CDE Detailed Report
Subdomain Name: General Health History
CRF: Family History
Displaying 1 - 10 of 10
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C18678 | Family history medical condition type other text | FamHistMedclCondTypOTH | 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 | 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 |
If a family member has a condition not listed, specify the condition under "Other". |
No references available | Adult;Pediatric | Supplemental | 1.10 | 2024-02-29 15:42:35.0 | Family History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
3165585 | ||||||||
| C18679 | Family history medical condition relative type other text | FamHistMedclCondReltvTypOTH | 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 | 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 | Other, specify | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.10 | 2024-02-29 15:42:37.0 | Family History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
3165810 | ||||||||
| C19903 | Familial inheritance status | FamilInheritStat | Status of familial inheritance of participant | Status of familial inheritance of participant | Pattern of inheritance | Autosomal recessive;Autosomal dominant;X-linked recessive;Maternal inheritance;Sporadic | Autosomal recessive;Autosomal dominant;X-linked recessive;Maternal inheritance;Sporadic | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Core | 2.00 | 2024-02-29 15:42:35.0 | Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C52564 | Data source family relation specify text | DataSourceFamRelSpecifyTxt | Free-text field specifying the relationship of the family member from which data on the participant was obtained | Free-text field specifying the relationship of the family member from which data on the participant was obtained | Family, specify relation | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.10 | 2024-02-29 15:42:33.0 | Family History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C00720 | Family history medical condition type | FamHistMedclCondTyp | Type of medical condition or health related event for which the family history is taken | Type of medical condition or health related event for which the family history is taken | Condition | Alzheimer's disease/dementia;Ataxia;Autism;Attention-deficit/hyperactivity disorder (ADHD);Depression;Schizophrenia;Developmental delays;Speech and language delays;Gross motor delays;Fine motor delays;Intellectual disability;Behavioral problems;Cognitive, language, motor and/or social regression;Epilepsy;Febrile seizures;Microcephaly: Congenital;Microcephaly: Acquired/postnatal onset;Memory loss;Migraine headaches;Cerebral palsy;Spasticity;Recurrent encephalopathy (Leigh syndrome);Stroke or stroke-like episodes;Learning disability;Toe walking;Muscle disease: Congenital;Muscle disease: acquired or postnatal onset;Exercise intolerance;Recurrent myoglobinuria;Neuromuscular junction: Postnatal onset;Neuromuscular junction: Congenital;Peripheral neuropathy;Mitochondrial disease;Miscarriages and pregnancy-related complications;Sudden Infant Death Syndrome (SIDS)/Apparent Life-threatening Event (ALTE);Child-onset diseases;Blindness;Ptosis/ophthalmoplegia;Sensorineural hearing loss;Failure to Thrive;Short stature;Cardiomyopathy (hypertrophic);Cardiac conduction block;Liver disease/failure;Renal disease (Fanconi syndrome);Intestinal pseudo-obstruction;Sideroblastic anemia;Diabetes mellitus;Hypoparathyroidism;Known genetic syndrome;Other, specify | Alzheimer's disease/dementia;Ataxia;Autism;Attention-deficit/hyperactivity disorder (ADHD);Depression;Schizophrenia;Developmental delays;Speech and language delays;Gross motor delays;Fine motor delays;Intellectual disability;Behavioral problems;Cognitive, language, motor and/or social regression;Epilepsy;Febrile seizures;Microcephaly: Congenital;Microcephaly: Acquired/postnatal onset;Memory loss;Migraine headaches;Cerebral palsy;Spasticity;Recurrent encephalopathy (Leigh syndrome);Stroke or stroke-like episodes;Learning disability;Toe walking;Muscle disease: Congenital;Muscle disease: acquired or postnatal onset;Exercise intolerance;Recurrent myoglobinuria;Neuromuscular junction: Postnatal onset;Neuromuscular junction: Congenital;Peripheral neuropathy;Mitochondrial disease;Miscarriages and pregnancy-related complications;Sudden Infant Death Syndrome (SIDS)/Apparent Life-threatening Event (ALTE);Child-onset diseases;Blindness;Ptosis/ophthalmoplegia;Sensorineural hearing loss;Failure to Thrive;Short stature;Cardiomyopathy (hypertrophic);Cardiac conduction block;Liver disease/failure;Renal disease (Fanconi syndrome);Intestinal pseudo-obstruction;Sideroblastic anemia;Diabetes mellitus;Hypoparathyroidism;Known genetic syndrome;Other, specify | Alphanumeric |
The family history condition types are classified as follows: Core: Ataxia;Autism;Attention-deficit/hyperactivity disorder (ADHD);Developmental delays;Speech and language delays;Gross motor delays;Fine motor delays;Intellectual disability;Behavioral problems;Cognitive, language, motor and/or social regression;Epilepsy;Recurrent encephalopathy (Leigh syndrome);Stroke or stroke-like episodes;Learning disability;Memory loss;Migraine headaches;Muscle disease: Congenital;Muscle disease: Acquired/postnatal onset;Exercise intolerance;Recurrent myoglobinuria;Peripheral neuropathy;Mitochondrial disease;Blindness;Ptosis/ophthalmoplegia;Sensorineural hearing loss;Failure to thrive;Short stature;Cardiomyopathy (hypertrophic);Cardiac conduction block;Liver disease/failure;Renal disease (Fanconi syndrome);Intestinal pseudoobstruction;Sideroblastic anemia;Diabetes mellitus;Hypoparathyroidism; Supplemental: Alzheimer's disease/ dementia;Depression;Schizophrenia;Febrile seizures;Microcephaly: Congenital;Microcephaly: Acquired/postnatal onset;Cerebral palsy;Spasticity;Toe walking;Neuromuscular junction: Congenital;Neuromuscular junction: Postnatal onset;Miscarriages and pregnancy-related complications;Sudden Infant Death Syndrome (SIDS)/Apparent Life-threatening Event (ALTE);Child-onset diseases;Known genetic syndrome;Other, specify: Memory loss should be considered relative to age-expected norms. This condition should be marked if there is an unexpected or sudden loss of memory, which may or may not be accompanied by neurological deterioration. |
Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:34.0 | Family History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
3165585 | ||||||||
| C00721 | Family history medical condition indicator | FamHistMedclCondInd | Indicator of whether a family member or first and second degree blood relatives of the participant has had a history of the particular medical condition or health related event | Indicator of whether a family member or first and second degree blood relatives of the participant 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, or Unknown |
Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:36.0 | Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
3165788 | ||||||||
| C00722 | Family history medical condition relative type | FamHistMedclCondReltvTyp | Relationship of the family member or ancestor with the medical condition or health related event to the participant | Relationship of the family member or ancestor with the medical condition or health related event to the participant | Relationship of Family Member to Participant | Mother;Father;Full sibling;Half sibling;Child;Maternal grandfather;Maternal grandmother;Paternal grandfather;Paternal grandmother;Maternal aunt;Maternal cousin;Maternal niece/nephew;Maternal uncle;Other, specify:;Paternal aunt;Paternal cousin;Paternal niece/nephew;Paternal uncle;Grandchild;Great-grandchild | Mother;Father;Full sibling;Half sibling;Child;Maternal grandfather;Maternal grandmother;Paternal grandfather;Paternal grandmother;Maternal aunt;Maternal cousin;Maternal niece/nephew;Maternal uncle;Other, specify:;Paternal aunt;Paternal cousin;Paternal niece/nephew;Paternal uncle;Grandchild;Great-grandchild | Alphanumeric |
Select the relationship from the options of the family members listed in the "relationship" of family member to participant" column. Record/choose more than one family member, if applicable |
Adult;Pediatric | Supplemental | 4.00 | 2024-03-18 15:21:17.0 | Family History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
3165810 | ||||||||
| C10813 | Adopted indicator | AdoptedInd | Indicator of whether the participant was adopted | Indicator of whether the participant was adopted | Is the participant adopted? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Core | 3.10 | 2024-02-29 15:42:33.0 | Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C12663 | Family history member with medical condition count | FamHistMembWithMedclCondCt | Count of family members with history of medical condition | Count 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. |
Adult;Pediatric | Supplemental | 4.00 | 2022-08-08 10:47:27.0 | Family History | General Health History | Participant History and Family History |
Free-Form Entry |
1 | 99 | |||||||||
| C17681 | Family history collection source | FamHxCollSource | The source of collected family history data | The source of collected family history data | Source from which medical and family history obtained? | Participant;Family, specify relation;Unknown | Participant;Family, specify relation;Unknown | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Core | 4.00 | 2024-02-29 15:42:31.0 | Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
