CDE Detailed Report
Disease: system
Subdomain Name: General Health History
CRF: files
Displaying 101 - 113 of 113
Subdomain Name: General Health History
CRF: files
Displaying 101 - 113 of 113
CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
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C57712 | Skin condition diagnosis other text | SkinCondDiagnosOthrTxt | Text specifying another skin condition the subject has ever been diagnosed with | Text specifying another skin condition the subject has ever been diagnosed wit | Other, specify: | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 10:37:03.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C57274 | Food hypersensitivity indicator | FoodHypersensInd | The indicator relating to whether the subject has food hypersensitivity | The indicator relating to whether the subject has food hypersensitivity | Food hypersensitivity | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:10:39.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C58437 | Gut condition inactive resolved other text | GutCondInactResolvOthTxt | Free-text field to describe other type of gut condition that is no longer active in the subject or is considered resolved or cured | Free-text field to describe other type of gut condition that is no longer active in the subject or is considered resolved or cure | Other, specify: | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 10:03:15.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C57422 | Ear nose throat condition medication current indicator | EarNoseThroatCondMedCurrInd | The indicator relating to whether the subject currently takes medication for an ear, nose, throat condition | The indicator relating to whether the subject currently takes medication for an ear, nose, throat condition | Currently take medications | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-08 09:30:14.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C57773 | Blood immune condition medication name | BldImmuneMedName | The name of any medication(s) the subject is taking for blood or immune conditions | The name of any medication(s) the subject is taking for blood or immune conditions | Medication name(s) | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 13:02:30.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C57315 | Adverse reaction drug route text | AdverseRxnDrugRouteTxt | Free-text field to describe the route used for a drug which causes an adverse reaction for the participant/subject | Free-text field to describe the route used for a drug which causes an adverse reaction for the participant/subject | Route | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:45:43.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C57590 | Lung condition inactive resolved type | LundCondInactResolvTyp | Any lung conditions the subject has had that are no longer active or are considered resolved or cured | Any lung conditions the subject has had that are no longer active or are considered resolved or cured | Condition(s) no longer active/resolved | Pneumonia in the past 12 weeks;Pneumonia, ever;Pleurisy;Asthma (as a child);Asthma (as an adult);Bronchitis;Emphysema;Chronic obstructive lung disease (COPD or COLD);Chronic restrictive lung disease;Silicosis;Asbestosis;Other, specify | Pneumonia in the past 12 weeks;Pneumonia, ever;Pleurisy;Asthma (as a child);Asthma (as an adult);Bronchitis;Emphysema;Chronic obstructive lung disease (COPD or COLD);Chronic restrictive lung disease;Silicosis;Asbestosis;Other, specify | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-09 09:29:41.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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C57263 | Antibiotic long term repeated history name | AntibLongTermRepHistName | The name of the antibiotic(s) that the subject has a history of using repeatedly or long term | The name of the antibiotic(s) that the subject has a history of using repeatedly or long term | If yes, what antibiotic(s): | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 09:56:26.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C57813 | Infection condition medication name | InfectCondMedName | The name of the medication(s) the subject is taking for infections | The name of the medication(s) the subject is taking for infections | Medication name(s) | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-11 08:51:25.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C57359 | ROME I criteria abdominal pain discomfort type | ROMEICritAbPainDiscomfrtTyp | The type of abdominal pain or discomfort that the subject might be experiencing in relation to the ROME I criteria for Irritable Bowel Syndrome | The type of abdominal pain or discomfort that the subject might be experiencing in relation to the ROME I criteria for Irritable Bowel Syndrom | Abdominal pain or discomfort that is: | Relieved with defecation;Associated with a change in consistency of stool;Associated with a change in frequency of stool | Relieved with defecation;Associated with a change in consistency of stool;Associated with a change in frequency of stool | Alphanumeric | Adult | Supplemental-Highly Recommended | 1.00 | 2018-01-05 12:15:40.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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C57379 | Eye condition medication past year indicator | EyeCondMedPastYrInd | The indicator relating to whether the subject has taken medications for eye conditions in the past year | The indicator relating to whether the subject has taken medications for eye conditions in the past yea | Take Medications | Optic neuritis;Uveitis or scleritis;Dry eye;Eye infections;Sjogren's syndrome;Other, specify | Optic neuritis;Uveitis or scleritis;Dry eye;Eye infections;Sjogren's syndrome;Other, specify | Alphanumeric |
Medications taken in the last year |
Adult | Exploratory | 1.00 | 2018-01-08 08:40:14.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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C57713 | Skin condition active indicator | SkinCondActInd | The indicator relating to whether the subject currently has active skin condition(s) | The indicator relating to whether the subject currently has active skin condition(s) | Condition(s) active | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 10:44:02.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C57275 | Food hypersensitivity component type | FoodHypersensCompTyp | The food component(s) to which the subject has a hypersensitivity | The food component(s) to which the subject has a hypersensitivity | Have hypersensitivity? | Lactose;Gluten (any intolerance);Gluten (celiac disease);Milk protein;Alcohol;Eggs;Sugar/Fructose;Caffeine;Nuts;Chocolate;Aspartame;Other, specify | Lactose;Gluten (any intolerance);Gluten (celiac disease);Milk protein;Alcohol;Eggs;Sugar/Fructose;Caffeine;Nuts;Chocolate;Aspartame;Other, specify | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:12:01.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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