2)
C0542341 (UMLS 2011AA ObjectClass-2)
C37940 (NCI Thesaurus Property)
C0011155 (UMLS 2011AA Property)
C28367 (NCI Thesaurus Property-2)
C1513492 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
Item
Cranial Nerve Deficit
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C37940 (NCI Thesaurus Property)
C0011155 (UMLS 2011AA Property)
C0010268 (NCI Metathesaurus ObjectClass)
CL.15
Code List
Cranial Nerve Deficit
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Minor, Intermittent (Minor, intermittent)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CranialNerveInvolvementSpecify
Item
Severe, specify nerves involved
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
C0010268 (NCI Metathesaurus ObjectClass)
Item
Sensory Deficit
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37940 (NCI Thesaurus Property)
C0011155 (UMLS 2011AA Property)
C28259 (NCI Thesaurus Property-2)
C0445254 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.16
Code List
Sensory Deficit
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Minor, Intermittent (Minor, intermittent)
CL Item
Moderate (Moderate)
CL Item
Severe, Specify Areas (Severe, specify areas)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
NeurologicalEvaluationSensoryDeficitSpecify
Item
Severe, specify areas
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37940 (NCI Thesaurus Property)
C0011155 (UMLS 2011AA Property)
C28259 (NCI Thesaurus Property-2)
C0445254 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
Item
Visual Test
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C38059 (NCI Thesaurus Property-2)
C0234621 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.17
Code List
Visual Test
CL Item
Intact (Intact)
C62399 (NCI Thesaurus)
C0205266 (UMLS 2011AA)
CL Item
Deficit (Deficit)
Item
Cerebral Deficit
text
C25262 (NCI Thesaurus ObjectClass)
C0205494 (UMLS 2011AA ObjectClass)
C25518 (NCI Thesaurus ObjectClass-2)
C0542341 (UMLS 2011AA ObjectClass-2)
C12439 (NCI Thesaurus Property)
C0006104 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property-2)
C0011155 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.18
Code List
Cerebral Deficit
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Minor, Intermittent (Minor, intermittent)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Reflex Function
text
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C25518 (NCI Thesaurus Property)
C0542341 (UMLS 2011AA Property)
C0034929 (NCI Metathesaurus Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.19
Code List
Reflex Function
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
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