CDASH for Peripheral Arterial Lesion

Collection Date	Collection Date TUDAT TUDTC	_________________
	Anatomical Part or Region Shown by the Image TULOC Hidden/pre-populated	LOWER LIMB REGION
	Lesion Identification Test Name TUTEST Pre-populated	Examination for Abnormality <TUTEST codelist>
If this location is a graft (or transplant), enter the name of the native tissue, organ or blood vessel on which the graft is built (or in which the transplant is implanted).	What was the location of the lesion based on the assessment of the image? TURESLOC TURESLOC when TUTEST = Examination for Abnormality	_________________ <LOC codelist>
Check "Yes" for this question if the lesion is located in a graft (or transplant) tissue, organ or blood vessel.	Indicate whether the located lesion is in a graft. TURLGFFL NSTU.TURLGFFL	Yes
	If applicable, indicate the laterality of the location of the lesion. TURESLAT TURESLAT when TUTEST = Examination for Abnormality	_________________ <LAT codelist>
	If applicable, provide more detail of the location of the lesion. TURESLDL TURESLDL when TUTEST = Examination for Abnormality	_________________
Sponsor-specified	What was the Lesion ID? TULNKID TULNKID, TRLNKID, RSLNKID	_________________

Order	Type	CDASHIG Variable	Question Text	Prompt	CRF Completion Instructions	SDTMIG Target	Controlled Terminology Codelist Name	Implementation Notes	Permissible Values	Pre-populated Value	Query Display	List Style	Hidden
1	text	TUDAT	Collection Date		Collection Date	TUDTC	N/A				Prompt
2	text	TULOC	What was the anatomical region shown by the imaging procedure?	Anatomical Part or Region Shown by the Image		TULOC		This is the general anatomical part or region made available for assessment by the imaging procedure.		LOWER LIMB REGION			Y
3	text	TUTEST	What was the lesion identification test name?	Lesion Identification Test Name	Record the name of the TU test, if not printed on the CRF. If collected on the CRF, the sponsor may provide additional instructions to ensure the data is entered as intended.	TUTEST	(TUTEST)	Required to identify to which test the result relates. It is recommended that test names be preprinted on the CRF rather than collected in a field that requires the site to enter text. If the form is laid out as a grid, then words such as Test can be included as the column header.		Examination for Abnormality	Prompt
5	text	TURESLOC	What was the location of the lesion based on the assessment of the image?	Result Anatomical Location	If this location is a graft (or transplant), enter the name of the native tissue, organ or blood vessel on which the graft is built (or in which the transplant is implanted).	TURESLOC when TUTEST = Examination for Abnormality	(LOC)
6	text	TURLGFFL	Indicate whether the located lesion is in a graft.	Graft Result Location Flag	Check "Yes" for this question if the lesion is located in a graft (or transplant) tissue, organ or blood vessel.	NSTU.TURLGFFL			Yes			checkbox
7	text	TURESLAT	If applicable, indicate the laterality of the location of the lesion.	Result Location Laterality		TURESLAT when TUTEST = Examination for Abnormality	(LAT)
8	text	TURESLDL	If applicable, provide more detail of the location of the lesion.	Result Location directionality		TURESLDL when TUTEST = Examination for Abnormality	N/A
9	text	TULNKID	What was the Lesion ID?	Lesion ID	Sponsor-specified	TULNKID, TRLNKID, RSLNKID	N/A	This variable is used to provide a unique code for each identified lesion in order to link records across related domains (TU, TR, RS).

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