CDE Detailed Report

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

Displaying 1 - 10 of 10
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
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

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 stroke. 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

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

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

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 - Highly Recommended: Stroke; Coronary artery disease (e.g., heart attack)

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 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 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
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".

No references available Adult;Pediatric Exploratory 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