CDE Detailed Report

Disease: Myasthenia Gravis
Sub-Domain: General Health History
CRF: Family History - MG

Displaying 1 - 11 of 11
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
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.

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

Free-Form Entry

3165810
C18866 Family history muscle disease other text FmlyHistMuscleDiseaseOTH The free-text field related to 'Family history muscle disease type' specifying other text. Type of muscle disease for which participant/subject has family history The free-text field related to 'Family history muscle disease type' specifying other text. Type of muscle disease for which participant/subject has family history Other, specify Alphanumeric

Select type(s) that have affected family members, if applicable. If Hereditary or Inflammatory, specify muscle disease

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Family History - MG General Health History Participant History and Family History 4000

Free-Form Entry

C19521 Thyroid condition type ThyroidConditionTyp Type of thyroid condition Type of thyroid condition If Family History, condition type (if applicable) Hypothyroidism;Hyperthyroidism;Hashimoto's Hypothyroidism;Hyperthyroidism;Hashimoto's Alphanumeric

Select type(s) that have affected family members, if applicable.

No references available Adult;Pediatric Supplemental 1.00 2014-07-11 09:23:34.0 Family History - MG General Health History Participant History and Family History

Single Pre-Defined Value Selected

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 Cancer;Diabetes mellitus;Epilepsy;Seizures without diagnosis of epilepsy;Systemic lupus erythematosus (SLE);Multiple sclerosis;Muscle disease;Myasthenia gravis;Rheumatoid arthritis;Thyroid condition;Other, specify Cancer;Diabetes mellitus;Epilepsy;Seizures without diagnosis of epilepsy;Systemic lupus erythematosus (SLE);Multiple sclerosis;Muscle disease;Myasthenia gravis;Rheumatoid arthritis;Thyroid condition;Other, specify Alphanumeric

Record the type of family history conditions present

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Family History - MG 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.

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

Single Pre-Defined Value Selected

3165788
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 Affected Family Member to Participant/Subject (Choose all that apply) 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 Core 3.00 2013-07-24 11:38:01.2 Family History - MG General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

3165810
C06358 Diabetes mellitus type DiabetesMellitusTyp Type of diabetes mellitus Type of diabetes mellitus If Family History, condition type (if applicable) Type 1;Type 2 Type 1;Type 2 Alphanumeric

Select type(s) that have affected family members, if applicable.

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Family History - MG General Health History Participant History and Family History

Single Pre-Defined Value Selected

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 - MG General Health History Participant History and Family History

Free-Form Entry

1 99
C12664 Family history condition text FamHistCondTxt The specific condition or type of condition the participant/subject or participant's/subject's family member has, if applicable The specific condition or type of condition the participant/subject or participant's/subject's family member has, if applicable If Family History, condition type (if applicable) Alphanumeric

No additional instructions

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Family History - MG General Health History Participant History and Family History 255

Free-Form Entry

C12666 Family history muscle disease type FmlyHistMuscleDiseaseTyp Type of muscle disease for which participant/subject has family history Type of muscle disease for which participant/subject has family history If Family History, condition type (if applicable) DMD or BMD;Other, specify;Hereditary, specify;Inflammatory, specify DMD or BMD;Other, specify;Hereditary, specify;Inflammatory, specify Alphanumeric

Select type(s) that have affected family members, if applicable. If Hereditary or Inflammatory, specify muscle disease

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Family History - MG General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

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

Record the type of family history conditions present

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

Free-Form Entry

3165585
CSV