Form:Chile-US CT Scan Baseline v1.1


CDE IDCDE Description
* 421EDRN Participant ID (Go To: 2176)
* 2176Visit code (Go To: 423)
 
Permissible Values (value):BLN1 (1)
 
 BLN2 (2)
 
 BLN3 (3)
 
 BLN4 (4)
* 423EDRN Protocol ID (Go To: 422)
* 422EDRN Site ID (Go To: 929)
* 929EDRN Staff ID of the person who collected the data: (Go To: 4561)
* 4561Date of imaging test (DD/MM/YYYY): (Go To: 3109)
* 3109Number of CT slices (Go To: 3110)
* 3110Thickness of CT slices: (Go To: 3063)
* 3063CT quality: (Go To: 3037)
 
Permissible Values (value):1=Good (1)
 
 2=Acceptable, with no technical defect likely to impair classification (2)
 
 3=Acceptable, with some technical defect but still adequate for classification purposes (3)
 
 4=Unreadable (4)
* 3037Is the film or scan completely negative? (Go To: 1097)
 
Permissible Values (value):No (0) (Go To: 3043)
 
 Yes (1)
* 3043Did the scan contain well defined rounded opacities? (Go To: 3042)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 3083)
* 3083Presence of P (<1.5 mm in diameter) opacities? (Go To: 3084)
 
Permissible Values (value):No (0)
 
 Yes (1)
* 3084Presence of Q (1.5-3 mm in diameter) opacities? (Go To: 3085)
 
Permissible Values (value):No (0)
 
 Yes (1)
* 3085Presence of R (3-10 mm in diameter) opacities? (Go To: 3050)
 
Permissible Values (value):No (0)
 
 Yes (1)
* 3050Well defined opacity distribution, right side, upper zone: (Go To: 3076)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3076Well defined opacity distribution, right side, middle zone: (Go To: 3075)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3075Well defined opacity distribution, right side, lower zone: (Go To: 3049)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3049Well defined opacity distribution, left side, upper zone: (Go To: 3073)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3073Well defined opacity distribution, left side, lower zone: (Go To: 3074)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3074Well defined opacity distribution, left side, middle zone: (Go To: 3092)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3092Well defined, rounded opacity summary grade: (Go To: 3042)
* 3042Presence of irregular and/or linear opacities? (Go To: 3036)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 3041)
* 3041Presence of intralobular opacities? (Go To: 3039)
 
Permissible Values (value):No (0)
 
 Yes (1)
* 3039Presence of interlobular opacities? (Go To: 3048)
 
Permissible Values (value):No (0)
 
 Yes (1)
* 3048Irregular/linear opacity distribution, right side, upper zone: (Go To: 3072)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3072Irregular/linear opacity distribution, right side, middle zone: (Go To: 3047)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3047Irregular/linear opacity distribution, right side, lower zone: (Go To: 3046)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3046Irregular/linear opacity distribution, left side, upper zone: (Go To: 3045)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3045Irregular/linear opacity distribution, left side, middle zone: (Go To: 3044)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3044Irregular/linear opacitydistribution, left side, lower zone: (Go To: 3116)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3116Irregular/linear opacity summary grade: (Go To: 3036)
* 3036Presence of inhomogeneous attenuation (IA)? (Go To: 3071)
 
Permissible Values (value):No (0)
 
 Yes (1)
* 3071Presence of ground glass opacities? (Go To: 3035)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 3082)
* 3082Ground glass opacity distribution, right side, upper zone: (Go To: 3081)
 
Permissible Values (value):MP=Mosaic Perfusion (0)
 
 1=focal (1)
 
 2=patchy (2)
 
 3=difuse (3)
* 3081Ground glass opacity distribution, right side, middle zone: (Go To: 3080)
 
Permissible Values (value):MP=Mosaic Perfusion (0)
 
 1=focal (1)
 
 2=patchy (2)
 
 3=difuse (3)
* 3080Ground glass opacity distribution, right side, lower zone: (Go To: 3079)
 
Permissible Values (value):MP=Mosaic Perfusion (0)
 
 1=focal (1)
 
 2=patchy (2)
 
 3=difuse (3)
* 3079Ground glass opacity distribution, left side, upper zone: (Go To: 3078)
 
Permissible Values (value):MP=Mosaic Perfusion (0)
 
 1=focal (1)
 
 2=patchy (2)
 
 3=difuse (3)
* 3078Ground glass opacity distribution, left side, middle zone: (Go To: 3077)
 
Permissible Values (value):MP=Mosaic Perfusion (0)
 
 1=focal (1)
 
 2=patchy (2)
 
 3=difuse (3)
* 3077Ground glass opacity distribution, left side, lower zone: (Go To: 3115)
 
Permissible Values (value):MP=Mosaic Perfusion (0)
 
 1=focal (1)
 
 2=patchy (2)
 
 3=difuse (3)
* 3115Ground glass opacity summary grade: (Go To: 3035)
* 3035Presence of honeycombing (HC)? (Go To: 3070)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 3034)
* 3034Honeycombing (HC), right upper: (Go To: 3033)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to 10 mm in the subpleural area (1)
 
 2=moderate; between 10 and 30 mm in the subpleural area (2)
 
 3=severe; >30 mm up to the whole area (3)
* 3033Honeycombing (HC), right middle: (Go To: 3032)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to 10 mm in the subpleural area (1)
 
 2=moderate; between 10 and 30 mm in the subpleural area (2)
 
 3=severe; >30 mm up to the whole area (3)
* 3032Honeycombing (HC), right lower: (Go To: 3031)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to 10 mm in the subpleural area (1)
 
 2=moderate; between 10 and 30 mm in the subpleural area (2)
 
 3=severe; >30 mm up to the whole area (3)
* 3031Honeycombing (HC), left upper: (Go To: 3030)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to 10 mm in the subpleural area (1)
 
 2=moderate; between 10 and 30 mm in the subpleural area (2)
 
 3=severe; >30 mm up to the whole area (3)
* 3030Honeycombing (HC), left middle: (Go To: 3029)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to 10 mm in the subpleural area (1)
 
 2=moderate; between 10 and 30 mm in the subpleural area (2)
 
 3=severe; >30 mm up to the whole area (3)
* 3029Honeycombing (HC), left lower: (Go To: 3114)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to 10 mm in the subpleural area (1)
 
 2=moderate; between 10 and 30 mm in the subpleural area (2)
 
 3=severe; >30 mm up to the whole area (3)
* 3114Honeycombing (HC) summary grade: (Go To: 3070)
* 3070Presence of emphysema? (Go To: 3123)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 3069)
* 3069Emphysema distribution, right side, upper zone: (Go To: 3068)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to to 15% of the area of one zone (1)
 
 2=moderate; between 15 and 39% (2)
 
 3=severe; >30% (3)
* 3068Emphysema distribution, right side, middle zone: (Go To: 3067)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to to 15% of the area of one zone (1)
 
 2=moderate; between 15 and 39% (2)
 
 3=severe; >30% (3)
* 3067Emphysema distribution, right side, lower zone: (Go To: 3066)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to to 15% of the area of one zone (1)
 
 2=moderate; between 15 and 39% (2)
 
 3=severe; >30% (3)
* 3066Emphysema distribution, left side, upper zone: (Go To: 3065)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to to 15% of the area of one zone (1)
 
 2=moderate; between 15 and 39% (2)
 
 3=severe; >30% (3)
* 3065Emphysema distribution, left side, middle zone: (Go To: 3064)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to to 15% of the area of one zone (1)
 
 2=moderate; between 15 and 39% (2)
 
 3=severe; >30% (3)
* 3064Emphysema distribution, left side, lower zone: (Go To: 3113)
 
Permissible Values (value):0=None (0)
 
 1=mild; up to to 15% of the area of one zone (1)
 
 2=moderate; between 15 and 39% (2)
 
 3=severe; >30% (3)
* 3113Emphysema summary grade: (Go To: 3123)
* 3123Presence of large opacities? (Go To: 3103)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 3124)
* 3124Large opacity size: (Go To: 3130)
 
Permissible Values (value):A=One or more opacities, extent>1 cm up to 1/4 of the area (quadrant) of the right side of the CT-slice at the carina (1)
 
 B=Area of one or sum of more opacities larger than "A," less than 1/2 of the area (2 quadrants) of the right side of the CT-slice at the carina (2)
 
 C=Area of one or sum of more opacities larger than half of the area of the right side of the CT-slice at the carina (3)
* 3130Large opacities distribution, right side, upper zone: (Go To: 3131)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3131Large opacity distribution, right side, middle zone: (Go To: 3141)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3141Large opcacity distribution, right side, lower zone: (Go To: 3132)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3132Large opacities distribution, left side, upper zone: (Go To: 3133)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3133Large opacity distribution, left side, middle zone: (Go To: 3134)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3134Large opcacity distribution, left side, lower zone: (Go To: 3103)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3103Predominant findings (check all that apply): (Go To: 3099)
 
Permissible Values (value):None (0)
 
 RO (Rounded opacities) (1)
 
 IR (Irregular/linear opacities) (2)
 
 GGO (Ground glass opacities) (3)
 
 HC (Honeycombing) (4)
 
 EM (Emphysema) (5)
 
 LO (Large opacities) (6)
* 3099Presence of pleural abnormalities? (Go To: 3101)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 3094)
* 3094Presence of pleural parietal type abnormalities? (Go To: 3096)
 
Permissible Values (value):No (0)
 
 Yes (1)
* 3096Presence of pleural visceral type abnormalities? (Go To: 3090)
 
Permissible Values (value):No (0)
 
 Yes (1)
* 3090Presence of pleural abnormalities of the mediastinum (M)? (Go To: 3086)
 
Permissible Values (value):No (0)
 
 Yes (1)
* 3086Presence of pleural abnormalities of the diaphragm (D)? (Go To: 3135)
 
Permissible Values (value):No (0)
 
 Yes (1)
* 3135Pleural abnormalities distribution, right side, upper zone: (Go To: 3136)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3136Pleural abnormalities distribution, right side, middle zone: (Go To: 3137)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3137Pleural abnormalities distribution, right side, lower zone: (Go To: 3138)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3138Pleural abnormalities distribution, left side, upper zone: (Go To: 3139)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3139Pleural abnormalities distribution, left side, middle zone: (Go To: 3140)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3140Pleural abnormalities distribution, left side, lower zone: (Go To: 3088)
 
Permissible Values (value):0=none that are definitive (0)
 
 1=mild; definitely present but few in number (1)
 
 2=moderate; numerous present (2)
 
 3=severe; very numerous, normal anatomical lung structures poorly visible (3)
* 3088Pleural abnormalities extent, right side: (Go To: 3098)
 
Permissible Values (value):0 (0)
 
 1=up to 90° (<1/4) (1)
 
 2=between 90° and 180° (1/4-1/2) (2)
 
 3= >180° (>1/2) (3)
* 3098Pleural abnormalities width, right side: (Go To: 3087)
 
Permissible Values (value):0 (0)
 
 a=up to 5 mm (1)
 
 b=5-10 mm (2)
 
 c=>10 mm (3)
* 3087Pleural abnormalities extent, left side: (Go To: 3097)
 
Permissible Values (value):0 (0)
 
 1=up to 90° (<1/4) (1)
 
 2=between 90° and 180° (1/4-1/2) (2)
 
 3= >180° (>1/2) (3)
* 3097Pleural abnormalities width, left side: (Go To: 3101)
 
Permissible Values (value):0 (0)
 
 a=up to 5 mm (1)
 
 b=5-10 mm (2)
 
 c=>10 mm (3)
* 3101Presence of pleural calcifications? (Go To: 4554)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 3100)
* 3100Pleural calcifications localization: (Go To: 4554)
 
Permissible Values (value):W (wall) (1)
 
 M (mediastinum) (2)
 
 D (diaphragm) (3)
* 4554Other CT findings (Check all that apply) (Go To: 1097)
 
Permissible Values (value):0=None (0)
 
 AX=Coalescence of small pneumoconiotic opacities (1)
 
 BE=Bronchiectasis: all types, including traction bronchiectasis (2)
 
 BR=Bronchial wall thickening (3)
 
 CA=Lung Cancer (5)
 
 CG=Calcified Granuloma (6)
 
 CV=Cavity: central necrosis, liquid and/or air containing (7)
 
 DI=Distortion of intrathoracic structures and organs (8)
 
 DO=Dependent Opacity (9)
 
 EF=Effusion: free or loculated pleural fluid (10)
 
 ES=Eggshell calcification of hilar and/or mediastinal lymph nodes (11)
 
 FP=Fat Pad: extrapleural/subcostal fat (12)
 
 FR=Fractured Rib(s) (13)
 
 ME=Malignant Mesothelioma of the pleura, the pericardium or the peritoneum (15)
 
 MP=Mosaic Perfusion (16)
 
 OD=Other Disease: comments under "Additional Findings" (17)
 
 PB=Parenchymal Band, due to pleuroparenchymal scars (18)
 
 RA=Rounded Atelectasis (19)
 
 SC=Subpleural curvilinear lines (20)
 
 TB=Tuberculosis (21)
 
 TD=Tree in Bud (22)
   1097Comments (do not include any participant identifiers) (Go To: End of Form)