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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: Stroke
Sub-Domain: General Health History
CRF: History Data Source and Reliability
Item count: 5 (5 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
C18667
Data source other text
DataSourcOTH
The free-text field related to 'Data source' specifying other text. Source of the data provided on the case report form
Other, specify
  
Alphanumeric
Choose all that apply.
No references available
Adult;Pediatric
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
History Data Source and Reliability
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C08147
Data source
DataSource
Source of the data provided on the case report form
From whom/ what were the medical history data obtained
Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Unknown;Spouse;Other, specify;
Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Unknown;Spouse;Other, specify;
Alphanumeric
Choose all that apply.
No references available
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
History Data Source and Reliability
General Health History
Participant History and Family History
Data source
 
Multiple Pre-Defined Values Selected
       
C11133
History data not obtained reason
HistDataNotObtRsn
Reason(s) the medical/family history data were not obtained from the participant/subject and instead were obtained from alternate source(s).
Indicate the reason(s) why
Dementia;Aphasia;Other cognitive impairment;Not fluent in examiner's language;Poor historian;Too young;Other, specify;
Dementia;Aphasia;Other cognitive impairment;Not fluent in examiner's language;Poor historian;Too young;Other, specify;
Alphanumeric
Choose all that apply. All the permissible values describe the participant/ subject.
No references available
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
History Data Source and Reliability
General Health History
Participant History and Family History
History data not obtained reason
 
Multiple Pre-Defined Values Selected
       
C18824
History data not obtained other text
HistDataNotObtOTH
The free-text field related to 'History data not obtained reason' specifying other text. Reason(s) the medical/family history data were not obtained from the participant/subject and instead were obtained from alternate source(s).
Other, specify
  
Alphanumeric
Choose all that apply. All the permissible values describe the participant/ subject.
No references available
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
History Data Source and Reliability
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C11134
History data reliability type
MedHistInfoReliablGrade
Overall assessment of the reliability of the medical/family history data obtained
Overall assessment of the reliability of the medical history data obtained
Definitely reliable;Probably reliable;Not reliable;
Definitely reliable;Probably reliable;Not reliable;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
History Data Source and Reliability
General Health History
Participant History and Family History
History data reliability type
 
Single Pre-Defined Value Selected
       
01-16-2019
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