CDE Detailed Report

Disease: Stroke
Sub-Domain: General Health History
CRF: Medical History

Displaying 51 - 70 of 70
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 / 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
C52604 Medical history carotid endarterectomy anatomic site MedHistCarotEndarcAnatSite The element related to the location of a carotid endarterectomy the participant/subject has had The element related to the location of a carotid endarterectomy the participant/subject has had If YES, indicate location Left side;Right side;Both;Unknown Left side;Right side;Both;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2017-01-26 14:49:56.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C15629 Postpartum indicator PstpartmInd Whether the participant/subject is currently in her postpartum phase, after pregnancy phase, of pregnancy. Whether the participant/subject is currently in her postpartum phase, after pregnancy phase, of pregnancy. Is the participant/subject post-partum? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Up to 12 weeks

Kamel H, Navi BB, Sriram N, Hovsepian DA, Devereux RB, Elkind MSV. Risk of a thrombotic event after the 6-week postpartum period. New Engl J Med. 2014;370(14):1307-1315. Adult;Pediatric Supplemental-Highly Recommended 3.00 2013-07-16 14:01:43.01 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C52695 Cancer diagnosis type CancerDiagTyp The element related to the type of cancer diagnosis the participant/subject has or had The element related to the type of cancer diagnosis the participant/subject has or had Type(s) of cancer Brain;Breast;Colorectal;Endometrial;Esophagus;Prostate;Renal;Skin;Other specify;Lung Brain;Breast;Colorectal;Endometrial;Esophagus;Prostate;Renal;Skin;Other specify;Lung Alphanumeric

No instructions available

No references available Adult;Pediatric Exploratory 3.00 2013-07-15 16:08:48.687 Medical History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C19078 Cardiovascular history cardiac surgery other text CardioHistCardSurgOTH The free-text field related to 'Cardiovascular history cardiac surgery type' specifying other text. Type of cardiac surgery or mechanical intervention the participant/subject underwent The free-text field related to 'Cardiovascular history cardiac surgery type' specifying other text. Type of cardiac surgery or mechanical intervention the participant/subject underwent Other, specify Alphanumeric

No instructions available

No references available Adult;Pediatric Exploratory 3.00 2013-07-15 16:08:48.687 Medical History General Health History Participant History and Family History 4000

Free-Form Entry

C58926 Medical history hemorrhagic stroke range MedHistHemStrokeRng The element related to the number of hemorrhagic strokes the participant/subject has had The element related to the number of hemorrhagic strokes the participant/subject has had Number of hemorrhagic strokes 1;>= 2;Unknown 1;>= 2;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Exploratory 1.00 2017-01-26 13:49:14.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C52605 Medical history carotid artery stenting anatomic site MedHistCarotArtStentAnatSite The element related to the location of carotid artery stenting the participant/subject has had The element related to the location of carotid artery stenting the participant/subject has had If YES, indicate location Left side;Right side;Both;Unknown Left side;Right side;Both;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2017-01-26 14:49:56.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C15630 Postpartum day week value PstpartmDayWkVal Number of days/weeks the participant/subject has been postpartum Number of days/weeks the participant/subject has been postpartum Number of weeks since delivery Numeric Values

Up to 12 weeks

Kamel H, Navi BB, Sriram N, Hovsepian DA, Devereux RB, Elkind MSV. Risk of a thrombotic event after the 6-week postpartum period. New Engl J Med. 2014;370(14):1307-1315. Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Medical History General Health History Participant History and Family History

Free-Form Entry

C52696 Infection within two weeks type InfectionWthnTwoWksTyp The element related to the type of infection(s) within the last two weeks the participant/subject has had The element related to the type of infection(s) within the last two weeks the participant/subject has had If YES, indicate type(s) Otitis media;Respiratory infection;Urinary tract infection;Cellulitis;Sepsis;Mastoiditis;Viral gastroenteritis;Fever lasting > 48 hours;Other infection, specify:;Influenza;Zoster/Shingles Otitis media;Respiratory infection;Urinary tract infection (UTI);Cellulitis;Sepsis;Mastoiditis;Viral gastroenteritis;Fever lasting > 48 hours;Other infection, specify:;Influenza;Zoster/Shingles Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-07-17 09:26:36.973 Medical History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C19174 Other cardiac disorder type OthrCardiacDisorderTyp Type of other cardiac disorder Type of other cardiac disorder Other cardiac disorders, specify Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2014-05-30 14:25:23.0 Medical History General Health History Participant History and Family History 4000

Free-Form Entry

C58927 Medical history hemorrhagic stroke recency rate MedHistHemStrokeRecenRt The element related to the recency of hemorrhagic strokes the participant/subject has had The element related to the recency of hemorrhagic strokes the participant/subject has had Most recent hemorrhagic stroke < 3 mos ago;>= 3 mos ago;Unknown < 3 mos ago;>= 3 mos ago;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2020-07-14 15:13:17.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00319 Medical history condition ongoing indicator MedclHistCondOngoingInd Indicator of whether a medical condition/disease experienced by the participant/subject is ongoing Indicator of whether a medical condition/disease experienced by the participant/subject is ongoing Ongoing? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose Yes or No to indicate if the medical condition/disease is still present.

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

Single Pre-Defined Value Selected

2736881
C00321 Medical history for body system indicator MedclHistBodySysInd Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body system. Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body system. Does the participant/subject have a history of any medical problems/conditions in the following body systems? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one for each body system.

No references available Adult;Pediatric Supplemental 3.00 2013-07-22 16:57:17.79 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00322 Medical history condition text MedclHistCondTxt Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history Medical history condition Alphanumeric

Record one Medical History term per line.

SNOMED CT Codes (http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html) Adult;Pediatric Core 3.00 2013-07-25 08:54:08.2 Medical History General Health History Participant History and Family History 4000

Free-Form Entry

2003874
C18666 Body system other text BodySysOTH The free-text field related to 'Body system category' specifying other text. Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured Free-text category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured interview and physical examination of all the body systems. Other, specify Alphanumeric

Record the appropriate body system for each line of medical history.

Review of Symptoms from Centers for Medicare and Medicaid Services https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/eval-mgmt-serv-guide-icn006764.pdf Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Medical History General Health History Participant History and Family History 4000

Free-Form Entry

2002895
C00312 Body system category BodySysCat Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured interview and physical examination of all the body systems. Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured interview and physical examination of all the body systems. Body System Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify: Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify: Alphanumeric

Record the appropriate body system for each line of medical history.

Review of Symptoms from Centers for Medicare and Medicaid Services https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/eval-mgmt-serv-guide-icn006764.pdf Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

2002895
C00313 Medical history condition SNOMED CT code MedclHistCondSNOMEDCTCode Systematized Nomenclature Of Medicine Clinical Terms (SNOMED CT) code for medical condition/disease reported by the participant/subject Systematized Nomenclature Of Medicine Clinical Terms (SNOMED CT) code for medical condition/disease reported by the participant/subject Medical History Term Alphanumeric

Code each of the medical history conditions using SNOMED CT

SNOMED CT Codes (http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html) Adult;Pediatric Core 3.00 2013-07-25 08:54:08.2 Medical History General Health History Participant History and Family History 255

Free-Form Entry

C00314 Medical history taken date and time MedclHistTakenDateTime Date (and time, if applicable and known) the participant/subject's medical history was taken Date (and time, if applicable and known) the participant/subject's medical history was taken Date Medical History Taken Date or Date & Time

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Medical History General Health History Participant History and Family History

Free-Form Entry

2179659
C00315 Medical history global assessment indicator MedclHistGlobalAssmtInd Indicator of whether the participant/subject has a history of any medical problems/conditions Indicator of whether the participant/subject has a history of any medical problems/conditions Does the participant/subject have a history of any medical problems/conditions in the following body systems Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one. If this question is answered NO then the rest of the form is blank. If the question is answered YES then the medical history for at least one body system should be recorded.

No references available Adult;Pediatric Supplemental-Highly Recommended 3.00 2013-07-25 08:54:08.2 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3145578
C00316 Medical history condition end date and time MedclHistCondEndDateTime Date (and time, if applicable and known) for the end of an event in the participant's/subject's medical history Date (and time, if applicable and known) for the end of an event in the participant's/subject's medical history End Date Date or Date & Time

Record the date (and time) the medical condition/disease stopped. For surgeries, start and stop dates will most likely be the same date. Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Medical History General Health History Participant History and Family History

Free-Form Entry

3145557
C00317 Medical history condition start date and time MedclHistCondStrtDateTime Date (and time, if applicable and known) for the start of an event in the participant's/subject's medical history Date (and time, if applicable and known) for the start of an event in the participant's/subject's medical history Start Date Date or Date & Time

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Medical History General Health History Participant History and Family History

Free-Form Entry

2543596
CSV