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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
Item count: 14 (14 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
C17872
Family history medical condition text
FmlyHistMedclCondTxt
Specification of other disease that a family member or ancestor of the participant/subject has had a history of a medical condition or health related event
Condition
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
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.
Supplemental - Highly Recommended
No references available
Adult;Pediatric
Supplemental–Highly Recommended
3.0
7/24/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
Family history medical condition indicator
 
Single Pre-Defined Value Selected
     
3165788
 
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.
Supplemental - Highly Recommended
No references available
Adult;Pediatric
Supplemental–Highly Recommended
1.0
5/27/2014
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
 
4000
Free-Form Entry
     
3165810
 
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 Family Member to Participant/ Subject
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
Supplemental - Highly Recommended
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–Highly Recommended
3.0
7/24/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
Family history medical condition relative type
 
Multiple Pre-Defined Values Selected
     
3165810
 
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
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
 
4000
Free-Form Entry
     
3165585
 
C00720
Family history medical condition type
FamHistMedclCondTyp
Type of medical condition or health related event for which the family history is taken
Condition
  
Alphanumeric
Supplemental - Highly Recommended
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
Family history medical condition type
 
Multiple Pre-Defined Values Selected
     
3165585
 
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
General Health History
Participant History and Family History
Family history members with medical condition number
 
Free-Form Entry
1
99
     
C12666
Family history muscle disease type
FmlyHistMuscleDiseaseTyp
Type of muscle disease for which participant/subject has family history
Muscle Disease not Duchenne Muscular Dystrophy or Becker Muscular Dystrophy
DMD or BMD;Other, specify;Hereditary, specify;Inflammatory, specify;
DMD or BMD;Other, specify;Hereditary, specify;Inflammatory, specify;
Alphanumeric
Supplemental - Highly Recommended
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Family History
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
Muscle Disease not Duchenne Muscular Dystrophy or Becker Muscular Dystrophy
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C18207
Family history DMD BMD diagnosis type
FmlyHistDMDBMDDiagnsisTyp
Type of diagnosis method for relative with DMD or BMD
Diagnosed?
Clinical diagnosis;Genetic Testing;Muscle biopsy;Obligate carrier based on family structure;Don’t know/ Unsure;Not applicable;
Clinical diagnosis;Genetic Testing;Muscle biopsy;Obligate carrier based on family structure;Don’t know/ Unsure;Not applicable;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/21/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C18201
Family history DMD BMD diagnosis age value
FmlyHistDMDBMDDiagnsisAgeVal
Age at which relative was diagnosed with DMD or BMD
Age when diagnosed?
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/21/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
  
Free-Form Entry
       
C18206
Family history DMD BMD relative decease indicator
FmlyHistDMDBMDReltvDeceseInd
Indicator for whether relative with DMD or BMD is deceased
Deceased?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/21/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C18205
Family history DMD BMD current decease age value
FmlyHistDMDBMDCrrntDecesAgeVal
Value of current age or age at death for relative with DMD or BMD
Current Age or Age at Death
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/21/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
  
Free-Form Entry
       
C18203
Family history DMD BMD death cause text
FmlyHistDMDBMDDeathCauseTxt
Text describing the cause of death for relative with DMD or BMD
Cause of Death?
  
Alphanumeric
Record the cause of death using explanatory text and the associated ICD-9-CM code. Include the primary cause of death first followed by any secondary causes.
No references available
Adult;Pediatric
Supplemental
3.0
7/21/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
07-20-2019
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