CDE Detailed Report
Disease: Cerebral Palsy
Subdomain Name: General Health History
CRF: Medical History
Displaying 1 - 50 of 117
Subdomain Name: General Health History
CRF: Medical History
Displaying 1 - 50 of 117
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C22671 | Medical history abnormal sleep EEG indicator | MedHistAbnSlpEEGInd | Indicator of whether a participant/subject has/had an abnormal sleep EEG | Indicator of whether a participant/subject has/had an abnormal sleep EEG | Abnormal sleep EEG | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:38:48.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17462 | Cardiovascular history abnormal echocardiogram decreased left ventricular function indicator | CardioHistAbnrmlECGDecLVFnInd | Indicator as to whether the participant/subject has or had an abnormal echocardiogram (ECG) specifically exhibiting decreased left ventricular (LV) function | Indicator as to whether the participant/subject has or had an abnormal echocardiogram (EKG) specifically exhibiting decreased left ventricular (LV) function | Decreased LV function | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C19247 | Subject ID | SubIDNam | Subject identification ID | Subject identification ID | Subject ID | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 1.00 | 2014-06-05 13:10:49.0 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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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. Make sure to record if the following events are in the medical history which are Core items: Any stroke; Ischemic stroke; Hemorrhagic stroke; Hemorrhagic stroke type; 4) Transient ischemic attack (TIA); Carotid stenosis; Epilepsy/ Seizure disorder; Central nervous system infection; Dementia; Head trauma; Head trauma type; Atrial fibrillation (AF)/ flutter; Rheumatic heart disease |
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 | ||||||||
| C10514 | Genetic diagnosis point mutation result | GenDiagnosPtMutReslt | The result of the genetic testing revealed a point mutation describe the position and amino acid change | The result of the genetic testing revealed a point mutation describe the position and amino acid change | Genetic diagnosis point mutation | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-11 15:03:49.2 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C52357 | Percent body fat value | PercentFatVal | Percent body fat calculated value | Percent body fat calculated value | % Body fat | Numeric Values |
Percent body fat calculations: Slaughter equations based on the triceps and subscapular skinfolds can be adapted for cerebral palsy. See Table II, Original Slaugter equations and corrections for children with cerebral palsy, in Gurka MJ, Kuperminc MN, Busby MG, Bennis JA, Grossberg RI, Houlihan CM, et al. Assessment and correction of skinfold thickness equations in estimating body fat in children with cerebral palsy. Dev Med Child Neurol. 2010;52(2):e35–e41 equations and corrections. |
Gurka MJ, Kuperminc MN, Busby MG, Bennis JA, Grossberg RI, Houlihan CM, et al. Assessment and correction of skinfold thickness equations in estimating body fat in children with cerebral palsy. Dev Med Child Neurol. 2010;52(2):e35–e41; Slaughter MH, Lohman TG, Boileau RA, Horswill CA, Stillman RJ, Van Loan MD, et al. Skinfold equations for estimation of body fatness in children and youth. Hum Biol. 1988;60(5):709–723. | Adult;Pediatric | Supplemental | 1.00 | 2017-01-12 10:42:26.0 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
0 | 100 | ||||||||
| C17473 | Cardiovascular history cardiac surgery date | CardioHistCardSurgDate | Date of most recent cardiac surgery or mechanical intervention performed on the participant/subject | Date of most recent cardiac surgery or mechanical intervention performed on the participant/subject | Date of most recent surgery | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C22650 | Medical history conductive impairment indicator | MedHistCondImpInd | Indicator of whether the participant/subject has been affected by conductive impairment | Indicator of whether the participant/subject has been affected by conductive impairment | Conductive impairment | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:24:49.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C22661 | Medical history laryngomalacia indicator | MedHistLarInd | Indicator of whether the participant has been diagnosed with layrngomalacia | Indicator of whether the participant has been diagnosed with layrngomalacia | Laryngomalacia | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:31:34.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C12208 | Gastrointestinal therapy nutrition supplement type | GITherpyNutritionSupplementTyp | Type(s) of nutritional supplement(s) being taken by the participant/subject | Type(s) of nutritional supplement(s) being taken by the participant/subject | If yes, indicate type | Beta Carotene;Calcium;Dehydroepiandrosterone (DHEA);Echinacea;Flax Seed Oil;Folic Acid;Ginkgo;Ginseng;Saw Palmetto;Soy Protein Powder;Soy Supplements;St. John's Wort;Vitamin A;Vitamin C;Vitamin E;Weight Loss Supplements;Wheat Germ;Turmeric;Fiber;Creatine;CoQ10;Other, specify | Beta Carotene;Calcium;Dehydroepiandrosterone (DHEA);Echinacea;Flax Seed Oil;Folic Acid;Ginkgo;Ginseng;Saw Palmetto;Soy Protein Powder;Soy Supplements;St. John's Wort;Vitamin A;Vitamin C;Vitamin E;Weight Loss Supplements;Wheat Germ;Turmeric;Fiber;Creatine;CoQ10;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
2183828 | |||||||||
| C17485 | Psychiatric history clinical depression past year indicator | PsychHistClinDepressPastYrInd | Indicator as to whether the participant/subject has had clinical depression within the last year | Indicator as to whether the participant/subject has had clinical depression within the last year | Clinical depression within the past year | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C22672 | Medical history behavior difficulty indicator | MedHIstBhvDiffInd | Indicator of whether participant/subject has/had behavior difficulties | Indicator of whether participant/subject has/had behavior difficulties | Behavior difficulties | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:39:26.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17463 | Cardiovascular history abnormal echocardiogram indicator | CardioHistAbnrmlECGInd | Indicator as to whether the participant/subject has or had an abnormal echocardiogram (ECG) | Indicator as to whether the participant/subject has or had an abnormal echocardiogram (EKG) | Abnormal echocardiogram | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C19760 | Medical history strabismus diagnosis indicator | MedHistStrbsmsDiagInd | Indicator of medical history of strabismus | Indicator of medical history of strabismus | Strabismus | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C00327 | Prior traumatic injury indicator | PriorTraumInjryInd | Indicator of prior traumatic injury found either historically, previous emergency department visits, radiographic findings, or signs or symptoms at time of presentation | Indicator of prior traumatic injury found either historically, previous emergency department visits, radiographic findings, or signs or symptoms at time of presentatio | Prior traumatic event | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C10515 | Scoliosis diagnosis indicator | ScolDiagnosInd | The indicator of whether the participant/subject has been diagnosed with scoliosis | The indicator of whether the participant/subject has been diagnosed with scoliosis | Scoliosis | Yes;No;Unknown | History reported and/or confirmed in medical record;History NOT reported and NOT confirmed in medical record;History reported as unknown or could not be collected | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-11 15:03:49.2 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C52358 | Epilepsy type | EpilepsyTyp | Type of epilepsy | Type of epilepsy | Epilepsy type | Medically intractable;Well controlled | Medically intractable;Well controlled | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 1.00 | 2017-01-12 11:32:55.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17474 | Cardiovascular history cardiac surgery indicator | CardioHistCardSurgInd | Indicator as to whether the participant/subject has had cardiac surgery or mechanical intervention | Indicator as to whether the participant/subject has had cardiac surgery or mechanical intervention | Cardiac surgery/mechanical intervention | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C22651 | Medical history sensori-neural indicator | MedHistSensNrlInd | Indicator of whether the participant/subject has been affected by sensori-neural impairment | Indicator of whether the participant/subject has been affected by sensori-neural impairment | Sensori-neural impairment | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:25:24.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C22662 | Medical history recurrent lower respiratory tract infection indicator | MedHistRecLwRespTrInfInd | Indicator of whether the participant/subject has been diagnosed with recurrent lower respiratory tract infections | Indicator of whether the participant/subject has been diagnosed with recurrent lower respiratory tract infections | Recurrent lower respiratory tract infections | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:32:03.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C13520 | Dysphagia indicator | DysphagiaInd | Did the participant/subject have dysphagia (difficulty swallowing) identified at bedside assessment? The dysphagia screening should utilize a validated tool that incorporates a swallow assessment and an assessment of level of consciousness and neurological function | Did the participant/subject have dysphagia (difficulty swallowing) identified at bedside assessment? The dysphagia screening should utilize a validated tool that incorporates a swallow assessment and an assessment of level of consciousness and neurological functio | Dysphagia indicator | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
The dysphagia screening should utilize a validated tool that incorporates a swallow assessment and an assessment of level of consciousness and neurological function. |
Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17486 | Psychiatric history clinical depressive diagnosis indicator | PsychHistClinDepressDiagnosInd | Indicator as to whether the participant/subject had a depressive disorder diagnosis | Indicator as to whether the participant/subject had a depressive disorder diagnosis | Depressive disorder diagnosis | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C00328 | Prior traumatic injury type | PriorTraumInjryType | General location of traumatic injury, if evidence of prior traumatic injury | General location of traumatic injury, if evidence of prior traumatic injury | Prior traumatic injury type | Brain Injury;Spine Injury;Other Extracranial Injury | Brain Injury;Spine Injury;Other Extracranial Injury | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-19 21:21:51.533 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C22673 | Medical history autism indicator | MedHistAutInd | Indicator of whether participant/subject has Autism | Indicator of whether participant/subject has Autism | Autism | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:40:25.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17464 | Cardiovascular history abnormal echocardiogram left ventricular hypertrophy indicator | CardioHistAbnrmlECGLVHInd | Indicator as to whether the participant/subject has or had an abnormal echocardiogram (ECG) specifically exhibiting left ventricular hypertrophy (LVH) | Indicator as to whether the participant/subject has or had an abnormal echocardiogram (EKG) specifically exhibiting left ventricular hypertrophy (LVH) | LVH | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C19769 | Medical history pulmonary aspiration diagnosis indicator | MedHistPlmnryAspirDiagInd | Indicator of history of aspiration | Indicator of history of aspiration | Pulmonary aspiration diagnosis indicator | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C10516 | Scoliosis maximum spine curvature measurement | ScolMaxSpnCrvtrMsrmnt | The maximum curvature of the spine in degrees for a participant/subject who has been diagnosed with scoliosis | The maximum curvature of the spine in degrees for a participant/subject who has been diagnosed with scoliosi | Scoliosis maximum spine curvature measurement | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-11 15:03:49.2 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C17475 | Cardiovascular history cardiac surgery type | CardioHistCardSurgTyp | Type of cardiac surgery or mechanical intervention the participant/subject underwent | Type of cardiac surgery or mechanical intervention the participant/subject underwent | If yes, indicate type (choose all that apply) | Coronary artery bypass graft;Cardiac valve surgery, including non-open surgery;Pacemaker;Implantable cardiac defibrillator;Other, specify | Coronary artery bypass graft (CABG);Cardiac valve surgery, including non-open surgery (i.e. percutaneous valvuloplasty);Pacemaker;Implantable cardiac defibrillator;Other, specify | Alphanumeric | 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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| C22652 | Medical history recurrent ear infection indicator | MedHistReccEarInfInd | Indicator of whether the participant/subject has been affected by recurrent ear infections | Indicator of whether the participant/subject has been affected by recurrent ear infections | Recurrent ear infections | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:25:54.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C22663 | Medical history gastroesophageal reflux disease (GERD) indicator | MedHistGERDInd | Indicator of whether the participant/subject has/had gastroesophageal reflux disease | Indicator of whether the participant/subject has/had gastroesophageal reflux disease | Gastroesophageal reflux disease | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:33:08.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C14126 | Seizure classification type | SeizClassTyp | The type of seizures present by classification | The type of seizures present by classificatio | Seizure classification type | Generalized;Focal;Unclassified | Generalized;Focal;Unclassified seizures are considered unidentifiable due to lack of data and do not fit in to the aforementioned categories for Generalized and Focal Seizures | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| 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, choose all disorders that apply | Schizophrenia;Bipolar disorder;Depression with psychotic features;Dementia with psychotic ideation;Other, specify | Schizophrenia;Bipolar disorder;Depression with psychotic features;Dementia with psychotic ideation;Other, specify | Alphanumeric | 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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| 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 | Core | 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 | |||||||
| C05460 | Seizure indicator | SeizInd | Indicator of seizure activity | Indicator of seizure activity | Seizures/Epilepsy | Yes;No;Suspected;Unknown | Yes;No;Suspected;Unknown | Alphanumeric | McHugh GS, Engel DC, Butcher I, et al. Prognostic value of secondary insults in traumatic brain injury: results from the IMPACT study. J Neurotrauma. 2007;24(2):287–293. Signorini DF, Andrews PJ, Jones PA, et al. Adding insult to injury: the prognostic value of early secondary insults for survival after traumatic brain injury. J Neurol Neurosurg Psychiatry. 1999;66(1):26–31. | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C22674 | Medical history obsessive compulsive disorder indicator | MedHistOCDInd | Indicator of whether participant/subject has Obsessive Compulsive Disorder (OCD) | Indicator of whether participant/subject has Obsessive Compulsive Disorder (OCD) | Obsessive Compulsive Disorder (OCD) | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:40:50.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17465 | Cardiovascular history abnormal echocardiogram other text | CardioHistAbnrmlECGOtherTxt | Text description of any abnormal characteristics other than left ventricular hypertrophy (LVH), or decreased left ventricular (LV) function that the participant/subject has ever exhibited on an echocardiogram (ECG) | Text description of any abnormal characteristics other than left ventricular hypertrophy (LVH), or decreased left ventricular (LV) function that the participant/subject has ever exhibited on an echocardiogram (EKG) | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C19835 | Pain indicator | PainInd | Indicator of pain present | Indicator of pain present | Pain indicator | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C10520 | Vision affected by disease indicator | VisAffectDisInd | The indicator of whether the disease/disorder has affected the participant's/subject's vision | The indicator of whether the disease/disorder has affected the participant's/subject's vision | Is vision affected | Yes;No;Unknown | History reported and/or confirmed in medical record;History NOT reported and NOT confirmed in medical record;History reported as unknown or could not be collected | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-11 15:03:49.2 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17476 | Cardiovascular history condition indicator | CardioHistCondInd | Indicator as to whether the participant/subject has or had a cardiac condition or complication | Indicator as to whether the participant/subject has or had a cardiac condition or complication | Cardiac condition | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C22653 | Medical history respiratory support indicator | MedHistRespSuppInd | Indicator of whether the participant/subject utilizes respiratory support/ventilation assist | Indicator of whether the participant/subject utilizes respiratory support/ventilation assist | Respiratory support/ventilation assist | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:26:36.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C22664 | Medical history delayed gastric empty indicator | MedHistDlyGasEmpInd | Indicator of whether the participant/subject has/had delayed gastric emptying | Indicator of whether the participant/subject has/had delayed gastric emptying | Delayed gastric emptying | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:33:37.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C14127 | Seizure generalized classification type | SeizGenClassTyp | The type of generalized epileptic seizures, considered to originate at some point within, and rapidly engage, bilaterally distributed networks and may include such bilateral networks as ortical and subcortical structures, but do not necessarily include the entire cortex, experienced by the participant/subject | The type of generalized epileptic seizures, considered to originate at some point within, and rapidly engage, bilaterally distributed networks and may include such bilateral networks as ortical and subcortical structures, but do not necessarily include the entire cortex, experienced by the participant/subjec | Seizure generalized classification type | Tonic clonic;Absence;Typical;Atypical;Myoclonic absence;Eyelid myoclonia;Myoclonic;Myoclonic atonic;Myoclonic tonic;Clonic;Tonic;Atonic;Epileptic spasms, focal or generalized | Tonic clonic (in any combination);Absence;Absence-Typical;Absence-Atypical;Absence-Myoclonic absence;Absence-Eyelid myoclonia;Myoclonic (not otherwise specified);Myoclonic-Myoclonic atonic;Myoclonic-Myoclonic tonic;Clonic;Tonic;Atonic;Epileptic spasms, focal or generalized | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17489 | Psychotic disorder indicator | PsychoDisorderInd | Indicator as to whether the participant/subject has had a psychotic disorder diagnosis | Indicator as to whether the participant/subject has had a psychotic disorder diagnosi | Psychotic disorder diagnosis | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| 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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| C06020 | Urinary incontinence past three months indicator | UrinIncntPstThreeMoInd | Indicator of involuntary urine leakage (incontinence) within the last three months. Urinary incontinence is defined by International Continence Society (Abrams et al. 2002) as the complaint of any involuntary leakage of urine | Indicator of involuntary urine leakage (incontinence) within the last three months. Urinary incontinence is defined by International Continence Society (Abrams et al. 2002) as the complaint of any involuntary leakage of urin | Urinary incontinence past three months frequency | No;Yes;Not applicable;Unknown | No;Yes;Not applicable;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-17 09:26:36.973 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C22675 | Medical history oppositional defiance indicator | MedHIstOppDefInd | Indicator of whether participant/subject displays oppositional defiance | Indicator of whether participant/subject displays oppositional defiance | Oppositional defiance | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:41:22.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17466 | Cardiovascular history arrhythmia atrial fibrillation indicator | CardioHistArrhythAtrialFibInd | Indicator as to whether the participant/subject has or had a cardiac arrhythmia in the form of atrial fibrillation | Indicator as to whether the participant/subject has or had a cardiac arrhythmia in the form of atrial fibrillation | Atrial Fibrillation | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C19836 | Pain anatomic site text | PainAntmicSiteTxt | Anatomic Site of body pain | Anatomic Site of body pain | If yes, where | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C10521 | Hearing affected by disease indicator | HearAffectDisInd | The indicator of whether the disease/disorder has affected the participant's/subject's hearing | The indicator of whether the disease/disorder has affected the participant's/subject's hearing | Is hearing affected | Yes;No;Unknown | History reported and/or confirmed in medical record;History NOT reported and NOT confirmed in medical record;History reported as unknown or could not be collected | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-11 15:03:49.2 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17477 | Cardiovascular history congenital heart disease indicator | CardioHistCongHeartDiseaseInd | Indicator as to whether the participant/subject has or had a congenital heart disease | Indicator as to whether the participant/subject has or had a congenital heart disease | Congenital heart disease | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
