CDE Detailed Report

Disease: Duchenne Muscular Dystrophy/Becker Muscular Dystrophy
Sub-Domain: General Health History
CRF: Surgical History

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
C05105 Surgical or therapeutic procedure end date and time SurgTherapuProcEndDateTime Date on which the surgical or therapeutic procedure ended Date on which the surgical or therapeutic procedure ended Discharge Date Date or Date & Time

Record the start date or admission date for the surgical procedure. If the start date is not known the approximate age of the participant/subject at the time of the surgery can be recorded. 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.). If age at admission is used instead of date, age can be captured in years or months.

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Surgical History General Health History Participant History and Family History

Free-Form Entry

C05106 Surgical or therapeutic procedure start date and time SurgTherapuProcStartDateTime Date (and time, if applicable and known) on which the surgical or therapeutic procedure started Date (and time, if applicable and known) on which the surgical or therapeutic procedure started Date of Procedure Date or Date & Time

Record the start date or admission date for the surgical procedure. If the start date is not known the approximate age of the participant/subject at the time of the surgery can be recorded. 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.). If age at admission is used instead of date, age can be captured in years or months.

No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Surgical History General Health History Participant History and Family History

Free-Form Entry

C05108 Surgical or therapeutic procedure type SurgTherapProcedurTyp Type of surgical or therapeutic procedure received by the participant/subject Type of surgical or therapeutic procedure received by the participant/subject Procedure Appendicectomy;Cholecystectomy;Colostomy;Ileostomy;Feeding tube placement;Fundoplication;Scoliosis surgery;Tendon release;Tympanostomy tubes;Tracheostomy;Airway surgery;Other surgery, specify;Unknown;Diagnostic;Anterior temporal lobectomy (ATL);Anterior temporal lobectomy plus (ATL+);Amygdalohippocampectomy;Lesionectomy;Lesionectomy plus (Lesionectomy +);Extratemporal resection (Topectomy);Multi-lobar resection;Hemispherectomy;Vagus nerve stimulation (VNS) surgery;Corpus callosotomy;Multiple subpial transaction;Radiosurgery;Therapeutic brain stimulation;Other, specify;Appendicostomy;Appendectomy;Neurological surgery;Bony orthopedic surgery Appendicectomy;Cholecystectomy;Colostomy;Ileostomy;Feeding tube placement;Fundoplication;Scoliosis surgery;Tendon release;Tympanostomy tubes;Tracheostomy;Airway surgery;Other surgery, specify;Unknown;Diagnostic surgery;Anterior temporal lobectomy (ATL);Anterior temporal lobectomy plus (ATL+);Amygdalohippocampectomy;Lesionectomy;Lesionectomy plus (Lesionectomy +);Extratemporal resection (Topectomy);Multi-lobar resection;Hemispherectomy;Vagus nerve stimulation (VNS) surgery;Corpus callosotomy;Multiple subpial transaction;Radiosurgery;Therapeutic brain stimulation;Other, specify;Appendicostomy (antegrade colonic anema);Appendectomy;Neurological surgery;Bony orthopedic surgery Alphanumeric International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): http://www.cdc.gov/nchs/icd/icd9cm.htm Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Surgical History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C08018 Surgery age value SurgAgeVal Age of the participant/subject at the time of the selected surgical procedure Age of the participant/subject at the time of the selected surgical procedure Age (approximate) Numeric Values No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Surgical History General Health History Participant History and Family History

Free-Form Entry

0 99
C18363 Past surgical history identification number PastSurgHistIdNum The number on a list to identify past surgical history. The number on a list to identify past surgical history. Surgery # Numeric Values No references available Adult;Pediatric Supplemental 3.00 2013-07-21 12:11:21.037 Surgical History General Health History Participant History and Family History

Free-Form Entry

C18765 Surgical or therapeutic procedure other text SurgTherapProcedurOTH The free-text field related to 'Surgical or therapeutic procedure type' specifying other text. Type of surgical or therapeutic procedure received by the participant/subject The free-text field related to 'Surgical or therapeutic procedure type' specifying other text. Type of surgical or therapeutic procedure received by the participant/subject Other, specify Alphanumeric International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): http://www.cdc.gov/nchs/icd/icd9cm.htm Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Surgical History General Health History Participant History and Family History 4000

Free-Form Entry

C21668 ICD-10-CM code SurgTherapuProcICD10CMCode Code from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for the selected surgical procedure Code from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for the selected surgical procedure Procedure MB;C;T;S;G;Other, specify Muscle biopsy;Contracture Release;Tracheostomy;Scoliosis;Gastrostomy;Other specify Alphanumeric

Record a reason for each surgery. If the data will be shared, code each surgical procedure using ICD-10-CM.

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): http://www.cdc.gov/nchs/icd/icd10cm.htm#icd2016 Adult;Pediatric Supplemental 1.00 2013-08-28 16:08:00.453 Surgical History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C21669 Surgical therapeutic procedure ICD-10-CM other text SurgTherapuProcICD10CMOthTxt The free-text field related to 'Surgical or therapeutic procedure ICD-10-CM code' specifying other text. Code from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for the selected surgical procedure The free-text field related to 'Surgical or therapeutic procedure ICD-10-CM code' specifying other text. Code from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for the selected surgical procedure Other, specify Alphanumeric

Record a reason for each surgery. If the data will be shared, code each surgical procedure using ICD-9-CM.

International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): http://www.cdc.gov/nchs/icd/icd9cm.htm Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Surgical History General Health History Participant History and Family History 4000

Free-Form Entry

CSV