CDE Detailed Report

Disease: Mitochondrial Disease
Sub-Domain: Physical Examinations
CRF: Mitochondrial and Gastrointestinal Diseases Assessment

Displaying 1 - 50 of 218
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (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 / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C20142 Mitochondrial disease swallow problem frequency MitDisSwallowProblmFreq The frequency with which the participant/subject has problems swallowing The frequency with which the participant/subject has problems swallowing How often does oral regurgitation occur? About once a year;At least once a week, but not daily;Daily;I don't know;Less than once a month, more than once a year;One to 4 times per month;Only once;Other About once a year;At least once a week, but not daily;Daily;I don't know;Less than once a month, more than once a year;One to 4 times per month;Only once;Other Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20078 Mitochondrial disease prior vomit episode trigger text MitDisPriorVomitEpisTrigTxt The free text field to specify the participant's/subject's past vomiting episode triggers The free text field to specify the participant's/subject's past vomiting episode triggers In the past, what had triggered vomiting episodes? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20174 Mitochondrial disease prior abdominal pain detail text MitDisPriAbdomnlPainDetlTxt The free text field to specify additonal details about participant's/subject's past abdominal pain The free text field to specify additonal details about participant's/subject's past abdominal pain Provide additional details if desired about what made you think they had abdominal pain. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20110 Mitochondrial disease current oral regurgitation onset age category MitDisCurrOralRegurgOnstAgeCat The category of participant/subject's age at onset of current oral regurgitation episodes The category of participant/subject's age at onset of current oral regurgitation episodes For the current oral regurgitation episodes, what was your/their age when the problems began? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20046 Mitochondrial disease special diet affect symptom text MitDisSpeclDietAffctSymptmTxt The free text field to specify whether specialized diet affected participant/subject symptoms The free text field to specify whether specialized diet affected participant/subject symptoms Has your/their symptoms changed since the diet started? Alphanumeric

(Specify)

Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20215 Mitochondrial disease current medication type MitDisCurrMedsType Select other medicines that participant/subject are currently taking Select other medicines that participant/subject are currently taking What other medicines are you/your child taking now? Other;Antibiotics;Levbid/Levsin/Bentyl;Pancreatic enzyme supplements (Creon);Gabapentin (Neurontin);Oxycarbazine (Trileptal);Topamax (Topiramate);Phenytoin (Dilantin);Pregabalin (Lyrica);Lamotrigine (Lamictal);Levetircetam (Keppra);Tiagabine (Gabatril);Felbatol (Felbamate);Ethosuximide (Zarontin);Carbamazepine (Tegretol, Carbatrol);Folinic acid;Alpha lipoic acid;Vitamin C;Vitamin E;B vitamins (other);L-Carnitine;L-Arginine;L-Creatine;Riboflavin (vitamin B2);CoQ10 (Ubiquinol, Ubiquinone);Linaclotide (Linzess);Tegaserod (Zelnorm, Zelmac);Reglan (metaclopramide);Domperidone (Motilium);Cisapride (Propulsid);Erythromycin;SSRI: Citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertaline (Zoloft);Tricyclic antidepressant: Amitriptyline, desipramine, imipramine, nortiptyline;Ondansetron (Zofran);Carafate;H-2 receptor antagonist: Pepcid (famotidine), Zantac (ranitidine), Tagemet (cimetidine);Proton pump inhibitor: Prilosec (omeprazole), Nexium, Prevacid (lansoprazole), Protonix (pantoprazole), or Aciphex (rabeprazole) Other;Antibiotics;Levbid/Levsin/Bentyl;Pancreatic enzyme supplements (Creon);Gabapentin (Neurontin);Oxycarbazine (Trileptal);Topamax (Topiramate);Phenytoin (Dilantin);Pregabalin (Lyrica);Lamotrigine (Lamictal);Levetircetam (Keppra);Tiagabine (Gabatril);Felbatol (Felbamate);Ethosuximide (Zarontin);Carbamazepine (Tegretol, Carbatrol);Folinic acid;Alpha lipoic acid;Vitamin C;Vitamin E;B vitamins (other);L-Carnitine;L-Arginine;L-Creatine;Riboflavin (vitamin B2);CoQ10 (Ubiquinol, Ubiquinone);Linaclotide (Linzess);Tegaserod (Zelnorm, Zelmac);Reglan (metaclopramide);Domperidone (Motilium);Cisapride (Propulsid);Erythromycin;SSRI: Citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertaline (Zoloft);Tricyclic antidepressant: Amitriptyline, desipramine, imipramine, nortiptyline;Ondansetron (Zofran);Carafate;H-2 receptor antagonist: Pepcid (famotidine), Zantac (ranitidine), Tagemet (cimetidine);Proton pump inhibitor: Prilosec (omeprazole), Nexium, Prevacid (lansoprazole), Protonix (pantoprazole), or Aciphex (rabeprazole) Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20057 Mitochondrial disease vomit episode trigger indicator MitDisVomitEpisTrigInd Indicator of whether there are particular triggers that induce vomiting episodes in participant/subject Indicator of whether there are particular triggers that induce vomiting episodes in participant/subject Are there particular triggers for vomiting episodes? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20226 Mitochondrial disease surgery type detail text MitDisSurgTypeDetailTxt The free text field to provide additional details about the type of surgery participant/subject had The free text field to provide additional details about the type of surgery participant/subject had Provide additional details about the type of surgery Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20153 Mitochondrial disease feed difficult text MitDisFeedDifficulttxt The free text field to give detailed comments about participant's/subject's feeding difficulties The free text field to give detailed comments about participant's/subject's feeding difficulties Can you tell me about your/your child's feeding difficulties? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20089 Mitochondrial disease prior vomit other text MitDisDetPriVomitOthrTxt The free text field to specify additional details about participant's/subject's past vomiting symptoms The free text field to specify additional details about participant's/subject's past vomiting symptoms Please provide additional details about past vomiting symptoms. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20185 Mitochondrial disease prior abdominal pain worsen text MitDisPriorAbdomnlPainWorseTxt The free text field to specify about what specifically made the participant's/subject's prior abdominal pain worse The free text field to specify about what specifically made the participant's/subject's prior abdominal pain worse Is there anything specific that made the pain worse? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20194 Mitochondrial disease prior bloat abdominal distension onset age category MtDsPriBltAbdmlDstnsnOnstAgCat The category of the participant/subject's age at onset of prior abdominal bloating/distension The category of the participant/subject's age at onset of prior abdominal bloating/distension What was your/your child's age when the past abdominal bloating/distension problems began? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20121 Mitochondrial disease prior oral regurgitation frequency other text MitDisPriorOralRegurgFrqOthTxt The free text field to specify past frequency of participant's/subject's other oral regurgitation The free text field to specify past frequency of participant's/subject's other oral regurgitation Past Oral regurgitation other Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20068 Mitochondrial disease current vomit detail text MitDisCurrVomitDetTxt The free text field to specify additional details about participant's/subject's current vomiting symptoms The free text field to specify additional details about participant's/subject's current vomiting symptoms Please provide additional details about current vomiting symptoms. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20237 Mitochondrial disease Munchausen by proxy syndrome health care professional setting type MitDisMBPSymHlthCrProSetTyp Select the setting when confronted by a health care professional about Munchausen by proxy syndrome Select the setting when confronted by a health care professional about Munchausen by proxy syndrome What setting was this in? ER;Other;Outpatient;Clinic;Hospital ER;Other;Outpatient;Clinic;Hospital Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20164 Mitochondrial disease abdominal pain trigger detail text MitDisAbdomnlPainTrigrDetlTxt The free text field to specify additional details about participant's/subject's abdominal pain triggers The free text field to specify additional details about participant's/subject's abdominal pain triggers Please provide additional details abdominal pain triggers? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20100 Mitochondrial disease GI detail text MitDisGIDetailText The free text field to specify additional details about participant's/subject's GERD, heartburn, mid-line chest pain, esophageal burning symptoms The free text field to specify additional details about participant's/subject's GERD, heartburn, mid-line chest pain, esophageal burning symptoms Please provide additional details about your/their GERD, heartburn, mid-line chest pain, esophageal burning symptoms. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20035 Height maternal measurement HgtMaternalMeasr Measurement of participant's/subject's Mother's height Measurement of participant's/subject's Mother's height Height (Specify) Numeric Values No references available Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Free-Form Entry

C20205 Mitochondrial disease bowel movement strain pass indicator MitDisBowelMovmntStrainPassInd Indicator of whether the participant/subject has to strain to pass a bowel movement Indicator of whether the participant/subject has to strain to pass a bowel movement Do you/they have to strain to pass bowel movements? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20132 Mitochondrial disease prior burp stop age category MitDisPriorBurpStopAgeCat The category of participant/subject's age at the end of prior burping episodes The category of participant/subject's age at the end of prior burping episodes What was your/their age when the burping problem stopped? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20143 Mitochondrial disease difficulty swallow change over time indicator MitDisDiffSwallwChngOvrTimeInd Indicator of whether participant's/subject's difficulty swallowing changes over time Indicator of whether participant's/subject's difficulty swallowing changes over time Has the difficulty in swallowing changed over time? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20079 Mitochondrial disease prior vomit prior problem type MitDisPriorVomitPriorProbTyp The types of problems that frequently occur prior to vomiting during participant's/subject's prior episodes of vomiting The types of problems that frequently occur prior to vomiting during participant's/subject's prior episodes of vomiting Did any of the following occur frequently before the vomiting started? Fasting more than 12 hours;Viral illness/Fever;Taking medicine;Right after feeding;Seizure;Headache/Migraine/Light sensitivity;Exercise;Stress Fasting more than 12 hours;Viral illness/Fever;Taking medicine;Right after feeding;Seizure;Headache/Migraine/Light sensitivity;Exercise;Stress Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20175 Mitochondrial disease prior abdominal pain anatomic site MitDisPriAbdomnlPainAntmicSite Select where participant's/subject's past abdominal pain was located Select where participant's/subject's past abdominal pain was located Where was past abdominal pain located? Entire abdomen;Entire lower abdomen;Entire upper abdomen;I don't know;Left lower quadrant;Lower abdomen midline;Near the belly button;Right lower quadrant;Upper abdomen midline;Upper abdomen on the left;Upper abdomen on the right;Variable locations Entire abdomen;Entire lower abdomen;Entire upper abdomen;I don't know;Left lower quadrant;Lower abdomen midline;Near the belly button;(below umbilicus);(between umbilicus bottom of ribs);Upper abdomen on the left;Upper abdomen on the right;Variable locations Alphanumeric

Choose all that apply. Response is obtained from participant/ subject, family member, friend, or chart/medical record.

Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20111 Mitochondrial disease oral regurgitation symptom consistent day to day indicator MitDisOrlRegrgSypCnstDyToDyInd Indicator of whether symptoms of oral regurgitation are consistent day to day Indicator of whether symptoms of oral regurgitation are consistent day to day Are the symptoms pretty consistent from day to day? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20047 Mitochondrial disease dietary other restriction text MitDisDietOthRestrictnTxt The free text field to specify whether participant/subject have other dietary retrictions The free text field to specify whether participant/subject have other dietary retrictions What other dietary restrictions does you/your child have? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20216 Mitochondrial disease medication other text MitDisMedsOtherTxt The free text field to specify the participant's/subject's other medications The free text field to specify the participant's/subject's other medications What other medicines do you/your child take? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20058 Mitochondrial disease vomit episode trigger text MitDisVomitEpisTrigTxt The free text field to specify the participant's/subject's vomiting episode triggers The free text field to specify the participant's/subject's vomiting episode triggers What triggers episodes? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20227 Mitochondiral disease life effect grade MitDisLifeEffectGrade The graded scale representing the effect of the symptoms on the participant's/subject's life. The graded scale representing the effect of the symptoms on the participant's/subject's life. How much do the symptoms we discussed affect your/your child's life? 1;10;2;3;4;5;6;7;8;9 1;10;2;3;4;5;6;7;8;9 Numeric Values

Choose one. 1 being not at all, 10 being severe interruption

Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20154 Mitochondrial disease abdominal pain age start type MitDisAbdomnlPainAgeStartTyp Select the pre-specified age of participant/subject when abdominal pain began Select the pre-specified age of participant/subject when abdominal pain began What was your/your child's age when abdominal problems began? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20090 Mitochondrial disease vomit diagnosis cyclic indicator MitDisVomitDiagnosCyclicInd Indicator of whether the participant/subject has a cyclic vomiting diagnosis. Indicator of whether the participant/subject has a cyclic vomiting diagnosis. Have you/your child ever been diagnosed with cyclic vomiting? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20186 Mitochondrial disease prior abdominal pain other text MitDisPriorAbdomnlPainOthrTxt The free text field to specify additional details about the participant's/subject's past abdominal pain The free text field to specify additional details about the participant's/subject's past abdominal pain Please provide additional details about past abdominal pain. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C01522 Height measurement HgtMeasr Measurement of participant's/subject's height. Measurement of participant's/subject's height. Height (Specify) Numeric Values Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Free-Form Entry

0 400 centimeter 649
C20195 Mitochondrial disease prior bloat abdominal distension stop age category MtDsPriBltAbdmlDistnsnStpAgCat The category of the participant/subject's age at cessation of prior abdominal bloating/distension The category of the participant/subject's age at cessation of prior abdominal bloating/distension What was your/your child's age when the abdominal bloating/distesion stopped? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20122 Mitochondrial disease prior oral regurgitation occurrence timing type MitDisPriOralRegurgOccurTmgTyp The type of timing of the participant/subject's prior episodes of oral regurgitation with respect to meals The type of timing of the participant/subject's prior episodes of oral regurgitation with respect to meals In the past, was the oral regurgitation before, during, or after meals? After;Before;During;Variable After;Before;During;Variable Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20069 Mitochondrial disease prior vomit onset age category MitDisPriVomitOnsetAgeCat The age category of the participant/subject when prior vomiting began The age category of the participant/subject when prior vomiting began How old were you/your child when you first started having issues with vomiting? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20238 Mitochondrial disease Munchausen by proxy syndrome health care professional setting other text MitDisMBPSymHlthCrProSetOTH The free text field to provide the other setting when participant/subject confronted by a health care professional about Munchausen by proxy syndrome The free text field to provide the other setting when participant/subject confronted by a health care professional about Munchausen by proxy syndrome Munchausen Setting Other Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20165 Mitochondrial disease abdominal pain disrupt activity indicator MitDisAbdmnlPainDisrptActivInd Indicator of whether participant's/subject's abdominal pain disrupts activity Indicator of whether participant's/subject's abdominal pain disrupts activity Does abdominal pain disrupt activity? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20101 Mitochondrial disease prior GERD heartburn mid-line chest pain esophageal burning onset age category MitDisPiGERDHeBuMLCPEBuOsAgCat The category of the participant/subject's age at prior past GERD, heartburn, mid-line chest, pain esophageal burning onset The category of the participant/subject's age at prior past GERD, heartburn, mid-line chest, pain esophageal burning onset For past GERD, heartburn, mid-line chest pain, esophageal burning episodes, what was your/your child's age when the problems began? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20036 Height paternal measurement HgtPaternalMeasr Measurement of participant's/subject'sFather's height Measurement of participant's/subject'sFather's height Height (Specify) Numeric Values No references available Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Free-Form Entry

C20206 Mitochondrial disease stool blood indicator MitDisStoolBloodInd Indicator of whether the participant/subject has blood in their stools Indicator of whether the participant/subject has blood in their stools Do you/your child ever have blood in the stool? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20133 Mitochondrial disease prior burp stopped specific text MitDisPriorBurpStopST The free text field to specify when participant's/subject's past burping stopped The free text field to specify when participant's/subject's past burping stopped What stopped the burping? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20144 Mitochondrial disease details swallow problem text MitDisDetSwallowPrblmTxt The free text field to specify additional details about participant's/subject's swallowing problems The free text field to specify additional details about participant's/subject's swallowing problems Please provide additional details about your/their swallowing problems Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20080 Mitochondrial disease prior vomit bright green yellow indicator MitDisPriorVomitBrghtGrnYelInd Indicator of whether participant's/subject's past vomit was bright green or yellow Indicator of whether participant's/subject's past vomit was bright green or yellow Did you/your child ever have bright green or yellow vomiting? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20176 Mitochondrial disease prior abdominal pain frequency MitDisPriorAbdomnlPainFreq The frequency with which the participant/subject had prior abdominal pain The frequency with which the participant/subject had prior abdominal pain How often did past abdominal pain occur? About once a year;At least once a week, but not daily;Daily;I don't know;Less than once a month, more than once a year;One to 4 times per month;Only once;Other About once a year;At least once a week, but not daily;Daily;I don't know;Less than once a month, more than once a year;One to 4 times per month;Only once;Other Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20112 Mitochondrial disease oral regurgitation frequency MitDisOralRegurgFreq The frequency with which participant/subject has oral regurgitation The frequency with which participant/subject has oral regurgitation How often does oral regurgitation occur? About once a year;At least once a week, but not daily;Daily;I don't know;Less than once a month, more than once a year;One to 4 times per month;Only once;Other About once a year;At least once a week, but not daily;Daily;I don't know;Less than once a month, more than once a year;One to 4 times per month;Only once;Other Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20048 Mitochondrial disease vomit current prior status MitDisVomitCurrPriorStat The status of whether the participant/subject's vomiting is current or past The status of whether the participant/subject's vomiting is current or past Does you/your child have vomiting currently or in the past? Past;Present Past;Present Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20217 Mitochondrial disease medication GI problem help text MitDisMedsGIProblmHlpTxt The free text field to specify about what medications helped the participant's/subject's GI problems The free text field to specify about what medications helped the participant's/subject's GI problems Have you/your child taken any medications in the past that you feel helped any of your/your child's GI problems? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20059 Mitochondrial disease vomit prior problem type MitDisVomitPriorProbTyp The types of problems that frequently occur prior to participant's/subject's vomiting The types of problems that frequently occur prior to participant's/subject's vomiting Do any of the following occur frequently before vomiting starts? Exercise;Fasting more than 12 hours;Headache/Migraine/Light sensitivity;Right after feeding;Seizure;Stress;Viral illness/Fever;Taking medicine Exercise;Fasting more than 12 hours;Headache/Migraine/Light sensitivity;Right after feeding;Seizure;Stress;Viral illness/Fever;Taking medicine Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20228 Mitochondrial disease GI clinical trial participate indicator MitDisGIClinTrialPartcipateInd Indicator of whether participant/subject would participate in a clinical trial Indicator of whether participant/subject would participate in a clinical trial If there was a clinical trial regarding GI issues, would you/they participate in it? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20155 Mitochondrial disease abdominal pain current prior status MitDisAbdomnlPainCurrPriStat Indicate whether participant/subject has/had abdominal pain Indicate whether participant/subject has/had abdominal pain Have you/your child experienced abdominal pain in the past or currently? Past;Present Past;Present Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

CSV