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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: Unruptured Cerebral Aneurysms and Subarachnoid Hemorrhage
Sub-Domain: General Health History
CRF: Medical History
Item count: 54 (54 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
C00314
Medical history taken date and time
MedclHistTakenDateTime
Date (and time, if applicable and known) the participant/subject's medical history was taken
Date medical 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.).
No references available
Adult;Pediatric
Core
3.0
7/25/2013
PT_REL_MED_HIST_DT
Medical History
General Health History
Participant History and Family History
Medical history taken date and time
 
Free-Form Entry
     
2179659
 
C00315
Medical history global assessment indicator
MedclHistGlobalAssmtInd
Indicator of whether the participant/subject has a history of any medical problems/conditions
Does the participant/subject have a history of any medical problems/conditions in the following body systems
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one. If this question is answered NO then the rest of the form is blank. If the question is answered YES then the medical history for at least one body system should be recorded.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
MED_HIST_YN
Medical History
General Health History
Participant History and Family History
Medical history global assessment indicator
 
Single Pre-Defined Value Selected
     
3145578
 
C18666
Body system other text
BodySysOTH
The free-text field related to 'Body system category' specifying other text. Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured
Other, specify
  
Alphanumeric
Record the appropriate body system for each line of medical history.
Review of Symptoms from Centers for Medicare and Medicaid Services https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/eval_mgmt_serv_guide-ICN006764.pdf
Adult;Pediatric
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
 
4000
Free-Form Entry
     
2002895
 
C00312
Body system category
BodySysCat
Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured interview and physical examination of all the body systems.
Body System
Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify:;
Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify:;
Alphanumeric
Record the appropriate body system for each line of medical history.
Review of Symptoms from Centers for Medicare and Medicaid Services https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/eval_mgmt_serv_guide-ICN006764.pdf
Adult;Pediatric
Core
3.0
7/25/2013
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
Body system category
 
Single Pre-Defined Value Selected
     
2002895
 
C00321
Medical history for body system indicator
MedclHistBodySysInd
Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body system.
Does the participant/subject have a history of any medical problems/conditions in the following body systems?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one for each body system.
No references available
Adult;Pediatric
Exploratory
3.0
7/22/2013
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
Medical history for body system indicator
 
Single Pre-Defined Value Selected
       
C00322
Medical history condition text
MedclHistCondTxt
Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history
Medical history condition
  
Alphanumeric
Record one Medical History term per line. Make sure to record if the following events are in the medical history which are Core items: Any stroke; Ischemic stroke; Hemorrhagic stroke; Hemorrhagic stroke type; 4) Transient ischemic attack (TIA); Carotid stenosis; Epilepsy/ Seizure disorder; Central nervous system infection; Dementia; Head trauma; Head trauma type; Atrial fibrillation (AF)/ flutter; Rheumatic heart disease
SNOMED CT Codes (http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html)
Adult;Pediatric
Core
3.0
7/25/2013
Refer to SCI CDE Annotated Form
Medical History
General Health History
Participant History and Family History
Medical history condition text
4000
Free-Form Entry
     
2003874
 
C00313
Medical history condition SNOMED CT code
MedclHistCondSNOMEDCTCode
Systematized Nomenclature Of Medicine Clinical Terms (SNOMED CT) code for medical condition/disease reported by the participant/subject
Medical History Term
  
Alphanumeric
Code each of the medical history conditions using SNOMED CT
SNOMED CT Codes (http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html)
Adult;Pediatric
Core
3.0
7/25/2013
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
Medical history condition SNOMED CT code
255
Free-Form Entry
       
C00317
Medical history condition start date and time
MedclHistCondStrtDateTime
Date (and time, if applicable and known) for the start of an event in the participant's/subject's medical history
Start Date
  
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.).
No references available
Adult;Pediatric
Exploratory
3.0
7/25/2013
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
Medical history condition start date and time
 
Free-Form Entry
     
2543596
 
C00316
Medical history condition end date and time
MedclHistCondEndDateTime
Date (and time, if applicable and known) for the end of an event in the participant's/subject's medical history
End Date
  
Date or Date & Time
Record the date (and time) the medical condition/disease stopped. For surgeries, start and stop dates will most likely be the same date.
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.).
No references available
Adult;Pediatric
Exploratory
3.0
7/25/2013
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
Medical history condition end date and time
 
Free-Form Entry
     
3145557
 
C00319
Medical history condition ongoing indicator
MedclHistCondOngoingInd
Indicator of whether a medical condition/disease experienced by the participant/subject is ongoing
Ongoing?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose Yes or No to indicate if the medical condition/disease is still present.
No references available
Adult;Pediatric
Exploratory
3.0
7/24/2013
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
Medical history condition ongoing indicator
 
Single Pre-Defined Value Selected
     
2736881
 
C06246
Medical history condition type
MedHistCondTyp
Pre-specified medical condition/disease asked about when collecting the medical history from the participant/subject or found documented in the medical record.
Has a doctor or other medical professional ever told you that you have or have had the following?
None;Unknown (any cardiovascular disorder);Cardiac pacemaker;Other cardiac disorders, specify;Hypertension;Hypotension;Orthostatic hypotension;Deep vein thrombosis;Neuropathy (alcoholic, diabetic, and others);Myocardial infarction;Stroke;Family history of cardiovascular disease;Other, specify:;Cardiac surgery, specify;Hemorrhagic stroke;Unruptured aneurysm;Dural sinus thrombosis/cerebral venous thrombosis;Ischemic Stroke;Transient Ischemic Attack (TIA);Arteriovenous malformation;Cavernous malformation;Transient monocular blindness;Migraines;Carotid stenosis;Carotid endarterectomy;Carotid artery stenting;Seizure episode;Epilepsy/Seizures;Meningitis;Dementia;Depression;Depressive disorder diagnosis;Current clinical anxiety;Anxiety Disorder;Psychotic Disorder/Schizophrenia;Atrial fibrillation/flutter;Coronary artery disease;Diabetes mellitus;Hypercholesterolemia;Cancer;Bleeding disorder;Sleep apnea;Hemorrhoids;Moyamoya Syndrome;Neurofibromatosis type 1 (NF1);Inborn errors of metabolism;Mitochondrial disease;Hereditary hemorrhagic telangiectasia (HHT);Ehlers-Danlos Syndrome Type IV;Marfan Syndrome;Fibromuscular dysplasia;Central nervous system infection;Head trauma;Neck trauma;Rheumatic heart disease;Angina;Valvular heart disease;Coronary stent or PTCA;Congestive heart failure;Congenital heart disease;Cardiac catheterization;Peripheral arterial disease;Aortic or thoracic aneurysm;Hypertriglyceridemia;Infection within two weeks;Dental disease;Sickle cell anemia;Hypercoagulable disorder;Lupus;Other connective tissue disease;Renal (kidney) failure;Nephrotic syndrome;Chronic liver failure;Iron deficiency/anemia;Inflammatory bowel disease;Down Syndrome;Sturge-Weber Syndrome;Coarctation of the aorta;Alpha 1-antitrypsin deficiency;Pheochromocytoma;
None;Unknown (any cardiovascular disorder);Cardiac pacemaker;Other cardiac disorders, specify;Hypertension;Hypotension;Orthostatic hypotension;Deep vein thrombosis;Neuropathy (alcoholic, diabetic, and others);Myocardial infarction;Stroke;Family history of cardiovascular disease;Other, specify:;Cardiac surgery, specify;Hemorrhagic stroke;Unruptured aneurysm;Dural sinus thrombosis/cerebral venous thrombosis;Ischemic Stroke;Transient Ischemic Attack (TIA);Arteriovenous malformation (AVM);Cavernous malformation;Transient monocular blindness;Migraines;Carotid stenosis;Carotid endarterectomy;Carotid artery stenting;Seizure episode;Epilepsy/Seizures;Meningitis;Dementia;Depression;Depressive disorder diagnosis;Current clinical anxiety;Anxiety Disorder;Psychotic Disorder/Schizophrenia;Atrial fibrillation/flutter;Coronary artery disease;Diabetes mellitus;Hypercholesterolemia;Cancer;Bleeding disorder;Sleep apnea;Hemorrhoids;Moyamoya Syndrome;Neurofibromatosis type 1 (NF1);Inborn errors of metabolism;Mitochondrial disease;Hereditary hemorrhagic telangiectasia (HHT);Ehlers-Danlos Syndrome Type IV;Marfan Syndrome;Fibromuscular dysplasia;Central nervous system infection;Head trauma;Neck trauma;Rheumatic heart disease;Angina;Valvular heart disease;Coronary stent or PTCA;Congestive heart failure;Congenital heart disease;Cardiac catheterization;Peripheral arterial disease;Aortic or thoracic aneurysm;Hypertriglyceridemia;Infection within two weeks;Dental disease;Sickle cell anemia;Hypercoagulable disorder;Lupus;Other connective tissue disease;Renal (kidney) failure;Nephrotic syndrome;Chronic liver failure;Iron deficiency/anemia;Inflammatory bowel disease;Down Syndrome;Sturge-Weber Syndrome;Coarctation of the aorta;Alpha 1-antitrypsin deficiency;Pheochromocytoma;
Alphanumeric
Core elements for SAH studies: Stroke, Unruptued aneurysm, Hypertension; Supplementa; - Highly Recommended elements: Transient ischemic attack, Arteriovenous malformation; Exploratory elements: Dural sinys thrombosis/cerebral venous thrombosis, carotid stenosis, carotid endarterectomy, carotid artery stenting, seizure episode, epilepsy/seizure disprder, central nervous system infection, meningitis, dementia, current clinical depression, depressive disorder diagnosis, current clinical anxiety, anxiety disorder diagnosis, psychotic disorder, head trauma, neck trauma, atrial fibrillation/flutter, rheumatic heart disease, coronary artery disease, myocardial infarction, angina, valvular heart disease, cardiac surgery, coronary stent or PTCA, Congestive heart failure, Congential heart disease, Cardiac catheterization, peripheral arterial disease, hypertriglyceridemia, cancer, sickle cell anemia, hypercoagulable disorder, lupus, other connective disease, sleep apnea, nephrotic syndrome, chronic liver failure, iron deficiency/anemia, inflammatory bowel disease, hemorrhoids, Moyamoya disease, Down Syndrome, Neurofibromatosis type I, Sturge-Weber Syndrome, inborn errors of metabolism, mitochondrial disease, hereditary hemorrhagic telangiectasia, fibromuscular dysplasia, coarctation or the aorta, Alphai-antitrypsin deficiency, pheochromocytoma, menarche, menopause
No references available
Adult;Pediatric
Supplemental
3.0
7/17/2013
Refer to SCI CDE Annotated Form
Medical History
General Health History
Participant History and Family History
Medical history condition type
 
Multiple Pre-Defined Values Selected
       
C52597
Medical history ischemic stroke count
MedHistIschemicStrokeCt
The element related to the number of ischemic strokes the participant/subject has had
Number of ischemic strokes
None;1;= 2;Unknown;
None;1;= 2;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
1/26/2017
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C52598
Medical history ischemic stroke recency rate
MedHistIschemicStrokeRecenRt
The element related to the recency of ischemic strokes the participant/subject has had
Recency of ischemic strokes
< 3 mos ago;= 3 mos ago;Unknown;
< 3 mos ago;= 3 mos ago;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
1/26/2017
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C52599
Medical history hemorrhagic stroke type
MedHistHemorrStrokeTyp
The element related to the type of hemorrhagic stroke the participant/subject has had
If YES, indicate type(s)
Intracerebral hemorrhage (ICH);Subarachnoid hemorrhage (SAH);Hemorrhage unspecified;Unknown;
Intracerebral hemorrhage (ICH);Subarachnoid hemorrhage (SAH);Hemorrhage unspecified;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
1/26/2017
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Multiple Pre-Defined Values Selected
       
C52600
Medical history transient ischemic attack count
MedHistTIACt
The element related to the number of transient ischemic attacks (TIAs) the participant/subject has had
Number of TIAs
None;1;2-10;> 10;Unknown;
None;1;2-10;> 10;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
1/26/2017
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C52601
Medical history transient ischemic attack recency rate
MedHistTIARecenRt
The element related to the recency of transient ischemic attacks (TIAs) the participant/subject has had
Recency of TIA
< 24 hours ago;24h - 7d ago;7d - 3 mos ago;> 3 mos ago;
< 24 hours ago;24h - 7d ago;7d - 3 mos ago;> 3 mos ago;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
1/26/2017
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C52602
Medical history migraine aura indicator
MedHistMigrAuraInd
The indicator related to the participant/subject having migraine(s) with aura
If YES, migraine(s) with aura
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
1/26/2017
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C52603
Medical history migraine active last year indicator
MedHistMigrActivLstYrInd
The indicator related to the participant/subject having had an active migraine within the last year
Active migraine within last year?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
1/26/2017
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C52604
Medical history carotid endartectomy anatomic site
MedHistCarotEndarcAnatSite
The element related to the location of a carotid endarctectomy the participant/subject has had
If YES, indicate location
Left side;Right side;Both;Unknown;
Left side;Right side;Both;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
1/26/2017
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C52605
Medical history carotid artery stenting anatomic site
MedHistCarotArtStentAnatSite
The element related to the location of carotid artery stenting the participant/subject has had
If YES, indicate location
Left side;Right side;Both;Unknown;
Left side;Right side;Both;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
1/26/2017
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C22679
Medical history first depressive episode diagnosis age value
MedHistFrstDepEpDiagAgeVal
Value of a participant's/subject's age when first depressive episode was diagnosed
If YES, age experienced first depressive episode/diagnosed with depression
  
Numeric Values
years
No references available
Adult;Pediatric
Supplemental
1.0
7/27/2016
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Free-Form Entry
  
year
    
C17488
Psychiatric history psychotic diagnosis type
PsychHistPsychoticDiagnosTyp
Type of psychotic disorder the participant/subject has been diagnosed with, if any
If YES, indicate type(s)
Schizophrenia;Bipolar disorder;Depression with psychotic features;Dementia with psychotic ideation;Other, specify;
Schizophrenia;Bipolar disorder;Depression with psychotic features;Dementia with psychotic ideation;Other, specify;
Alphanumeric
Choose all that apply
No references available
Adult;Pediatric
Supplemental
3.0
7/15/2013
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Multiple Pre-Defined Values Selected
       
C19058
Psychiatric history psychotic diagnosis other text
PsychHistPsychoticDiagnosOTH
The free-text field related to 'Psychiatric history psychotic diagnosis type' specifying other text. Type of psychotic disorder the participant/subject has been diagnosed with, if any
Other, specify:
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/15/2013
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C52617
Head trauma result type
HdTrmResTyp
The element related to the result of head trauma
If YES, indicate if head trauma resulted in any of the following
Loss of consciousness > 30 minutes;Post traumatic amnesia > 24 hours;Abnormal brain imaging findings;None of the above;
Loss of consciousness > 30 minutes;Post traumatic amnesia > 24 hours;Abnormal brain imaging findings;None of the above;
Alphanumeric
Choose all that apply
No references available
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Multiple Pre-Defined Values Selected
       
C52618
Medical history neck trauma recency rate
MedHistNeckTraumaRecenRt
The element related to the recency of neck trauma
If YES, indicate recency:
< 8 days before current stroke/TIA;8 days - 4 weeks ago;> 4 weeks ago;Unknown;
< 8 days before current stroke/TIA;8 days - 4 weeks ago;> 4 weeks ago;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
1/26/2017
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C52619
Medical history atrial fibrillation other cause indicator
MedHistAtrlFibOthCauseInd
The indicator related to other cause of atrial fibrillation
Other cause of AF
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
AF: atrial fibrillation
No references available
Adult;Pediatric
Exploratory
1.0
1/27/2017
Aliases for variable name not defined
Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
07-21-2019
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