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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: Family History - MG
Item count: 11 (11 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
C00720
Family history medical condition type
FamHistMedclCondTyp
Type of medical condition or health related event for which the family history is taken
Condition
  
Alphanumeric
Record the type of family history conditions present
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Family History - MG
General Health History
Participant History and Family History
Family history medical condition type
 
Multiple Pre-Defined Values Selected
     
3165585
 
C00721
Family history medical condition indicator
FamHistMedclCondInd
Indicator of whether a family member or first and second degree blood relatives of the participant/subject has had a history of the particular medical condition or health related event
Family History?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
If there is a history of this condition in the first or second degree family, indicate YES, otherwise choose NO.
No references available
Adult;Pediatric
Core
3.0
7/24/2013
Aliases for variable name not defined
Family History - MG
General Health History
Participant History and Family History
Family history medical condition indicator
 
Single Pre-Defined Value Selected
     
3165788
 
C18678
Family history medical condition other text
FamHistMedclCondOTH
The free-text field related to 'Family history medical condition type' specifying other text. Type of medical condition or health related event for which the family history is taken
Other, specify
  
Alphanumeric
Record the type of family history conditions present
No references available
Adult;Pediatric
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
Family History - MG
General Health History
Participant History and Family History
 
4000
Free-Form Entry
     
3165585
 
C12664
Family history condition text
FamHistCondTxt
The specific condition or type of condition the participant/subject or participant's/subject's family member has, if applicable
If Family History, condition type (if applicable)
  
Alphanumeric
No additional instructions
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Family History - MG
General Health History
Participant History and Family History
Family history condition text
255
Free-Form Entry
       
C06358
Diabetes mellitus type
DiabetesMellitusTyp
Type of diabetes mellitus
If Family History, condition type (if applicable)
Type 1;Type 2;
Type 1;Type 2;
Alphanumeric
Select type(s) that have affected family members, if applicable.
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
DIABTYHX
Family History - MG
General Health History
Participant History and Family History
Diabetes mellitus type
 
Single Pre-Defined Value Selected
       
C12666
Family history muscle disease type
FmlyHistMuscleDiseaseTyp
Type of muscle disease for which participant/subject has family history
If Family History, condition type (if applicable)
DMD or BMD;Other, specify;Hereditary, specify;Inflammatory, specify;
DMD or BMD;Other, specify;Hereditary, specify;Inflammatory, specify;
Alphanumeric
Select type(s) that have affected family members, if applicable. If Hereditary or Inflammatory, specify muscle disease
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Family History - MG
General Health History
Participant History and Family History
Muscle disease type
 
Multiple Pre-Defined Values Selected
       
C18866
Family history muscle disease other text
FmlyHistMuscleDiseaseOTH
The free-text field related to 'Family history muscle disease type' specifying other text. Type of muscle disease for which participant/subject has family history
Other, specify
  
Alphanumeric
Select type(s) that have affected family members, if applicable. If Hereditary or Inflammatory, specify muscle disease
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Family History - MG
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C19521
Thyroid condition type
ThyroidConditionTyp
Type of thyroid condition
If Family History, condition type (if applicable)
Hypothyroidism;Hyperthyroidism;Hashimoto's;
Hypothyroidism;Hyperthyroidism;Hashimoto's;
Alphanumeric
Select type(s) that have affected family members, if applicable.
No references available
Adult;Pediatric
Supplemental
1.0
7/11/2014
Aliases for variable name not defined
Family History - MG
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C00722
Family history medical condition relative type
FamHistMedclCondReltvTy
Relationship of the family member or ancestor with the medical condition or health related event to the participant/subject
Relationship of Affected Family Member to Participant/Subject (Choose all that apply)
Mother;Father;Full sibling;Half sibling;Child;Maternal grandmother;Paternal grandmother;Maternal grandfather;Paternal grandfather;Maternal aunt;Paternal aunt;Maternal uncle;Paternal uncle;Maternal niece/nephew;Paternal niece/nephew;Grandchild;Maternal cousin;Paternal cousin;Great-grandchild;Other, specify;
Mother;Father;Full sibling;Half sibling;Child;Maternal grandmother;Paternal grandmother;Maternal grandfather;Paternal grandfather;Maternal aunt;Paternal aunt;Maternal uncle;Paternal uncle;Maternal niece/nephew;Paternal niece/nephew;Grandchild;Maternal cousin;Paternal cousin;Great-grandchild;Other, specify;
Alphanumeric
Select the relationship from the options of the family members listed in the "Relationship of family member to participant/subject" column. Record/choose more than one family member, if applicable.
No references available
Adult;Pediatric
Core
3.0
7/24/2013
Aliases for variable name not defined
Family History - MG
General Health History
Participant History and Family History
Family history medical condition relative type
 
Multiple Pre-Defined Values Selected
     
3165810
 
C18679
Family history medical condition relative other text
FamHistMedclCondReltvOTH
The free-text field related to 'Family history medical condition relative type' specifying other text. Relationship of the family member or ancestor with the medical condition or health related event to the participant/subject
Other, specify
  
Alphanumeric
Select the relationship from the options of the family members listed in the "Relationship of family member to participant/subject" column. Record/choose more than one family member, if applicable.
No references available
Adult;Pediatric
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
Family History - MG
General Health History
Participant History and Family History
 
4000
Free-Form Entry
     
3165810
 
C12663
Family history member with medical condition number
FamHistMembMedclCondNum
Number of family members with history of medical condition
Number of Affected Family Members
  
Numeric Values
Record the total number of family members affected by condition.
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Family History - MG
General Health History
Participant History and Family History
Family history members with medical condition number
 
Free-Form Entry
1
99
     
07-15-2019
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