CDE Detailed Report

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

Displaying 201 - 218 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
C20077 Mitochondrial disease prior vomit episode trigger indicator MitDisPriorVomitEpisTrigInd Indicator of whether there were particular triggers that induced prior vomiting episodes in participant/subject Indicator of whether there were particular triggers that induced prior vomiting episodes in participant/subject In the past, were there any 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

C20173 Mitochondrial disease prior abdominal pain reason MitDisPriorAbdomnPainReasn The reason the participant/subject thinks they or their child experienced prior abdominal pain The reason the participant/subject thinks they or their child experienced prior abdominal pain What makes you think they had abdominal pain? Cried all the time;Cried with meals;Cried without another obvious cause;Held belly;Held belly and cried or looked uncomfortable;I don't know;Irritability;Other;The child told me;Woke up from sleep Cried all the time;Cried with meals;Cried without another obvious cause;Held belly;Held belly and cried or looked uncomfortable;I don't know;Irritability;Other;The child told me;Woke up 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

C20109 Mitochondrial disease oral regurgitation current prior status MitDisOralRegurgCurrPriorStat The status, present or prior, of the participant/subject's episodes of oral regurgitation The status, present or prior, of the participant/subject's episodes of oral regurgitation Do you/your child have oral regurgitation or have they had oral regurgitation in the past? Past;Present Past;Present 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

C20044 Mitochondrial disease special diet other text MitDisSpecialDietOthrTxt The free text field to specify the type of specialized diet if not listed The free text field to specify the type of specialized diet if not listed Specialized diet 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

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

C20227 Mitochondiral disease life effect grade MitDisLifeEffectGrade The graded scale representing the effect of the symptoms on the participant's/subject's life. The graded scale representing the effect of the symptoms on the participant's/subject's life. How much do the symptoms we discussed affect your/your child's life? 1;10;2;3;4;5;6;7;8;9 1;10;2;3;4;5;6;7;8;9 Numeric Values

Choose one. 1 being not at all, 10 being severe interruption

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

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

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

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

C20195 Mitochondrial disease prior bloat abdominal distension stop age category MtDsPriBltAbdmlDistnsnStpAgCat The category of the participant/subject's age at cessation of prior abdominal bloating/distension The category of the participant/subject's age at cessation of prior abdominal bloating/distension What was your/your child's age when the abdominal bloating/distesion 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

C20206 Mitochondrial disease stool blood indicator MitDisStoolBloodInd Indicator of whether the participant/subject has blood in their stools Indicator of whether the participant/subject has blood in their stools Do you/your child ever have blood in the stool? 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

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

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

C20238 Mitochondrial disease Munchausen by proxy syndrome health care professional setting other text MitDisMBPSymHlthCrProSetOTH The free text field to provide the other setting when participant/subject confronted by a health care professional about Munchausen by proxy syndrome The free text field to provide the other setting when participant/subject confronted by a health care professional about Munchausen by proxy syndrome Munchausen Setting 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

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

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

CSV