CDE Detailed Report
Disease: content
Subdomain Name: General Health History
CRF: welcome
Displaying 51 - 70 of 70
Subdomain Name: General Health History
CRF: welcome
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
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| 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 | |||||||||
| 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 |
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| 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 |
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| 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 |
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| 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 |
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| C52623 | Aortic thoracic aneurysm specify text | AorticThorAneurSpTxt | The free-text field related to the type of aortic or thoracic aneurysm | The free-text field related to the type of aortic or thoracic aneurysm | If YES, specify type | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 13:49:14.0 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C10541 | Diabetes treatment type | DiabetTreatTyp | Type of treatment the participant/subject is receiving or has received for diabetes mellitus | Type of treatment the participant/subject is receiving or has received for diabetes mellitus | Treatment for diabetes | Diet;Oral medication;Insulin;None;Unknown | Diet;Oral medication;Insulin;None;Unknown | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-11 15:03:49.2 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C18793 | Medical history condition other text | MedHistCondOTH | The free-text field related to 'Medical history condition type', specifying other text. Pre-specified medical condition/disease asked about when collecting the medical history from the participant or found documented in the medical record | The free-text field related to 'Medical history condition type', specifying other text. Pre-specified medical condition/disease asked about when collecting the medical history from the participant or found documented in the medical record | Other, specify | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:42:42.0 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C52706 | Mitochondrial encephalomyopathy lactic acidosis stroke like episodes indicator | MELASInd | The indicator related to whether the participant/subject has or had mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) | The indicator related to whether the participant/subject has or had mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) | If YES, do you have/have you had mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric |
Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes - MELAS |
No references available | Adult;Pediatric | Exploratory | 3.00 | 2013-07-24 11:38:01.2 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| 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 |
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| 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 |
