CDE Detailed Report
Disease: system
Subdomain Name: General Health History
CRF: files
Displaying 51 - 70 of 70
Subdomain Name: General Health History
CRF: files
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C15624 | Pregnancy indicator | PregInd | Indicates if the participant/subject is currently pregnant | Indicates if the participant/subject is currently pregnant | Is the participant/subject pregnant? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
No instructions available |
Kamel H, Navi BB, Sriram N, Hovsepian DA, Devereux RB, Elkind MSV. Risk of a thrombotic event after the 6-week postpartum period. New Engl J Med. 2014;370(14):1307-1315. | Adult;Pediatric | Supplemental-Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C52693 | High cholesterol treatment type | HighCholesTreatTyp | Type of treatment for high blood cholesterol | Type of treatment for high blood cholesterol | If YES, indicate treatment(s) | Diet;None;Statins;Other medicines;Unknown | Diet;None;Statins;Other medicines;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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| 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 | 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 | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
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| C58354 | Other cancer type text | OthrCancerTypTxt | Text of type of other cancer(s) that the subject/participant has ever been diagnosed with | Text of type of other cancer(s) that the subject/participant has ever been diagnosed wit | Other, specify | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Exploratory | 1.00 | 2018-02-08 10:03:58.0 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C52604 | Medical history carotid endarterectomy anatomic site | MedHistCarotEndarcAnatSite | The element related to the location of a carotid endarterectomy the participant/subject has had | The element related to the location of a carotid endarterectomy 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 | 1.00 | 2017-01-26 14:49:56.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C15629 | Postpartum indicator | PstpartmInd | Whether the participant/subject is currently in her postpartum phase, after pregnancy phase, of pregnancy | Whether the participant/subject is currently in her postpartum phase, after pregnancy phase, of pregnanc | Is the participant/subject post-partum? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Up to 12 weeks |
Kamel H, Navi BB, Sriram N, Hovsepian DA, Devereux RB, Elkind MSV. Risk of a thrombotic event after the 6-week postpartum period. New Engl J Med. 2014;370(14):1307-1315. | Adult;Pediatric | Supplemental-Highly Recommended | 3.00 | 2013-07-16 14:01:43.01 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C52695 | Cancer diagnosis type | CancerDiagTyp | The element related to the type of cancer diagnosis the participant/subject has or had | The element related to the type of cancer diagnosis the participant/subject has or had | Type(s) of cancer | Brain;Breast;Colorectal;Endometrial;Esophagus;Prostate;Renal;Skin;Other specify;Lung | Brain;Breast;Colorectal;Endometrial;Esophagus;Prostate;Renal;Skin;Other specify;Lung | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Exploratory | 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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| C19078 | Cardiovascular history cardiac surgery other text | CardioHistCardSurgOTH | The free-text field related to 'Cardiovascular history cardiac surgery type' specifying other text. Type of cardiac surgery or mechanical intervention the participant/subject underwent | The free-text field related to 'Cardiovascular history cardiac surgery type' specifying other text. Type of cardiac surgery or mechanical intervention the participant/subject underwent | Other, specify | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Exploratory | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
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| C58926 | Medical history hemorrhagic stroke range | MedHistHemStrokeRng | The element related to the number of hemorrhagic strokes the participant/subject has had | The element related to the number of hemorrhagic strokes the participant/subject has had | Number of hemorrhagic strokes | 1;>= 2;Unknown | 1;>= 2;Unknown | 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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| C52605 | Medical history carotid artery stenting anatomic site | MedHistCarotArtStentAnatSite | The element related to the location of carotid artery stenting the participant/subject has had | 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 | 1.00 | 2017-01-26 14:49:56.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| 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 |
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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 |
