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CDE Detailed Report
This report contains detailed information about the selected CDEs.
Note: If at least one CDE was selected from a copyright- or trademark-protected instrument/scale then all of the CDEs from that instrument/scale are included in this report.
Disease:
Sub-Domain: General Health History
CRF: Surgical and Hospitalization History - SMA
Item count: 20 (20 distinct CDEs)
CDE ID
CDE Name
Variable Name
Definition / Description
Question Text
Permissible Value
Description
Data Type
Instructions
References
Population
Classification (e.g., Core)
Version #
Version Date
Aliases for Variable Name
CRF Module / Guideline
© or TM
Sub-Domain
Domain
Previous Title
Size
Input Restrictions
Min Value
Max Value
Measurement Type
LOINC ID
SNOMED
caDSR ID
CDISC ID
C17971
Hospitalization non surgical number
HosptlizatnNonSurgNum
Number used to identify the non-surgical hospitalization being described
Hospitalization Number
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
  
Free-Form Entry
1
99
     
C21669
Surgical or therapeutic procedure ICD-10-CM other text
SurgTherapuProcICD10CMOTH
The free-text field related to 'Surgical or therapeutic procedure ICD-10-CM code' specifying other text. Code from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for the selected surgical procedure
Other, specify
  
Alphanumeric
If the data will be shared, code each surgical procedure using ICD-10-CM
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): http://www.cdc.gov/nchs/icd/icd10cm.htm#icd2016
Adult;Pediatric
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C18765
Surgical or therapeutic procedure other text
SurgTherapProcedurOTH
The free-text field related to 'Surgical or therapeutic procedure type' specifying other text. Type of surgical or therapeutic procedure received by the participant/subject
Other, specify
  
Alphanumeric
Additional lines and other surgeries should be added as appropriate
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): http://www.cdc.gov/nchs/icd/icd9cm.htm
Adult;Pediatric
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C05108
Surgical or therapeutic procedure type
SurgTherapProcedurTyp
Type of surgical or therapeutic procedure received by the participant/subject
Past Surgical History
Appendicectomy;Cholecystectomy;Colostomy;Ileostomy;Feeding tube placement;Fundoplication;Scoliosis surgery;Tendon release;Tympanostomy tubes;Tracheostomy;Airway surgery;Other surgery, specify;Unknown;Diagnostic;Anterior temporal lobectomy (ATL);Anterior temporal lobectomy plus (ATL+);Amygdalohippocampectomy;Lesionectomy;Lesionectomy plus (Lesionectomy +);Extratemporal resection (Topectomy);Multi-lobar resection;Hemispherectomy;Vagus nerve stimulation (VNS) surgery;Corpus callosotomy;Multiple subpial transaction;Radiosurgery;Therapeutic brain stimulation;Other, specify;Appendicostomy;Appendectomy;Neurological surgery;Bony orthopedic surgery;
Appendicectomy;Cholecystectomy;Colostomy;Ileostomy;Feeding tube placement;Fundoplication;Scoliosis surgery;Tendon release;Tympanostomy tubes;Tracheostomy;Airway surgery;Other surgery, specify;Unknown;Diagnostic surgery;Anterior temporal lobectomy (ATL);Anterior temporal lobectomy plus (ATL+);Amygdalohippocampectomy;Lesionectomy;Lesionectomy plus (Lesionectomy +);Extratemporal resection (Topectomy);Multi-lobar resection;Hemispherectomy;Vagus nerve stimulation (VNS) surgery;Corpus callosotomy;Multiple subpial transaction;Radiosurgery;Therapeutic brain stimulation;Other, specify;Appendicostomy (antegrade colonic anema);Appendectomy;Neurological surgery;Bony orthopedic surgery;
Alphanumeric
Additional lines and other surgeries should be added as appropriate
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): http://www.cdc.gov/nchs/icd/icd9cm.htm
Adult;Pediatric
Supplemental
3.0
7/25/2013
Refer to SCI CDE Annotated Form
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Surgical or therapeutic procedure type
 
Multiple Pre-Defined Values Selected
       
C21668
ICD-10-CM code
SurgTherapuProcICD10CMCode
Code from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-10-CM) for the selected surgical procedure
Reason
  
Alphanumeric
If the data will be shared, code each surgical procedure using ICD-10-CM
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): http://www.cdc.gov/nchs/icd/icd10cm.htm#icd2016
Adult;Pediatric
Supplemental
1.0
8/28/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
  
Multiple Pre-Defined Values Selected
       
C06025
Surgical or therapeutic procedure performed indicator
SurgTherProcedurPerfInd
Indicator whether the participant/subject has undergone the selected surgical procedure
Yes/No
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
For each type of surgical procedure indicate if it was ever performed
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Refer to SCI CDE Annotated Form
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Surgical or therapeutic procedure type performed indicator
 
Single Pre-Defined Value Selected
       
C18868
Surgical history procedure scoliosis other text
SurgHistProcedurScoliosisOTH
The free-text field related to 'Surgical history procedure scoliosis type' specifying other text. Type of surgical procedure the participant/ subject has undergone for the treatment of scoliosis
Other, specify
  
Alphanumeric
Choose all that apply. Only answer if 'Scoliosis surgery' is answered Yes.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C12674
Surgical history procedure scoliosis type
SurgHistProcedurScoliosisTyp
Type of surgical procedure the participant/ subject has undergone for the treatment of scoliosis
If Yes, type of scoliosis surgery
Non-extendable rod;Extendable rod;Vertical Expandable Prosthetic Titanium Rib;Fusion;Other, specify;
Non-extendable rod;Extendable rod;Vertical Expandable Prosthetic Titanium Rib (VEPTR);Fusion;Other, specify;
Alphanumeric
Choose all that apply. Only answer if 'Scoliosis surgery' is answered Yes.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Scoliosis surgical or therapeutic procedure type
 
Multiple Pre-Defined Values Selected
       
C12675
Surgical history procedure tendon release type
SurgHistProcedurTendnReleasTyp
Type of surgical procedure the participant/ subject has undergone for tendon release
If Yes
Achilles tendon;Hip release;Tensor fascia lata release;Knee release;Elbow release;Other, specify;
Achilles tendon;Hip release;Tensor fascia lata release;Knee release;Elbow release;Other, specify;
Alphanumeric
Choose all that apply. Only answer if 'Tendon release surgery' is answered Yes.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Tendon release type
 
Multiple Pre-Defined Values Selected
       
C18869
Surgical history procedure tendon release other text
SurgHistProcedurTendnReleasOTH
The free-text field related to 'Surgical history procedure tendon release type' specifying other text. Type of surgical procedure the participant/ subject has undergone for tendon release
Other, specify
  
Alphanumeric
Choose all that apply. Only answer if 'Tendon release surgery' is answered Yes.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C12677
Surgical history procedure tympanostomy same ear count
SrgHistProcdrTympnostSameEarCt
Count of times that the participant/subject has undergone tympanostomy tube insertion in the same ear
If Yes, how many times in the same ear?
  
Numeric Values
Only answer if 'Tympanostomy tubes' was answered Yes.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Tympanostomy tube insertion same ear number
 
Free-Form Entry
1
42
     
C05106
Surgical or therapeutic procedure start date and time
SurgTherapuProcStartDateTime
Date (and time, if applicable and known) on which the surgical or therapeutic procedure started
Date(s) - list all (MM/YYYY) or Age (approximate)
  
Date or Date & Time
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Refer to SCI CDE Annotated Form
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Surgical or therapeutic procedure start date and time
 
Free-Form Entry
       
C08018
Surgery age value
SurgAgeVal
Age of the participant/subject at the time of the selected surgical procedure
Date(s) - list all (MM/YYYY) or Age (approximate)
  
Numeric Values
This value can be captured in years or months.
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Surgery age value
 
Free-Form Entry
0
99
     
C12678
Hospitalization non surgical total lifetime count
HosptlNonSurgTtlLifetimCt
Count of the total number of times that the participant/subject has been hospitalized for a non-surgical reason
Total number of hospitalizations in lifetime
  
Numeric Values
No additional instructions
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Hospitalization total lifetime number
 
Free-Form Entry
0
99
     
C10609
Hospitalization reason
HospitRsn
Reason why the participant/subject was hospitalized, excluding all surgeries
Reason
Pneumonia or Respiratory;Failure to Thrive;Dehydration;Other, specify;Trauma;Infection other than pneumonia;Fracture;Seizures;Cardiomyopathy/Arrhythmia;
Pneumonia or Respiratory;Failure to Thrive;Dehydration;Other, specify;Trauma;Infection other than pneumonia;Fracture;Seizures;Cardiomyopathy/Arrhythmia;
Alphanumeric
Record the letter corresponding to the reason applicable in the “Reasons” list. For “Other, specify”, also record the other reason the subject/participant was admitted to the hospital.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Hospitalization reason
 
Multiple Pre-Defined Values Selected
       
C18805
Hospitalization other text
HospitOTH
The free-text field related to 'Hospitalization reason' specifying other text. Reason why the participant/subject was hospitalized, excluding all surgeries
Other, specify
  
Alphanumeric
Record the letter corresponding to the reason applicable in the “Reasons” list. For “Other, specify”, also record the other reason the subject/participant was admitted to the hospital.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C12680
Hospitalization non-surgical elective indicator
HosptlizatnNonSurgElectvInd
Indicator of whether the enumerated non-surgical hospitalization was elective
Elective?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Record if hospitalization was elective (versus emergent)
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Hospitalization elective indicator
 
Single Pre-Defined Value Selected
       
C05408
Hospital admission date and time
HospitlAdmissDateTime
Date (and time, if applicable and known) the participant/subject was admitted to the hospital
Admission Date (MM/YYYY) or Age (approximate)
  
Date or Date & Time
Record the admission date for each hospitalization episode. Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). If date unknown, use approximate age.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
SCI CDEs: ADMITDT
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Hospital admission date and time
 
Free-Form Entry
       
C04804
Hospital discharge date and time
HospitDischgDateTime
Date (and time, if applicable and known) the participant/subject was discharged from the hospital
Discharge Date (MM/YYYY) or Age (approximate)
  
Date or Date & Time
Record the discharge date for each hospitalization episode. Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). If date unknown, use approximate age.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Hospital discharge date and time
 
Free-Form Entry
       
C12681
Hospitalization non-surgical ventilation indicator
HospitlNonSurgVentilatnInd
Indicator of whether the participant/subject was ventilated while in the hospital for the specified non-surgical reason
Ventilated?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one for each hospitalization episode
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Surgical and Hospitalization History - SMA
General Health History
Participant History and Family History
Hospital ventilated indicator
 
Single Pre-Defined Value Selected
       
12-17-2018
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