of0
Export
 
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: History of Disease/Injury Event
CRF: Medical and Family History of Headache/Migraine
Item count: 13 (13 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
C16005
Headache migraine type
HeadachMigranTyp
Type of headache or migraine
Diagnosis
Migraine with aura;Migraine without aura;Chronic Migraine;Hemiplegic Migraine;Menstrual Headache;Tension Type Headache;Episodic Tension Type;Chronic Tension Type;Trigeminal Autonomic Cephalgias;Cluster Headache;Trigeminal Headache;Other TAC type, specify;Other primary type headache, specify;Other secondary type headache, specify;
Migraine with aura;Migraine without aura;Chronic Migraine;Hemiplegic Migraine;Menstrual Headache;Tension Type Headache;Episodic Tension Type;Chronic Tension Type;Trigeminal Autonomic Cephalgias (TACS);Cluster Headache;Trigeminal Headache;Other TAC (Trigeminal Autonomic Cephalgia) type, specify;Other primary type headache, specify;Other secondary type headache, specify;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
Headache or migraine type
 
Single Pre-Defined Value Selected
       
C19039
Headache migraine other text
HdchMigranOTH
The free-text field related to 'Headache migraine type' specifying other text. Type of headache or migraine
Other, specify
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
 
4000
Free-Form Entry
       
C16010
Headache migraine diagnosis indicator
HeadachMigranDiagnsInd
Indicator of whether the participant/subject has been diagnosed with the type of headache or migraine
Participant/subject diagnosed?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
If the participant/subject has a history of this condition, indicate yes.
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
Headache or migraine diagnosed indicator
 
Single Pre-Defined Value Selected
       
C56045
Headache migraine physician diagnosis medical documentation indicator
HdachMgrnPhyscnMdclDcmntatnInd
Indicator of whether the participant/subject has a physician diagnosis or medical documentation of headaches or migraines
Physician diagnosis or medical documentation supporting diagnosis?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C56046
Headache migraine participant affected condition indicator
HdachMgrnPrtcpntAffctdCndtnInd
Indicator of whether the participant/subject has been affected by their condition related to headaches or migraines
Participant affected by condition?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
  
Single Pre-Defined Value Selected
       
C00721
Family history medical condition indicator
FamHistMedclCondInd
Indicator of whether a family member or first and second degree blood relatives of the participant/subject has had a history of the particular medical condition or health related event
Relative affected (first and second-degree relatives ONLY)?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
Family history medical condition indicator
 
Single Pre-Defined Value Selected
     
3165788
 
C16019
Family history relative first-degree affect count
FamHistReltv1stDegAffctCt
The number of first-degree relatives affected with the medical condition.
Number of first degree relatives number affected
  
Numeric Values
If there is a history of this condition in the family, indicate the total number of relatives with a history of the condition, the number of relatives affected (patient reported diagnosis), and if the number of relatives that were diagnosed by a physician.
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
Family history first-degree relatives affected number
 
Free-Form Entry
       
C16006
Family history first-degree physician diagnosed count
FamHist1stDegPhyscnDiagnsCt
The number of first-degree relatives with the medical condition confirmed by a physician
Number of first degree relatives number with physician diagnosis
  
Numeric Values
If there is a history of this condition in the family, indicate the total number of relatives with a history of the condition, the number of relatives affected (patient reported diagnosis), and if the number of relatives that were diagnosed by a physician.
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
Family history first-degree relatives physician diagnosed number
 
Free-Form Entry
       
C16207
Family history medical condition first-degree relative type
FamHistMedclCondFrstDegReltTyp
Relationship of the first-degree family member or ancestor with the medical condition or health related event to the participant/subject
Relationship of relative(s) to participant/subject
1;2;3;4;5;6;7;8;9;10;
Biological Mother;Biological Father;Sibling Male;Sibling Female;Non-identical or dizygotic twin Male;Non-identical or dizygotic twin Female;Identical twin Male;Identical twin Female;Full biologic child Male;Full biologic child Female;
Numeric Values
Select the relationship from the options of the family members provided in the “Name of Family Member with Condition” code list. Record more than 1 family member, if applicable. Choose all that apply.
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
Family history medical condition first-degree relative type
 
Multiple Pre-Defined Values Selected
       
C16021
Family history second-degree relative affected count
FamHistScndDegReltvAffctCt
The number of second-degree relatives affected with the medical condition.
Number of second degree relatives number affected.
  
Numeric Values
If there is a history of this condition in the family, indicate the total number of relatives with a history of the condition, the number of relatives affected (patient reported diagnosis), and if the number of relatives that were diagnosed by a physician.
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
Family history second-degree relatives affected number
 
Free-Form Entry
       
C16025
Family history second-degree physician diagnosis count
FamHistScndDegPhyscnDiagnsCt
The number of second-degree relatives with the medical condition confirmed by a physician
Number of second degree relatives number with physician diagnosis.
  
Numeric Values
If there is a history of this condition in the family, indicate the total number of relatives with a history of the condition, the number of relatives affected (patient reported diagnosis), and if the number of relatives that were diagnosed by a physician.
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
Family history second-degree relatives physician diagnosed number
 
Free-Form Entry
       
C16208
Family history medical condition second-degree relative type
FamHistMedclCondScndDegReltTyp
Relationship of the second-degree family member or ancestor with the medical condition or health related event to the participant/subject
Relationship of relative(s) to participant/subject
11;12;13;14;15;16;17;18;19;20;21;22;23;24;
Half-Sibling Male;Half-Sibling Female;Maternal Grandmother;Maternal Grandfather;Paternal Grandmother;Paternal Grandfather;Maternal Aunt;Maternal Uncle;Paternal Aunt;Paternal Uncle;Grandchild Male;Grandchild Female;Nephew;Niece;
Numeric Values
Separate multiple codes with comma
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
Family history medical condition second-degree relative type
 
Multiple Pre-Defined Values Selected
       
C17992
Additional comment text
AddtnalCommntTxt
Text describing any additional information about the participant or the participant's family history
Additional Comments
  
Alphanumeric
Record any pertinent information regarding the participant/subject, and/or family in the comments filed.
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Medical and Family History of Headache/Migraine
History of Disease/Injury Event
Disease/Injury Related Events
 
255
Free-Form Entry
       
06-16-2019
Page 1 of 1