CDE Detailed Report
Subdomain Name: General Health History
CRF: welcome
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C58930 | Hypertension treatment type | HypertensionTreatmentTyp | Type of treatment the participant/subject is receiving or has received for hypertension | Type of treatment the participant/subject is receiving or has received for hypertension | Treatment for hypertension | Lifestyle modification only;Oral medication;None;Unknown | Lifestyle modification only;Oral medication;None;Unknown | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2020-07-14 15:20:32.0 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C52620 | Medical history atrial fibrillation other cause text | MedHistAtrlFibOthCauseTxt | The free-text field related to other cause of atrial fibrillation | The free-text field related to other cause of atrial fibrillation | If YES, specify other cause | Alphanumeric |
No instructions available |
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 | 255 |
Free-Form Entry |
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| C17475 | Cardiovascular history cardiac surgery type | CardioHistCardSurgTyp | Type of cardiac surgery or mechanical intervention the participant/subject underwent | Type of cardiac surgery or mechanical intervention the participant/subject underwent | Indicate type(s) | Coronary artery bypass graft;Cardiac valve surgery, including non-open surgery;Pacemaker;Implantable cardiac defibrillator;Other, specify | Coronary artery bypass graft (CABG);Cardiac valve surgery, including non-open surgery (i.e. percutaneous valvuloplasty);Pacemaker;Implantable cardiac defibrillator;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 |
Multiple Pre-Defined Values Selected |
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| C52701 | Bleeding disorder type text | BleedDisorderTypeTxt | Free-text field related to the type of bleeding disorder | Free-text field related to the type of bleeding disorder | If YES, specify type | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2016-10-13 12:39:16.0 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C52599 | Medical history hemorrhagic stroke type | MedHistHemorrStrokeTyp | The element related to the type of hemorrhagic stroke the participant/subject has had | The element related to the type of hemorrhagic stroke the participant/subject has had | If YES, indicate type(s) | Intracerebral hemorrhage (ICH);Subarachnoid hemorrhage (SAH);Hemorrhage unspecified;Unknown | Intracerebral hemorrhage (ICH);Subarachnoid hemorrhage (SAH);Hemorrhage unspecified;Unknown | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 14:10:41.0 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C58931 | Menopause treatment type | MenopauseTreatmtTyp | Type of treatment the participant/subject is receiving or has received for menopause | Type of treatment the participant/subject is receiving or has received for menopause | Treatment for menopause | Hormone therapy;Other, specify;Unknown | Hormone therapy;Other, specify;Unknown | Alphanumeric |
No instructions available |
No references available | Adult | Exploratory | 1.00 | 2020-07-14 15:24:25.0 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C06246 | Medical history condition type | MedHistCondTyp | Type of pre-specified medical condition/disease asked about when collecting the medical history from the participant or found documented in the medical record | Type of pre-specified medical condition/disease asked about when collecting the medical history from the participant/subject or found documented in the medical record | Has a doctor or other medical professional ever told you that you have or have had the following? | Other cardiac disorders, specify;Hypertension;Orthostatic hypotension;Myocardial infarction;Stroke;Other, specify:;Hemorrhagic stroke;Unruptured aneurysm;Dural sinus thrombosis/cerebral venous thrombosis;Ischemic Stroke;Transient Ischemic Attack (TIA);Arteriovenous malformation;Cavernous malformation;Transient monocular blindness;Migraines;Carotid stenosis;Carotid endarterectomy;Carotid artery stenting;Seizure episode;Meningitis;Dementia;Depressive disorder diagnosis;Current clinical anxiety;Atrial fibrillation/flutter;Coronary artery disease;Diabetes mellitus;Cancer;Bleeding disorder;Sleep apnea;Hemorrhoids;Moyamoya Syndrome;Neurofibromatosis type 1 (NF1);Inborn errors of metabolism;Mitochondrial disease;Hereditary hemorrhagic telangiectasia (HHT);Ehlers-Danlos Syndrome Type IV;Marfan Syndrome;Fibromuscular dysplasia;Central nervous system infection;Head trauma;Neck trauma;Rheumatic heart disease;Angina;Valvular heart disease;Coronary stent or PTCA;Congestive heart failure;Congenital heart disease;Cardiac catheterization;Peripheral arterial disease;Hypertriglyceridemia;Infection within two weeks;Sickle cell anemia;Hypercoagulable disorder;Lupus;Other connective tissue disease;Renal (kidney) failure;Nephrotic syndrome;Chronic liver failure;Iron deficiency/anemia;Inflammatory bowel disease;Down Syndrome;Sturge-Weber Syndrome;Coarctation of the aorta;Alpha 1-antitrypsin deficiency;Pheochromocytoma;Anxiety/panic disorder diagnosis;Aortic aneurysm;Artificial valve;Cardiac surgery;Epilepsy/Seizure disorder;Current clinical depression;High blood cholesterol/ Hypercholesterolemia;Indwelling catheter;Periodontal disease;Psychotic disorder | Other cardiac disorders, specify;Hypertension;Orthostatic hypotension;Myocardial infarction;Stroke;Other, specify:;Hemorrhagic stroke;Unruptured aneurysm;Dural sinus thrombosis/cerebral venous thrombosis;Ischemic Stroke;Transient Ischemic Attack (TIA);Arteriovenous malformation (AVM);Cavernous malformation;Transient monocular blindness;Migraines;Carotid stenosis;Carotid endarterectomy (CEA);Carotid artery stenting (CAS);Seizure episode;Meningitis;Dementia;Depressive disorder diagnosis;Current clinical anxiety;Atrial fibrillation/flutter;Coronary artery disease;Diabetes mellitus;Cancer;Bleeding disorder;Sleep apnea;Hemorrhoids;Moyamoya Syndrome;Neurofibromatosis type 1 (NF1);Inborn errors of metabolism;Mitochondrial disease;Hereditary hemorrhagic telangiectasia (HHT);Ehlers-Danlos Syndrome Type IV;Marfan Syndrome;Fibromuscular dysplasia;Central nervous system infection;Head trauma;Neck trauma;Rheumatic heart disease;Angina;Valvular heart disease;Coronary stent or PTCA;Congestive heart failure;Congenital heart disease;Cardiac catheterization;Peripheral arterial disease;Hypertriglyceridemia;Infection within two weeks;Sickle cell anemia;Hypercoagulable disorder;Lupus;Other connective tissue disease;Renal (kidney) failure;Nephrotic syndrome;Chronic liver failure;Iron deficiency/anemia;Inflammatory bowel disease;Down Syndrome;Sturge-Weber Syndrome;Coarctation of the aorta;Alpha 1-antitrypsin deficiency;Pheochromocytoma;Anxiety/panic disorder diagnosis;Aortic aneurysm;Artificial valve;Cardiac surgery;Epilepsy/Seizure disorder;Current clinical depression;High blood cholesterol/ Hypercholesterolemia;Indwelling catheter;Periodontal disease;Psychotic disorder | Alphanumeric |
This CDE should be collected along with the "Medical history condition diagnosis indicator". The medical history condition types are classified as follows: Supplemental - Highly Recommended: Stroke; Ischemic stroke; Hemorrhagic stroke Supplemental: Transient ischemic attack (TIA); Transient monocular blindness; Unruptured aneurysm; Dural sinus thrombosis/cerebral venous thrombosis; Arteriovenous malformation (AVM); Cavernous malformation; Migraine(s); Carotid stenosis; Carotid endarterectomy; Carotid artery stenting; Seizure episode; Epilepsy/Seizure disorder; Central nervous system infection; Meningitis; Dementia; Current clinical depression; Depressive disorder diagnosis; Current clinical anxiety; Anxiety/panic disorder diagnosis; Psychotic disorder; Head trauma; Neck trauma; Atrial fibrillation (AF)/flutter; Rheumatic heart disease; Coronary artery disease; Myocardial infarction; Angina; Valvular heart disease; Cardiac surgery; Artificial valve; Coronary stent or PTCA; Congestive heart failure; Congenital heart disease; Cardiac catheterization; Other cardiac disorders, specify; Peripheral arterial disease; Aortic aneurysm; Hypertension; Orthostatic hypotension; Diabetes melllitus; High blood cholesterol/ Hypercholesterolemia; Hypertriglyceridemia; Cancer; Sickle cell anemia; Hypercoagulable disorder; Bleeding disorder; Lupus; Other connective tissue disease; Sleep apnea; Renal (kidney) failure; Nephrotic syndrome; Indwelling catheter; Chronic liver failure; Iron deficiency/Anemia; Inflammatory bowel disease; Hemorrhoids; Moyamoya Syndrome; Down syndrome; Neurofibromatosis type I (NFI); Sturge-Weber syndrome; Inborn error metabolism; Mitochondrial disease; Hereditary hemorrhagic telangiectasia; Ehlers-Danlos Syndrome Type IV; Marfan syndrome; Fibromuscular dysplasia; Coarctation of the aorta; Alpha1-antitrypsin deficiency; Pheochromocytoma; Other, specify Exploratory: Infection within two weeks; Periodontal disease |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:40.0 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C52621 | Medical history artificial valve type | MedHistArtificialVlvTyp | The element related to the type of artificial valve | The element related to the type of artificial valve | If YES, indicate type | Biological/tissue valve;Mechanical/non-tissue valve;Valvuloplast;Unknown type of valve | Biological/tissue valve;Mechanical/non-tissue valve;Valvuloplast;Unknown type of valve | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Exploratory | 1.00 | 2017-01-27 08:34:45.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17480 | Diabetes mellitus complications type | EndocrineHistDiabMellCompliTyp | Type(s) of complications related to diabetes mellitus the participant/subject has experienced or is experiencing | Type(s) of complications related to diabetes mellitus the participant/subject has experienced or is experiencing | Complications of diabetes | Nephropathy;Neuropathy;Retinopathy;Other, specify;None | Nephropathy;Neuropathy;Retinopathy;Other, specify;None | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C52702 | Connective tissue disease other type text | ConnTissDisTypTxt | The free-text field related to other type of connective tissue disease | The free-text field related to other type of connective tissue disease | If YES, specify type | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2016-10-19 12:03:19.0 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| 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 | ||||||||
| 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 |
