CDE Detailed Report

Disease: Congenital Muscular Dystrophy
Sub-Domain: General Health History
CRF: Intake Medical History

Displaying 1 - 50 of 81
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
C58647 Breast bud formation not applicable indicator BrestBudFrmatnNotApplicblInd Indicator that breast bud formation is/was not applicable to the subject/participant for whom data are being collected. Indicator that breast bud formation is/was not applicable to the subject/participant for whom data are being collected. If female, at what age did you notice breast bud formation? Not applicable Not applicable Alphanumeric

If participant/subject is male, check N/A

No references available Adult;Pediatric Supplemental 1.00 2019-11-05 13:42:58.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19805 Medical history endocrine osteoporosis indicator MedHistEndcrnOstprsisInd Indicator of history of osteoporosis Indicator of history of osteoporosis Any history of osteoporosis? No;Yes No;Yes Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19838 Pain position text PainPosTxt The free-text field related to 'Pain Position indicator' Indicator of pain within a certain position of the body The free-text field related to 'Pain Position indicator' Indicator of pain within a certain position of the body If Yes, specify Alphanumeric

Only answered if Pain question #2 is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History 255

Free-Form Entry

C19772 Medical history pulmonary function test assessment indicator MedHistPFTAssessInd Indicator of pulmonary function tests completed Indicator of pulmonary function tests completed Any pulmonary function tests done? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19816 Medical history musculoskeletal total broken bones type MedHistMusclskltlBrknBonesTyp Type of bones broken Type of bones broken If Yes, specify bones broken and mechanism broken: Femur;Tibia/Fibia;Radius/Ulna;Vertebral body;Humerus;Carpal Femur;Tibia/Fibia;Radius/Ulna;Vertebral body;Humerus;Carpal Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C19783 Medical history pulmonary bilevel positive airway pressure indicator MedHistPlmnryBiPAPInd Indicator of bilevel positive airway pressure Indicator of bilevel positive airway pressure BiPAP currently? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19794 Medical history cardiovascular enlarged heart diagnosis indicator MedHistCardioEnlrgdHetDiagInd Indicator of history of enlarged heart Indicator of history of enlarged heart Is there a history of an enlarged heart? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19828 Learning disability mental retardation indicator NeuroLearnDisabMentlRetrdnInd Indicator of mental retardation Indicator of mental retardation If Yes, is the learning disability characterized as mental retardation (IQ <70) either through formal IQ testing or exam? No;Yes;Unknown No;Yes;Unknown Alphanumeric

Only answered if question #3 under neurologic is answered Yes

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19762 Medical history myopia diagnosis indicator MedHistMyopiaDiagInd Indicator of history of myopia Indicator of history of myopia Myopia No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19806 Medical history endocrine diabetes indicator MedHistEndcrnDiabetInd Indicator of diabetes Indicator of diabetes Ever have diabetes? No;Yes No;Yes Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19839 Pain exersice indicator PainExrcseInd Indicator of pain while excercising Indicator of pain while excercising Pain with exercise? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19773 Medical history pulmonary function test assessment date MedHistPFTAssessDt Date of pulmonary function test completed Date of pulmonary function test completed If Yes, date done Date or Date & Time

The date should be recorded in the format YYYY/MM.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

C19817 Medical history musculoskeletal total broken bones mechanism type MedHistMusclBrknBonMechTyp Type of mechanism broken Type of mechanism broken If Yes, specify bones broken and mechanism broken: Alphanumeric

Answer for all applicable broken bones

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History 255

Free-Form Entry

C19784 Medical history pulmonary bilevel positive airway pressure frequency MedHistPlmnryBiPAPFreq Frequency of bilevel positive airway pressure Frequency of bilevel positive airway pressure If Yes, how many hours a day? 0-4 hours/day;5-16 hours/day;>16 hours/day 0-4 hours/day;5-16 hours/day;>16 hours/day Alphanumeric

Only answered if Pulmonary question #1 is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19795 Medical history cardiovascular enlarged heart diagnosis date MedHistCardioEnlrgdHeDiagDt Date of first detection of enlarged heart Date of first detection of enlarged heart If Yes, date first detected Date or Date & Time

The date should be recorded in the format YYYY/MM and only answered if Cardiovascular question #2 is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

C19829 Behavioral issues indicator BehavrIssuesInd Indicator of behavioral issues Indicator of behavioral issues Behavioral issues? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19763 Medical history cataracts diagnosis indicator MedHistCatrctsDiagInd Indicator of history of cataracts Indicator of history of cataracts Cataracts No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19807 Medical history abdominal difficulty eating indicator MedHistAbdmnlDfcltyEatingInd Indicator of history of difficulty eating Indicator of history of difficulty eating History of difficulty eating? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19774 Medical history snoring presence indicator MedHistPlmnrySnorePresInd Indicator of snoring Indicator of snoring Any snoring? No;Yes No;Yes Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19818 Medical history musculoskeletal total broken bones trauma type MedHistMusclBrknBonTraumaTyp Type of broken bone trauma Type of broken bone trauma If Yes, specify bones broken and mechanism broken: Major trauma;Minor trauma (slip and fall) Major trauma;Minor trauma (slip and fall) Alphanumeric

Answer for all applicable broken bones

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C19785 Medical history pulmonary bilevel positive airway pressure start date MedHistLabPrPlBiPAPStrtDt Date of start of bilevel positive airway pressure Date of start of bilevel positive airway pressure If Yes, when started Date or Date & Time

The date should be recorded in the format YYYY/MM, and only answered if Pulmonary question #1 is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

C19796 Medical history cardiovascular enlarged heart diagnosis method type MedHistCardioEnlHeDiagMetTyp Indicator of enlarged heart detection method Indicator of enlarged heart detection method If Yes, how detected: Chest X-ray;Echocardiogram Chest X-ray;Echocardiogram Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19830 Behavioral issues onset date BehavrIssuesOnstDate Date of onset of behavioral issues Date of onset of behavioral issues If Yes, date of onset Date or Date & Time

The date should be recorded in the format YYYY/MM, and only answered if Neurologic question #5 is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

C19764 Medical history retinal detachment diagnosis indicator MedHistRetnlDetachDiagInd Indicator of history of retinal detachment Indicator of history of retinal detachment Retinal detachment No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19808 Medical history abdominal difficulty swallowing indicator MedHistAbdmnlDfclSwallInd Indicator of history of difficulty swallowing Indicator of history of difficulty swallowing History of difficulty swallowing? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19775 Medical history sleep pulmonary assessment indicator MedHistSleepPulAssessInd Indicator of sleep study completed Indicator of sleep study completed Any sleep study done? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19786 Medical history pulmonary bilevel positive airway pressure hospitalization indicator MedHistPlmnryBiPAPHosptlInd Indicator of bilevel positive airway pressure hospitilization Indicator of bilevel positive airway pressure hospitilization BiPAP only with hospitalization or illness: No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19819 Medical history musculoskeletal joint dislocation indicator MedHistMusclJointDislocInd Indicator of joint dislocation Indicator of joint dislocation Joint dislocation? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19797 Medical history endocrine early puberty indicator MedHistEndcrnErlyPubrtyInd Indicator of history of early puberty Indicator of history of early puberty Any history of early puberty? No;Yes No;Yes Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19831 Psychiatric anxiety indicator PsychAnxInd Indicator of anxiety Indicator of anxiety Anxiety: No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19765 Medical history auditory deafness diagnosis indicator MedHistAudtryDeafDiagInd Indicator of any history of deafness Indicator of any history of deafness Any history of deafness? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19809 Medical history abdominal constipation indicator MedHistAbdmnlConstptnInd Indicator of history of constipation Indicator of history of constipation History of constipation? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19776 Medical history sleep pulmonary assessment date MedHistSleepPulAssessDate Date of sleep study completed Date of sleep study completed If Yes, date sleep study done Date or Date & Time

The date should be recorded in the format YYYY/MM.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

C19787 Medical history pulmonary ventilator use indicator MedHistPlmnryVentltrUseInd Indicator of ventilator used Indicator of ventilator used Ventilator: No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19820 Medical history musculoskeletal total joint dislocations count MedHistMusclTtlJointDislocCt Number of total joints dislocated Number of total joints dislocated If Yes, total number of joint dislocations: Numeric Values

Only answered if Musculoskeletal question # 2 is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

C19799 Medical history endocrine breast bud formation age value MedHistEndcrnBrBudFormAgeVal Text of age of breast bud formation detected Text of age of breast bud formation detected If female, at what age did you notice breast bud formation? Numeric Values

Only to be answered if participant/subject is female.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

C19832 Psychiatric anxiety onset date PsychAnxOnstDate Date of onset of anxiety Date of onset of anxiety If Yes, date of onset Date or Date & Time

The date should be recorded in the format YYYY/MM, and only answered if Psychiatric question #1 is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

C19766 Medical history auditory deafness diagnosis date MedHistAudtryDeafDiagDate Date deafness first detected Date deafness first detected If Yes, date first detected: Date or Date & Time

The date should be recorded in the format YYYY/MM.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

C19810 Medical history abdominal kidney problem indicator MedHistAbdmnlKdnyProbInd Indicator of history of kidney problem Indicator of history of kidney problem Ever have a kidney problem? No;Yes No;Yes Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19777 Medical history wheezing pulmonary assessment indicator MedHistWheezPulAssessInd Indicator of wheezing Indicator of wheezing Wheezing? No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19788 Medical history pulmonary ventilator use frequency MedHistPlmnryVentltrUseFreq Frequency of use of ventilator Frequency of use of ventilator If Yes, how many hours a day? Numeric Values

The answer should be recorded as the number of hours per day.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

C19821 Medical history musculoskeletal joint dislocation type MedHistMusclskltlJointDislocTyp Type of joints dislcoated Type of joints dislcoated If Yes, specify joints dislocated and mechanism Elbow;Patella (knee cap);Wrist;Shoulder Elbow;Patella (knee cap);Wrist;Shoulder Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C19800 Medical history endocrine menarche indicator MedHistEndcrnMenarcheInd Indicator of start of menarche Indicator of start of menarche If female, start of her period (menarche)? No;Yes;Unknown No;Yes;Unknown Alphanumeric

Only to be answered if participant/subject is female.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19833 Psychiatric depression indicator PsychDepressInd Indicator of history of depression Indicator of history of depression Depression: No;Yes;Unknown No;Yes;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19767 Medical history pulmonary difficulty diagnosis indicator MedHistoryPlmnryDfltcyDiagInd Indicator of difficulty breathing Indicator of difficulty breathing Any difficulty breathing? Yes;No;Sometimes Yes;No;Sometimes Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19811 Medical history abdominal liver problem indicator MedHistAbdmnlLiverProbInd Indicator of history of liver problem Indicator of history of liver problem Ever have a liver problem? No;Yes No;Yes Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19778 Medical history wheezing pulmonary nebulizer use frequency MedHistWheezPulNebulUseFreq Frequency of nebulizer use in relation to wheezing Frequency of nebulizer use in relation to wheezing If Yes, how often do you use nebulizer? Numeric Values

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

C19789 Medical history pulmonary cough assist status MedHistPlmnryCghAstStatus Status of cough assist Status of cough assist Mechanical In/Ex-sufflation (cough assist): Daily;Only when ill;Don't use;Unknown Daily;Only when ill;Don't use;Unknown Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19823 Medical history musculoskeletal joint dislocation trauma type MedHistMusclskltlJointDislocTaumaTyp Type of joint dislocation trauma Type of joint dislocation trauma If Yes, specify joints dislocated and mechanism Major trauma;Minor trauma (slip and fall) Major trauma;Minor trauma (slip and fall) Alphanumeric

Answer for all applicable joints dislocated

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C19801 Medical history endocrine menarche onset date MedHistEndcrnMenarcheOnstDate Date of start of onset of menarche Date of start of onset of menarche If Yes, date of onset Date or Date & Time

The date should be recorded in the format YYYY/MM and only answered if Endocrine question #3 is answered Yes.

No references available Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Intake Medical History General Health History Participant History and Family History

Free-Form Entry

CSV