CDE Detailed Report

Disease: Neuromuscular Diseases
Sub-Domain: General Health History
CRF: Family History

Displaying 1 - 7 of 7
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (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 / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
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 the family member or ancestor with the medical condition or health related event to the participant/subject Relationship of Family Member to Participant/ Subject Mother;Father;Full sibling;Half sibling;Child;Maternal grandmother;Paternal grandmother;Maternal grandfather;Paternal grandfather;Maternal aunt;Paternal aunt;Maternal uncle;Paternal uncle;Maternal niece/nephew;Paternal niece/nephew;Grandchild;Other, specify;Maternal cousin;Paternal cousin;Great-grandchild Mother;Father;Full sibling;Half sibling;Child;Maternal grandmother;Paternal grandmother;Maternal grandfather;Paternal grandfather;Maternal aunt;Paternal aunt;Maternal uncle;Paternal uncle;Maternal niece/nephew;Paternal niece/nephew;Grandchild;Other, specify;Maternal cousin;Paternal cousin;Great-grandchild Alphanumeric

Select the relationship from the options of the family members listed in the "Relationship of family member to participant/subject" column. Record/choose more than one family member, if applicable.
Supplemental - Highly Recommended

No references available Adult;Pediatric Core 3.00 2013-07-24 11:38:01.2 Family History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

3165810
C12663 Family history member with medical condition number FamHistMembMedclCondNum Number of family members with history of medical condition Number 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.

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Family History General Health History Participant History and Family History

Free-Form Entry

1 99
C17872 Family history medical condition text FmlyHistMedclCondTxt Specification of other disease that a family member or ancestor of the participant/subject has had a history of a medical condition or health related event Specification of other disease that a family member or ancestor of the participant/subject has had a history of a medical condition or health related event Condition Alphanumeric No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:24:12.51 Family History General Health History Participant History and Family History 255

Free-Form Entry

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 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

Answer for first and second degree blood relatives. The majority of the medical conditions are Supplemental with the exception of the following which are Core: Developmental Delays; Epilepsy (pediatric only); Seizures without epilepsy diagnosis (pediatric only); Heart Disease; Muscle Disease; Peripheral Neuropathy

No references available Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Family History General Health History Participant History and Family History 4000

Free-Form Entry

3165585
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 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

Select the relationship from the options of the family members listed in the "Relationship of family member to participant/subject" column. Record/choose more than one family member, if applicable.
Supplemental - Highly Recommended

No references available Adult;Pediatric Core 1.00 2014-05-27 13:34:46.0 Family History General Health History Participant History and Family History 4000

Free-Form Entry

3165810
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;Amyotrophic lateral sclerosis (ALS);Ataxia;Autism;Bi-polar disorder;Cancer;Depression;Developmental delays;Diabetes mellitus;Epilepsy;Seizures without diagnosis of epilepsy;Headaches;Heart disease;Learning disability;Memory loss;Multiple sclerosis;Muscle disease;Neuromuscular junction;Peripheral neuropathy;Parkinson's disease;Schizophrenia;Suicide or suicide attempt;Stroke;Tourette syndrome;Other, specify Alzheimer's disease;Amyotrophic lateral sclerosis (ALS);Ataxia;Autism;Bi-polar disorder;Cancer;Depression;Developmental delays;Diabetes mellitus;Epilepsy;Seizures without diagnosis of epilepsy;Headaches;Heart disease;Learning disability;Memory loss;Multiple sclerosis;Muscle disease;Neuromuscular junction;Peripheral neuropathy;Parkinson's disease;Schizophrenia;Suicide or suicide attempt;Stroke;Tourette syndrome;Other, specify Alphanumeric

Answer for first and second degree blood relatives. The majority of the medical conditions are Supplemental with the exception of the following which are Core: Developmental Delays; Epilepsy (pediatric only); Seizures without epilepsy diagnosis (pediatric only); Heart Disease; Muscle Disease; Peripheral Neuropathy

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 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/subject 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/subject 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.
Supplemental - Highly Recommended

No references available Adult;Pediatric Core 3.00 2013-07-24 11:38:01.2 Family History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3165788
CSV