CDE Detailed Report | NINDS Common Data Elements

Disease: Congenital Muscular Dystrophy
Subdomain Name: General Health History
CRF: Intake Medical History

Displaying 1 - 50 of 81

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
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 collecte	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
C19782	Medical history asthma pulmonary inhalers use frequency	MedHistAsthmaPlInhalUseFreq	Frequency of use of steroid inhalers used for asthma	Frequency of use of steroid inhalers used for asthma	If Yes, how often?	Daily;Monthly;Yearly	Daily;Monthly;Yearly	Alphanumeric	Only answered if Pulmonary question #7 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
C19815	Medical history musculoskeletal total broken bones count	MedHistMusclTtlBrknBonesCt	Number of toral bones broken	Number of toral bones broken	If Yes, total number of broken bones:			Numeric Values	Only answered if Musculoskeletal 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
C19761	Medical history glaucoma diagnosis indicator	MedHistGlcmaDiagInd	Indicator of history of Glaucoma	Indicator of history of Glaucoma	Glaucoma	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
C19793	Medical history cardiovascular heart arrhythmia diagnosis date	MedHistCardioHeArrhDiagDt	Date of first detection of heart arrhythmia	Date of first detection of heart arrhythmia	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 #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
C19827	Seizure type	NeuroSeizTyp	Type of seizures had	Type of seizures had	What kind of seizure	Grand Mal;Partial Complex;Absence;Ferbile;Don't know	Grand Mal;Partial Complex;Absence;Ferbile;Don't know	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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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