CDE Detailed Report
Disease: Stroke
Subdomain Name: General Health History
CRF: Medical History
Displaying 51 - 70 of 70
Subdomain Name: 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 / 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C58928 | Medical history carotid endarterectomy recent date | MedHistCarotEndarcRecentDate | Date of most recent carotid endarterectomy performed on the participant/subject | Date of most recent carotid endarterectomy performed on the participant/subject | Date of most recent carotid endarterectomy (M M/D D/Y Y Y Y) | 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, year, month and day). |
No references available | Adult;Pediatric | Exploratory | 1.00 | 2020-07-14 15:16:51.0 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C22679 | Medical history first depressive episode diagnosis age value | MedHistFrstDepEpDiagAgeVal | Value of a participant's/subject's age when first depressive episode was diagnosed | Value of a participant's/subject's age when first depressive episode was diagnosed | If YES, age experienced first depressive episode/diagnosed with depression | Numeric Values |
years |
No references available | Adult;Pediatric | Exploratory | 1.00 | 2016-07-27 11:43:54.0 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C52618 | Medical history neck trauma recency rate | MedHistNeckTraumaRecenRt | The element related to the recency of neck trauma | The element related to the recency of neck trauma | If YES, indicate recency | < 8 days before current stroke/TIA;8 days - 4 weeks ago;> 4 weeks ago;Unknown | < 8 days before current stroke/TIA;8 days - 4 weeks ago;> 4 weeks ago;Unknown | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 13:49:14.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16174 | Menopause indicator | MenopauseInd | Indicates whether participant is currently menopausal | Indicates whether participant/subject is currently menopausa | Are you in menopause? | Yes;No | Yes;No | Alphanumeric |
No instructions available |
No references available | Adult | Exploratory | 3.00 | 2013-06-11 00:00:00.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C52699 | Sickle cell anemia blood transfusion treatment indicator | SickleCellAnemBloodTransfInd | The indicator related to whether blood transfusions are used for treatment for sickle cell anemia | The indicator related to whether blood transfusions are used for treatment for sickle cell anemia | If YES, are blood transfusions used for treatment? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58929 | Medical history carotid artery stenting recent date | MedHistCarotArtStentRecentDate | Date of most recent carotid artery stenting performed on the participant/subject | Date of most recent carotid artery stenting performed on the participant/subject | Date of most recent carotid artery stenting (M M/D D/Y Y Y Y) | 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, year, month and day). |
No references available | Adult;Pediatric | Exploratory | 1.00 | 2020-07-14 15:18:41.0 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C52597 | Medical history ischemic stroke range | MedHistIschemicStrokeRng | The element related to the number of ischemic strokes the participant/subject has had | The element related to the number of ischemic strokes the participant/subject has had | Number of ischemic strokes | 1;>= 2;Unknown | 1;>= 2;Unknown | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 13:49:14.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C52619 | Medical history atrial fibrillation other cause indicator | MedHistAtrlFibOthCauseInd | The indicator related to other cause of atrial fibrillation | The indicator related to other cause of atrial fibrillation | Other cause of AF | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric |
AF: atrial fibrillation |
No references available | Adult;Pediatric | Exploratory | 1.00 | 2017-01-27 08:23:58.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17473 | Cardiovascular history cardiac surgery date | CardioHistCardSurgDate | Date of most recent cardiac surgery or mechanical intervention performed on the participant/subject | Date of most recent cardiac surgery or mechanical intervention performed on the participant/subject | Date of most recent cardiac surgery | 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). |
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 |
Free-Form Entry |
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| C52700 | Hypercoagulable disorder type text | HypercoagDisrdrTypeTxt | The free-text field related to the type of hypercoagulable disorder | The free-text field related to the type of hypercoagulable disorder | If YES, specify type | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C18666 | Body system category other text | BodySysCatOTH | 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 | 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 | 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 | 1.10 | 2023-11-07 08:40:35.0 | 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 system | 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 |
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| C00314 | Medical history taken date and time | MedclHistTakenDateTime | Date (and time, if applicable and known) the participant's medical history was taken | Date (and time, if applicable and known) the participant '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 | 3.20 | 2024-02-29 15:42:39.0 | 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 has a history of any medical problems/conditions | Indicator of whether the participant 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 | 3.10 | 2024-02-29 15:42:39.0 | 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 medical history | Date (and time, if applicable and known) for the end of an event in the participant'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 | 3.10 | 2024-02-29 15:42:44.0 | 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 medical history | Date (and time, if applicable and known) for the start of an event in the participant'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 | 3.10 | 2024-02-29 15:42:43.0 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
2543596 | |||||||||
| C00319 | Medical history condition ongoing indicator | MedclHistCondOngoingInd | Indicator of whether a medical condition/disease experienced by the participant is ongoing | Indicator of whether a medical condition/disease experienced by the participant 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 | 4.00 | 2024-02-29 15:42:44.0 | 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 syste | 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 |
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| 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 |
