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ACE Subject Physical Exam

ace_physexam

01

ACE Subject Physical Exam Form

Download Definition as
Download Submission Template as
Files
PDF file iconACE Subject Physical Exam Form.pdf
URLs
Element NameData TypeSizeRequiredDescriptionValue RangeNotesAliases
subjectkeyGUIDRequiredThe NDAR Global Unique Identifier (GUID) for research subjectNDAR*GUID
src_subject_idString20RequiredSubject ID how it's defined in lab/project
interview_ageIntegerRequiredAge in months at the time of the interview/test/sampling/imaging.0 :: 1260Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month.
interview_dateDateRequiredDate on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYYRequired field
genderString20RequiredSex of the subjectM;FM = Male; F = Female
comments_miscString4,000RecommendedMiscellaneous comments on study, interview, methodology relevant to this form datacomments
height_metFloatRecommendedHeight - Metric Unitheight_cm
weight_metFloatRecommendedWeight - Metric Unitweight_kg
head_circumFloatRecommendedHead Circumference (in cm)-1 = Not knownhead_circumference_cm
head_facialaString50RecommendedFacial Asymmetry
Yes;No;NK
NK = Not knownCharge_physicalexam_head_faciala, is_there_any_facial_asymmetry
facial_dysmorpString10RecommendedAre there dysmorphic facial features (e.g. eyes too closely or widely spaced, ears lowset)?Yes;No;NKNK = Not knownthere_dysmorphic_facial_featur
child_visionimpString50RecommendedDoes the Child have a vision impairment?
Yes;No; NK
NK = Not knownvision_abnormal
eye_correctIntegerRecommendedIf yes, is there any correction/what kind?1;21=Glasses or Corrective lens; 2=Surgeryvision_correction
child_hearingimpString50RecommendedDoes the Child have a hearing impairment?
Yes;No; NK
NK = Not knownhearing_abnormal
hear_corr_typeIntegerRecommendedIf yes, is there any correction/what kind1;21 = Hearing aids; 2 = Cochlear implantshearing_correction
eye_movString10RecommendedAre the eye movements full and symmetric?Yes;No;NKeye_movements_full_symmetric
eyes_strabismusString50RecommendedStrabismusYes; No; NK (not known/not examined)there_strabismus
eyes_nystagmusString50RecommendedNystagmus
Yes;No;NK
NK = Not knownCharge_physicalexam_eyes_nystagmus, there_nystagmus
eyes_ptosisString50RecommendedPtosis
Yes;No;NK
NK = Not knownCharge_physicalexam_eyes_ptosis, there_ptosis
medprob_earString50RecommendedEars: Is there any known abnormality in this area?
No;Yes;NK
NK = Not knowndo_ears_appear_abnormal
ear_ab_typeString50RecommendedIf yes, how do they appear?Cupped; Prominent; Lowset; Tags
jaw_abString10RecommendedDoes the jaw appear abnormal?Yes;No;NKNK = Not knowndoes_jaw_appear_abnormal
rev_mouthcleftlipString50RecommendedIs there a cleft lip and/or cleft palate?
Yes;No;NK
NK = Not knownthere_cleft_lip_or_cleft_palat
neck_webbedString50RecommendedIs the neck short and/or webbed?
Yes;No;NK
NK = Not knownCharge_physicalexam_neck_webbed, neck_short_or_webbed
neck_pectString10RecommendedIs there a pectus deformity (breastbone scooped in or prominent)?Yes;No;NKNK = Not knownthere_pectus_deformity_breastb
neck_scoliosisString50RecommendedIs there scoliosis (curvature of the spine)?
Yes;No;NK
NK = Not knownCharge_physicalexam_neck_scoliosis, there_scoliosis_curvature_of_s
cardio_murmurString50RecommendedIs there a heart murmur or abnormal heart examination?
Yes;No;NK
NK = Not knownCharge_physicalexam_cardio_murmur, there_heart_murmur_or_abnormal
abdomen_hepatomString50RecommendedIs there evidence of hepato(spleno)megaly (large liver or spleen)?
Yes;No;NK
NK = Not knownis_there_evidence_of_hepato_sp
genit_examString10RecommendedIs the genital exam abnormal?Yes;No;NKNK = Not knownis_the_genital_exam_abnormal
genit_exam_specIntegerRecommendedIf yes, what findings?1::61 = Hypospadias; 2 = Cryptorchidism; 3 = Enlarged testicles; 4 = Micropenis; 5 = Hypoplastic labia; 6=other
limb_abnorString10RecommendedAre there any digital abnormalities (extra or missing fingers or toes)?Yes;No;NKNK = Not knownthere_any_digital_abnormalitie
limb_abnor_detIntegerRecommendedIf yes, what findings?1::51 = Extra fingers; 2 = Missing fingers; 3= Extra toes; 4 = Missing toes; 5 = Fused digits
limb_joint_loosString10RecommendedAre joints excessively loose?Yes;No;NKNK = Not knownjoints_excessively_loose
limb_jointlimitationsString50RecommendedAre there joint contractures?
Yes;No;NK
NK = Not knownCharge_physicalexam_limb_jointlimitations, there_joint_contractures
skin_hypopigmenString50RecommendedAre there areas of hypopigmentation (ash-leaf spots)?
Yes;No;NK
NK = Not knownCharge_physicalexam_skin_hypopigmen, there_areas_of_hypopigmentatio
skin_hyperpigString50RecommendedAre there areas of hyperpigmentation (cafe-au-lait spots)?
Yes;No;NK
NK = Not knownCharge_physicalexam_skin_hyperpig, there_areas_of_hyperpigmentati
skin_freckString10RecommendedAre there freckles under the arms and/or groin area?Yes;No;NKNK = Not knownthere_freckles_under_arms_or_g
skin_neurofibString50RecommendedAre there neurofibromas (bumps under the skin, sometimes with a bluish tinge)?
Yes;No;NK
NK = Not knownCharge_physicalexam_skin_neurofib, there_neurofibromas
skin_abnormString10RecommendedAny other skin abnormalities?Yes;No;NKNK = Not knownCharge_physicalexam_skin_comments, any_other_skin_abnormalities
hypotoniaIntegerRecommendedDoes (did) the Child have Hypotonia (low muscle tone)?0;1;20 = No; 1 = Yes; 2 = Not knownthere_any_evidence_of_hypotoni
hypertoniaIntegerRecommendedDoes (did) the Child have Hypertonia (tight muscle tone)?0;1;20 = No; 1 = Yes; 2 = Not knownthere_any_evidence_of_hyperton
muscle_strengString10RecommendedIs muscle strength abnormal?Yes;No;NKNK = Not knownmuscle_strength_abnormal
muscle_streng_detIntegerRecommendedIf yes, what findings1;21 = Generalized weakness; 2 = Focal weaknessmuscle_strength_findings
gait_ataxString10RecommendedIs there evidence of poor coordination or gait ataxia (difficulty walking straight)?Yes;No;NKNK = Not knownthere_evidence_of_poor_coordin
neuro_involunmoveString50RecommendedAre there any involuntary movements?
Yes;No;NK
NK = Not knownCharge_physicalexam_neuro_involunmove, there_any_involuntary_movement
cran_nervString10RequiredAre the cranial nerves normal (do face, tongue and palate move normally)?Yes;No;NKNK = Not knowncranial_nerves_normal
sens_examString10RecommendedIs sensory exam normal?Yes;No;NKNK = Not knownsensory_exam_normal
neuro_dtrbicrightIntegerRecommendedDTR Biceps - Right0;1;2;3;40 = Reflex absent; 1 = Reflex small, less than normal; includes a trace response, or a response brought out only by reinforcement; 2 = Reflex in lower half of normal range; 3 = Reflex in upper half of normal range; 4 = Reflex enhanced, more than normal; includes clonus if present, which optionally can be noted in an added verbal description of the reflexdtr_biceps_r
neuro_dtrbicleftIntegerRecommendedDTR Biceps - Left0;1;2;3;40 = Reflex absent; 1 = Reflex small, less than normal; includes a trace response, or a response brought out only by reinforcement; 2 = Reflex in lower half of normal range; 3 = Reflex in upper half of normal range; 4 = Reflex enhanced, more than normal; includes clonus if present, which optionally can be noted in an added verbal description of the reflexdtr_biceps_l
neuro_dtrtricrightIntegerRecommendedDTR Triceps - Right0;1;2;3;40 = Reflex absent; 1 = Reflex small, less than normal; includes a trace response, or a response brought out only by reinforcement; 2 = Reflex in lower half of normal range; 3 = Reflex in upper half of normal range; 4 = Reflex enhanced, more than normal; includes clonus if present, which optionally can be noted in an added verbal description of the reflexdtr_triceps_r
neuro_dtrtricleftIntegerRecommendedDTR Triceps - Left0;1;2;3;40 = Reflex absent; 1 = Reflex small, less than normal; includes a trace response, or a response brought out only by reinforcement; 2 = Reflex in lower half of normal range; 3 = Reflex in upper half of normal range; 4 = Reflex enhanced, more than normal; includes clonus if present, which optionally can be noted in an added verbal description of the reflexdtr_triceps_l
neuro_dtrpatrightIntegerRecommendedDTR Patella - Right0;1;2;3;40 = Reflex absent; 1 = Reflex small, less than normal; includes a trace response, or a response brought out only by reinforcement; 2 = Reflex in lower half of normal range; 3 = Reflex in upper half of normal range; 4 = Reflex enhanced, more than normal; includes clonus if present, which optionally can be noted in an added verbal description of the reflexdtr_patella_r
neuro_dtrpatleftIntegerRecommendedDTR Patella - Left0;1;2;3;40 = Reflex absent; 1 = Reflex small, less than normal; includes a trace response, or a response brought out only by reinforcement; 2 = Reflex in lower half of normal range; 3 = Reflex in upper half of normal range; 4 = Reflex enhanced, more than normal; includes clonus if present, which optionally can be noted in an added verbal description of the reflexdtr_patella_l
neuro_dtranklerightIntegerRecommendedDTR Ankle - Right0;1;2;3;40 = Reflex absent; 1 = Reflex small, less than normal; includes a trace response, or a response brought out only by reinforcement; 2 = Reflex in lower half of normal range; 3 = Reflex in upper half of normal range; 4 = Reflex enhanced, more than normal; includes clonus if present, which optionally can be noted in an added verbal description of the reflexdtr_ankles_r
neuro_dtrankleleftIntegerRecommendedDTR Ankle - Left0;1;2;3;40 = Reflex absent; 1 = Reflex small, less than normal; includes a trace response, or a response brought out only by reinforcement; 2 = Reflex in lower half of normal range; 3 = Reflex in upper half of normal range; 4 = Reflex enhanced, more than normal; includes clonus if present, which optionally can be noted in an added verbal description of the reflexdtr_ankles_l
neuro_dtrstrruIntegerRecommendedStrength RU1::51=Abnormally Low; 5=Full Strengthstrength_ru
neuro_dtrstrluIntegerRecommendedStrength LU1::51=Abnormally Low; 5=Full Strengthstrength_lu
neuro_dtrstrrlIntegerRecommendedStrength RL1::51=Abnormally Low; 5=Full Strengthstrength_rl
neuro_dtrstrllIntegerRecommendedStrength LL1::51=Abnormally Low; 5=Full Strengthstrength_ll
neuro_extraocmoveString50RecommendedExtraocular MovementsNormal;Abnormal;NE;_BLANK_NE = Not examinedextramov
neuro_extraocmovedescString255RecommendedExtraocular Movements - Describeextramov_descr
neuro_smileString50RecommendedSymmetry of SmileNormal;Abnormal;NE;_BLANK_NE = Not examinedsymmsmile
neuro_smiledescribeString255RecommendedSymmetry of Smile - Describesymmsmile_descr
neuro_gaitString50RecommendedGaitNormal;Abnormal;NE;_BLANK_NE = Not examinedgait
neuro_gaitdescribeString255RecommendedGait - Describegait_descr
Data Structure

This page displays the data structure defined for the measure identified in the title and structure short name. The table below displays a list of data elements in this structure (also called variables) and the following information:

  • Element Name: This is the standard element name
  • Data Type: Which type of data this element is, e.g. String, Float, File location.
  • Size: If applicable, the character limit of this element
  • Required: This column displays whether the element is Required for valid submissions, Recommended for valid submissions, Conditional on other elements, or Optional
  • Description: A basic description
  • Value Range: Which values can appear validly in this element (case sensitive for strings)
  • Notes: Expanded description or notes on coding of values
  • Aliases: A list of currently supported Aliases (alternate element names)
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Distribution for DataStructure: ace_physexam01 and Element:
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