CDE Detailed Report

Disease: Multiple Sclerosis
Sub-Domain: Laboratory Tests and Biospecimens/Biomarkers
CRF: Genetics

Displaying 1 - 8 of 8
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
C16198 Biological sample in repository consent form signed indicator BioSampReposConsentSignedInd Indicates whether the participant/subject provided signed informed consent for the biological sample collection and storage in a repository Indicates whether the participant/subject provided signed informed consent for the biological sample collection and storage in a repository Do you have the consent form you signed at the time the sample was taken Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one. Only answered if "Yes" is answered for "Have you had a sample drawn for DNA banking?"

No references available Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Genetics Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

C18679 Family history medical condition relative other text FamHistMedclCondReltvOTH The free-text field related to 'Family history medical condition relative type' specifying other text. Relationship of the family member or ancestor with the medical condition or health related event to the participant/subject The free-text field related to 'Family history medical condition relative type' specifying other text. Relationship of the family member or ancestor with the medical condition or health related event to the participant/subject Other, specify Alphanumeric

Answer the family history items for each relative type. Select the relationship from the options of the family members listed. Record/choose more than one family member, if applicable. For MS: Use this element along with "Family history relative type biological sample in repository indicator" (C08001) to record which relatives had a DNA sample banked in a repository. For HD: If no first degree relatives have been diagnosed with HD, do not complete family history for second degree relatives. If either or both of the participant's/subject's parents have been diagnosed with HD, complete family history for second degree relatives by considering only the parent(s) diagnosed with HD to determine maternal/paternal relationship.

Krassioukov A, Alexander MS, Karlsson AK, Donovan W, Mathias CJ, Biering-SØrensen F. International spinal cord injury cardiovascular function basic data set. Spinal Cord. 2010 Aug;48(8):586-90. Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Genetics Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 4000

Free-Form Entry

3165810
C00722 Family history medical condition relative type FamHistMedclCondReltvTy Relationship of the family member or ancestor with the medical condition or health related event to the participant/subject Relationship of the family member or ancestor with the medical condition or health related event to the participant/subject Relative Type Mother;Father;Full sibling;Half sibling;Child;Maternal grandmother;Paternal grandmother;Maternal grandfather;Paternal grandfather;Maternal aunt;Paternal aunt;Maternal uncle;Paternal uncle;Maternal niece/nephew;Paternal niece/nephew;Grandchild;Other, specify;Maternal cousin;Paternal cousin;Great-grandchild Mother;Father;Full sibling;Half sibling;Child;Maternal grandmother;Paternal grandmother;Maternal grandfather;Paternal grandfather;Maternal aunt;Paternal aunt;Maternal uncle;Paternal uncle;Maternal niece/nephew;Paternal niece/nephew;Grandchild;Other, specify;Maternal cousin;Paternal cousin;Great-grandchild Alphanumeric

Answer the family history items for each relative type. Select the relationship from the options of the family members listed. Record/choose more than one family member, if applicable. For MS: Use this element along with "Family history relative type biological sample in repository indicator" (C08001) to record which relatives had a DNA sample banked in a repository. For HD: If no first degree relatives have been diagnosed with HD, do not complete family history for second degree relatives. If either or both of the participant's/subject's parents have been diagnosed with HD, complete family history for second degree relatives by considering only the parent(s) diagnosed with HD to determine maternal/paternal relationship.

Krassioukov A, Alexander MS, Karlsson AK, Donovan W, Mathias CJ, Biering-SØrensen F. International spinal cord injury cardiovascular function basic data set. Spinal Cord. 2010 Aug;48(8):586-90. Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Genetics Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Multiple Pre-Defined Values Selected

3165810
C08001 Family history relative type biological sample in repository indicator FmlyHistRelTypBioSampleRepInd Indicator of whether the participant's/subject's family member has donated biological sample(s) to a repository Indicator of whether the participant's/subject's family member has donated biological sample(s) to a repository DNA Sample Banked in a Repository Yes;No;Unknown Yes;No;Unknown Alphanumeric

Use this element along with "Family history medical condition relative type" (C00722). Choose one for each relative type to record which relatives had DNA samples banked in a repository.

No references available Adult;Pediatric Supplemental 3.00 2013-07-22 16:57:17.79 Genetics Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

C16194 Biological sample in repository indicator BioSampReposInd Indicates whether participant/subject had a biological sample or specimen drawn and banked in a repository Indicates whether participant/subject had a biological sample or specimen drawn and banked in a repository Have you had a sample drawn for DNA banking Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one to indicate if a DNA sample was banked

No references available Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Genetics Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

C16195 Biological sample in repository specimen type BioSampReposSpecmnTyp Type of biological sample or specimen collected and stored in a repository Type of biological sample or specimen collected and stored in a repository Specify the type of sample drawn Buccal swab;Saliva;Blood Buccal swab;Saliva;Blood Alphanumeric

Choose one. Only answered if "Yes" is answered for "Have you had a sample drawn for DNA banking?"

No references available Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Genetics Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

C16196 Biological sample in repository study initially requested name BioSampReposStdyIReqNme The name of the study for which the biological sample or specimen was initially taken The name of the study for which the biological sample or specimen was initially taken Specify the study for which the sample was initially taken Alphanumeric

Only answered if "Yes" is answered for "Have you had a sample drawn for DNA banking?"

No references available Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Genetics Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C16197 Biological sample in repository location name BioSampReposLocNme The location of the banked biological sample or specimen, if known The location of the banked biological sample or specimen, if known Specify where the sample is banked, if known Alphanumeric

Only answered if "Yes" is answered for "Have you had a sample drawn for DNA banking?" If the location of patient's DNA sample banking is unknown, leave blank.

No references available Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Genetics Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

CSV