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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: Migraine History
Item count: 23 (23 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 pre-filled
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
6/5/2014
Aliases for variable name not defined
Migraine 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
Migraine History
General Health History
Participant History and Family History
Site name
255
Free-Form Entry
       
C19247
Subject ID
SubIDNam
Subject identification ID
Site Name
  
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
6/5/2014
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
 
255
Free-Form Entry
       
C54373
Headache past three month alcohol substance use unrelated indicator
HdachePstThrMoAlcSubUseUnrlInd
Indicator for whether the participant/subject has had a headache in the past three months that is unrelated to alcohol/substance use
Have you had one or more headaches in the past 3 months, unrelated to alcohol/substance use?
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
Migraine History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C54374
Headache start within two week concussion indicator
HdacheStrtWithnTwoWkConcussInd
Indicator for whether the participant/subject has had headaches that started within two weeks of concussion
Did headaches start within 2 weeks of concussion?
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
Migraine History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C54376
Brain abnormality indicator
BrainAbnormalInd
The indicator related to brain abnormalities
Do you have any brain abnormalities?
Yes;No;
Yes;No;
Alphanumeric
(unrelated to concussion)
No references available
Adult;Pediatric
Supplemental
1.0
12/4/2016
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C54379
Headache daily occurrence indicator
HdacheDailyOccurInd
The indicator related to whether the participant/subject has a headache every day
Do you have a headache every day?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
12/4/2016
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C54381
Headache pain medication more than four days week indicator
HdachPainMedMoreFourDysWkInd
Indicator for whether the participant/subject takes headache pain medication more than four days per week
Do you take over the counter or pescription pain or headache medication more than 4 days per week?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C54382
Headache chronicity type
HeadacheChronicityTyp
The type as related to headache chronicity.
Do you have intermittent or constant headache?
Intermittent;Chronic;
Intermittent;Chronic;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
6/2/2016
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C54383
Headache episode duration
HdacheEpisdDur
The element related to the duration of a headache episode
How long does each headache episode last?
Less than 2 hours;Greater than 2 hours;
Less than 2 hours;Greater than 2 hours;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
6/6/2016
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C54384
Headache neurological symptom before during type
HdacheNeuroSympBefDurTyp
The element related to the type of neurological symptoms before and/or during headache
Do you have neurological symptoms immediately before and/or during your headache?
Visual scotoma;Visual hallucination;Weakness or numbness on one side of the body;
Visual scotoma (blind or black spots);Visual hallucination (zig zag or wavy lines, colored lights or balls, shimmering patterns);Weakness or numbness on one side of the body;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
1.0
6/6/2016
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C54385
Migraine headache pain symptom type
MigrHeadachePainSymptmTyp
The element related to the type of pain symptoms the participant/subject experiences with migraine headaches
Do you have any of these symptoms with headache?
Pain on one side of head only;Throbbing or pulsing pain sensation;Pain limits or restricts routine activities;Pain made worse by routine activity;
Pain on one side of head only;Throbbing or pulsing pain sensation;Pain limits or restricts routine activities;Pain made worse by routine activity;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
  
Multiple Pre-Defined Values Selected
       
C54386
Migraine headache symptom type
MigrHeadacheSymptmTyp
The element related to the type of pain symptoms the participant/subject experiences with migraine headaches
Do you have any of these symptoms with your headache?
Nausea/vomiting;Increased sensitivity to normal light AND sound;Pain on one side of head only;Throbbing or pulsing pain sensation;Pain limits or restricts routine activities;Pain made worse by routine activity;
Nausea/vomiting;Increased sensitivity to normal light AND sound;Pain on one side of head only;Throbbing or pulsing pain sensation;Pain limits or restricts routine activities;Pain made worse by routine activity;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
  
Multiple Pre-Defined Values Selected
       
C54387
Headache prior treatment indicator
HeadachPriorTxInd
Indicator related to prior treatment for headache
Prior treatment for headache?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C53072
Migraine headache indicator
MigraineHeadacheInd
Indicator as to whether the participant/subject has a medical history of migraine headache
Personal history of migraine headache
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/15/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C54388
Migraine headache family history indicator
MigrHeadacheFamHisInd
Indicator as to whether the participant/subject has a family history of migraine headache
Any family history of migraine headaches
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
No instructions available
No references available
Adult;Pediatric
Supplemental
3.0
7/15/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
C17022
Migraine Disability Assessment (MIDAS) - School work absent past three month day count
MIDASSchoWorkAbsPast3MDayCt
Number of days in the last three months the participant/subject has missed work or school because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.
On how many days in the last 3 months did you miss work or school because of your headaches?
  
Numeric Values
If you're not working or going to school, just enter 0.
INSTRUCTIONS: Please answer the following questions about ALL your headaches you have
had over the last 3 months. Write your answer in the box next to each question. Write 0 if you
did not do the activity in the last 3 months. Please provide numbers; example: everyday
headache = 90
Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
MIDAS Q1
 
Free-Form Entry
  
day
    
C17023
Migraine Disability Assessment (MIDAS) - School work productivity reduction past three months day count
MIDASSchlWrkProRedP3MDayCt
Number of days in the last three months the participant/subject has experienced productivity reduction by half or more while at work or school because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.
How many days in the last 3 months was your productivity at work or school reduced by half or more because of your headaches?
  
Numeric Values
If you're not working or going to school. Just enter 0. (Do not include days you counted in question 1 where you missed work or school).
INSTRUCTIONS: Please answer the following questions about ALL your headaches you have
had over the last 3 months. Write your answer in the box next to each question. Write 0 if you
did not do the activity in the last 3 months. Please provide numbers; example: everyday
headache = 90
Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
MIDAS Q2
 
Free-Form Entry
  
day
    
C17024
Migraine Disability Assessment (MIDAS) - Household work not done past three months day count
MIDASHshldNotDoneP3MDayCt
Number of days in the last three months the participant/subject has not done household work because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.
On how many days in the last 3 months did you not do household work because of your headaches?
  
Numeric Values
INSTRUCTIONS: Please answer the following questions about ALL your headaches you have
had over the last 3 months. Write your answer in the box next to each question. Write 0 if you
did not do the activity in the last 3 months. Please provide numbers; example: everyday
headache = 90
Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
MIDAS Q3
 
Free-Form Entry
  
day
    
C17025
Migraine Disability Assessment (MIDAS) - Household work productivity half reduction past three months day count
MIDASHshldWrkProHReP3MCt
Number of days in the last three months the participant/subject has experienced productivity reduction by half or more while doing household work because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.
How many days in the last 3 months was your productivity in household work reduced by hald or more because of your headaches?
  
Numeric Values
Do not include days you counted in question 3 where you did not do household work).
INSTRUCTIONS: Please answer the following questions about ALL your headaches you have
had over the last 3 months. Write your answer in the box next to each question. Write 0 if you
did not do the activity in the last 3 months. Please provide numbers; example: everyday
headache = 90
Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
MIDAS Q4
 
Free-Form Entry
  
day
    
C17026
Migraine Disability Assessment (MIDAS) - Activity missed past three months day count
MIDASActMissP3MDayCt
Number of days in the last three months the participant/subject has missed family, social, or leisure activities because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.
On how many days in the last 3 months did you miss family, social or leisure activities because of your headaches?
  
Numeric Values
INSTRUCTIONS: Please answer the following questions about ALL your headaches you have
had over the last 3 months. Write your answer in the box next to each question. Write 0 if you
did not do the activity in the last 3 months. Please provide numbers; example: everyday
headache = 90
Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
MIDAS Q5
 
Free-Form Entry
  
day
    
C17028
Migraine Disability Assessment (MIDAS) - Headache past three months day count
MIDASHdacheP3MDayCt
Count the total number of days in the past three months the participant/subject had headache, as part of the Migraine Disability Assessment (MIDAS) Test form.
On how many days in the last 3 months did you have a headache?
  
Numeric Values
If a headache lasted more than 1 day, count each day.
INSTRUCTIONS: Please answer the following questions about ALL your headaches you have
had over the last 3 months. Write your answer in the box next to each question. Write 0 if you
did not do the activity in the last 3 months. Please provide numbers; example: everyday
headache = 90
No references available
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
MIDAS QA
 
Free-Form Entry
  
day
    
C17029
Migraine Disability Assessment (MIDAS) - Headache average pain intensity scale
MIDASHdcheAvePainIntenScl
Average pain scale of the headache experienced by the participant/subject, as part of the Migraine Disability Assessment (MIDAS) Test form.
On a scale of 0-10, on average how painful were these headaches?
  
Numeric Values
(Where 0 = no pain at all and 10 = pain as bad as it can be).
INSTRUCTIONS: Please answer the following questions about ALL your headaches you have
had over the last 3 months. Write your answer in the box next to each question. Write 0 if you
did not do the activity in the last 3 months. Please provide numbers; example: everyday
headache = 90
Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.
Adult;Pediatric
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Migraine History
General Health History
Participant History and Family History
MIDAS QB
 
Free-Form Entry
0
10
     
12-19-2018
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