CDE Detailed Report

Disease: Traumatic Brain Injury
Subdomain Name: Family and Environment
CRF: Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives

Displaying 1 - 18 of 18
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 Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C52644 Family History Research Diagnostic Criteria (FH-RDC) - Informant participant relationship type FHRDCInfmntPtcpntRelatshpTyp The relationship of the informant to participant/subject, as part of the Family History - Research Diagnostic Criteria (FH-RDC) The relationship of the informant to participant/subject, as part of the Family History - Research Diagnostic Criteria (FH-RDC Relationship of Informant to Index Subject 1;2;3;4;5;6;7 Self;Spouse;Mother;Father;Sibling;Child;Other (consensus) Alphanumeric Adult;Pediatric Supplemental 3.00 2013-08-30 17:06:52.8 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C52886 Family History Research Diagnostic Criteria (FH-RDC) - Comment narrative text FHRDCCommentNarratvTxt The free-text field for recording comments and narrative for the subject/participant's relative being described, as part of the Family History - Research Diagnostic Criteria (FH-RDC) The free-text field for recording comments and narrative for the subject/participant's relative being described, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Comments Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-27 09:22:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points 4000

Free-Form Entry

C52892 Family History Research Diagnostic Criteria (FH-RDC) - Relationship type FHRDCRelatnshpTyp The type of relationship the subject/participant's relative(s) being described has/have with the subject/participant, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet The type of relationship the subject/participant's relative(s) being described has/have with the subject/participant, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet Paternal grandfather;Paternal grandmother;Paternal aunt;Paternal uncle;Paternal cousin;Maternal grandfather;Maternal grandmother;Maternal aunt;Maternal uncle;Maternal cousin;Niece;Granddaughter;Grandson;Nephew Paternal grandfather;Paternal grandmother;Paternal aunt;Paternal uncle;Paternal cousin;Maternal grandfather;Maternal grandmother;Maternal aunt;Maternal uncle;Maternal cousin;Niece;Granddaughter;Grandson;Nephew Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-27 09:22:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C52928 Family History Research Diagnostic Criteria (FH-RDC) - Relationship type suitable psychiatric interview count FHRDCRltnTypStblPsychiIntrvwCt Count of relatives of the selected type of relationship to the subject/participant who are suitable to participate in a psychiatric interview, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheets Count of relatives of selected type of relationship to the subject/participant who are suitable to participate in a psychiatric interview, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheets No. Suitable for Psych. Interview Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-27 09:22:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points

Free-Form Entry

C19247 Subject ID SubIDNam Subject identification ID Subject identification ID ID Number of Subject whose relatives are being evaluated Alphanumeric Adult;Pediatric Supplemental 1.00 2014-06-05 13:10:49.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points 255

Free-Form Entry

C52937 Family History Research Diagnostic Criteria (FH-RDC) - Relationship type total count FHRDCRelatnshpTypTotalCt The count of all individuals having the specified relationship to the subject/participant, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet The count of all individuals having the specified relationship to the subject/participant, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet Total No. Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-27 09:22:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points

Free-Form Entry

C21117 Subject name SubjectName Name of subject/participant Name of subject/participan Name of Subject whose relatives are being evaluated Alphanumeric Adult;Pediatric Supplemental 1.00 2015-06-12 15:16:39.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points 255

Free-Form Entry

C52939 Family History Research Diagnostic Criteria (FH-RDC) - Relationship type living total count FHRDCRelatnshpTypLvngTtlCt The count of all living individuals having the specified relationship to the subject/participant, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet The count of all living individuals having the specified relationship to the subject/participant, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet No. Living Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-27 09:22:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points

Free-Form Entry

C52626 Data sheet reference code DataSheetRefCode Reference code for the data sheet being recorded Reference code for the data sheet being recorded Card No. Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-27 09:27:54.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points 50

Free-Form Entry

C52940 Family History Research Diagnostic Criteria (FH-RDC) - Relationship type dead total count FHRDCRelatnshpTypDeadTtlCt The count of all deceased individuals having the specified relationship to the subject/participant, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet The count of all deceased individuals having the specified relationship to the subject/participant, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet No. Dead Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-27 09:22:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points

Free-Form Entry

C52627 Study identification code StudyIdentificationCode Code used to identify the study for which data are being collected Code used to identify the study for which data are being collected Study No. Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-27 09:32:38.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points 50

Free-Form Entry

C52942 Family History Research Diagnostic Criteria (FH-RDC) - Relationship type suicide total count FHRDCRelatnshpTypSuicdTtlCt The count of all deceased individuals having the specified relationship to the subject/participant who died of suicide, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet The count of all deceased individuals having the specified relationship to the subject/participant who died of suicide, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet No. Suicide(s) Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-27 09:22:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points

Free-Form Entry

C52629 Interviewer identification code IntrviewrIdentificatnCode Code identifying the interviewer who collected the data being recorded Code identifying the interviewer who collected the data being recorded Rater No. Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-27 09:38:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points 50

Free-Form Entry

C52943 Family History Research Diagnostic Criteria (FH-RDC) - Relationship type psychiatrically ill total count FHRDCRelatnshpTypPsyciIllTtlCt The count of all individuals having the specified relationship to the subject/participant with any psychiatric illness, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet The count of all individuals having the specified relationship to the subject/participant with any psychiatric illness, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet No. Psychiatrically Ill Total Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-27 09:22:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points

Free-Form Entry

C52630 Interviewee name IntervieweeName Name of the person interviewed for data collection Name of the person interviewed for data collection Name of Informant Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-27 09:40:39.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points 255

Free-Form Entry

C52945 Family History Research Diagnostic Criteria (FH-RDC) - Relationship type psychiatrically ill possible affective disorder count FHRDCRltTypPsyIlPosAffDsrTtlCt The count of all individuals having the specified relationship to the subject/participant with a possible affective disorder, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet The count of all individuals having the specified relationship to the subject/participant with a possible affective disorder, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet No. Psychiatrically Ill Poss Alc. Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-27 09:22:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points

Free-Form Entry

C52631 Family History Research Diagnostic Criteria (FH-RDC) - Relative description relationship code FHRDCRelatvDescripRelatCode Code for the relationship of the relative being described to the subject/participant, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Code for the relationship of the relative being described to the subject/participant, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Relationship code of relative being described 7 All Second Degree Relatives Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-27 09:22:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C52947 Family History Research Diagnostic Criteria (FH-RDC) - Relationship type psychiatrically ill possible alcoholism count FHRDCRltTypPsyIlPosAlclsmTtlCt The count of all individuals having the specified relationship to the subject/participant with possible alcoholism, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet The count of all individuals having the specified relationship to the subject/participant with possible alcoholism, as part of the Family History - Research Diagnostic Criteria (FH-RDC) Summary Data Sheet No. Psychiatrically Ill Poss AD Numeric Values Adult;Pediatric Supplemental 1.00 2017-01-27 09:22:30.0 Family History Research Diagnostic Criteria Summary Data Sheet for Second Degree Relatives Family and Environment Outcomes and End Points

Free-Form Entry

CSV