CDE Detailed Report
Disease: Spinal Muscular Atrophy
Subdomain Name: General Health History
CRF: Family History - SMA
Displaying 1 - 6 of 6
Subdomain Name: General Health History
CRF: Family History - SMA
Displaying 1 - 6 of 6
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2022-08-08 10:47:27.0 | Family History - SMA | General Health History | Participant History and Family History |
Free-Form Entry |
1 | 99 | ||||||||
| 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 |
Answer for first and second degree blood relatives. |
No references available | Adult;Pediatric | Supplemental | 1.10 | 2024-02-29 15:42:35.0 | Family History - SMA | 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 |
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. |
No references available | Adult;Pediatric | Supplemental | 1.10 | 2024-02-29 15:42:37.0 | Family History - SMA | 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;Dystonia;Epilepsy;Seizures without diagnosis of epilepsy;Early childhood death;Headaches;Heart disease;Learning disability;Memory loss;Multiple sclerosis;Muscle disease;Neuromuscular disease;Neuropathy;Peripheral neuropathy;Parkinson's disease;Schizophrenia;Spinal muscular atrophy (SMA);Suicide or suicide attempt;Stroke;Tourette syndrome;Walking delays / Late acquisition of walking;Other, specify | Alzheimer's disease;Amyotrophic lateral sclerosis (ALS);Ataxia;Autism;Bi-polar disorder;Cancer;Depression;Developmental delays;Diabetes mellitus;Dystonia;Epilepsy;Seizures without diagnosis of epilepsy;Early childhood death;Headaches;Heart disease;Learning disability;Memory loss;Multiple sclerosis;Muscle disease;Neuromuscular disease;Neuropathy;Peripheral neuropathy;Parkinson's disease;Schizophrenia;Spinal muscular atrophy (SMA);Suicide or suicide attempt;Stroke;Tourette syndrome;Walking delays / Late acquisition of walking;Other, specify | Alphanumeric |
Answer for first and second degree blood relatives. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:34.0 | Family History - SMA | 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. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:36.0 | Family History - SMA | 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/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. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-03-18 15:21:17.0 | Family History - SMA | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
3165810 |
