CDE Detailed Report
Disease: content
Subdomain Name: Drugs
CRF: welcome
Displaying 51 - 72 of 72
Subdomain Name: Drugs
CRF: welcome
Displaying 51 - 72 of 72
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C54991 | Cocaine use duration | CocaineUseDur | Duration in months for which the subject/participant took or has taken cocaine | Duration in months for which the subject/participant took or has taken cocaine | Duration of Use (months) | Numeric Values |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2017-04-13 14:32:36.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Free-Form Entry |
Months | |||||||||
| C58963 | Medication antiplatelet past week other text | MedctnAntiplatltPastWkOTH | The free-text field related to 'Medication antiplatelet past week type', specifying other text | The free-text field related to 'Medication antiplatelet past week type', specifying other text | Other, specify | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2020-07-30 16:32:41.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data | 4000 |
Free-Form Entry |
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| C58995 | Medication other current former take indicator | MedctnOthrCurrFrmrTkInd | The indicator relating to whether the subject/participant has formerly or currently taken other medications | The indicator relating to whether the subject/participant has formerly or currently taken other medications | Any other medications not already listed | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2020-08-13 15:17:35.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Single Pre-Defined Value Selected |
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| C58974 | Medication antihypertensive current former take indicator | MedctnAntihyprtnsCurrFrmrTkInd | The indicator relating to whether the subject/participant has formerly or currently taken antihypertensive medications | The indicator relating to whether the subject/participant has formerly or currently taken antihypertensive medications | Antihypertensive medications | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric |
Was the participant/ subject taking the following medication prior to admission or at the time of evaluation? |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2020-08-13 11:12:02.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Single Pre-Defined Value Selected |
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| C58985 | Medication ACE inhibitor past week other text | MedctnACEInhibitrPastWkOTH | The free-text field related to 'Medication ACE inhibitor past week type', specifying other text | The free-text field related to 'Medication ACE inhibitor past week type', specifying other text | Other, specify | Alphanumeric |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2020-08-13 13:48:16.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data | 4000 |
Free-Form Entry |
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| C54992 | Cocaine exposure age start value | CocaineExposureAgeStartVal | Age in years at which the subject/participant began exposure to cocaine | Age in years at which the subject/participant began exposure to cocaine | Age when use started (years) | Numeric Values |
No instructions available |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2017-04-13 14:32:36.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Free-Form Entry |
Years | |||||||||
| C58964 | Medication anticoagulant current former take indicator | MedctnAnticoaglntCurrFrmrTkInd | The indicator relating to whether the subject/participant has formerly or currently taken anticoagulant medications | The indicator relating to whether the subject/participant has formerly or currently taken anticoagulant medications | Anticoagulants | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric |
Was the participant/ subject taking the following medication prior to admission or at the time of evaluation? |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2020-07-30 16:35:40.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Single Pre-Defined Value Selected |
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| C58996 | Medication other past week type | MedctnOthrPastWkTyp | Type of other medication taken by the subject/participant within the past week | Type of other medication taken by the subject/participant within the past week | Type of other medication taken by the subject/participant within the past week | Digoxin/cardiac glycosides;Thyroid preparations;Benzodiazepines (Valium, Librium, Ativan, Xanax);Anti-Parkinsonian meds (including selegiline);Non-aspirin salicylates (salsalate);Other nonsteroidal anti-inflammatory drugs;Ginkgo derivatives/other herbals;Vitamin E (more than multivitamins);SSRIs and new-generation antidepressants;Antiarrhythmic drugs (quinidine, amiodarone);Tricyclic antidepressants (amitriptyline, imipramine, doxepin);H2 blocker (e.g., cimetidine) or proton pump inhibitor (e.g., omeprazole);Donepezil and related meds;Analgesics (acetaminophen, codeine)–daily;COX 2 inhibitors (e.g., celecoxib);COX inhibitors (e.g., ibuprofen, naproxen);Multivitamin;Other, specify;Nitrates | Digoxin/cardiac glycosides;Thyroid preparations;Benzodiazepines (Valium, Librium, Ativan, Xanax);Anti-Parkinsonian meds (including selegiline);Non-aspirin salicylates (salsalate);Other nonsteroidal anti-inflammatory drugs;Ginkgo derivatives/other herbals;Vitamin E (more than multivitamins);SSRIs and new-generation antidepressants;Antiarrhythmic drugs (quinidine, amiodarone);Tricyclic antidepressants (amitriptyline, imipramine, doxepin);H2 blocker (e.g., cimetidine) or proton pump inhibitor (e.g., omeprazole);Donepezil and related meds;Analgesics (acetaminophen, codeine)–daily;COX 2 inhibitors (e.g., celecoxib);COX inhibitors (e.g., ibuprofen, naproxen);Multivitamin;Other, specify;Nitrates | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2020-08-13 15:21:26.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Multiple Pre-Defined Values Selected |
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| C02011 | Medication prior or concomitant dose frequency | MedctnPriorConcmtntDoseFreq | Frequency of use of a prior/concomitant medication | Frequency of use of a prior/concomitant medicatio | Frequency | BID;TID;QID;q2h;q4h;q6h;q8h;QAM;QPM;QD;alt. d.;HS;PRN;OTH;UNK;NA | twice a day;three times a day;four times a day;every 2 hours;every 4 hours;every 6 hours;every 8 hours;every morning;every evening;one a day;every other day (on alternate days);at bedtime;as needed;Other, specify;unknown;Not applicable | Alphanumeric |
Record how often the medication is being taken |
CDISC SDTM Frequency Terminology (Code C71113) - http://evs.nci.nih.gov/ftp1/CDISC/SDTM/ | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 21:00:23.88 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Single Pre-Defined Value Selected |
3162733 | |||||||
| C02013 | Medication prior or concomitant dose unit of measure UCUM code | MedctnPriorOrConDseUOMUCUMCode | Code that represents the dosage unit of measure of the prior or concomitant medication administered. Unified Code for Units of Measure (UCUM) | Code that represents the dosage unit of measure of the prior or concomitant medication administered. Unified Code for Units of Measure (UCUM) | Dose Units | Alphanumeric |
Code the unit of measure of the medication dosage using Unified Code for Units of Measure (UCUM). |
Unified Code for Units of Measure (UCUM) - http://unitsofmeasure.org/ | Adult;Pediatric | Supplemental | 3.10 | 2022-08-02 14:42:09.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data | 255 |
Free-Form Entry |
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| C02014 | Medication prior or concomitant name | MedctnPriorConcomName | Name of the prior/concomitant agent or drug administered | Name of the prior/concomitant agent or drug administere | Medication Name | Alphanumeric |
Record the verbatim name (generic or trade name) of the medication the participant/subject reports taking. The following types of medications should definitely be queried and recorded: Antiplatelet; Anticoagulant history; Cholesterol-reducer history; Diabetic medication history; Antihypertensive history; Hormonal replacement history; Oral contraceptive history; and Implanted contraceptive history. |
RXNorm (http://www.nlm.nih.gov/research/umls/rxnorm/) | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data | 4000 |
Free-Form Entry |
3162728 | ||||||||
| C02015 | Medication prior or concomitant route type | MedctnPriorOrConcomRteTyp | Type of access route for the administration of the prior/concomitant medication | Type of access route for the administration of the prior/concomitant medication | Route | Buccal;Inhaled;Intramuscular;Intravenous;Nasal;Oral;Rectal;By ear;Topical;Subcutaneous;Sublingual;Transdermal;Unknown;Other, specify | Buccal;Inhaled;Intramuscular;Intravenous;Nasal;Oral;Rectal;By Ear;Topical;Subcutaneous;Sublingual;Transdermal;Unknown;Other, specify | Alphanumeric |
Record the route of administration. |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2022-08-02 14:44:16.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Single Pre-Defined Value Selected |
3162743 | |||||||
| C02016 | Medication prior or concomitant start date and time | MedctnPriorOrConcmStrtDateTime | The date (and time, if applicable and known) on which the prior/concomitant medication usage began | The date (and time, if applicable and known) on which the prior/concomitant medication usage began. | 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.). Start Date can be used to distinguish between prior medications and concomitant medications. |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2022-08-02 16:58:56.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Free-Form Entry |
3162752 | |||||||||
| C02022 | Medication prior or concomitant dose unit of measure | MedctnPriorOrConcomDoseUOM | Dosage unit of measure of the prior or concomitant medication administered | Dosage unit of measure of the prior or concomitant medication administered | Dose Units | g;mcg;mcL;mg;mL;oz;Other, specify;Unknown;NA | gram;microgram;microliter;milligram;milliliter;ounce;Other, specify;Unknown;Not applicable | Alphanumeric |
Record the units of the medication the participant/subject is taking |
Unified Code for Units of Measure (UCUM) - http://unitsofmeasure.org/ | Adult;Pediatric | Supplemental | 3.10 | 2022-08-02 14:36:00.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Single Pre-Defined Value Selected |
3162730 | |||||||
| C02024 | Medication prior or concomitant indication text | MedctnPriorConcomIndTxt | Text describing reason for administration of a prior/concomitant (nonstudy) agent or measure. This is not the pharmacologic classification of an agent (antibiotic, analgesic, etc.), but the reason for its administration to the participant/subject | Text describing reason for administration of a prior/concomitant (nonstudy) agent or measure. This is not the pharmacologic classification of an agent (antibiotic, analgesic, etc.), but the reason for its administration to the participant/subjec | Indication | Alphanumeric |
Record the reason the participant/subject gives for taking the medication. If given for an AE, enter exact term from Adverse Event CRF. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data | 4000 |
Free-Form Entry |
3158920 | ||||||||
| C02002 | Medication prior or concomitant use indicator | MedctnPriorConcomUseInd | Indicator of whether the participant/subject reported taking any medications during the time period relevant to the study protocol | Indicator of whether the participant/subject reported taking any medications during the time period relevant to the study protocol | Did the participant/subject take any medications (please specify below) days before or during the study | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. If this question is answered YES then at least one prior/concomitant medication record needs to be recorded. Do NOT record study medications taken (if study has a drug intervention) on this form. Refer to the Study Drug Dosing form instructions to record study medications. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Single Pre-Defined Value Selected |
2220500 | |||||||
| C02025 | Medication prior or concomitant RXNorm code | MedctnPriorConcomRxNormCode | Code for name of the prior/concomitant agent or drug administered | Code for name of the prior/concomitant agent or drug administere | Code | Alphanumeric |
Code the verbatim name (generic or trade name) of the medication using RXNorm. |
RXNorm (http://www.nlm.nih.gov/research/umls/rxnorm/) | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data | 255 |
Free-Form Entry |
3162728 | ||||||||
| C02003 | Medication prior or concomitant ongoing indicator | MedctPrConcomOngoingInd | Indicator of or description that the prior/concomitant medication usage is ongoing | Indicator of or description that the prior/concomitant medication usage is ongoin | Ongoing | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. Answer YES if the participant/subject is still taking the medication or NO if the participant/subject has stopped taking the medication. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Single Pre-Defined Value Selected |
2321822 | |||||||
| C18736 | Medication prior or concomitant dose unit of measure other text | MedctnPriorOrConcomDoseUoMOTH | The free-text field related to 'Medication prior or concomitant dose unit of measure', specifying other text. Dosage unit of measure of the prior or concomitant medication administered | The free-text field related to 'Medication prior or concomitant dose unit of measure', specifying other text. Dosage unit of measure of the prior or concomitant medication administere | Other, specify | Alphanumeric |
Record the units of the medication the participant/subject is taking |
Unified Code for Units of Measure (UCUM) - http://unitsofmeasure.org/ | Adult;Pediatric | Supplemental | 2.10 | 2022-08-02 14:27:44.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data | 4000 |
Free-Form Entry |
3162730 | ||||||||
| C02006 | Medication prior or concomitant dose | MedctnPriorOrConcomDose | Dose of prior/concomitant medication taken per administration | Dose of prior/concomitant medication taken per administration | Dose | Numeric Values |
Record the strength of the medication the participant/subject is taking. |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2022-08-02 14:33:32.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Free-Form Entry |
3162729 | |||||||||
| C18737 | Medication prior or concomitant route type other text | MedctnPriorOrConcomRteTypOTH | The free-text field related to 'Medication prior or concomitant route type', specifying other text. Type of access route for the administration of the prior/concomitant medication | The free-text field related to 'Medication prior or concomitant route type', specifying other text. Type of access route for the administration of the prior/concomitant medication | Other, specify | Alphanumeric |
Record the route of administration. |
No references available | Adult;Pediatric | Supplemental | 2.00 | 2022-08-02 16:52:05.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data | 4000 |
Free-Form Entry |
3162743 | ||||||||
| C02008 | Medication prior or concomitant end date and time | MedctnPriorOrConcomEndDateTime | The date (and time, if applicable and known) the administration of the prior/concomitant medication ended | The date (and time, if applicable and known) the administration of the prior/concomitant medication ended. | End 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.). Stop Date should be recorded if Continuing Medication is answered No. Conversely, Stop Date should remain blank if Continuing Medication is answered Yes. |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2022-08-02 16:59:51.0 | Prior and Concomitant Medications | Drugs | Treatment%2FIntervention Data |
Free-Form Entry |
3162753 |
