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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: Facioscapulohumeral Muscular Dystrophy
Sub-Domain: General Health History
CRF: Family History
Item count: 12 (12 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
The majority of the medical conditions are Supplemental with the exception of the following which are Core: Developmental Delays; Epilepsy (pediatric only); Seizures without epilepsy diagnosis (pediatric only); Heart Disease; Muscle Disease; Peripheral Neuropathy
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
 
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
Answer for first and second degree blood relatives. The majority of the medical conditions are Supplemental with the exception of the following which are Core: Developmental Delays; Epilepsy (pediatric only); Seizures without epilepsy diagnosis (pediatric only); Heart Disease; Muscle Disease; Peripheral Neuropathy
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
 
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. Unknown response should be used if uncertain about family history.
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 indicator
 
Single Pre-Defined Value Selected
     
3165788
 
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;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;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
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
 
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
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
General Health History
Participant History and Family History
Family history members with medical condition number
 
Free-Form Entry
1
99
     
C19667
Family history diagnosis type
FmlyHistDiagnsisTyp
Type of diagnosis method for relative
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
1.0
2/18/2015
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C19669
Family history diagnosis age value
FmlyHistDiagnsisAgeVal
Age at which relative was diagnosed with the disease in question
Age when diagnosed?
  
Numeric Values
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
2/18/2015
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
  
Free-Form Entry
0
130
years
    
C19670
Family history diagnosis age indicator
FmlyHistDiagnsisAgeInd
Indicator for whether the participant/subject knows the age of the relative when diagnosed
Age when diagnosed?
Not known;
Not known;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
2/18/2015
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C14943
Family history relative deceased indicator
FamHxReltvDeceaseInd
Indicator of whether family member is deceased
Deceased?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/14/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
Deceased indicator
 
Single Pre-Defined Value Selected
       
C19671
Family history current decease age value
FmlyHistCrrntDecesAgeVal
Value of current age or age at death for relative with the disease in question
Current Age, or Age at Death
  
Numeric Values
If applicable.
No references available
Adult;Pediatric
Supplemental
1.0
2/18/2015
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
  
Free-Form Entry
0
130
years
    
C16147
Family history relative death cause text
FmlyHistRltvDeathCauseTxt
Cause of death of the participant/subject's relative, if applicable
Cause of Death?
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
6/11/2013
Aliases for variable name not defined
Family History
General Health History
Participant History and Family History
Family history relative death cause text
255
Free-Form Entry
       
07-15-2019
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