CDE Detailed Report

Disease: system
Subdomain Name: General Health History
CRF: files

Displaying 101 - 117 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
C12207 Gastrointestinal therapy take nutrition supplement indicator GITherTakeNutritionSupplInd Indicator whether the participant/subject is taking nutritional supplements Indicator whether the participant/subject is taking nutritional supplements Nutritional supplements Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C17484 Psychiatric history clinical anxiety past year indicator PsychHistClinAnxietyPastYrInd Indicator as to whether the participant/subject had clinical anxiety within the last year Indicator as to whether the participant/subject had clinical anxiety within the last year Clinical anxiety 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
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
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
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
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
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
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
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
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
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
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
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
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
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
CSV