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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: Myotonic Muscular Dystrophy
Sub-Domain: General Health History
CRF: Family History
Item count: 13 (13 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
For each question below, regarding relationship of family member, please indicate all that apply:
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
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
 
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?
  
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
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
  
Alphanumeric
(choose all that apply)
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
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
     
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
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
Family history members with medical condition number
 
Free-Form Entry
1
99
     
C19668
Family history medical condition relationship type
FamHistMedclCondRelshpTyp
Relationship of the family member with the medical condition or health related event to the participant/subject
Relative Relationship of Family Member to Participant/Subject
Mother;Father;Brother;Sister;Son;Daughter;Maternal grandmother;Maternal grandfather;Paternal grandmother;Paternal grandfather;Maternal aunt;Maternal uncle;Paternal aunt;Paternal uncle;
Mother;Father;Brother;Sister;Son;Daughter;Maternal grandmother;Maternal grandfather;Paternal grandmother;Paternal grandfather;Maternal aunt;Maternal uncle;Paternal aunt;Paternal uncle;
Alphanumeric
If there is a family history of myotonic muscular dystrophy, complete the table below.
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
  
Multiple Pre-Defined Values Selected
       
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
 
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
       
C19673
Family history relative decease indicator
FmlyHistReltvDeceseInd
Indicator for whether relative with the disease in question is deceased
Deceased?
Yes;No;
Yes;No;
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
       
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
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
    
C19672
Family history death cause text
FmlyHistDeathCauseTxt
Text describing the cause of death for relative with the disease in question
Cause of Death?
  
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
 
255
Free-Form Entry
       
12-10-2018
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