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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: Sport Related Concussion
SubDisease: Comprehensive
Sub-Domain: General Health History
CRF: Personal Medical History
Item count: 42 (42 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
C19256
Study protocol name
StudyProtocolName
Name of study protocol
Study Name/ID
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
6/5/2014
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C17402
Site name
SiteName
The name of the site for the study
Site Name
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
6/21/2013
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
Site name
255
Free-Form Entry
       
C19247
Subject ID
SubIDNam
Subject identification ID
Subject ID
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
6/5/2014
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
C08113
Born prematurely indicator
BornPrematurInd
Indicator of whether the participant/subject was informed by a physician or parent/guardian that he/she was born prematurely
Premature birth
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one.
No references available
Adult;Pediatric
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
Born prematurely indicator
 
Single Pre-Defined Value Selected
       
C53042
Neonatal intensive care unit (NICU) indicator
NICUInd
Indicator of whether the participant/subject has a medical history of being in the Neonatal Intensive Care Unit (NICU) at birth.
NICU (Neonatal Intensive Care Unit) at Birth
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one.
No references available
Adult;Pediatric
Supplemental
1.0
2/3/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C53043
Developmental disorder indicator
DevelopmenatlDisorderInd
Indicator of whether the participant/subject has a medical history of a developmental disorder.
Other developmental disorder
Yes;No;
Yes;No;
Alphanumeric
Choose one.
No references available
Adult;Pediatric
Supplemental
1.0
2/3/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C53045
Developmental disorder type
DevelopmentallDisorderTyp
Type of developmental disorder of the participant/subject.
Check all that apply
ADD;HD;LD;Other specify;
ADD;HD;LD;Other specify;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.1
7/30/2018
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Multiple Pre-Defined Values Selected
       
C53061
Developmental disorder type other text
DevelopmntlDisordrOtherTypeTxt
The free-text field related to 'Developmental disorder type' specifying other text
Other specify
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.1
7/30/2018
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
C53049
Traumatic brain injury indicator
TraumaticBrainInjuryInd
Indicator of whether participant/subject has medical history of traumatic brain injury.
Moderate/Severe Traumatic Brain injury
Yes;No;
Yes;No;
Alphanumeric
This does NOT include concussions
No references available
Adult;Pediatric
Supplemental
1.0
2/3/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C53050
Vision problem indicator
VisionProblemInd
Indicator of whether participant/subject has medical history of a vision problem.
Vision Problems (other than need for glasses/contacts)
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
2/3/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C53057
Vision problem indicator text
VisionProblemIndicatorTxt
Text relating to participant/subject medical history of a vision problem.
Comment
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
2/3/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
C53052
Hearing problem indicator
HearingProblemInd
Indicator of whether participant/subject has medical history of a hearing problem.
Hearing Problems
Yes;No;
Yes;No;
Alphanumeric
Choose one.
No references available
Adult;Pediatric
Supplemental
1.0
2/3/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C53058
Hearing problem indicator text
HearingProblemIndicatorTxt
Text relating to participant/subject medical history of a hearing problem.
Comment
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
2/3/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
C53059
Stroke indicator
StrokeInd
Indicator of whether participant/subject has a medical history of stroke.
Stroke
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
2/3/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C53060
Stroke indicator text
StrokeIndicatorTxt
Text relating to participant/subject medical history of stroke.
Comment
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
2/3/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
C55574
Major cv risk type
MajorCvRisktype
Type of major cv risk the participant/subject has
Major CV risk
HTN;CAD/MI;PVD;
Hypertension;Coronary artery disease/Myocardial infarction;Peripheral vascular disease;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
2/3/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
C55662
Major CV risk type text
MajorCVRiskTypeTxt
Text regarding type of cardiovascular risk type.
Comment
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/22/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
C55568
Arthritis Indicator
ArthritisInd
Indicator as to whether the participant/subject has been diagnosed with arthritis
Arthritis
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/12/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Multiple Pre-Defined Values Selected
       
C55572
Arthritis indicator text
ArthritisIndicatorTxt
Text relating to participant/subject medical history of arthritis
Comment
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
2/3/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
C55575
Neurological disorder indicator
NeuroDisorderInd
Indicator as to whether the participant/subject has a neurological disorder
Neurological Disorder
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/12/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Multiple Pre-Defined Values Selected
       
C55576
Neurological disorder indicator text
NeuroDisorderIndTxt
Text relating to whether the participant/subject has a neurological disorder
Comment
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
5/12/2017
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Multiple Pre-Defined Values Selected
       
C53062
Diabetes mellitus medical history indicator
DiabetesMellMedHistInd
Indicator as to whether the participant/subject has a medical history of diabetes mellitus (type I or type II)
Diabetes
Yes;No;
Yes;No;
Alphanumeric
Choose one
No references available
Adult;Pediatric
Supplemental
3.0
7/15/2013
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C53064
Diabetes mellitus indicator text
DiabetesMellIndTxt
Text related to participant/subject medical history of diabetes mellitus (type I or type II)
Comment
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/15/2013
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
C53063
Confusion indicator
ConfusionInd
Indicator as to whether the participant/subject has a medical history of confusion
Confusion
Yes;No;
Yes;No;
Alphanumeric
Choose one.
No references available
Adult;Pediatric
Supplemental
3.0
7/15/2013
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C53065
Confusion indicator text
ConfusionIndicatorTxt
Text related to participant/subject medical history of confusion
Comment
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/15/2013
Aliases for variable name not defined
Personal Medical History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
12-15-2018
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