CDE Detailed Report
Subdomain Name: General Health History
CRF: welcome
Displaying 1 - 21 of 21
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C16177 | Post-menopausal indicator | PostMnpslInd | Indicates whether participant is post-menopausal | Indicates whether participant/subject is post-menopausal | Are you post-menopausal | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one if female |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16167 | Given birth or fathered a child indicator | GivenBirthFartheredChildInd | Indicates whether participant/subject has ever given birth or fathered a child | Indicates whether participant/subject has ever given birth or fathered a child | Have you ever given birth or fathered a child | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. Include current pregnancy and any pregnancies that resulted in early pregnancy loss, whether by choice or not. If "Yes" is answered, go to next question. If "No" is answered and participant/subject is a woman, skip to question 3. If "No" is answered and participant/subject is male, end form. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16178 | Post-menopausal cause type | PostMnpslCauseTyp | Type of cause or reason for the post-menopausal period in the participant | Tpye of cause or reason for the post-menopausal period in the participant | Indicate cause | Natural;Surgical (complete hysterectomy- ovaries and uterus removed);Surgical (partial hysterectomy-only uterus removed);Medications or chemotherapy | Natural;Surgical (complete hysterectomy- ovaries and uterus removed);Surgical (partial hysterectomy-only uterus removed);Medications or chemotherapy | Alphanumeric |
Only answered if "Yes" is answered for "Are you post-menopausal?". Choose all that apply. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-03-18 15:21:17.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C16168 | Pregnancy self or contribute sperm number | PregSelfOrContributeSpermNum | Number of each pregnancy for the participant or the pregnant individual (if the participant contributed sperm to the pregnancy) | Number of each pregnancy for the participant or the pregnant individual (if the participant contributed sperm to the pregnancy) | # | Numeric Values |
Numbers should be assigned in ascending numerical order, #1 being the most recent pregnancy. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-01 15:39:08.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C16179 | Post-menopausal surgery date/time | PostMnpslSurgDateTime | The date and time (if applicable and known) of the surgery that induced the post-menopausal period | Date (and time if applicable and known) of the surgery that induced the post-menopausal period | date | Date or Date & Time |
Only answered if "Surgical (complete hysterectomy - ovaries and uterus removed)" or "Surgical (partial hysterectomy - only uterus removed) are answered for "If yes, indicate cause" 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 | 4.00 | 2024-02-02 13:21:13.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C16169 | Pregnancy outcome type | PregOutcmeTyp | Type of outcome of the pregnancy experienced by the participant or the pregnant individual (if the participant contributed sperm to the pregnancy) | Type of outcome of the pregnancy experienced by the participant or the pregnant individual (if the participant contributed sperm to the pregnancy) | Pregnancy Outcome | Currently pregnant;Live birth;Miscarriage;Therapeutic abortion or elective termination;Still birth | Currently pregnant;Live birth;Spontaneous abortion (<20 weeks);Therapeutic abortion or elective termination;Fetal death/stillbirth (>20 weeks) | Alphanumeric |
Choose one. Answer for all pregnancies experienced by the participant/subject or the participant/subject's partner |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-03-18 15:21:17.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16180 | Hormone-related syndrome indicator | HormoneRltdSyndmInd | Indicator of whether the participant has known hormone-related/endocrine syndromes or disorders | Indicator of whether the participant has known hormone-related/endocrine syndromes or disorders | Any other known hormone-related/endocrine syndromes or disorders | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-02 13:55:35.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16170 | Menstrual period occurrence indicator | MenstrualPrdOcurInd | Indicates whether participant has ever had a menstrual period | Indicates whether participant has ever had a menstrual period | Have you ever had a menstrual period | Yes;No | Yes;No | Alphanumeric |
Choose one. If participant/subject is male, select "N/A - male". |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-02 08:23:32.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16193 | Pregnancy outcome date/time | PregOutcomeDateTime | The date and time (if applicable and known) of the outcome (i.e., delivery of live birth, miscarriage, etc.) of the pregnancy experienced by the participant or the pregnant individual (if the participant contributed sperm to the pregnancy) | The date and time (if applicable and known) of the outcome (i.e., delivery of live birth, miscarriage, etc.) of the pregnancy experienced by the participant or the pregnant individual (if the participant contributed sperm to the pregnancy) | Date | Date or Date & Time |
At a minimum record the month and year for each pregnancy. 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 | 4.00 | 2024-02-01 16:22:32.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C16171 | Menstrual period first occurrence age value | MenstrualPrd1stOcurAgeVal | Youngest age the participant had a menstrual period, otherwise known as the age of menarche | Youngest age the participant had a menstrual period, otherwise known as the age of menarche | What age was your first period | Numeric Values |
If YES is answered for having received a menstrual period, record the age first received in years |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-02 08:26:11.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
0 | 100 | year | |||||||
| C10980 | Childbearing potential indicator | ChldbrngPtntlInd | Indicator of whether the participant is of childbearing potential | Indicator of whether the participant is of childbearing potential | Are you of child-bearing potential | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. No should be chosen if the participant/subject is a male. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 16:57:17.79 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16172 | Pregnant current indicator | PregCurntInd | Indicator of whether the participant is currently pregnant | Indicator of whether the participant is currently pregnant | Are you currently pregnant | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one for females |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-02 11:45:08.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C10981 | Birth control method type | BirthCntrlMethdTyp | The participant's method of birth control | The participant's method of birth control | Indicate all forms of contraception used | Oral contraceptives – combined pill;Oral contraceptives – progestin-only pill;Transdermal patch;Shot/injection;Vaginal ring;Implantable devices with hormone;Abstinence;None of these | Oral contraceptives – combined pill;Oral contraceptives – progestin-only pill;Transdermal patch;Shot/injection;Vaginal ring;Implantable devices with hormone;Abstinence;None of these | Alphanumeric |
Only answered if "Is the subject of childbearing potential?" is answered Yes. Choose all that apply. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-03-18 15:21:17.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C16173 | Pregnancy estimate delivery date and time | PregEstDeliveryDateTime | The date and time (if applicable) the participant is estimated to deliver the pregnancy | The date and time (if applicable) the participant is estimated to deliver the pregnancy | Indicate your due date | Date or Date & Time |
Only answered if "Yes" is answered for "Are you currently pregnant?" 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 | 2024-02-02 11:48:32.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C16008 | Birth control indicator | BirthControlInd | Indicates if participant uses birth control | Indicates if participant uses birth control | Do you use any forms of contraception (periods may be regular or irregular) | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16174 | Menopause indicator | MenopauseInd | Indicates whether participant is currently menopausal | Indicates whether participant/subject is currently menopausa | Do you believe you are currently experiencing menopause | Yes;No | Yes;No | Alphanumeric |
Choose one for females |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16163 | Hormone therapy name | HormoneTherapyNme | The name of the hormone therapy taken by the participant | The name of the hormone therapy taken by the participant/subjec | Specify name of hormonal therapy taken | Alphanumeric |
Only answered if "Yes" is answered for "Have you taken hormonal therapy?" |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C16175 | Menstrual period last date | MenstrualPeriodLastDate | Date of the participant's last menstrual period | Date of the participant's last menstrual period | Indicate the approximate date of your last menstrual period | Date or Date & Time |
Only answered if "Yes" is answered for "Do you believe you are currently experiencing menopause?" 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 | 2024-02-02 12:18:50.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C16164 | Hormonal therapy start date/time | HormonalTherapyStartDateTime | The date and time (if applicable and known) the participant started hormonal therapy | Date (and time, if applicable and known) the participant started hormonal therapy | Date Started | Date or Date & Time |
Only answered if "Yes" is answered for "Have you taken hormonal therapy?" 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 | 4.00 | 2024-02-02 12:57:37.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C16176 | Hormone therapy indicator | HormoneTherapyInd | Indicates whether participant/subject has taken hormonal therapy | Indicates whether participant/subject has taken hormonal therapy | Have you taken hormonal therapy | Yes;No | Yes;No | Alphanumeric |
Choose one for females |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-06-11 00:00:00.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16165 | Hormonal therapy stop date/time | HormonalTherapyStopDateTIme | The date and time (if applicable and known) the participant stopped hormonal therapy | Date (and time, if applicable and known) the participant stopped hormonal therapy | Date Stopped | Date or Date & Time |
Only answered if "Yes" is answered for "Have you taken hormonal therapy?" 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 | 4.00 | 2024-02-02 13:04:55.0 | Reproductive and Hormonal History | General Health History | Participant History and Family History |
Free-Form Entry |
