CDE Detailed Report
Disease: content
Subdomain Name: History of Disease/Injury Event
CRF: welcome
Displaying 1 - 22 of 22
Subdomain Name: History of Disease/Injury Event
CRF: welcome
Displaying 1 - 22 of 22
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C15917 | Headache typical pain intensity rate scale | HeadacheTypPainIntstyRateScl | Rating scale for the pain of this headache on a scale of 0 -10 | Rating scale for the pain of this headache on a scale of 0 -10 | Intensity on a 1 to 10 scale without medication | 1;2;3;4;5;6;7;8;9;10 | 1;2;3;4;5;6;7;8;9;10 | Numeric Values |
1 to 10 integer units only |
Adult;Pediatric | Supplemental | 4.10 | 2023-06-02 10:23:14.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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| C21834 | Headache symptom association score | HeaSymptmAssScore | The score related to symptoms consistently associated with headache | The score related to symptoms consistently associated with headach | Score | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 08:10:36.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
0 | 10 | ||||||||||
| C21778 | Headache primary anatomic site | HeaPriAntmicSite | The location related to the anatomic site of the primary headache | The location related to the anatomic site of the primary headache | Primary headache site | Suboccipital;Retro-orbital;Frontal;Temporal;Vertex;Whole head;N/A | Suboccipital;Retro-orbital;Frontal;Temporal;Vertex;Whole head;N/A | Alphanumeric |
"Max score (Primary area) S: 3+2 = 5 R: 3+2=5 F: 1+2=3 T: 1+2=3 V: 2+2=4 W: 3+2=5 Total - 5 Max; 0 Min" |
Adult;Pediatric | Exploratory | 1.00 | 2016-06-02 14:38:03.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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| C21835 | Headache temporal association type | HeaTemAssTyp | The type as related to time of occurrence of consistent headache | The type as related to time of occurrence of consistent headach | Consistent headache occurrence in time | Daily;Menstrual;With activity/stress;Present on awakening;Nocturnal;After awakening;End of day;With quiet/rest | Daily;Menstrual;With activity/stress;Present on awakening;Nocturnal;After awakening;End of day;With quiet/rest | Alphanumeric |
Scoring criteria: Identify any that apply. Daily=3 With activity/stress=3 Nocturnal=3 Present on awakening=2 Menstrual=1 After awaking=1End of day=1 With quiet/rest=1 Max score: 15. |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 08:13:02.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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| C21780 | Headache primary laterality anatomic site | HeaPriLatAntmicSite | The location related to the lateral site of the primary headache | The location related to the lateral site of the primary headache | Primary headache site | Left;Right;Both;N/A | Left;Right;Both;N/A | Alphanumeric |
"Max score (Primary area) S: 3+2 = 5 R: 3+2=5 F: 1+2=3 T: 1+2=3 V: 2+2=4 W: 3+2=5 Total - 5 Max; 0 Min" |
Adult;Pediatric | Exploratory | 1.00 | 2016-06-02 14:48:46.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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| C21836 | Headache temporal association score | HeaTemAssScore | The score related to time of occurrence of consistent headache | The score related to time of occurrence of consistent headach | Score | Numeric Values |
Max Score: 15 |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 08:18:44.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
0 | 15 | |||||||||
| C21782 | Headache primary laterality anatomic site score | HeaPriLatAntmicSitScore | The score relating to the anatomic site of the primary headache | The score relating to the anatomic site of the primary headach | Score | Numeric Values | Adult;Pediatric | Exploratory | 1.00 | 2016-06-02 14:51:33.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
0 | 5 | ||||||||||
| C21837 | Headache duration type | HeaDurTyp | The type as related to duration of headache | The type as related to duration of headach | Length of time headache is present | Hours;Days;Weeks;Continuous/prolonged;Fleeting | Hours;Days;Weeks;Continuous/prolonged;Fleeting | Alphanumeric |
"identify single descriptive Max score: 5" |
Adult;Pediatric | Exploratory | 1.00 | 2016-06-06 08:20:12.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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| C21783 | Headache focal point extension radiation type | HeaFocPoiExtRadTyp | The type of extension from the focal point of the headache | The type of extension from the focal point of the headache | Extension from a focal point | Cervical;Retro-orbital;Frontal;Temporal;Vertex | Cervical;Retro-orbital;Frontal;Temporal;Vertex | Alphanumeric |
"Cervical(3) =3 Retro-orbital(R) = 3 Frontal (F) = 1 Temporal (T) = 1 Vertex(V) = 2 Max score: C: 3+2 = 5 R: 3+2=5 F: 1+2=3 T: 1+2=3 V: 2+2=4 W: 3+2=5 Total - 25 Max; 0 Min" |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-02 14:53:46.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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| C21838 | Headache duration score | HeaDurScore | The score related to type of duration of headache | The score related to type of duration of headach | Score | Numeric Values |
Max score: 5 |
Adult;Pediatric | Exploratory | 1.00 | 2016-06-06 08:22:55.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
1 | 5 | |||||||||
| C21785 | Headache focal point extension radiation score | HeaFocPoiExtRadScore | The score relating to the extension from the focal point of a headache | The score relating to the extension from the focal point of a headach | Score | Numeric Values |
"Max score: C: 3+2 = 5 R: 3+2=5 F: 1+2=3 T: 1+2=3 V: 2+2=4 W: 3+2=5 Total - 25 Max; 0 Min" |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-02 14:57:08.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
0 | 25 | |||||||||
| C21839 | Headache pain relief factor type | HeaPaiRelFacTyp | The type as related to pain relief factor for headache | The type as related to pain relief factor for headach | Factor relieving headache pain | Lying down;Sleeping;Medication (anti-inflam);Sitting or standing up;Wearing neck collar | Lying down;Sleeping;Medication (anti-inflam);Sitting or standing up;Wearing neck collar | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 08:24:05.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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| C21786 | Headache combination quality type | HeaCombQuaTyp | The quality of the patient's headache | The quality of the patient's headach | Essential nature, attribute or characteristic | Pressure;Pounding;Dull ache;Sharp;Burning;Electric-like | Pressure;Pounding;Dull ache;Sharp;Burning;Electric-like | Alphanumeric |
"Pressure (P)=3 Pounding (P1)=3 Dull ache (D)=2 Sharp (S)=1 Burning (B)=1 Electric-like (E)=0 Max score (All qualities):10" |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-02 14:58:55.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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| C21841 | Headache pain relief factor score | HeaPaiRelFacScore | The score related to pain relief factor for headache | The score related to pain relief factor for headach | Score | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 08:31:23.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
0 | 10 | ||||||||||
| C21788 | Headache quality score | HeaQuaScore | The score related to the quality of the patient's headache | The score related to the quality of the patient's headach | Score | Numeric Values |
"Pressure (P)=3 Pounding (P1)=3 Dull ache (D)=2 Sharp (S)=1 Burning (B)=1 Electric-like (E)=0" |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-02 15:02:06.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
0 | 10 | |||||||||
| C21842 | Headache aggravating pain factor type | HeaAggPaiRelFacTyp | The type as related to factor aggravating headache pain | The type as related to factor aggravating headache pai | Factors increasing headache pain | Coughing;Exercise;Neck: Rotation;Sneezing;Lifting;Straining at stool;Laughing;Singing;Crying;Orgasm;Neck: Flexion;Neck: Extension | Coughing;Exercise;Neck: Rotation;Sneezing;Lifting;Straining at stool;Laughing;Singing;Crying;Orgasm;Neck: Flexion;Neck: Extension | Alphanumeric |
"Coughing=3 Sneezing=3 Lifting=3 Straining at stool=3 Exercise=3 Laughing=3 Singing=2 Crying=1 Orgasm=1 Neck: Flexion=1 Neck: Extension=1 Neck: Rotation=1" Identify any that apply |
Adult;Pediatric | Exploratory | 1.00 | 2016-06-06 08:32:49.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
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| C21790 | Headache frequency type | HeaFreqTyp | The rate at which a headache occurs over a period of time | The rate at which a headache occurs over a period of tim | Rate at which headache occurs over a period of time | Continuous/prolonged;Daily;Weekly;Monthly;Yearly | Continuous/prolonged;Daily;Weekly;Monthly;Yearly | Alphanumeric |
"identify single descriptive Max score: 5" |
Adult;Pediatric | Exploratory | 1.00 | 2016-06-02 15:04:05.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
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| C21843 | Headache aggravating pain factor score | HeaAggPaiFacScore | The score related to factor aggravating headache pain | The score related to factor aggravating headache pai | Score | Numeric Values | Adult;Pediatric | Exploratory | 1.00 | 2016-06-06 08:38:27.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
0 | 25 | ||||||||||
| C21791 | Headache frequency score | HeaFreqScore | The score relating to the rate at which the patient's headache occurs over a period of time | The score relating to the rate at which the patient's headache occurs over a period of tim | Score | Numeric Values |
"identify single descriptive Max score: 5" |
Adult;Pediatric | Exploratory | 1.00 | 2016-06-02 15:07:05.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
1 | 5 | |||||||||
| C21844 | Headache assessment total score | HeaAssTotScore | The total score of headache assessment | The total score of headache assessmen | Total Score | Numeric Values | Adult;Pediatric | Exploratory | 1.00 | 2016-06-06 08:39:26.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
0 | 120 | ||||||||||
| C05400 | Injury date time | InjDateTime | Date (and time, if applicable and known) of injury | Date (and time, if applicable and known) of injury | Date of injury | Date or Date & Time | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
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| C21833 | Headache symptom association type | HeaSymptmAssTyp | The type as related to symptoms consistently associated with headache | The type as related to symptoms consistently associated with headache | Symptoms consistently associated with headache | Nausea;Vomiting;Phonophobia;Photophobia;Scotoma;Scintillations | Nausea;Vomiting;Phonophobia;Photophobia;Scotoma;Scintillations | Alphanumeric |
"Nausea=3 Vomiting=2 Scotoma=2 Scintillations=1 Photophobia=1 Phonophobia=1 Identify any that apply Max score: 10" |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 08:01:29.0 | CMI - Headache Score | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
