CDE Detailed Report

Disease: Mitochondrial Disease
Sub-Domain: Physical Examinations
CRF: Mitochondrial and Gastrointestinal Diseases Assessment

Displaying 1 - 50 of 218
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
C20120 Mitochondrial disease prior oral regurgitation frequency MitDisPriorOralRegurgFreq The frequency with which participant/subject had oral regurgitation in the past The frequency with which participant/subject had oral regurgitation in the past In the past, how often did the oral regurgitation occur? About once a year;At least once a week, but not daily;Daily;I don't know;Less than once a month, more than once a year;One to 4 times per month;Only once;Other About once a year;At least once a week, but not daily;Daily;I don't know;Less than once a month, more than once a year;One to 4 times per month;Only once;Other Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20056 Mitochondrial disease vomit time of day category MitDisVomitTimeDyCat The time-of-day category of when the participant/subject usually vomits The time-of-day category of when the participant/subject usually vomits Does the vomiting happen during a specific time of of day? Afternoon;All times of the day;Evening;I don't know;Morning;Overnight (12pm - 5pm);All times of the day;(5pm - Bed);I don't know;(wake up until 12pm);(wakes from sleep) Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20152 Mitochondrial disease esophagus diagnosis ever type MitDisEsophagsDiagnEvrTyp The type of esophageal disorder with which the participant/subject has ever been diagnosed The type of esophageal disorder with which the participant/subject has ever been diagnosed Have you/your child ever been diagnosed with any of the following? Achalasia;Eosinophilic Esophagitis;Esophageal stricture Failure of smooth muscle fibers of the esophagus to relax, which can cause a sphincter to remain closed and fail to open when needed;Allergic inflammatory condition of the esophagus that involves eosinophils (white blood cells).;Narrowing or tightening of the esophagus that causes swallowing difficulties Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20088 Mitochondrial disease prior vomit trigger other text MitDisPriVomitTrigrOthrTxt The free text field to specify additional details about what triggered the participant's/subject's past vomiting symptoms The free text field to specify additional details about what triggered the participant's/subject's past vomiting symptoms Past Triggers Other, Specify Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20213 Mitochondrial disease bowel movement problem text MitDisBowelMovemntProblmTxt The free text field to specify additional details about the participant's/subject's bowel movement problems The free text field to specify additional details about the participant's/subject's bowel movement problems Please provide additional details about bowel movement problems Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20184 Mitochondrial disease prior abdominal pain improve text MitDisPriorAbdomnlPainImprvTxt The free text field to specify about what specifically made the participant's/subject's prior abdominal pain better The free text field to specify about what specifically made the participant's/subject's prior abdominal pain better Is there anything specific that made the pain better? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20224 Mitochondrial disease surgery ever indicator MitDisSurgeryEverInd Indicator of whether the participant/subject has had surgery Indicator of whether the participant/subject has had surgery Have you/your child ever had surgery? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20034 Mitochondrial disease person relationship category MitDisPersnRelatedCat The type of relationship of participant/subject to family member with mitochondrial disease The type of relationship of participant/subject to family member with mitochondrial disease How is person related to the person with mitochondrial disease? Mother;Father;Grandmother;Grandfather;Guardian;Sister;Brother;Spouse;Other;The person with mitochondrial disease Mother;Father;Grandmother;Grandfather;Guardian;Sister;Brother;Spouse;Other;The person with mitochondrial disease Alphanumeric

Choose one.

Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20131 Mitochondrial disease prior burp onset age category MitDisPriorBurpOnsetAgeCat The category of participant/subject's age at onset of prior burping episodes The category of participant/subject's age at onset of prior burping episodes For the past burping problems, what was your/your child's age when the problems began? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20067 Mitochondrial disease vomit most severe episode type MitDisVomitMostSevEpTyp The type of symptom that is most severe during the participant/subject's vomiting episodes The type of symptom that is most severe during the participant/subject's vomiting episodes Which symptom is most severe with vomiting episodes? Abdominal pain;Nausea;Both Abdominal pain;Nausea;Both Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20192 Mitochondrial disease swallow air indicator MitDisSwallowAirInd Indicator of whether participant/subject are air swallowers Indicator of whether participant/subject are air swallowers Are you/your child an air swallower? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20163 Mitochondrial disease event frequent before abdominal pain type MisDisEventFrqBfrAbdmnlPainTyp The type of event frequently experienced by the particpant/subject before abdominal pain begins The type of event frequently experienced by the particpant/subject before abdominal pain begins Do any of the following occur frequently before abdominal pain starts? Anxiety;Depression;Exercise;Fasting more than 12 hours;Headache/Migraine/Light sensitivity;Other;Other Psychological Issues;Particular Foods;Right after feeding;Seizure;Stress;Taking medicine;Viral illness/Fever Anxiety;Depression;Exercise;Fasting more than 12 hours;Headache/Migraine/Light sensitivity;Other;Other Psychological Issues;Particular Foods;Right after feeding;Seizure;Stress;Taking medicine;Viral illness/Fever Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20099 Mitochondrial disease GERD heartburn mid-line chest pain esophageal burn wake indicator MitDisGERDHeBuMLCPEBuWakeInd Indicator of whether GERD, heartburn, mid-line chest pain, esophageal burning wakes participant/subject from sleep Indicator of whether GERD, heartburn, mid-line chest pain, esophageal burning wakes participant/subject from sleep Does GERD, heartburn, mid-line chest pain, esophageal burning wake you/your child from sleep? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20110 Mitochondrial disease current oral regurgitation onset age category MitDisCurrOralRegurgOnstAgeCat The category of participant/subject's age at onset of current oral regurgitation episodes The category of participant/subject's age at onset of current oral regurgitation episodes For the current oral regurgitation episodes, what was your/their age when the problems began? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20235 Mitochondrial disease concern accused Munchausen by proxy syndrome indicator MitDisConcrnAccsdMchsnBPSynInd Indicator of whether participant/subject is concerned about being accused of having Munchausen by proxy? Indicator of whether participant/subject is concerned about being accused of having Munchausen by proxy? Have you ever been concerned about Munchausen by proxy accusation? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20046 Mitochondrial disease special diet affect symptom text MitDisSpeclDietAffctSymptmTxt The free text field to specify whether specialized diet affected participant/subject symptoms The free text field to specify whether specialized diet affected participant/subject symptoms Has your/their symptoms changed since the diet started? Alphanumeric

(Specify)

Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20142 Mitochondrial disease swallow problem frequency MitDisSwallowProblmFreq The frequency with which the participant/subject has problems swallowing The frequency with which the participant/subject has problems swallowing How often does oral regurgitation occur? About once a year;At least once a week, but not daily;Daily;I don't know;Less than once a month, more than once a year;One to 4 times per month;Only once;Other About once a year;At least once a week, but not daily;Daily;I don't know;Less than once a month, more than once a year;One to 4 times per month;Only once;Other Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20078 Mitochondrial disease prior vomit episode trigger text MitDisPriorVomitEpisTrigTxt The free text field to specify the participant's/subject's past vomiting episode triggers The free text field to specify the participant's/subject's past vomiting episode triggers In the past, what had triggered vomiting episodes? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20203 Mitochondrial disease toilet diaper use type MitDisToiletDiaperUseTyp Select whether the participant/subject uses a toilet or diaper Select whether the participant/subject uses a toilet or diaper Do you/your child use a toilet or a diaper? Diaper;Toilet Diaper;Toilet Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20174 Mitochondrial disease prior abdominal pain detail text MitDisPriAbdomnlPainDetlTxt The free text field to specify additonal details about participant's/subject's past abdominal pain The free text field to specify additonal details about participant's/subject's past abdominal pain Provide additional details if desired about what made you think they had abdominal pain. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20121 Mitochondrial disease prior oral regurgitation frequency other text MitDisPriorOralRegurgFrqOthTxt The free text field to specify past frequency of participant's/subject's other oral regurgitation The free text field to specify past frequency of participant's/subject's other oral regurgitation Past Oral regurgitation other Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20057 Mitochondrial disease vomit episode trigger indicator MitDisVomitEpisTrigInd Indicator of whether there are particular triggers that induce vomiting episodes in participant/subject Indicator of whether there are particular triggers that induce vomiting episodes in participant/subject Are there particular triggers for vomiting episodes? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20153 Mitochondrial disease feed difficult text MitDisFeedDifficulttxt The free text field to give detailed comments about participant's/subject's feeding difficulties The free text field to give detailed comments about participant's/subject's feeding difficulties Can you tell me about your/your child's feeding difficulties? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20089 Mitochondrial disease prior vomit other text MitDisDetPriVomitOthrTxt The free text field to specify additional details about participant's/subject's past vomiting symptoms The free text field to specify additional details about participant's/subject's past vomiting symptoms Please provide additional details about past vomiting symptoms. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20214 Mitochondrial disease poor appetite growth affect text MitDisPoorAppetGrwthAffctTxt The free text field to specify affects of poor appetite on participant's/subject's growth The free text field to specify affects of poor appetite on participant's/subject's growth Can you tell me more about the poor appetite affecting growth? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20185 Mitochondrial disease prior abdominal pain worsen text MitDisPriorAbdomnlPainWorseTxt The free text field to specify about what specifically made the participant's/subject's prior abdominal pain worse The free text field to specify about what specifically made the participant's/subject's prior abdominal pain worse Is there anything specific that made the pain worse? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20225 Mitochondrial disease surgery type MitDisSurgTyp Select the type of surgery participant/subject had Select the type of surgery participant/subject had What type of surgery have you/they had? Muscle biopsy;Organ transplant;Ortopedic surgery (bone or joint);Spleen surgery;Liver surgery;Kidney surgery;Airway surgery (tracheostomy, laryngomalacia);Lung surgery;Bladder surgery;Brain surgery;Esophageal impedence monitoring;Esophageal pH monitoring;Gastric emptying studies;Anorectal manometry;Colon manometry;Esophageal manometry;Antroduodenal manometry;Colonoscopy;Upper endoscopy;Botox injection;Bowel dilation;Bowel resection;Fundoplication (Nissen, Toupet);Hirschsprung (Swenson, Duhamel, Soave);Cecostomy (to treat refractory constipation);Jejunostomy;Colostomy;G J - tube (e.g., for venting and feeding);J-tube;G-tube;Ileostomy Muscle biopsy;Organ transplant;Ortopedic surgery (bone or joint);Spleen surgery;Liver surgery;Kidney surgery;Airway surgery (tracheostomy, laryngomalacia);Lung surgery;Bladder surgery;Brain surgery;Esophageal impedence monitoring;Esophageal pH monitoring;Gastric emptying studies;Anorectal manometry;Colon manometry;Esophageal manometry;Antroduodenal manometry;Colonoscopy;Upper endoscopy;Botox injection;Bowel dilation;Bowel resection;Fundoplication (Nissen, Toupet);Hirschsprung (Swenson, Duhamel, Soave);Cecostomy (to treat refractory constipation);Jejunostomy;Colostomy;G J - tube (e.g., for venting and feeding);J-tube;G-tube;Ileostomy Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20035 Height maternal measurement HgtMaternalMeasr Measurement of participant's/subject's Mother's height Measurement of participant's/subject's Mother's height Height (Specify) Numeric Values No references available Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Free-Form Entry

C20132 Mitochondrial disease prior burp stop age category MitDisPriorBurpStopAgeCat The category of participant/subject's age at the end of prior burping episodes The category of participant/subject's age at the end of prior burping episodes What was your/their age when the burping problem stopped? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20068 Mitochondrial disease current vomit detail text MitDisCurrVomitDetTxt The free text field to specify additional details about participant's/subject's current vomiting symptoms The free text field to specify additional details about participant's/subject's current vomiting symptoms Please provide additional details about current vomiting symptoms. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20193 Mitochondrial disease bloat abdominal distension text MitDisBloatAbdmnlDistensnTxt The free text field to specify additional details about the participant's/subject's abdominal bloating/distension The free text field to specify additional details about the participant's/subject's abdominal bloating/distension Please provide additional details about abdominal bloating and distension. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20164 Mitochondrial disease abdominal pain trigger detail text MitDisAbdomnlPainTrigrDetlTxt The free text field to specify additional details about participant's/subject's abdominal pain triggers The free text field to specify additional details about participant's/subject's abdominal pain triggers Please provide additional details abdominal pain triggers? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20100 Mitochondrial disease GI detail text MitDisGIDetailText The free text field to specify additional details about participant's/subject's GERD, heartburn, mid-line chest pain, esophageal burning symptoms The free text field to specify additional details about participant's/subject's GERD, heartburn, mid-line chest pain, esophageal burning symptoms Please provide additional details about your/their GERD, heartburn, mid-line chest pain, esophageal burning symptoms. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20111 Mitochondrial disease oral regurgitation symptom consistent day to day indicator MitDisOrlRegrgSypCnstDyToDyInd Indicator of whether symptoms of oral regurgitation are consistent day to day Indicator of whether symptoms of oral regurgitation are consistent day to day Are the symptoms pretty consistent from day to day? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20236 Mitochondrial disease Munchausen by proxy syndrome health care professional setting indicator MitDisMBPSymHlthCrProSetInd Indicator of whether participant/subject has been confronted by a health care professional about Munchausen by proxy syndrome Indicator of whether participant/subject has been confronted by a health care professional about Munchausen by proxy syndrome Have you ever had a confrontation with a health care professional about Munchausen by proxy syndrome? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20047 Mitochondrial disease dietary other restriction text MitDisDietOthRestrictnTxt The free text field to specify whether participant/subject have other dietary retrictions The free text field to specify whether participant/subject have other dietary retrictions What other dietary restrictions does you/your child have? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20143 Mitochondrial disease difficulty swallow change over time indicator MitDisDiffSwallwChngOvrTimeInd Indicator of whether participant's/subject's difficulty swallowing changes over time Indicator of whether participant's/subject's difficulty swallowing changes over time Has the difficulty in swallowing changed over time? No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20079 Mitochondrial disease prior vomit prior problem type MitDisPriorVomitPriorProbTyp The types of problems that frequently occur prior to vomiting during participant's/subject's prior episodes of vomiting The types of problems that frequently occur prior to vomiting during participant's/subject's prior episodes of vomiting Did any of the following occur frequently before the vomiting started? Fasting more than 12 hours;Viral illness/Fever;Taking medicine;Right after feeding;Seizure;Headache/Migraine/Light sensitivity;Exercise;Stress Fasting more than 12 hours;Viral illness/Fever;Taking medicine;Right after feeding;Seizure;Headache/Migraine/Light sensitivity;Exercise;Stress Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20204 Mitochondrial disease bowel movement problem onset age category MitDisBowelMvmntPrblmOnstAgCat The category of the participant/subject's age at onset of bowel movement problems The category of the participant/subject's age at onset of bowel movement problems What was your/your child's age when the bowel movement problems began? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20175 Mitochondrial disease prior abdominal pain anatomic site MitDisPriAbdomnlPainAntmicSite Select where participant's/subject's past abdominal pain was located Select where participant's/subject's past abdominal pain was located Where was past abdominal pain located? Entire abdomen;Entire lower abdomen;Entire upper abdomen;I don't know;Left lower quadrant;Lower abdomen midline;Near the belly button;Right lower quadrant;Upper abdomen midline;Upper abdomen on the left;Upper abdomen on the right;Variable locations Entire abdomen;Entire lower abdomen;Entire upper abdomen;I don't know;Left lower quadrant;Lower abdomen midline;Near the belly button;(below umbilicus);(between umbilicus bottom of ribs);Upper abdomen on the left;Upper abdomen on the right;Variable locations Alphanumeric

Choose all that apply. Response is obtained from participant/ subject, family member, friend, or chart/medical record.

Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20122 Mitochondrial disease prior oral regurgitation occurrence timing type MitDisPriOralRegurgOccurTmgTyp The type of timing of the participant/subject's prior episodes of oral regurgitation with respect to meals The type of timing of the participant/subject's prior episodes of oral regurgitation with respect to meals In the past, was the oral regurgitation before, during, or after meals? After;Before;During;Variable After;Before;During;Variable Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20058 Mitochondrial disease vomit episode trigger text MitDisVomitEpisTrigTxt The free text field to specify the participant's/subject's vomiting episode triggers The free text field to specify the participant's/subject's vomiting episode triggers What triggers episodes? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20154 Mitochondrial disease abdominal pain age start type MitDisAbdomnlPainAgeStartTyp Select the pre-specified age of participant/subject when abdominal pain began Select the pre-specified age of participant/subject when abdominal pain began What was your/your child's age when abdominal problems began? 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth 13 mo to 18 mo;14 y to 18 y;19 mo to 3 y;2 mo to 5 mo;4 y to 6 y;6 mo to 12 mo;7 y to 13 y;Greater than 18 y;I don't know;Less than 2 mo old (not on day of birth);On the day of birth Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20090 Mitochondrial disease vomit diagnosis cyclic indicator MitDisVomitDiagnosCyclicInd Indicator of whether the participant/subject has a cyclic vomiting diagnosis. Indicator of whether the participant/subject has a cyclic vomiting diagnosis. Have you/your child ever been diagnosed with cyclic vomiting? I don't know;No;Yes I don't know;No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Single Pre-Defined Value Selected

C20215 Mitochondrial disease current medication type MitDisCurrMedsType Select other medicines that participant/subject are currently taking Select other medicines that participant/subject are currently taking What other medicines are you/your child taking now? Other;Antibiotics;Levbid/Levsin/Bentyl;Pancreatic enzyme supplements (Creon);Gabapentin (Neurontin);Oxycarbazine (Trileptal);Topamax (Topiramate);Phenytoin (Dilantin);Pregabalin (Lyrica);Lamotrigine (Lamictal);Levetircetam (Keppra);Tiagabine (Gabatril);Felbatol (Felbamate);Ethosuximide (Zarontin);Carbamazepine (Tegretol, Carbatrol);Folinic acid;Alpha lipoic acid;Vitamin C;Vitamin E;B vitamins (other);L-Carnitine;L-Arginine;L-Creatine;Riboflavin (vitamin B2);CoQ10 (Ubiquinol, Ubiquinone);Linaclotide (Linzess);Tegaserod (Zelnorm, Zelmac);Reglan (metaclopramide);Domperidone (Motilium);Cisapride (Propulsid);Erythromycin;SSRI: Citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertaline (Zoloft);Tricyclic antidepressant: Amitriptyline, desipramine, imipramine, nortiptyline;Ondansetron (Zofran);Carafate;H-2 receptor antagonist: Pepcid (famotidine), Zantac (ranitidine), Tagemet (cimetidine);Proton pump inhibitor: Prilosec (omeprazole), Nexium, Prevacid (lansoprazole), Protonix (pantoprazole), or Aciphex (rabeprazole) Other;Antibiotics;Levbid/Levsin/Bentyl;Pancreatic enzyme supplements (Creon);Gabapentin (Neurontin);Oxycarbazine (Trileptal);Topamax (Topiramate);Phenytoin (Dilantin);Pregabalin (Lyrica);Lamotrigine (Lamictal);Levetircetam (Keppra);Tiagabine (Gabatril);Felbatol (Felbamate);Ethosuximide (Zarontin);Carbamazepine (Tegretol, Carbatrol);Folinic acid;Alpha lipoic acid;Vitamin C;Vitamin E;B vitamins (other);L-Carnitine;L-Arginine;L-Creatine;Riboflavin (vitamin B2);CoQ10 (Ubiquinol, Ubiquinone);Linaclotide (Linzess);Tegaserod (Zelnorm, Zelmac);Reglan (metaclopramide);Domperidone (Motilium);Cisapride (Propulsid);Erythromycin;SSRI: Citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertaline (Zoloft);Tricyclic antidepressant: Amitriptyline, desipramine, imipramine, nortiptyline;Ondansetron (Zofran);Carafate;H-2 receptor antagonist: Pepcid (famotidine), Zantac (ranitidine), Tagemet (cimetidine);Proton pump inhibitor: Prilosec (omeprazole), Nexium, Prevacid (lansoprazole), Protonix (pantoprazole), or Aciphex (rabeprazole) Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20186 Mitochondrial disease prior abdominal pain other text MitDisPriorAbdomnlPainOthrTxt The free text field to specify additional details about the participant's/subject's past abdominal pain The free text field to specify additional details about the participant's/subject's past abdominal pain Please provide additional details about past abdominal pain. Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C01522 Height measurement HgtMeasr Measurement of participant's/subject's height. Measurement of participant's/subject's height. Height (Specify) Numeric Values Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Free-Form Entry

0 400 centimeter 649
C20226 Mitochondrial disease surgery type detail text MitDisSurgTypeDetailTxt The free text field to provide additional details about the type of surgery participant/subject had The free text field to provide additional details about the type of surgery participant/subject had Provide additional details about the type of surgery Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

C20036 Height paternal measurement HgtPaternalMeasr Measurement of participant's/subject'sFather's height Measurement of participant's/subject'sFather's height Height (Specify) Numeric Values No references available Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Free-Form Entry

C20133 Mitochondrial disease prior burp stopped specific text MitDisPriorBurpStopST The free text field to specify when participant's/subject's past burping stopped The free text field to specify when participant's/subject's past burping stopped What stopped the burping? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 4000

Free-Form Entry

CSV