CDE Detailed Report

Disease: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Subdomain Name: Demographics
CRF: Demographics

Displaying 1 - 10 of 10
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
C58638 Sex type code other text SexTypeCodeOTH The free-text field relating to 'Sex Type Code' specifying other text The free-text field relating to 'Sex Type Code' specifying other text Other = please specify Alphanumeric Adult Supplemental 1.00 2019-07-05 11:46:01.0 Demographics Demographics Participant Characteristics 25

Free-Form Entry

C58639 Marital status code MaritalStatusCode Code for the subject/participant's marital status Code for the subject/participant's marital status Marital status 1;2;3;4;5;99 Married or living with partner;Separated;Divorced;Widowed;Never married;Missing Numeric Values Adult Core 1.00 2019-07-05 11:59:55.0 Demographics Demographics Participant Characteristics

Single Pre-Defined Value Selected

C58636 Race USA category code RaceUSACategoryCode Code for the subject/participant's self declared racial origination, independent of ethnic origination, using OMB approved categories Code for the subject/participant's self declared racial origination, independent of ethnic origination, using OMB approved categorie Race 0;1;2;3;4;5;99 White;Black/African American;American Indian or Alaska Native;Asian/Pacific Islander;Other;Two or more races;Missing Numeric Values Adult Core 1.00 2019-07-05 11:18:19.0 Demographics Demographics Participant Characteristics

Single Pre-Defined Value Selected

C58637 Sex type code SexTypeCode Code for the subject/participant's sex Code for the subject/participant's sex Gender 1;2 Male;Female Numeric Values Adult Core 1.00 2019-07-05 11:40:21.0 Demographics Demographics Participant Characteristics

Single Pre-Defined Value Selected

C00007 Birth date BirthDate Date (and time, if applicable and known) the participant/subject was born Date (and time, if applicable and known) the participant/subject was born Month and Year of Birth Date or Date & Time

When date/time data are prepared for aggregation or sharing they should be converted to the format specified by ISO 8601, YYYY-MM-DDThh:mm:ss.

Adult;Pediatric Core 3.00 2013-07-25 08:54:08.2 Demographics Demographics Participant Characteristics

Free-Form Entry

793
C00020 Ethnicity USA category EthnUSACat Category of ethnicity the participant/subject most closely identifies with Category of ethnicity the participant/subject most closely identifies with Ethnicity Hispanic or Latino;Not Hispanic or Latino;Unknown;Not reported;Other, specify A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. The term "Spanish origin" can also be used in addition to "Hispanic or Latino.";A person not meeting the definition for Hispanic or Latino.;Could not be determined or unsure;Not reported;Other, specify Alphanumeric Adult;Pediatric Core 3.00 2013-08-28 16:08:00.453 Demographics Demographics Participant Characteristics

Single Pre-Defined Value Selected

2192217
C15993 Dependent children number DpndntChildNum Number of dependent children Number of dependent children How many children do you have? Numeric Values Adult Supplemental 3.00 2013-07-16 14:01:43.01 Demographics Demographics Participant Characteristics

Free-Form Entry

C58323 Have children indicator HveChildrenInd Indicator of subject having children Indicator of subject having children Do you have children No;Yes No;Yes Alphanumeric Adult Supplemental 1.00 2018-02-07 14:18:18.0 Demographics Demographics Participant Characteristics

Single Pre-Defined Value Selected

C58326 Live with children indicator LiveWithChildrenInd Indicator of whether the subject/participant lives with their children Indicator of whether the subject/participant lives with their children Do you live with them? No;Yes No;Yes Alphanumeric Adult Supplemental 1.00 2018-02-07 14:33:23.0 Demographics Demographics Participant Characteristics

Single Pre-Defined Value Selected

C58327 Children under 18 years age count ChildUnder18YrAgeCt Count of the number of children the participant/subject has under 18 years of age Count of the number of children the participant/subject has under 18 years of age How many children are under 18 years of age? Numeric Values Adult Supplemental 1.00 2018-02-07 14:35:45.0 Demographics Demographics Participant Characteristics

Free-Form Entry

CSV