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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: Friedreich's Ataxia
Sub-Domain: General Health History
CRF: History Data Source and Reliability
Item count: 6 (6 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
C08147
Data source
DataSource
Source of the data provided on the case report form
Indicate how the medical/family history information was obtained
Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Unknown;Spouse;Other, specify;
Participant/subject;Mother;Father;Sister;Brother;Son;Daughter;Family, specify relation;Friend;Physician;Chart/Medical record;Unknown;Spouse;Other, specify;
Alphanumeric
Choose all that apply
No references available
Adult;Pediatric
Exploratory
3.0
7/20/2013
Aliases for variable name not defined
History Data Source and Reliability
General Health History
Participant History and Family History
Data source
 
Multiple Pre-Defined Values Selected
       
C18667
Data source other text
DataSourcOTH
The free-text field related to 'Data source' specifying other text. Source of the data provided on the case report form
Other, specify
  
Alphanumeric
Choose all that apply
No references available
Adult;Pediatric
Exploratory
1.0
5/27/2014
Aliases for variable name not defined
History Data Source and Reliability
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C18824
History data not obtained other text
HistDataNotObtOTH
The free-text field related to 'History data not obtained reason' specifying other text. Reason(s) the medical/family history data were not obtained from the participant/subject and instead were obtained from alternate source(s).
Other, specify
  
Alphanumeric
Choose all that apply
No references available
Adult;Pediatric
Exploratory
3.0
7/11/2013
Aliases for variable name not defined
History Data Source and Reliability
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C11133
History data not obtained reason
HistDataNotObtRsn
Reason(s) the medical/family history data were not obtained from the participant/subject and instead were obtained from alternate source(s).
If the medical/family history information was not obtained from the participant/subject, indicate the reason(s) the information were obtained from alternate source(s).
Dementia;Aphasia;Other cognitive impairment;Not fluent in examiner's language;Poor historian;Too young;Other, specify;
Dementia;Aphasia;Other cognitive impairment;Not fluent in examiner's language;Poor historian;Too young;Other, specify;
Alphanumeric
Choose all that apply
No references available
Adult;Pediatric
Exploratory
3.0
7/11/2013
Aliases for variable name not defined
History Data Source and Reliability
General Health History
Participant History and Family History
History data not obtained reason
 
Multiple Pre-Defined Values Selected
       
C17501
Medical history information source family text
MedHistInfoSourceFmlyTxt
Text specifying the relation of the family member, from whom medical/family history information was obtained, to the participant.
Family, specify relation
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Exploratory
3.0
7/15/2013
Aliases for variable name not defined
History Data Source and Reliability
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
C11134
History data reliability type
MedHistInfoReliablGrade
Overall assessment of the reliability of the medical/family history data obtained
Overall assessment fo the reliability of the medical/family history information obtained
Definitely reliable;Probably reliable;Not reliable;
Definitely reliable;Probably reliable;Not reliable;
Alphanumeric
Choose one
No references available
Adult;Pediatric
Exploratory
3.0
7/11/2013
Aliases for variable name not defined
History Data Source and Reliability
General Health History
Participant History and Family History
History data reliability type
 
Single Pre-Defined Value Selected
       
07-21-2019
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