CDE Detailed Report

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

Displaying 101 - 150 of 218
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
C20029 Mitochondrial disease diagnosis text MitDisDiagnosisTxt The free-text field specifying the mitochondrial disease diagnosis that is present. The free-text field specifying the mitochondrial disease diagnosis that is present. What mitochondrial disease diagnosis is present? Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-26 00:00:00.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations 255

Free-Form Entry

C20199 Mitochondrial disease prior bloat abdominal distension text MitDisPriBloatAbdminlDstnsnTxt The free text field to specify additional details about the participant's/subject's past abdominal bloating/distension The free text field to specify additional details about the participant's/subject's past abdominal bloating/distension Please provide additional details about past 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

C20126 Mitochondrial disease current burp consistent day to day indicator MitDisCurrBurpConsistDytoDyInd Indicator of whether current symptoms of burping are consistent day to day Indicator of whether current symptoms of burping are consistent day to day Is the burping 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

C20137 Mitchondrial disease prior burp specific food drink cause text MtDisPriBurpSpfcFdDrinkCausTxt This free text field to specify which specific foods or drinks caused participant's/subject's past burping This free text field to specify which specific foods or drinks caused participant's/subject's past burping What food or drink? 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

C20073 Mitochondrial disease prior vomit frequency MitDisPriorVomitFreq The frequency of the participant/subject's prior episodes of vomiting The frequency of the participant/subject's prior episodes of vomiting During that period, how often did you/they vomit? 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

C20330 Mitochondrial disease special diet reason text MitDisSpeclDietReasonTxt The free text field to specify why the participant/subject is on a specialized diet The free text field to specify why the participant/subject is on a specialized diet Why are you/they on a specialized diet? 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

C20169 Mitochondrial disease current abdominal pain detail text MitDisCurrAbdomnlPainDetlTxt The free text field to specify additional details about the participant's/subject's present abdominal pain The free text field to specify additional details about the participant's/subject's present abdominal pain Please provide additional details about present 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

C20105 Mitochondrial disease prior GERD heartburn mid-line chest pain esophogeal burning frequency MitDisPrirGERDHeBuCPEsBuFreq The frequency of the participant/subject's prior GERD, heartburn, mid-line chest pain, esophageal burning The frequency of the participant/subject's prior GERD, heartburn, mid-line chest pain, esophageal burning How often did you/they have GERD, heartburn, mid-line chest pain, esophageal burning? 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

C20040 Mitochondrial disease eat reason text MitDisWhyEatRsnTxt The free text field to specify why participant/subject eats that way The free text field to specify why participant/subject eats that way Why do you/they eat that way? 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

C20210 Mitochondrial disease defecation other treatment text MitDisDefecateOtherTreatmntTxt The free text field to specify about the participant's/subject's use of other treatment to defecate The free text field to specify about the participant's/subject's use of other treatment to defecate Defecation Treatment 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

C20221 Mitochondrial disease alternative medicine treatment other text MitDisAlternMedsTreatOtherTxt The free text field to specify other alternative medicine used to treatment The free text field to specify other alternative medicine used to treatment What other alternative medicine have you/your child tried? 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

C20148 Mitochondrial disease food stuck esophagus indicator MitDisFoodStuckEsophagusInd Indicator of whether participant's/subject's gets food stuck in their esophagus Indicator of whether participant's/subject's gets food stuck in their esophagus Do you/your child feel food gets stuck in your/their esophagus? 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

C20084 Mitochondrial disease prior vomit blood clot indicator MitDisPriorVomitBloodClotInd Indicator of whether participant's/subject's vomit had blood clots Indicator of whether participant's/subject's vomit had blood clots Did you ever see blood clots in what you/they vomited?` 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

C20180 Mitochondrial disease prior abdominal pain trigger type MitDisPriorAbdomnlPainTrigrTyp The type of trigger of the participant's/subject's prior abdominal pain The type of trigger of the participant's/subject's prior abdominal pain Did any of the following trigger's occur before past abdominal pain started? 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

C20189 Mitochondrial disease bloat abdominal distension onset age category MitDisBloatAbdmlDstnOnstAgeCat The category of the participant/subject's age at onset of abdominal bloating/distension The category of the participant/subject's age at onset of abdominal bloating/distension What was your/your child's age when abdominal bloating/distension 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

C20116 Mitochondrial disease prior oral regurgitation onset age category MitDisPriOralRegurgOnstAgeCat The category of participant/subject's age at onset of prior oral regurgitation episodes The category of participant/subject's age at onset of prior oral regurgitation episodes In the past oral regurgitation episodes, 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

C20052 Mitochondrial disease symptom consistent indicator MitDisSymptmConsistInd Indicator of whether symptoms are consistent day to day Indicator of whether symptoms 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

C20063 Mitochondrial disease vomit color blood category MitDisVomitColorBloodCat The category of color of the blood present in participant's/subject's vomit The category of color of the blood present in participant's/subject's vomit What color is the blood? Bright red;Dark red (maroon);Black;I don't know;Brown Bright red;Dark red (maroon);Black;I don't know;Brown 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

C20232 Mitochondrial disease significant GI symptom prior diagnosis text MitDisSignifGISymptmPriDiagTxt The free text field to provide significant GI symptoms before mitochondrial diseas diagnosis The free text field to provide significant GI symptoms before mitochondrial diseas diagnosis Were your/your child's GI symptoms recognized as significant before diagnosis of mitochondrial disease? 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

C20159 Mitochondrial disease abdominal frequency pain type MitDisAbdomnlFreqPainTyp Select how often a participant/subject has abdominal pain Select how often a participant/subject has abdominal pain How often does abdominal pain 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

C20095 Mitochondrial disease current GERD heartburn mid-line chest pain esophageal burning age category MitDisCrtGERDHtbnMLCPEBuAgeCat The category of the participant/subject's age at GERD, heartburn, mid-line chest, pain esophageal burning onset The category of the participant/subject's age at GERD, heartburn, mid-line chest, pain esophageal burning onset For current GERD, heartburn, mid-line chest pain, esophageal burning 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

C20030 Mitochondrial disease known genetic diagnosis indicator MitDisKnownGenDiagInd Indicator of whether the participant/subject has a known genetically diagnosed mitochondrial disease. Indicator of whether the participant/subject has a known genetically diagnosed mitochondrial disease. Is there a known genetic diagnosis? No;Yes No;Yes Alphanumeric

Choose one. 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

Single Pre-Defined Value Selected

C20200 Mitochondrial disease bowel movement frequency type MitDisBowelMovemntFreqTyp Select the participant's/subject's bowel movement frequency Select the participant's/subject's bowel movement frequency How often do you have bowel movements? A few times a week;Every other day;I don't know;Less than one a week;More than once a day;Once a day;Once a week;Only after a suppository;Only after an enema/irrigation/suppository;Other;Requires disimpaction with a finger;Requires Go Lightly by mouth or tube;Uses a cecostomy to induce bowel movements A few times a week;Every other day;I don't know;Less than one a week;More than once a day;Once a day;Once a week;Only after a suppository;Only after an enema/irrigation/suppository;Other;Requires disimpaction with a finger;(Laxative that works by drawing large amounts of water into the colon);Uses a cecostomy to induce bowel movements 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

C20127 Mitochondrial disease burp reflux abdominal distention accompany type MitDisBurpReflxAbDistnAccmpTyp The type of reflux or abdominal distention that accompanies current burping episodes for the participant/subject. The type of reflux or abdominal distention that accompanies current burping episodes for the participant/subject. Does the burping occur with reflux or abdominal distention? Abdominal distension;Both;Reflux Abdominal distension;Both;Reflux 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

C20138 Mitochondrial disease prior burp detail text MitDisPriorBurpDetailTxt The free text field to specify additional details about participant's/subject's past burping symptoms The free text field to specify additional details about participant's/subject's past burping symptoms Please provide additional details about your/their past burping 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

C20074 Mitochondrial disease vomit time period frequency other text MitDisVomitTimePeriodFreqOTH The free text field to specify how often the participant/subject vomited in the past The free text field to specify how often the participant/subject vomited in the past Past vomiting frequency, 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

C20331 Mitochondrial disease severe vomit symptom type MitDisSevVomitSympTyp The type of symptom that was most severe with the patient/subject's vomiting episodes. The type of symptom that was most severe with the patient/subject's vomiting episodes. Which symptom was most severe with past vomiting episodes? Abdominal pain;Nausea;Both Abdominal pain;Nausea;Both Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-18 15:47:25.0 Mitochondrial and Gastrointestinal Diseases Assessment Physical Examinations Assessments and Examinations

Multiple Pre-Defined Values Selected

C20170 Mitochondrial disease prior abdominal pain onset age category MitDisPriAbdomnlPainOnstAgeCat The category of the participant/subject's age at onset of prior abdominal pain The category of the participant/subject's age at onset of prior abdominal pain What was your/your child's age when past abdominal pain 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

C20106 Mitochondrial disease prior GERD heartburn mid-line chest pain esophageal burn disrupt activity indicator MitDisPriGRDHeBuCPEBnDsrpAcInd Indicator of whether past GERD, heartburn, mid-line chest pain, esophageal burning disrupted activity Indicator of whether past GERD, heartburn, mid-line chest pain, esophageal burning disrupted activity Did past GERD, heartburn, mid-line chest pain, esophageal disrupt activity? 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

C20041 Mitochondrial disease liquid diet text MitDisLiqDietTxt The free text field to specify the type of liquid diet used by participant/subject The free text field to specify the type of liquid diet used by participant/subject What liquid diet do you/they use? 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

C20211 Mitochondrial disease prior bowel movement other treatment text MitDisPriBwlMvmntOthrTrtmntTxt Indicate whether participant/subject used other treatments for bowel movements in the past Indicate whether participant/subject used other treatments for bowel movements in the past Have they used any other treatments in the past to help with bowel movements? 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

C20053 Mitochondrial disease vomit frequency MitDisVomitFreq The frequency with which the participant/subject vomits The frequency with which the participant/subject vomits How often does your child vomit? 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

C20222 Mitochondrial disease alternative medicine treatment improve GI problem text MitDisAltrnMedTrtImpvGIPblmTxt The free text field to specify about what alternative medicines made the participant's/subject's GI problems better The free text field to specify about what alternative medicines made the participant's/subject's GI problems better Did any of these alternative medicine treatments help your/your child's GI 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

C20149 Mitochondrial disease food stuck esophagus anatomic site MitDisFoodStuckEsphgsAntmicSit The anatomic site of food getting stuck in the participant/subject's esophagus The anatomic site of food getting stuck in the participant/subject's esophagus Where do you feel things get stuck? Back of the throat;Lower chest;Neck;Upper chest Back of the throat;Lower chest;Neck;Upper chest 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

C20085 Mitochondrial disease prior stool black indicator MitDisPriorStoolBlackInd Indicator of whether participant's/subject's stools were black Indicator of whether participant's/subject's stools were black Did you/your child ever have black stools? 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

C20181 Mitochondrial disease prior abdominal pain trigger text MitDisPriorAbdomnlPainTrigrTxt The free text field to specify additional details about participant's/subject's past abdominal pain triggers The free text field to specify additional details about participant's/subject's past abdominal pain triggers Please provide additional comments about past 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

C20190 Mitochondrial disease bloat abdominal distension time type MitDisBloatAbdmnlDstnsnTimeTyp The type, as time of day, at which the abdominal bloating/distension is worse for the participant/subject. The type, as time of day, at which the abdominal bloating/distension is worse for the participant/subject. Is the bloating or abdominal distension worse at any particular time 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

C20117 Mitochondrial disease age prior oral regurgitation stop age category MitDisPriOralRegurgStopAgeCat The category of participant/subject's age at end of prior oral regurgitation episodes The category of participant/subject's age at end of prior oral regurgitation episodes How old were you/your child when the symptoms 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

C20064 Mitochondrial disease vomit blood clot indicator MitDisVomitBloodClotsInd Indicator of whether participant's/subject's vomit has blood clots Indicator of whether participant's/subject's vomit has blood clots Do you ever see blood clots in what you/they vomit? 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

C20233 Mitochondrial disease delay treatment GI problem indicator MitDisDelayTreatmntGIProblmInd Indicator of whether participant/subject delayed treatment of GI problem Indicator of whether participant/subject delayed treatment of GI problem Have you ever delayed treatment for your/their GI problems for fear of not being believed about these symptoms? 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

C20160 Mitochondrial disease abdominal pain frequency other text MitDisAbdomnlPainFreqOtherTxt The free text field to specify frequency of participant's/subject's other abdominal pain The free text field to specify frequency of participant's/subject's other abdominal pain Abdominal Pain 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

C20096 Mitochondrial disease GI symptom consistent day to day indicator MitDisGISymptmConsistDyToDyInd Indicator of whether symptoms of GERD, heartburn, mid-line chest pain, esophageal burning were consistent day to day Indicator of whether symptoms of GERD, heartburn, mid-line chest pain, esophageal burning were 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

C20031 Mitochondrial disease DNA mutation type MitDisDNAMutatTyp The type of DNA mutation (nuclear or mitochondrial) present in the participant/subject's genetic diagnosis The type of DNA mutation (nuclear or mitochondrial) present in the participant/subject's genetic diagnosis Is this a nuclear or mitochondrial DNA mutation? Mitochondrial;Nuclear Mitochondrial;Nuclear Alphanumeric

Choose one. 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

Single Pre-Defined Value Selected

C20201 Mitochondrial disease bowel movement other frequency text MitDisBowelMvmtOthrFrqTxt The free text field to specify the participant's/subject's other stool frequency The free text field to specify the participant's/subject's other stool frequency Stool Frequency 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

C20128 Mitochondrial disease burp occur specific drink food indicator MitDisBurpOccSpecDrinkFoodInd Indicator of whether participant's/subject's burping occurs with specific drinks or food Indicator of whether participant's/subject's burping occurs with specific drinks or food Does the burping occur with any specific drinks or food? 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

C20139 Mitochondrial disease swallow difficult pain type MitDisSwallowDiffcultPainTyp The type of difficulty or pain experienced by the participant/subject when swallowing The type of difficulty or pain experienced by the participant/subject when swallowing Do you/your child have difficulty or pain with swallowing? Both;Difficulty;Pain Both;Difficulty;Pain 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

C20075 Mitochondrial disease vomit prior episode intensity type MitDisVomitPriorEpiIntTyp The type of intensity of the participant/subject's prior episodes of vomiting The type of intensity of the participant/subject's prior episodes of vomiting In the past, when you/your child had vomiting, was it only a single episode or did you/they usually vomit repeatedly? Single episode;Vomit more than once;Vomit repeatedly until there is nothing left Single episode;Vomit more than once;Vomit repeatedly until there is nothing left 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

C20171 Mitochondrial disease prior abdominal pain stop age category MitDisPriAbdomnlPainStopAgeCat The category of the participant/subject's age at the end of prior abdominal pain episodes The category of the participant/subject's age at the end of prior abdominal pain episodes What was your/your child's age when past abdominal pain 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

C20107 Mitochondrial disease prior GERD heartburn mid-line chest pain esophageal burn wake indicator MitDisPriGERDHeBuMLCPEBuWakInd Indicator of whether past GERD, heartburn, mid-line chest pain, esophageal burning woke participant/subject from sleep Indicator of whether past GERD, heartburn, mid-line chest pain, esophageal burning woke participant/subject from sleep Did past 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

C20042 Mitochondrial disease restrict diet indicator MidtDisRestrictDietInd Indicator of whether participant/subject are on a restricted diet Indicator of whether participant/subject are on a restricted diet Are you/your child currently on a restricted diet? 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

CSV