CDE Detailed Report
Disease: content
Subdomain Name: General Health History
CRF: welcome
Displaying 1 - 11 of 11
Subdomain Name: General Health History
CRF: welcome
Displaying 1 - 11 of 11
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
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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 | 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 | 4.00 | 2024-02-29 15:42:34.0 | 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 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 | Core | 4.00 | 2024-02-29 15:42:36.0 | Family History - MG | 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 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 | 4.00 | 2024-03-18 15:21:17.0 | 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 | 4.00 | 2024-02-29 15:41:20.0 | Family History - MG | 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. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2022-08-08 10:47:27.0 | 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 |
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| 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 |
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| 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 |
Record the type of family history conditions present |
No references available | Adult;Pediatric | Supplemental | 1.10 | 2024-02-29 15:42:35.0 | Family History - MG | 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 - 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 |
