CDE Detailed Report

Disease: content
Sub-Domain: General Health History
CRF: welcome

Displaying 1 - 50 of 61
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 / 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
C17993 Prenatal test text PrenatalTestTxt Text notes of any comments regarding the selected prenatal testing type Text notes of any comments regarding the selected prenatal testing type Comments Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C16017 Prenatal testing result PrenatalTestReslt Results of the selected prenatal testing type Results of the selected prenatal testing type Results of Test Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C19044 Pregnancy prior history toxic exposure other text PregPriorHistToxExposOTH The free-text field related to 'Pregnancy prior history toxic exposure type' specifying other text. Type of any substances or radiation potentially harmful to the embryo or fetus to which the participant/subject has ever been exposed during pregnancy The free-text field related to 'Pregnancy prior history toxic exposure type' specifying other text. Type of any substances or radiation potentially harmful to the embryo or fetus to which the participant/subject has ever been exposed during pregnancy Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 4000

Free-Form Entry

C16042 Delivery mode induced reason DeliveryModeInduceRsn Type of induced delivery that occurred during the live infant birth Type of induced delivery that occurred during the live infant birth Induced; specify reason Hemorrhage and placental complications;Hypertension, preeclampsia or eclampsia;Rupture of membranes-premature, prolonged;Maternal conditions complicating pregnancy/delivery;Fetal conditions complicating pregnancy/delivery;Malposition and malpresentation of fetus;Late pregnancy;Prior uterine surgery;Other, specify;Unknown Hemorrhage and placental complications;Hypertension, preeclampsia or eclampsia;Rupture of membranes-premature, prolonged;Maternal conditions complicating pregnancy/delivery;Fetal conditions complicating pregnancy/delivery;Malposition and malpresentation of fetus;Late pregnancy;Prior uterine surgery;Other, specify;Unknown Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C16058 Activity pulse grimace appearance respiration ten minute child score APGARTenMinChldScore Assessment of a newborn which is recorded at ten minutes from the time of birth and expressed as a number quantifying the overall physical condition, which includes heart rate, muscle tone, respiratory effort, color, and reflex responsiveness. This score describes the participant's/subject's child. Activity pulse grimace appearance respiration (APGAR) Assessment of a newborn which is recorded at ten minutes from the time of birth and expressed as a number quantifying the overall physical condition, which includes heart rate, muscle tone, respiratory effort, color, and reflex responsiveness. 10-minute APGAR score Numeric Values

Record the score (0 - 10 points, inclusive)

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Free-Form Entry

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 pregnancy information/outcome obtained? 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.).

ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Pregnancy General Health History Participant History and Family History

Free-Form Entry

C17994 Pregnancy complication text PregComplicationTxt Text specifying any complications the participant/subject experienced during this pregnancy Text specifying any complications the participant/subject experienced during this pregnancy If Yes, specify: Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C16018 Pregnancy complication indicator PregComplicationInd Indicator of whether the participant/subject had complications during the pregnancy Indicator of whether the participant/subject had complications during the pregnancy Did/Has the participant/subject experienced any complications during this pregnancy? Yes, specify;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19577 Length infants measurement unit of measure LngthInfantMeasUOM Unit of measure for the length numerical value for subject/participant Unit of measure for the length numerical value for subject/participant Inches;Centimeters Inches;Centimeters Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-18 00:00:00.0 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

2538920
C16044 Delivery cesarean section reason DelCesSctnRsn Reason for the Cesarean section Reason for the Cesarean section Specify reason Alphanumeric

Answer only if Cesarean was the delivery route.

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C16059 Weight delivery mother measurement WgtDelMotherMeasr Measurement of participant's/subject's weight at the time she gave birth Measurement of participant's/subject's weight at the time she gave birth Mother's weight at the time of birth Numeric Values

Record in kg or lb

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Free-Form Entry

C10556 Pregnant ever indicator PregEverInd Indicator as to whether or not the participant/subject has every been pregnant, both term and not to term Indicator as to whether or not the participant/subject has every been pregnant, both term and not to term Has the participant/subject ever been pregnant? Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C17995 Pregnancy infection illness text PregInfectnIllnessTxt Text specifying any infections or illnesses the participant/subject experienced during this pregnancy Text specifying any infections or illnesses the participant/subject experienced during this pregnancy If Yes, specify: Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C16020 Pregnancy infection illness indicator PregInfectnIllnessInd Indicator of whether there were any infections/illnesses that occurred during this pregnancy Indicator of whether there were any infections/illnesses that occurred during this pregnancy Did/Has the participant/subject experienced any infections or illnesses during this pregnancy? Yes, specify;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19626 FSHD prenatal testing indicator FSHDPrenatTestInd Indicator of whether prenatal testing for FSHD was performed Indicator of whether prenatal testing for FSHD was performed Was prenatal testing for FSHD performed? No;Yes;Unknown No;Yes (specify below);Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2015-01-05 13:31:29.0 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C16046 Pregnancy labor delivery complication indicator PregLabDelCompInd Indicator of whether there were complications during labor/delivery Indicator of whether there were complications during labor/delivery Did the participant/subject experience any complications during labor/delivery? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one. If yes, explain the labor/delivery complication.

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C16060 Weight delivery mother unit of measure WgtDelMotherUoM Units for the measurement of the participant's/subject's weight at the time she gave birth Units for the measurement of the participant's/subject's weight at the time she gave birth Mother's weight at the time of birth lb;kg Pounds;Kilograms Alphanumeric

Choose one unit

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C10558 Delivery or pregnancy termination last date and time DeliveryPregTerminLstDateTime Date (and time if applicable and known) the female participant/subject last delivered a pregnancy or the pregnancy terminated (e.g., miscarriage, abortion) Date (and time if applicable and known) the female participant/subject last delivered a pregnancy or the pregnancy terminated (e.g., miscarriage, abortion) Outcome 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.).

ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html) Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Free-Form Entry

C17996 Pregnancy prior history birth defect text PregPriorHistBirthDefectTxt Text of any comments about any birth defects that occurred during the participant/subject's previous pregnancies Text of any comments about any birth defects that occurred during the participant/subject's previous pregnancies If Yes, specify birth defect Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C16022 Pregnancy prior history births full-term count PregPriorHistBirthFulltermCt Count of the total number of pregnancies the participant/subject has carried for a full term (>= 37 weeks) Count of the total number of pregnancies the participant/subject has carried to a full term (>= 37 weeks) Prior full-term (>= 37 weeks) births Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Free-Form Entry

0 30
C19627 FSHD prenatal testing text FSHDPrenatTestTxt Text specifying results from FSHD prenatal testing that was performed on the participant/subject Text specifying results from FSHD prenatal testing that was performed on the participant/subject If Yes, specify the result: Alphanumeric Adult;Pediatric Supplemental 1.00 2015-01-05 14:01:43.0 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C16048 Tocolytic agents required during preterm labor indicator ToclytcAgntReqDrnPretermLabInd Indicator of whether medications used to suppress premature labor were required during preterm labor Indicator of whether medications used to suppress premature labor were required during preterm labor Did the participant/subject require tocolytic agents during preterm labor? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one. If yes, explain the agent(s) administered.

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C16062 Pregnancy fetal diagnostic test performed indicator PregFetDignstcTestPerfmInd Indicates whether there were any abnormal fetal diagnostic tests performed during the pregnancy Indicates whether there were any abnormal fetal diagnostic tests performed during the pregnancy Any abnormal fetal diagnostic tests performed during pregnacy? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C11065 Gravida maternal value GravidaMaternalVal Total number of times the participant's/subject's mother has been pregnant, regardless of whether these pregnancies were carried to term Total number of times the participant's/subject's mother has been pregnant, regardless of whether these pregnancies were carried to term Number of prior pregnancies: Numeric Values

Both to term and not to term

Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Pregnancy General Health History Participant History and Family History

Free-Form Entry

1 99
C17997 Pregnancy fetus not normal description text PregFetusNotNormDescriptTxt Description of the abnormal pregnancy fetus Description of the abnormal pregnancy fetus No, describe Alphanumeric No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C16023 Pregnancy prior history births pre-term count PregPriorHistBirthPretermCt Count of the total number of pregnancies the participant/subject carried for less than a full term (< 37 weeks) Count of the total number of pregnancies the participant/subject carried for less than a full term (< 37 weeks) Prior pre-term (< 37 weeks) births Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Free-Form Entry

0 30
C19628 Breastfeeding indicator BreastFeedInd Indicator of whether the mother breastfed the newborn Indicator of whether the mother breastfed the newborn Breastfeeding? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-01-06 15:48:48.0 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C16049 Birth child date and time BrthChildDateTime Date of birth of participant/subject's most recent live birth Date of birth of participant/subject's most recent live birth Birth 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.).

ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html) Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Free-Form Entry

C16063 Pregnancy fetal diagnostic test date PregFetDignstcTestDate Date the fetal diagnostic testing was performed during the pregnancy Date the fetal diagnostic testing was performed during the pregnancy Date(s) of testing 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.).

ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html) Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Free-Form Entry

C11078 Delivery mode type DeliveryModeTyp Type of delivery mode of the neonate Type of delivery mode of the neonate Delivery type? Spontaneous;Induced, specify reason Spontaneous;Induced, specify reason Alphanumeric

Choose only one

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

Single Pre-Defined Value Selected

C17998 Pregnancy labor delivery complication specification text PregLabDelCompSpecTxt Text about the participant/subject's experience with any complications during labor/delivery Text about the participant/subject's experience with any complications during labor/delivery If Yes, specify Alphanumeric No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C16024 Pregnancy prior history birth defect indicator PregPriorHistBirthDefectInd Indicator of whether a birth defect occurred in any of the participant/subject's previous pregnancies Indicator of whether a birth defect occurred in any of the participant/subject's previous pregnancies Did a birth defect occur in any previous pregnancy? Yes, specify;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19629 Breastfeeding Absent text BreastFeedAbsentTxt Text describing the reason why the mother did not breastfeed Text describing the reason why the mother did not breastfeed No (specify the reason) Alphanumeric Adult;Pediatric Supplemental 1.00 2015-01-06 15:55:21.0 Pregnancy General Health History Participant History and Family History 4000

Free-Form Entry

C16050 Phenotypic sex child type PhenotypSexChildTyp Sex of the participant/subject's child based on physical examination Sex of the participant/subject's child based on physical examination Birth sex Female;Male;Unknown Female;Male;Unknown Alphanumeric

Choose one

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C16064 Pregnancy fetal diagnostic test result PregFetDignstcTestReslt Results of the fetal diagnostic testing performed during the pregnancy Results of the fetal diagnostic testing performed during the pregnancy Results of Fetal Diagnositc Testing Alphanumeric

Answer this question if abnormal fetal diagnostic tests performed

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C11079 Neonate delivery route type NeonateDelivRteTyp Route of delivery of the neonate Route of delivery of the neonate Delivery route? Vaginal;Caesarean;Unknown Vaginal;Caesarean;Unknown Alphanumeric

Choose only one

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

Single Pre-Defined Value Selected

C17999 Tocolytic agents required during preterm specification text ToclytcAgntReqDrnPretermLabTxt Text specifying the tocolytic agents the participant/subject required during preterm labor Text specifying the tocolytic agents the participant/subject required during preterm labor If Yes, specify Alphanumeric No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C16026 Pregnancy prior history loss indicator PregPriorHistLossInd Indicator of whether a miscarriage (<= 20 weeks) or stillbirth (> 20 weeks) occurred in any previous pregnancy Indicator of whether a miscarriage (<= 20 weeks) or stillbirth (> 20 weeks) occurred in any previous pregnancy Did a miscarriage (<= 20 weeks) or stillbirth (> 20 weeks) occur in any previous pregnancy? Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C16051 Birth weight child value WgtChildVal Value of the weight of the participant/subject's child at birth Value of the weight of the participant/subject's child at birth Birth weight Numeric Values

Record in g or oz

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Free-Form Entry

C19630 Breastfeeding Month Count BreastFeedMoCount The value of the number of months the mother breastfed The value of the number of months the mother breastfed Yes, for __ months Numeric Values Adult;Pediatric Supplemental 1.00 2015-01-06 16:06:46.0 Pregnancy General Health History Participant History and Family History

Free-Form Entry

C16065 Congenital anomaly child indicator CongAnmlChldInd Indicates whether there were congenital anomalies in the participant's/subject's child Indicates whether there were congenital anomalies in the participant's/subject's child Were there any congenital anomalies? Yes, specify;No;Unknown Yes;No;Unknown Alphanumeric

Choose one. If YES, explain the anomalies

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C11080 Delivery modality type DeliveryModltyTyp Type of modality of the participant/subject's intrauterine orientation at delivery Type of modality of the participant/subject's intrauterine orientation at delivery Delivery modality type Breech;Cephalic;Unknown Breech;Cephalic;Unknown Alphanumeric

Choose one

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

Single Pre-Defined Value Selected

C18000 Congenital anomalies child specification text CongAnmlChildSpecTxt Text specifying any congenital anomalies of the participant/subject Text specifying any congenital anomalies of the participant/subject If Yes, specify Alphanumeric No references available Adult Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C16027 Pregnancy prior history loss week count PregPriorHistLossWeekCt Number of the week of pregnancy during which the stillbirth or miscarriage occurred Number of the week of pregnancy during which the stillbirth or miscarriage occurred If Yes, in what week of pregnancy did the miscarriage or stillbirth occur? Numeric Values Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Free-Form Entry

1 45 week
C16053 Birth length child value LngthChildVal Value of the length of the participant's/subject's child at birth Value of the length of the participant's/subject's child at birth Birth length Numeric Values

Record in inches or centimeters

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Free-Form Entry

C19632 Weight pediatric unit of measure WgtPedUoM Unit of measure for the pediatric weight numerical value Unit of measure for the pediatric weight numerical value g;oz gram;ounce Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-18 00:00:00.0 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

2630200
C16067 Newborn complication child indicator NewbrnCompChldInd Indicates whether there were other newborn complications experienced by the participant's/subject's child Indicates whether there were other newborn complications experienced by the participant's/subject's child Were there other newborn complications? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one. If YES, explain the complications

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C11081 Delivery caesarean timing status DeliveryCaesareanTimingStatus Status of the caesarean delivery Status of the caesarean delivery Timing of cesarean Emergency;Elective Emergency;Elective Alphanumeric

Choose one. Answer only if Cesarean was the delivery route.

No references available Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

C18001 Newborn complication child specification text NewbrnCompChldSpecTxt Text specifying other newborn complications Text specifying other newborn complications If Yes, specify Alphanumeric No references available Adult Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History 255

Free-Form Entry

C16028 Pregnancy prior history toxic exposure type PregPriorHistToxExposTyp Type of any substances or radiation potentially harmful to the embryo or fetus to which the participant/subject has ever been exposed during pregnancy Type of any substances or radiation potentially harmful to the embryo or fetus to which the participant/subject has ever been exposed during pregnancy Has the participant/subject ever had exposure to any of the following during pregnancy? Concurrent medications;Teratogens;Smoking;Exposure to X-ray;Alcohol;Other, specify Concurrent medications;Teratogens;Smoking;Exposure to X-ray;Alcohol;Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

CSV