CDE Detailed Report
Disease: Chiari I Malformation
Subdomain Name: Epidemiology/Environmental History
CRF: Allergy
Displaying 1 - 12 of 12
Subdomain Name: Epidemiology/Environmental History
CRF: Allergy
Displaying 1 - 12 of 12
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C21676 | Allergy medication reaction type | AllergyMedReactTyp | Type of allergic reaction to medication | Type of allergic reaction to medication | Medication Allergy Reaction type | Anaphylaxis;Rash;Itching;Hives;Swelling;Difficulty breathing | Anaphylaxis;Rash;Itching;Hives;Swelling;Difficulty breathing | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-05-25 11:39:52.0 | Allergy | Epidemiology/Environmental History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C21677 | Allergy food type text | AllergyFoodTypTxt | Free-text field to specify the type of food causing an allergic reaction | Free-text field to specify the type of food causing an allergic reaction | Food type | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-05-25 12:03:49.0 | Allergy | Epidemiology/Environmental History | Participant History and Family History | 500 |
Free-Form Entry |
|||||||||||
| C21678 | Allergy food reaction type | AllergyFoodRnTyp | Type of reaction caused by food allergy | Type of reaction caused by food allergy | Food Allergy Reaction Type | Anaphylaxis;Rash;Itching;Hives;Swelling;Difficulty breathing | Anaphylaxis;Rash;Itching;Hives;Swelling;Difficulty breathing | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-05-25 12:07:02.0 | Allergy | Epidemiology/Environmental History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C21679 | Allergy reaction plastic tape indicator | AllergyReactPlTpInd | Indicator related to allergic reaction to plastic tape | Indicator related to allergic reaction to plastic tap | Plastic tape | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2016-05-25 13:16:58.0 | Allergy | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C21680 | Allergy reaction latex indicator | AllergyReacLatxInd | Indicator related to allergic reaction to latex | Indicator related to allergic reaction to late | Latex | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-05-25 13:26:49.0 | Allergy | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C21681 | Allergy reaction acrylic indicator | AllergyReacAcylInd | Indicator related to allergic reaction to acrylic | Indicator related to allergic reaction to acryli | Acrylic | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2016-05-25 13:30:30.0 | Allergy | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C21682 | Allergy reaction other source text | AllergyReacOtherSrcTxt | Free-text field to specify other source of allergy | Free-text field to specify other source of allerg | Specify | Alphanumeric |
If yes, specify |
Adult;Pediatric | Exploratory | 1.00 | 2016-05-25 13:33:10.0 | Allergy | Epidemiology/Environmental History | Participant History and Family History | 500 |
Free-Form Entry |
||||||||||
| C06005 | Data collected date and time | DataCollDateTime | Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed | Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performe | Date | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 21:00:23.88 | Allergy | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
||||||||||||
| C21683 | Allergy reaction other source indicator | AllergyRnOthSrcInd | Indicator related to other source of allergic reaction | Indicator related to other source of allergic reaction | Other | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2016-05-25 13:30:30.0 | Allergy | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C21673 | Allergy medication antibiotic reaction type | AllergyMedAntiRTyp | Type related to allergic reaction to antibiotic medication | Type related to allergic reaction to antibiotic medication | Antibiotic Allergy Reaction Type | Anaphylaxis;Rash;Itching;Hives;Swelling;Difficulty breathing | Anaphylaxis;Rash;Itching;Hives;Swelling;Difficulty breathing | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-05-25 11:11:15.0 | Allergy | Epidemiology/Environmental History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C21674 | Allergy medication antibiotic name | AllergyMedAntiNam | Name to indicate the antibiotic causing the allergy | Name to indicate the antibiotic causing the allergy | Antibiotic name/type | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-05-25 11:28:24.0 | Allergy | Epidemiology/Environmental History | Participant History and Family History | 4000 |
Free-Form Entry |
|||||||||||
| C21675 | Allergy medication name | AllergyMedNam | Name related to the medication causing allergic reaction | Name related to the medication causing allergic reaction | Medication name | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-05-25 11:34:09.0 | Allergy | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
