CDE Detailed Report
Disease: content
Subdomain Name: General Health History
CRF: welcome
Displaying 1 - 34 of 34
Subdomain Name: General Health History
CRF: welcome
Displaying 1 - 34 of 34
| 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 / Guideline) | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C57243 | Polycystic ovary syndrome indicator | PolyOvarySyndInd | The indicator related to whether the subject has polycystic ovary syndrome | The indicator related to whether the subject has polycystic ovary syndrom | Polycystic ovary syndrome | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:49:53.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57254 | Diabetes mellitus other text | DiabMellOthrTxt | Text describing another type of diabetes mellitus the subject has | Text describing another type of diabetes mellitus the subject ha | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 11:14:51.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
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| C16176 | Hormone therapy indicator | HormoneTherapyInd | Indicates whether participant/subject has taken hormonal therapy | Indicates whether participant/subject has taken hormonal therapy |
Are you currently on, or have you been on within the past year, sex hormone-related therapy? (Includes, but not limited to, hormonal contraceptives, including hormone-releasing contraceptive devices; hormone replacement therapy, eg, estrogens, progestins; testosterone) |
Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57244 | Polycystic ovary syndrome diagnosis age value | PolyOvarySyndDiagnosAgeVal | The value representing the age the subject was when she was diagnosed with polycystic ovary syndrome | The value representing the age the subject was when she was diagnosed with polycystic ovary syndrom | If yes, age at diagnosis | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:51:12.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
year | |||||||||||
| C57255 | Diabetes insipidus indicator | DiabInsipInd | The indicator relating to whether the subject has diabetes insipidus | The indicator relating to whether the subject has diabetes insipidu | Diabetes insipidus | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 11:16:07.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16177 | Post-menopausal indicator | PostMnpslInd | Indicates whether participant/subject is post-menopausal | Indicates whether participant/subject is post-menopausal | Are you post-menopausal? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57245 | Hyperthyroidism indicator | HyperthyInd | The indicator relating to whether the subject has hyperthyroidism | The indicator relating to whether the subject has hyperthyroidis | Hyperthyroidism | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:52:19.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57256 | Diabetes insipidus diagnosis age value | DiabInsipDiagnosAgeVal | The value representing the age the subject was when he/she was diagnosed with diabetes insipidus | The value representing the age the subject was when he/she was diagnosed with diabetes insipidu | If yes, age at diagnosis | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 11:21:23.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
year | |||||||||||
| C16178 | Post-menopausal cause type | PostMnpslCauseTyp | Cause or reason for the post-menopausal period in the female participant/subject | Cause or reason for the post-menopausal period in the female participant/subject | If Yes, indicate cause | Natural;Medications or chemotherapy;Surgical (complete hysterectomy- ovaries and uterus removed) | Natural;Medications or chemotherapy;Surgical (complete hysterectomy- ovaries and uterus removed) | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C57246 | Hyperthyroidism diagnosis age value | HyperthyDiagnosAgeVal | The value representing the age the subject was when he/she was diagnosed with hyperthyroidism | The value representing the age the subject was when he/she was diagnosed with hyperthyroidis | If yes, age at diagnosis | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:53:12.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
year | |||||||||||
| C06358 | Diabetes mellitus type | DiabetesMellitusTyp | Type of diabetes mellitus | Type of diabetes mellitus | Type | Type 1;Type 2;Unknown;Other, specify | Type 1;Type 2;Unknown;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 21:00:23.88 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57257 | Diabetes insipidus type | DiabInsipTyp | The type of diabetes insipidus the subject has | The type of diabetes insipidus the subject ha | Type | Central;Nephrogenic;Other, specify | Central;Nephrogenic;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 11:24:35.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16179 | Post-menopausal surgery date | PostMnpslSurgDate | The date and time (if applicable and known) of the surgery that induced the post-menopausal period | Date (and time if applicable and known) of the surgery that induced the post-menopausal period | Date last ovary removed | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C57247 | Hypothyroidism indicator | HypothyInd | The indicator relating to whether the subject has hypothyroidism | The indicator relating to whether the subject has hypothyroidis | Hypothyroidism | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:52:19.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16164 | Hormonal therapy start date | HormonalTherapyStartDate | The date and time (if applicable and known) the participant/subject started hormonal therapy | Date (and time, if applicable and known) the participant/subject started hormonal therapy | Start date | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C57258 | Diabetes insipidus other text | DaibInsipOthrTxt | Text describing another type of diabetes insipidus the subject has been diagnosed with | Text describing another type of diabetes insipidus the subject has been diagnosed wit | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 11:28:14.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
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| C53062 | Diabetes mellitus medical history indicator | DiabetesMellMedHistInd | Indicator as to whether the participant/subject has a medical history of diabetes mellitus (type I or type II) | Indicator as to whether the participant/subject has a medical history of diabetes mellitus (type I or type II) | Diabetes mellitus | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57248 | Hypothyroidism diagnosis age value | HypothyDiagnosAgeVal | The value representing age the subject was when he/she was diagnosed with hypothyroidism | The value representing age the subject was when he/she was diagnosed with hypothyroidis | If yes, age at diagnosis | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:53:12.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
year | |||||||||||
| C16165 | Hormonal therapy stop date | HormonalTherapyStopDate | The date and time (if applicable and known) the participant/subject stopped hormonal therapy | Date (and time, if applicable and known) the participant/subject stopped hormonal therapy | End date | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C57238 | Hormonal therapy medication device name | HormTherpyMedDevName | The name of the medication or device being used for hormonal therapy | The name of the medication or device being used for hormonal therap | Medication/device name | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:41:12.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C57249 | Cushings syndrome indicator | CushSyndInd | The indicator relating to whether the subject has Cushing's syndrome | The indicator relating to whether the subject has Cushing's syndrom | Cushing's sydrome indicator | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:55:10.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16170 | Menstrual period occurrence indicator | MenstrualPrdOcurInd | Indicates whether participant/subject has ever had a menstrual period | Indicates whether participant/subject has ever had a menstrual perio | Have you ever had a menstrual period? | Yes;No | Yes;No | Alphanumeric |
If no, section is complete. Do not proceed to further questions. |
Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57239 | Hormonal therapy medication device dose frequency text | HormTherMedDevDoseFreqTxt | Text indicating the dose of the medication or frequency of the device being used for hormonal therapy | Text indicating the dose of the medication or frequency of the device being used for hormonal therap | Dose/frequency (if applicable) | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:44:01.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C57250 | Cushings syndrome diagnosis age value | CushSyndDiagnosAgeVal | The value representing the age the subject was when he/she was diagnosed with Cushing's syndrome | The value representing the age the subject was when he/she was diagnosed with Cushing's syndrom | If yes, age at diagnosis | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:56:35.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
year | |||||||||||
| C16172 | Pregnant current indicator | PregCurntInd | Whether the female participant/subject is currently pregnant | Whether the female participant/subject is currently pregnant | Pregnant? | Yes;No;Don't know | Yes;No;Don't know | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57240 | Pregnant in past year indicator | PregPastYrInd | The indicator relating to whether the subject was pregnant within the past year | The indicator relating to whether the subject was pregnant within the past yea | If no, pregnant within past year? | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:45:42.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57251 | Adrenal insufficiency indicator | AdrInsufInd | The indicator relating to whether the subject has adrenal insuffciency | The indicator relating to whether the subject has adrenal insuffcienc | Adrenal insufficiency | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 11:00:15.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16173 | Pregnancy estimated delivery date and time | PregEstDeliveryDateTime | The date and time (if applicable) the participant/subject is estimated to deliver the pregnancy | The date and time (if applicable) the participant/subject is estimated to deliver the pregnancy | If yes, estimated due date: | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C57241 | Nursing indicator | NursingInd | The indicator relating to whether the subject is nursing | The indicator relating to whether the subject is nursin | Nursing? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:47:24.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57252 | Adrenal insufficiency diagnosis age value | AdrInsufDiagnosAgeVal | The value representing the age the subject was when he/she was diagnosed with adrenal insufficiency | The value representing the age the subject was when he/she was diagnosed with adrenal insufficienc | If yes, age at diagnosis | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 11:01:15.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
year | |||||||||||
| C16174 | Menopause indicator | MenopauseInd | Indicates whether participant/subject is currently menopausal | Indicates whether participant/subject is currently menopausa | Do you believe you are currently experiencing menopause (perimenopausal)? | Yes;No;Don't know | Yes;No;Don't know | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57242 | Menstrual period regularity type | MenstPdRegTyp | The type of menstrual period regularity the subject has been experiencing, if applicable | The type of menstrual period regularity the subject has been experiencing, if applicabl | Menstrual periods | Regular;Irregular;Not applicable | Regular;Irregular;Not applicable | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 10:48:07.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57253 | Diabetes mellitus diagnosis age value | DiabMellDiagnosAgeVal | The value representing the age the subject was when he/she was diagnosed with diabetes mellitus | The value representing the age the subject was when he/she was diagnosed with diabetes mellitu | If yes, age at diagnosis | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2018-01-04 11:05:34.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
year | |||||||||||
| C16175 | Menstrual period last date | MenstrualPeriodLastDate | Date of the participant's/subject's last menstrual period | Date of the participant's/subject's last menstrual period | If Yes, indicate the approximate date of your last menstrual period | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
