CDE Detailed Report

Disease: Stroke
Subdomain Name: General Health History
CRF: Medical History

Displaying 51 - 70 of 70
CDE ID CDE Name Variable Name Definition Short Description Question Text Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C17480 Diabetes mellitus complications type EndocrineHistDiabMellCompliTyp Type(s) of complications related to diabetes mellitus the participant/subject has experienced or is experiencing Type(s) of complications related to diabetes mellitus the participant/subject has experienced or is experiencing Complications of diabetes Nephropathy;Neuropathy;Retinopathy;Other, specify;None Nephropathy;Neuropathy;Retinopathy;Other, specify;None Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Medical History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C52702 Connective tissue disease other type text ConnTissDisTypTxt The free-text field related to other type of connective tissue disease The free-text field related to other type of connective tissue disease If YES, specify type Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2016-10-19 12:03:19.0 Medical History General Health History Participant History and Family History 255

Free-Form Entry

C52600 Medical history transient ischemic attack range MedHistTIARng The element related to the number of transient ischemic attacks (TIAs) the participant/subject has had The element related to the number of transient ischemic attacks (TIAs) the participant/subject has had Number of TIAs 1;2-10;> 10;Unknown 1;2-10;> 10;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2017-01-26 14:29:36.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58932 Menopause treatment type other text MenopauseTreatmtOTH The free-text field related to 'Menopause treatment type', specifying other text The free-text field related to 'Menopause treatment type', specifying other tex Other, specify Alphanumeric

No instructions available

No references available Adult Exploratory 1.00 2020-07-14 15:29:14.0 Medical History General Health History Participant History and Family History 4000

Free-Form Entry

C10539 Diabetes first diagnosis age value DiabetFrstDiagnosisAgeVal Value representing the age, in years, at which the participant was first diagnosed with diabetes mellitus Value representing the age, in years, at which the participant was first diagnosed with diabetes mellitus Age diabetes first diagnosed Numeric Values

years

No references available Adult;Pediatric Supplemental 3.10 2024-02-29 15:41:16.0 Medical History General Health History Participant History and Family History

Free-Form Entry

year
C52622 Medical history cardiac catheterization recency rate MedHistCardCathRecenRt The element related to the recency of cardiac catheterization the participant/subject has had The element related to the recency of cardiac catheterization the participant/subject has had If YES, indicate recency <= 2 weeks;> 2 weeks ago;Unknown;30 days or more <= 2 weeks;> 2 weeks ago;Unknown;30 days or more Alphanumeric

No instructions available

No references available Adult;Pediatric Exploratory 1.00 2017-01-26 13:49:14.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C17488 Psychiatric history psychotic diagnosis type PsychHistPsychoticDiagnosTyp Type of psychotic disorder the participant/subject has been diagnosed with, if any 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;Psychotic disorder, not otherwise specified;Unknown Schizophrenia;Bipolar disorder;Depression with psychotic features;Dementia with psychotic ideation;Other, specify;Psychotic disorder, not otherwise specified;Unknown Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Medical History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C52703 Sleep apnea type text SleepApneaTypTxt The free-text field related to the type of sleep apnea The free-text field related to the type of sleep apnea If YES, specify type Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Medical History General Health History Participant History and Family History 255

Free-Form Entry

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 The element related to the recency of transient ischemic attacks (TIAs) the participant/subject has had Most recent TIA < 24 hours ago;24h - 7d ago;7d - 3 mos ago;> 3 mos ago;Unknown < 24 hours ago;24h - 7d ago;7d - 3 mos ago;> 3 mos ago;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2017-01-26 14:29:36.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58933 Acquired heart disease indicator AcquiredHeartDiseaseInd The indicator related to whether the participant/subject has acquired heart disease The indicator related to whether the participant/subject has acquired heart disease Acquired heart disease No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Pediatric Supplemental 1.00 2020-07-14 15:32:05.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00314 Medical history taken date and time MedclHistTakenDateTime Date (and time, if applicable and known) the participant's medical history was taken Date (and time, if applicable and known) the participant '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 Supplemental 3.20 2024-02-29 15:42:39.0 Medical History General Health History Participant History and Family History

Free-Form Entry

2179659
C00315 Medical history global assessment indicator MedclHistGlobalAssmtInd Indicator of whether the participant has a history of any medical problems/conditions Indicator of whether the participant 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-Highly Recommended 3.10 2024-02-29 15:42:39.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3145578
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 medical history Date (and time, if applicable and known) for the end of an event in the participant'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 Supplemental 3.10 2024-02-29 15:42:44.0 Medical History General Health History Participant History and Family History

Free-Form Entry

3145557
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 medical history Date (and time, if applicable and known) for the start of an event in the participant'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 Supplemental 3.10 2024-02-29 15:42:43.0 Medical History General Health History Participant History and Family History

Free-Form Entry

2543596
C00319 Medical history condition ongoing indicator MedclHistCondOngoingInd Indicator of whether a medical condition/disease experienced by the participant is ongoing Indicator of whether a medical condition/disease experienced by the participant 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 Supplemental 4.00 2024-02-29 15:42:44.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

2736881
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 Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body syste 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 Supplemental 3.00 2013-07-22 16:57:17.79 Medical History General Health History Participant History and Family History

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 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.

SNOMED CT Codes (http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html) Adult;Pediatric Core 3.00 2013-07-25 08:54:08.2 Medical History General Health History Participant History and Family History 4000

Free-Form Entry

2003874
C18666 Body system category other text BodySysCatOTH 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 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 1.10 2023-11-07 08:40:35.0 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 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 system 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 Supplemental 3.00 2013-07-25 08:54:08.2 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

2002895
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 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 3.00 2013-07-25 08:54:08.2 Medical History General Health History Participant History and Family History 255

Free-Form Entry

CSV