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CDE Detailed Report
This report contains detailed information about the selected CDEs.
Note: If at least one CDE was selected from a copyright- or trademark-protected instrument/scale then all of the CDEs from that instrument/scale are included in this report.
Disease: Headache
Sub-Domain: General Health History
CRF: Behavioral History
Item count: 32 (32 distinct CDEs)
CDE ID
CDE Name
Variable Name
Definition / Description
Question Text
Permissible Value
Description
Data Type
Instructions
References
Population
Classification (e.g., Core)
Version #
Version Date
Aliases for Variable Name
CRF Module / Guideline
© or TM
Sub-Domain
Domain
Previous Title
Size
Input Restrictions
Min Value
Max Value
Measurement Type
LOINC ID
SNOMED
caDSR ID
CDISC ID
C18670
Subscribed drug or substance illicitly used other text
SbscrbdDrgSubIllctUseOTH
The free-text field related to 'Drug or substance illicitly used category' specifying other text. Category of illegal drugs, prescription, or over-the-counter drugs the participant/subject used for purposes other than those for which they are meant to be used, or in large amounts
Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol)
  
Alphanumeric
No instructions available
No references available
Adult
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
 
4000
Free-Form Entry
     
3171797
 
C00714
Behavioral history assessment date and time
BehavrlHistAssmtDateTime
Date (and time, if applicable and known) the participant/subject behavioral history was taken.
Date behavioral history taken:
  
Date or Date & Time
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).
Supplemental - Highly Recommended based on study type, disease stage and disease type.
No references available
Adult;Pediatric
Supplemental
3.0
7/18/2013
BEHAV_HIST_DT
Behavioral History
General Health History
Participant History and Family History
Behavioral history assessment date and time
 
Free-Form Entry
     
3170040
 
C00710
Tobacco current use indicator
TobcoUseCurntInd
Indicator for whether the participant/subject regularly uses tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) at the present time.
Current tobacco use?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.
Supplemental - Highly Recommended based on study type, disease stage and disease type.
No references available
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Tobacco current use indicator
 
Single Pre-Defined Value Selected
     
3170060
 
C00711
Tobacco prior use indicator
TobcoPriorUseInd
Indicator of the participant's/subject's past regular tobacco (e.g., cigarettes, cigars, chewing tobacco or pipe) use prior to the past 12 months
Past tobacco use? (Regular use of cigarettes, cigars, chewing tabacco or pipes prior ro the past year)
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type
No references available
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Tobacco prior use indicator
 
Single Pre-Defined Value Selected
     
3170080
 
C00703
Tobacco use started age value
TobcoUseStrtAgeVal
Age in years when participant/subject started using tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe)
Age started tobacco use (years):
  
Numeric Values
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected.
No references available
Adult;Pediatric
Supplemental
3.0
7/18/2013
AGE_BEG_SMK_YR
Behavioral History
General Health History
Participant History and Family History
Tobacco use started age value
 
Free-Form Entry
0
120
year
  
2178045
 
C00701
Tobacco use stopped age value
TobcoUseStopAgeVal
Age in years when participant/subject stopped using tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe)
Age stopped tobacco use (years):
  
Numeric Values
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected.
No references available
Adult;Pediatric
Supplemental
3.0
7/18/2013
AGE_DX_SMK_YR
Behavioral History
General Health History
Participant History and Family History
Tobacco use stopped age value
 
Free-Form Entry
0
120
year
  
2524471
 
C55953
Tobacco use stopped not applicable text
TobcoUseStopAgeNtApplcblTxt
Text reporting that the participant/subject never stopped using tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe)
N/A - still using tobacco
  
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type
No references available
Adult;Pediatric
Supplemental
3.0
7/18/2013
AGE_DX_SMK_YR
Behavioral History
General Health History
Participant History and Family History
  
Free-Form Entry
     
2524471
 
C55959
Tobacco packs smoked daily average value
TobcoPackSmokedDlyAvgVal
Average number of packs of cigarettes the participant/subject smokes daily (On the days you smoked cigarettes during the past 30 days, how many cigarettes did you smoke per day, on average?)
Average number of cigarettes smoked per day, Number of Packs:
  
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type
No references available
Adult;Pediatric
Supplemental
3.0
7/18/2013
SCI CDEs: NOCIGRTS
Behavioral History
General Health History
Participant History and Family History
 
255
Free-Form Entry
     
3170853
 
C06108
Tobacco smoke pack-year value
TobccoSmkePckYrVal
If participant is a former or current cigarette smoker, documents the number of pack-years of smoking [(average number smoked daily)/20] x (number of years smoked) = pack-years]
For former or current cigarette smokers only, indicate the number of pack-years of smoking: [(average number of cigarettes smoked daily)/20] x (number of years smoked: _____pack-years
  
Numeric Values
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type
No references available
Adult;Pediatric
Supplemental
3.0
7/17/2013
SMKPCKYR
Behavioral History
General Health History
Participant History and Family History
Tobacco smoking pack-years number
 
Free-Form Entry
  
pack-years
    
C00709
Tobacco cigarettes smoked daily average number
TobcoCigaretSmokedDlyAvgNum
Average number of cigarettes the participant/subject smokes daily (On the days you smoked cigarettes during the past 30 days, how many cigarettes did you smoke per day, on average?)
Average number of cigarettes smoked per day, Number of Cigarettes:
  
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.
PhenX Toolkit: https://www.phenxtoolkit.org/index.php - Protocol 1: Tobacco - 30-Day Quantity and Frequency (Adolescent Protocol) #030801
Adult;Pediatric
Supplemental
3.0
7/18/2013
SCI CDEs: NOCIGRTS
Behavioral History
General Health History
Participant History and Family History
Tobacco cigarettes smoked daily average count
 
Single Pre-Defined Value Selected
     
3170853
 
C00705
Alcohol current use indicator
AlcCurntUseInd
Indicator of whether the participant/subject consumed at least one alcoholic drink within the past 12 months
Current drinker? (Consumed at least one drink within the past year)
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.
In the U.S., a single drink serving contains about 14 grams of ethanol or "pure" alcohol. Although the drinks below are different sizes, each one contains the same amount of pure alcohol and counts as a single drink: 12 oz. of beer (about %% alcohol) = 8-9 oz. of malt liquor (about 7% alcohol) = 5 oz. of wine (about 12% alcohol) = 1.5 oz. of hard liquor (about 40% alcohol)
No references available
Adult;Pediatric
Supplemental
3.0
7/18/2013
ALCHL_CUR_USE_YNU
Behavioral History
General Health History
Participant History and Family History
Alcohol current use indicator
 
Single Pre-Defined Value Selected
     
3171540
 
C00706
Alcohol prior use indicator
AlcPriorUseInd
Indicator of the participant's/subject's alcohol consumption prior to the past 12 months
Past drinker? (Consumed at least one drink prior to the past year)
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.
No references available
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Alcohol prior use indicator
 
Single Pre-Defined Value Selected
     
3171578
 
C00702
Alcohol use started age value
AlcUseStrtAgeVal
Age in years when participant/subject started ingesting alcoholic beverages, including social drinking
Age started drinking (years):
  
Numeric Values
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected.
No references available
Adult;Pediatric
Supplemental
3.0
7/18/2013
ALC_USE_START_AGE_YR
Behavioral History
General Health History
Participant History and Family History
Alcohol use started age value
 
Free-Form Entry
0
120
year
  
2008447
 
C00700
Alcohol use stopped age value
AlcUseStopAgeVal
Age in years when participant/subject stopped ingesting alcoholic beverages, including social drinking
Age quit drinking (years):
  
Numeric Values
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected.
No references available
Adult;Pediatric
Supplemental
3.0
7/18/2013
ALC_USE_STOP_AGE_YR
Behavioral History
General Health History
Participant History and Family History
Alcohol use stopped age value
 
Free-Form Entry
0
120
year
  
2008448
 
C55966
Alcohol used stopped not applicable text
AlcUseStopNtApplcblTxt
Text recording that the participant/subject never stopped ingesting alcoholic beverages, including social drinking
N/A -- still drinking alcohol
  
Alphanumeric
Skip is Q7 and Q8 are both no
No references available
Adult;Pediatric
Supplemental
3.0
7/18/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
 
255
Free-Form Entry
     
2008448
 
C00730
Alcohol use frequency
AlcUseFreq
The frequency of consumption of alcohol by the participant.
How often do you have a drink containing alcohol?
Never;Monthly or less;2 to 4 times a month;2 to 3 times a week;4 or more times a week;
Never;Monthly or less;2 to 4 times a month;2 to 3 times a week;4 or more times a week;
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type
Question is from the Alcohol Use Disorders Identification Test (AUDIT) - http://www.who.int/substance_abuse/activities/sbi/en/
Adult;Pediatric
Supplemental
3.0
7/18/2013
ALCHL_USE_FRQ
Behavioral History
General Health History
Participant History and Family History
Alcohol use frequency
 
Single Pre-Defined Value Selected
     
3171627
 
C00704
Alcohol drinking day average drinks consumed range
AlcDrinkingDayAvgDrinks
The counted number of drinks containing alcohol consumed by the participant/subject on a typical day when he/she is drinking. It is noted that the meaning of "drinks consumed" differs from one nation and culture to another, so the most common alcoholic beverages likely to be consumed will be defined as well as quantity of each that constitutes a drink (approximately 10 grams of pure ethanol). For example, one bottle of beer (330 ml at 5% ethanol), a glass of wine (140 ml at 12% ethanol), and a shot of spirits (40 ml at 40% ethanol) represent a standard drink of about 13 g of ethanol.
How many alcoholic drinks do you have on a typical day when you are drinking?
1 or 2;3 or 4;5 or 6;7, 8, or 9;10 or more;Unknown;
1 or 2;3 or 4;5 or 6;7, 8, or 9;10 or more;Unknown;
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.
Question is from the Alcohol Use Disorders Identification Test (AUDIT) - http://www.who.int/substance_abuse/activities/sbi/en/
Adult;Pediatric
Supplemental
3.0
7/18/2013
ALCHL_USE_COUNT_DY
Behavioral History
General Health History
Participant History and Family History
Alcohol drinking day average drinks consumed range
 
Single Pre-Defined Value Selected
     
3171647
 
C00707
Alcohol consume six or more drinks frequency
AlcConsume6MoreDrinkFreq
The rate of occurrence for when the participant/subject consumes six or more drinks containing alcohol on one occasion. It is noted that the meaning of "drinks consumed" differs from one nation and culture to another, so the most common alcoholic beverages likely to be consumed will be defined as well as quantity of each that constitutes a drink (approximately 10 grams of pure ethanol). For example, one bottle of beer (330 ml at 5% ethanol), a glass of wine (140 ml at 12% ethanol), and a shot of spirits (40 ml at 40% ethanol) represent a standard drink of about 13 g of ethanol.
How often do you have six or more drinks on one occasion?
Never;Less than monthly;Monthly;Weekly;Daily or almost daily;
Never;Less than monthly;Monthly;Weekly;Daily or almost daily;
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.
Question is from the Alcohol Use Disorders Identification Test (AUDIT) - http://www.who.int/substance_abuse/activities/sbi/en/
Adult;Pediatric
Supplemental
3.0
7/18/2013
ALCHL_FIVE_MOR_FRQ
Behavioral History
General Health History
Participant History and Family History
Alcohol consume six or more drinks frequency
 
Single Pre-Defined Value Selected
     
3171659
 
C00708
Alcohol use related to hospitalization indicator
AlcUseRelatedHospInd
Indicator of whether the participant/subject has been hospitalized for an alcohol-related problem (i.e., esophageal varices, delirium tremens (DTs), cirrhosis and others)
Have you ever been hospitalized for an alcohol-related problem? (e.g., esophageal varices, delirium tremens (DTs), cirrhosis, etc.)
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.
No references available
Adult;Pediatric
Supplemental
3.0
7/18/2013
ALCHL_HIST_HOSP_YNU
Behavioral History
General Health History
Participant History and Family History
Alcohol use related to hospitalization indicator
 
Single Pre-Defined Value Selected
     
3171677
 
C00713
Drug or substance current illicit use indicator
DrgSubstCurrntIllicitUseInd
Indicator of participant's/subject's use of illegal drugs, prescription or over-the-counter drugs in the past year for purposes other than those for which they are meant to be used, or in large amounts
Current drug user?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type
No references available
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
Drug or substance current illicit use indicator
 
Single Pre-Defined Value Selected
     
3171724
 
C55907
Nonsubscribed drug or substance illicitly used category
NonsbscrbdDrgSubIllctUseCat
Category of illegal drugs, prescription, or over-the-counter drugs unsubscribed by the participant/subject, and used for purposes other than those for which they are meant to be used, or in large amounts
If YES, specify type(s) used (select all that apply):
Sedatives (e.g., sleeping pills, barbiturates, Seconal, Quaaludes, or Chloral Hydrate);Tranquilizers or anti-anxiety drugs (e.g., Valium, Librium, muscle relaxants, or Zanax);Painkillers (e.g., Codeine, Darvon, Percodan, Dilaudid, or Demerol);Stimulants (e.g., Preludin, Benzedrine, Methadrine, uppers, or speed);Marijuana, hash, THC, or grass;Cocaine or crack;Hallucinogens (e.g., Ecstasy, LSD, mescaline, psilocybin, PCP, angel dust, or peyote);Inhalants or Solvents (e.g., amyl nitrate, nitrous oxide, glue, toluene, or gasoline;Heroin;Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol);
Sedatives (e.g., sleeping pills, barbiturates, Seconal, Quaaludes, or Chloral Hydrate);Tranquilizers or anti-anxiety drugs (e.g., Valium, Librium, muscle relaxants, or Zanax);Painkillers (e.g., Codeine, Darvon, Percodan, Dilaudid, or Demerol);Stimulants (e.g., Preludin, Benzedrine, Methadrine, uppers, or speed);Marijuana, hash, THC, or grass;Cocaine or crack;Hallucinogens (e.g., Ecstasy, LSD, mescaline, psilocybin, PCP, angel dust, or peyote);Inhalants or Solvents (e.g., amyl nitrate, nitrous oxide, glue, toluene, or gasoline;Heroin;Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol);
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.
PhenX Toolkit - Substances - Lifetime Use Protocol #031100: https://www.phenxtoolkit.org/index.php
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
  
Multiple Pre-Defined Values Selected
     
3171797
 
C55977
Overall diet health scale
OverallDietHealthScl
A general scale of how healthy the participant/subject's diet is
In general, how healthy is your overall diet?
  
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type
No references available
Adult;Pediatric
Supplemental
1.0
6/5/2017
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C55989
Regular aerobic exercise indicator
RegularAerobicExerciseInd
Indicator related to whether or not the participant/subject participates in regular aerobic exercise
Regular aerobic exercise
  
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type
No references available
Adult;Pediatric
Supplemental
1.0
6/5/2017
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
  
Free-Form Entry
       
C55993
Regular aerobic exercise days week number
RglrArbcExrcsDysWkNum
Number of days per typical week that the participant/subject engages in aerobic exercises
If yes, during a typical week how many days do you get regular aerobic exercise
  
Alphanumeric
History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type
No references available
Adult;Pediatric
Supplemental
1.0
6/5/2017
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C56008
Perceived Stress Scale (PSS) - Unable control important thing life scale
PSSUnablCntrlImprtntThngLfScl
Scale of how often in the last month that the participant/subject has felt that he or she was unable to control the important things in his/her life
In the last month, how often have you felt that you were unable to control the important things in your life?
  
Alphanumeric
The four questions listed were taken from the PSS-4 item questionnaire. The questions in this scale ask about the participant's feelings and thoughts during the last month.
No references available
Adult;Pediatric
Supplemental
1.0
6/5/2017
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C56009
Perceived Stress Scale (PSS) - Confident handle personal problem scale
PSSCnfdntHndlPrsnlPrblmScl
Scale of how often in the last month that the participant/subject has felt confident in his or her ability to handle his or her personal problems
In the last month, how often have you felt confident about your ability to handle your personal problems?
  
Alphanumeric
The four questions listed were taken from the PSS-4 item questionnaire. The questions in this scale ask about the participant's feelings and thoughts during the last month.
No references available
Adult;Pediatric
Supplemental
1.0
6/5/2017
Aliases for variable name not defined
Behavioral History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
06-16-2019
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