CDE Detailed Report
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 |
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C52696 | Infection within two weeks type | InfectionWthnTwoWksTyp | The element related to the type of infection(s) within the last two weeks the participant/subject has had | The element related to the type of infection(s) within the last two weeks the participant/subject has had | If YES, indicate type(s) | Otitis media;Respiratory infection;Urinary tract infection;Cellulitis;Sepsis;Mastoiditis;Viral gastroenteritis;Fever lasting > 48 hours;Other infection, specify:;Influenza;Zoster/Shingles | Otitis media;Respiratory infection;Urinary tract infection (UTI);Cellulitis;Sepsis;Mastoiditis;Viral gastroenteritis;Fever lasting > 48 hours;Other infection, specify:;Influenza;Zoster/Shingles | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-17 09:26:36.973 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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C15630 | Postpartum day week value | PstpartmDayWkVal | Number of days/weeks the participant/subject has been postpartum | Number of days/weeks the participant/subject has been postpartum | Number of weeks since delivery | Numeric Values |
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 | 3.00 | 2013-07-16 14:01:43.01 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
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C58927 | Medical history hemorrhagic stroke recency rate | MedHistHemStrokeRecenRt | The element related to the recency of hemorrhagic strokes the participant/subject has had | The element related to the recency of hemorrhagic strokes the participant/subject has had | Most recent hemorrhagic stroke | < 3 mos ago;>= 3 mos ago;Unknown | < 3 mos ago;>= 3 mos ago;Unknown | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2020-07-14 15:13:17.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C19174 | Other cardiac disorder type | OthrCardiacDisorderTyp | Type of other cardiac disorder | Type of other cardiac disorder | Other cardiac disorders, specify | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2014-05-30 14:25:23.0 | Medical History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
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C52617 | Head trauma result type | HdTrmResTyp | The element related to the result of head trauma | 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;Unknown | Loss of consciousness > 30 minutes;Post traumatic amnesia > 24 hours;Abnormal brain imaging findings;None of the above;Unknown | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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C52697 | Infection within two weeks other text | InfectionWthnTwoWksOTH | The free-text field related to the type of infection(s) within the last two weeks the participant/subject has had | The free-text field related to the type of infection(s) within the last two weeks the participant/subject has had | Other infection, specify | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-17 09:26:36.973 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C16012 | Medical history condition diagnosis indicator | MedclHistCondDiagnsInd | Indicator of whether the participant has been diagnosed with the medical condition/disease | Indicator of whether the participant has been diagnosed with the medical condition/disease | Has a doctor or other medical professional ever told you that you have or have had the following? | Yes;No;Unknown | Yes;No;Unknown | 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 |
Single Pre-Defined Value Selected |
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C58928 | Medical history carotid endarterectomy recent date | MedHistCarotEndarcRecentDate | Date of most recent carotid endarterectomy performed on the participant/subject | Date of most recent carotid endarterectomy performed on the participant/subject | Date of most recent carotid endarterectomy (M M/D D/Y Y Y Y) | 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, year, month and day). |
No references available | Adult;Pediatric | Exploratory | 1.00 | 2020-07-14 15:16:51.0 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
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C22679 | Medical history first depressive episode diagnosis age value | MedHistFrstDepEpDiagAgeVal | Value of a participant's/subject's age when first depressive episode was diagnosed | 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 | Exploratory | 1.00 | 2016-07-27 11:43:54.0 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
C52618 | Medical history neck trauma recency rate | MedHistNeckTraumaRecenRt | The element related to the recency of neck trauma | 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 | 1.00 | 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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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 | |||||||||
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 |