CDE Detailed Report
Subdomain Name: General Health History
CRF: Family History
Displaying 1 - 10 of 10
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C52569 | Brain aneurysm family member relationship text | brainAneurysmFamMemRelTxt | Specify the relationship(s) that a family member with brain aneurysm(s) has with the subject/participant | Specify the relationship(s) that a family member with brain aneurysm(s) has with the subject/participant | If YES, please indicate relationship to patient | Alphanumeric |
(i.e., parents, siblings, children) |
No references available | Adult;Pediatric | Exploratory | 3.00 | 2013-07-25 08:54:08.2 | Family History | General Health History | Participant History and Family History | 50 |
Free-Form Entry |
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| C52570 | Subarachnoid hemorrhage family member relationship text | SAHFamMemRelTxt | Specify the relationship(s) that a family member with subarachnoid hemorrhage has with the subject/participant | Specify the relationship(s) that a family member with subarachnoid hemorrhage has with the subject/participant | If YES, please indicate relationship to patient | Alphanumeric |
(i.e., parents, siblings, children) |
No references available | Adult;Pediatric | Exploratory | 3.00 | 2013-07-25 08:54:08.2 | Family History | General Health History | Participant History and Family History | 50 |
Free-Form Entry |
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| C58947 | Family history stroke youngest age unknown status | FamHistStrokYoungAgeUnkStat | Status indicating the youngest age an immediate family member (parent, sibling, child) suffered a stroke is unknown, if there is a family history of stroke | Status indicating the youngest age an immediate family member (parent, sibling, child) suffered a stroke is unknown, if there is a family history of strok | Youngest age immediate family member suffered a stroke | Unknown | Unknown | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2020-07-15 10:34:10.0 | Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58948 | Family history coronary artery disease (CAD) youngest age unknown status | FamHistCADYoungAgeUnkStat | Status indicating 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) | Status indicating 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 | If YES, youngest age immediate family member was diagnosed with condition/ suffered a heart attack | Unknown | Unknown | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2020-07-15 10:35:41.0 | Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value 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 |
This CDE should be collected along with the "Family history medical condition indicator". |
No references available | Adult;Pediatric | Exploratory | 1.10 | 2024-02-29 15:42:35.0 | Family History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
3165585 | ||||||||
| 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 | Brain aneurysm;Stroke;Subarachnoid hemorrhage (SAH);Migraines;Coronary artery disease;Epilepsy;Dementia;Abdominal aortic aneurysm;Psychiatric illness;Multiple miscarriages;Bleeding disorder;Clotting disorder;Intracranial vascular malformation;Hereditary hemorrhagic telangiectasia (HHT);Polycystic kidney disease;Multiple endocrine neoplasia type I;Ehlers-Danlos Syndrome Type IV;Marfan Syndrome;Neurofibromatosis type 1 (NF1);Other, specify;Arterial dissection;Ischemic Stroke;Mitochondrial disorders;Sudden deaths of unknown etiology;Hemorrhagic stroke | Brain aneurysm;Stroke;Subarachnoid hemorrhage (SAH);Migraines;Coronary artery disease;Epilepsy;Dementia;Abdominal aortic aneurysm;Psychiatric illness;Multiple miscarriages;Bleeding disorder;Clotting disorder;Intracranial vascular malformation;Hereditary hemorrhagic telangiectasia (HHT);Polycystic kidney disease;Multiple endocrine neoplasia type I;Ehlers-Danlos Syndrome Type IV;Marfan Syndrome;Neurofibromatosis type 1 (NF1);Other, specify;Arterial dissection;Ischemic Stroke;Mitochondrial disorders;Sudden deaths of unknown etiology;Hemorrhagic stroke | Alphanumeric |
This CDE should be collected along with the "Family history medical condition indicator". The family history condition types are classified as follows: Supplemental: Ischemic stroke; Hemorrhagic stroke; Subarachnoid hemorrhage (SAH); Brain aneurysm; Migraines; Epilepsy; Dementia; Psychiatric illness; Multiple miscarriages; Bleeding disorder (e.g., hemophilia); Clotting disorder (e.g., thrombophilia); Sudden deaths of unknown etiology; Intracranial vascular malformations; Exploratory: Abdominal aortic aneurysm; Hereditary Hemorrhagic Telangiectasia (HHT); Polycystic kidney disease; Multiple endocrine neoplasia type I; Ehlers-Danlos Syndrome Type IV; Marfan Syndrome; Neurofibromatosis type I (NF1); Arterial dissection; Mitochondrial disorders; Other, specify: |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:34.0 | 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 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 | 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 | 4.00 | 2024-02-29 15:42:36.0 | 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 performe | 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 |
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| 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 strok | 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 | If YES, 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 |
