CDE Detailed Report
Disease: Myalgic Encephalomyelitis%2FChronic Fatigue Syndrome
Subdomain Name: General Health History
CRF: Medical History - Immune Module
Displaying 1 - 50 of 113
Subdomain Name: General Health History
CRF: Medical History - Immune Module
Displaying 1 - 50 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C57372 | Medical history eye condition type | MedHistEyeCondTyp | The type of any eye conditions that the subject has ever had | The type of any eye conditions that the subject has ever ha | Condition diagnosed: | 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 |
Check any eye condtiions if you were ever diagnosed |
Adult | Exploratory | 1.00 | 2018-01-05 14:17:55.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C57709 | Gut condition inactive resolved type | GutCondInactResolvTyp | Any type of gut condition that is no longer active in the subject or is considered resolved or cured | Any type of gut condition that is no longer active in the subject or is considered resolved or cure | Condition(s) no longer active/resolved | Peptic ulcer;Hiatus hernia;Hepatitis A;Hepatitis B;Hepatitis C;Hepatitis, type unspecified;Gall bladder disease;Liver disease;Cirrhosis;Chronic pancreatitis;Pancreatitis;Celiac disease;Irritable bowel syndrome;Crohn's disease;Colorectal cancer;Ulcerative colitis;Other, specify | Peptic ulcer;Hiatus hernia;Hepatitis A;Hepatitis B;Hepatitis C;Hepatitis, type unspecified;Gall bladder disease;Liver disease;Cirrhosis;Chronic pancreatitis;Pancreatitis;Celiac disease;Irritable bowel syndrome;Crohn's disease;Colorectal cancer;Ulcerative colitis;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 |
Multiple Pre-Defined Values Selected |
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| C57271 | Medical history immune diagnosis year text | MedHistImmDiagYrTxt | Year of diagnosis for immune condition(s) the participant/subject has as part of medical history | Year of diagnosis for immune condition(s) the participant/subject has as part of medical history | Year of diagnosis | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:08:32.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C58435 | Eye condition inactive resolved other text | EyeCondInactResolvOthTxt | Free-text field to describe other eye conditions that are considered no longer active or resolved | Free-text field to describe other eye conditions that are considered no longer active or resolved | Other, specify: | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-08 09:14:39.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C57419 | Ear nose throat condition active indicator | EarNoseThroatCondActInd | The indicator relating to whether the subject currently has an active ear, nose, throat condition | The indicator relating to whether the subject currently has an active ear, nose, throat condition | Condition active | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-08 09:28:44.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57770 | Blood immune condition medication past year indicator | BldImmuneMedPastYrInd | The indicator relating to whether the subject has taken medication for blood or immune conditions in the past year | The indicator relating to whether the subject has taken medication for blood or immune conditions in the past year | Take medication | No;Yes | No;Yes | Alphanumeric |
In the past year |
Adult | Exploratory | 1.00 | 2018-01-10 13:00:12.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57312 | Adverse drug reaction indicator | AdvDrugRxnInd | The indicator relating to whether the subject experiences reactions to adverse drugs | The indicator relating to whether the subject experiences reactions to adverse drug | Adverse drug reactions | No;Yes | No;Yes | Alphanumeric |
If yes, specify |
Adult | Exploratory | 1.00 | 2018-01-05 10:41:26.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57346 | Vaccine unusual received year text | VaccUnusualRecYrTxt | The year(s) the participant/subject received unusual vaccine(s) | The year(s) the participant/subject received unusual vaccine(s) | Year(s) Received | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 11:21:44.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C57499 | Lung condition medication work well indicator | LungCondMedWorkWellInd | The indicator relating to whether the medication(s) the subject is taking for lung condition(s) is(are) working | The indicator relating to whether the medication(s) the subject is taking for lung condition(s) is(are) working | Medications work well | Yes;No;Not applicable | Yes;No;Not applicable | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-08 14:06:42.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57261 | Immune symptom onset type | ImmSymptmOnsetTyp | The type of general immune/infectious symptom(s) that the subject experienced at onset (within first month of illness) | The type of general immune/infectious symptom(s) that the subject experienced at onset (within first month of illness | At onset (within first month of illness), did participant/subject experience of the following? | Fever;Chills;Night sweats;Sore throats;Swollen/tender glands;Rashes;N/V/D;Arthalgia/arthritis;Mouth ulcers;History of autoimmune disease;Family history of autoimmune disease (biological relatives only, if applicable) | Fever;Chills;Night sweats;Sore throats;Swollen/tender glands;Rashes;N/V/D;Arthalgia/arthritis;Mouth ulcers;History of autoimmune disease;Family history of autoimmune disease (biological relatives only, if applicable) | Alphanumeric |
Check all that apply |
Adult | Core | 1.00 | 2018-01-05 09:23:33.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C57810 | Infection condition medication past year indicator | InfectCondMedPastYrInd | The indicator relating to whether the subject has taken medication for infections in the past year | The indicator relating to whether the subject has taken medication for infections in the past year | Take medications | No;Yes | No;Yes | Alphanumeric |
In the past year |
Adult | Exploratory | 1.00 | 2018-01-11 08:46:57.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57373 | Medical history eye condition other text | MedHistEyeCondOthrTxt | Text describing another eye condition the subject has a medical history of | Text describing another eye condition the subject has a medical history o | Other, specify: | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 14:20:56.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C57711 | Skin condition diagnosis type | SkinCondDiagnosTyp | Any type of the skin conditions listed that the subject has ever been diagnosed with | Any type of the skin conditions listed that the subject has ever been diagnosed wit | Condition diagnosed | Psoriasis;Eczema;Dermatomyositis;Contact dermatitis;Vasculitis;Zoster;Other allergic skin reactions;Other, specify;Hives | Psoriasis;Eczema;Dermatomyositis;Contact dermatitis;Vasculitis;Zoster;Other allergic skin reactions;Other, specify;Hives | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 10:09:26.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C57273 | Gut condition diagnosis year value | GutCondDiagnosYrVal | The year that the subject was diagnosed with gut condition(s) | The year that the subject was diagnosed with gut condition(s) | Year(s) of diagnosis | Numeric Values | Adult | Exploratory | 1.00 | 2018-01-05 10:09:40.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Free-Form Entry |
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| C58436 | Lung condition inactive resolved other text | LundCondInactResolvOthTxt | Free-text field to specify any other lung conditions the subject has had that are no longer active or are considered resolved or cured | Free-text field to specify any other lung conditions the subject has had that are no longer active or are considered resolved or cured | 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 | 255 |
Free-Form Entry |
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| C57420 | Ear nose throat condition medication past year indicator | EarNoseThroatCondMedPastYrInd | The indicator relating to whether the subject has taken medication for an ear, nose, throat condition in the past year | The indicator relating to whether the subject has taken medication for an ear, nose, throat condition in the past yea | Take medications | No;Yes | No;Yes | Alphanumeric |
In the past year |
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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| C57772 | Blood immune condition medication currently indicator | BldImmuneMedCurrentInd | The indicator relating to whether the subject takes medication for blood or immune conditions daily | The indicator relating to whether the subject takes medication for blood or immune conditions daily | Currently take medication(s) | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 13:00:12.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57313 | Adverse reaction drug name | AdverseRxnDrugName | The name of the drug to which the participant/subject has an adverse reaction | The name of the drug to which the participant/subject has an adverse reaction | Drug name | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:42:39.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C57358 | ROME I criteria type | ROMEICritTyp | The type of ROME I criteria for Irritable Bowel Syndrome that has continuously or recurrently occurred for at least 3 months | The type of ROME I criteria for Irritable Bowel Syndrome that has continuously or recurrently occurred for at least 3 month | At least three months of continuous or recurrent symptoms: | Abdominal pain or dscomfort;Two or more of the following, on at least one-fourth of occasions or days | Abdominal pain or dscomfort;Two or more of the following, on at least one-fourth of occasions or days | Alphanumeric | Adult | Supplemental-Highly Recommended | 1.00 | 2018-01-05 12:11:14.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C57584 | Ear nose throat condition diagnosed other specify text | EarNoseThroatCondDiagOthSpTxt | Free-text field related to describe other ear, nose, throat conditions with which the participant/subject has been diagnosed | Free-text field related to describe other ear, nose, throat conditions with which the participant/subject has been diagnosed | Other, specify: | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-09 09:23:51.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 500 |
Free-Form Entry |
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| C57262 | Antibiotic long term repeated history indication text | AntibLngTermRepHistIndicTxt | Free-text field to describe the indication for which the participant/subject has had a history of long-term or repeated use | Free-text field to describe the indication for which the participant/subject has had a history of long-term or repeated use | Indication: | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 09:42:20.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C57812 | Infection condition medication currently indicator | InfectCondMedCurrentInd | The indicator relating to whether the subject takes medication for infections daily | The indicator relating to whether the subject takes medication for infections daily | Currently take medications | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-11 08:46:57.0 | 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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| C57378 | Eye condition active indicator | EyeCondActiveInd | The indicator relating to whether the subject currently has an eye condition | The indicator relating to whether the subject currently has an eye condition | Condition active | 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 | Adult | Exploratory | 1.00 | 2018-01-08 08:39:13.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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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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| 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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| 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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| 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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| 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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| C57423 | Ear nose throat condition medication name | EarNoseThroatCondMedName | The name of the medication(s) the subject is taking for an ear, nose, throat condition | The name of the medication(s) the subject is taking for an ear, nose, throat condition | Medication name(s) | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-08 09:38:14.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C57774 | Blood immune condition medication work well indicator | BldImmuneMedWorkWellInd | The indicator relating to whether the medication(s) the subject is taking for blood or immune conditions is (are) working well | The indicator relating to whether the medication(s) the subject is taking for blood or immune conditions is (are) working well | Medications work well | Yes;No;Not applicable | Yes;No;Not applicable | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 13:02:58.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57316 | Adverse reaction drug receive year text | AdverseRxnDrugYrTxt | Free-text field to indicate the year(s) the participant/subject has received a drug which causes an adverse reaction | Free-text field to indicate the year(s) the participant/subject has received a drug which causes an adverse reaction | Year(s) received | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:46:28.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C57361 | ROME I criteria PLUS type | ROMEICritPLUSTyp | The ROME I criteria that requires two or more of the following conditions under the PLUS section | The ROME I criteria that requires two or more of the following conditions under the PLUS sectio | Two or more of the following, on at least one-fourth of occassions or days: | Altered stool form (lumpy and hard, or loose and watery);Altered stool passage (straining, urgency, or a feeling of incomplete evacuatioin);Altered stool freuqency (for research purposes, ''altered'' may be defined as more than three bowel movements each day or fewer than three bowel movements each week);Passage of mucus;Bloating or feeling of abdominal | Altered stool form (lumpy and hard, or loose and watery);Altered stool passage (straining, urgency, or a feeling of incomplete evacuatioin);Altered stool freuqency (for research purposes, ''altered'' may be defined as more than three bowel movements each day or fewer than three bowel movements each week);Passage of mucus;Bloating or feeling of abdominal | Alphanumeric | Adult | Supplemental-Highly Recommended | 1.00 | 2018-01-05 12:45:19.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C57595 | Gut condition diagnosis type | GutCondDiagnosTyp | Any gut conditions the subject has ever been diagnosed with | Any gut conditions the subject has ever been diagnosed wit | Condition diagnosed | Peptic ulcer;Hiatus hernia;Hepatitis A;Hepatitis B;Hepatitis C;Hepatitis, type unspecified;Gall bladder disease;Liver disease;Cirrhosis;Chronic pancreatitis;Pancreatitis;Celiac disease;Irritable bowel syndrome;Crohn's disease;Colorectal cancer;Ulcerative colitis;Other, specify | Peptic ulcer;Hiatus hernia;Hepatitis A;Hepatitis B;Hepatitis C;Hepatitis, type unspecified;Gall bladder disease;Liver disease;Cirrhosis;Chronic pancreatitis;Pancreatitis;Celiac disease;Irritable bowel syndrome;Crohn's disease;Colorectal cancer;Ulcerative colitis;Other, specify | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-09 10:24:06.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C57264 | Antibiotic long term repeated history use year text | AntibLongTermRepHistUseYrTxt | The year(s) that the subject has used antibiotics repeatedly or long term | The year(s) that the subject has used antibiotics repeatedly or long ter | When (year(s)): | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 09:57:29.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C57814 | Infection condition medication work well indicator | InfectCondMedWorkWellInd | The indicator relating to whether the medication(s) the subject is taking for infections is (are) working well | The indicator relating to whether the medication(s) the subject is taking for infections is (are) working well | Medications work well | Yes;No;Not applicable | Yes;No;Not applicable | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-11 08:54:19.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57381 | Eye condition medication current indicator | EyeCondMedctnCurrentInd | The indicator relating to whether the subject currently takes medication for eye conditions | The indicator relating to whether the subject currently takes medication for eye conditions | Currently 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 | 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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| C57714 | Skin condition medication past year indicator | SkinCondMedPastYrInd | The indicator relating to whether the subject has taken medication for skin condition(s) in the past year | The indicator relating to whether the subject has taken medication for skin condition(s) in the past yea | Take medications | No;Yes | No;Yes | Alphanumeric |
In the past year |
Adult | Exploratory | 1.00 | 2018-01-10 11:02:19.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57277 | Food component hypersensitivity reaction type text | FoodCompHypersRxnTypTxt | Free-text field describing the reaction the participant/subject has as a result of a food component hypersensitivity | Free-text field describing the reaction the participant/subject has as a result of a food component hypersensitivity | Reaction | Alphanumeric |
Hives, vomiting, other |
Adult | Exploratory | 1.00 | 2018-01-05 10:16:42.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 500 |
Free-Form Entry |
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| C57319 | Atopy allergic disorder history indicator | AtopyAllDisordrHistInd | The indicator relating to whether the participant/subject has a history of atopy/allergic disorders | The indicator relating to whether the participant/subject has a history of atopy/allergic disorder | History of atopy/allergic disorders | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:49:14.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57424 | Ear nose throat condition medication work well indicator | EarNoseThroatMedWorkWellInd | The indicator relating to whether the medication(s) the subject is taking for ear, nose, throat condition(s) is(are) working well | The indicator relating to whether the medication(s) the subject is taking for ear, nose, throat condition(s) is(are) working wel | Medication(s) work well | Yes;No;Not applicable | Yes;No;Not applicable | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-08 09:39:58.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57780 | Blood immune condition active indicator | BldImmuneCondActInd | The indicator relating to whether the subject currently has an active blood or immune condition | The indicator relating to whether the subject currently has an active blood or immune condition | Condition active | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 13:27:49.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C57362 | ROME I criteria indicator | ROMEICritInd | The indicator relating to whether the ROME I criteria for Irritable Bowel Syndrome has been met | The indicator relating to whether the ROME I criteria for Irritable Bowel Syndrome has been me | Rome I criteria: | No;Yes | No;Yes | Alphanumeric | Adult | Supplemental-Highly Recommended | 1.00 | 2018-01-05 12:49:23.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
