CDE Detailed Report

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

Displaying 1 - 6 of 6
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
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 Stroke;Brain aneurysm;Migraines;Coronary artery disease;Epilepsy;Dementia;Psychiatric illness;Multiple miscarriages;Bleeding disorder;Clotting disorder;Sudden deaths;Intracranial vascular malformation;Hereditary hemorrhagic telangiectasia (HHT);Other, specify Stroke;Brain aneurysm;Migraines;Coronary artery disease;Epilepsy;Dementia;Psychiatric illness;Multiple miscarriages;Bleeding disorder;Clotting disorder;Sudden deaths;Intracranial vascular malformation;Hereditary hemorrhagic telangiectasia (HHT);Other, specify Alphanumeric

This CDE should be collected along with the "Family history medical condition indicator". Two of the family history condition types are Core: Any stroke family history and Coronary artery disease (CAD) family history. It is strongly recommended that the immediate family history of Friedreich's ataxia and ataxia be collected but collecting the family history of the other conditions is optional. Answer for first and second degree blood relatives. The majority of the medical conditions are Supplemental with the exception of the following which are Core: Developmental Delays; Epilepsy (pediatric only); Seizures without epilepsy diagnosis (pediatric only); Heart Disease; Muscle Disease; Peripheral Neuropathy

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Family History 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 Has a doctor or other medical professional ever told an immediate family member (i.e., parent, sibling, child) that he/she has or has had the following Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one based on whether there is a history of the condition in a first degree family member.

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

Single Pre-Defined Value Selected

3165788
C06005 Data collected date and time DataCollDateTime Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. Date information collected 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 2013-07-24 21:00:23.88 Family History General Health History Participant History and Family History

Free-Form Entry

C14145 Family history stroke youngest age value FamHistStrokYoungAgeVal If there is a family history of stroke, specify the youngest age an immediate family member (parent, sibling, child) suffered a stroke. If there is a family history of stroke, specify the youngest age an immediate family member (parent, sibling, child) suffered a stroke. Youngest age immediate family member suffered a stroke Numeric Values

History can be obtained from participant/ subject, family member, friend, or chart/ medical record. Enter the youngest age to the nearest integer or choose Unknown.

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Family History General Health History Participant History and Family History

Free-Form Entry

0 99 year
C14147 Family history coronary artery disease (CAD) youngest age value FamHistCADYoungAgeVal If there is a family history of coronary artery disease (CAD), specify the youngest age an immediate family member (parent, sibling, child) was diagnosed with the condition/ suffered a heart attack If there is a family history of coronary artery disease (CAD), specify the youngest age an immediate family member (parent, sibling, child) was diagnosed with the condition/ suffered a heart attack Youngest age immediate family member was diagnosed with condition/ suffered a heart attack Numeric Values

History can be obtained from participant/ subject, family member, friend, or chart/ medical record. Enter the youngest age to the nearest integer or choose Unknown.

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Family History General Health History Participant History and Family History

Free-Form Entry

0 99 year
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

This CDE should be collected along with the "Family history medical condition indicator". Two of the family history condition types are Core: Any stroke family history and Coronary artery disease (CAD) family history. It is strongly recommended that the immediate family history of Friedreich's ataxia and ataxia be collected but collecting the family history of the other conditions is optional. Answer for first and second degree blood relatives. The majority of the medical conditions are Supplemental with the exception of the following which are Core: Developmental Delays; Epilepsy (pediatric only); Seizures without epilepsy diagnosis (pediatric only); Heart Disease; Muscle Disease; Peripheral Neuropathy

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

Free-Form Entry

3165585
CSV