CDE Detailed Report
Disease: Chiari I Malformation
Subdomain Name: General Health History
CRF: Past History (on intake)
Displaying 1 - 30 of 30
Subdomain Name: General Health History
CRF: Past History (on intake)
Displaying 1 - 30 of 30
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C19779 | Medical history asthma pulmonary assessment indicator | MedHistAsthmaPulAssesInd | Indicator of history of asthma | Indicator of history of asthma | Asthma | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21879 | Surgical history prosthetic implantation indicator | SurgHistProsImpInd | The indicator related to surgical history of prosthetic implantation | The indicator related to surgical history of prosthetic implantatio | Prosthetic Implantation | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 11:00:30.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C19806 | Medical history endocrine diabetes indicator | MedHistEndcrnDiabetInd | Indicator of diabetes | Indicator of diabetes | Diabetes | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21880 | Surgical history valve replacement indicator | SurgHistValRepInd | The indicator related to surgical history of valve replacement | The indicator related to surgical history of valve replacement | Valve Replacement | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 11:02:18.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21869 | Medical history coronary artery disease indicator | MedHistCorArtDisInd | The indicator related to personal medical history of coronary artery disease | The indicator related to personal medical history of coronary artery diseas | Coronary Artery Disease | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 10:48:12.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21882 | Surgical history cataract removal indicator | SurgHistCatRemInd | The indicator related to surgical history of cataract removal | The indicator related to surgical history of cataract remova | Cataract Removal | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 1.00 | 2016-06-06 11:04:34.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C05454 | Hypertension indicator | HypertensInd | Indicator of hypertension. In adults, hypertension is defined as a systolic pressure >= 140 and a diastolic >= 90. In children, it is defined as systolic blood pressure >95th percentile for age | Indicator of hypertension. In adults, hypertension is defined as a systolic pressure >= 140 and a diastolic >= 90. In children, it is defined as systolic blood pressure >95th percentile for ag | Hypertension | Yes;No;Unknown;Suspected | Yes;No;Unknown;Suspected | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21870 | Medical history Lyme disease indicator | MedHistLymDisInd | The indicator related to personal medical history of Lyme disease | The indicator related to personal medical history of Lyme diseas | Lyme Disease | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 10:50:40.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21883 | Surgical history other text | SurgHistOthrTxt | The free-text field related to other past surgery | The free-text field related to other past surger | Other, specify: | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 11:06:15.0 | Past History (on intake) | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
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| C12875 | Echocardiogram mitral valve prolapse indicator | EchcrdgrmMitrlValvProlapseInd | Indicator of the absence or presence of prolapse of the mitral valve, often with regurgitation, associated with myxomatous proliferation of the leaflets of the mitral valve as assessed by echocardiography | Indicator of the absence or presence of prolapse of the mitral valve, often with regurgitation, associated with myxomatous proliferation of the leaflets of the mitral valve as assessed by echocardiography | Mitral Valve Prolapse | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:50:22.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21871 | Medical history chronic obstructive pulmonary disease indicator | MedHistChrObstPulDisInd | The indicator related to personal medical history of chronic obstructive pulmonary disease (COPD) | The indicator related to personal medical history of chronic obstructive pulmonary disease (COPD | COPD | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 10:52:17.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21884 | Pain lower back indicator | PainLowrBackInd | The indicator relating to lower back pain | The indicator relating to lower back pai | Lower back pain? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 1.00 | 2016-06-06 11:07:41.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C13758 | Imaging diagnosis stroke transient ischemic attack indicator | ImgDiagStrokeTIAInd | Indicator of the diagnosis of stroke/transient ischemic attack (TIA) for imaging positive | Indicator of the diagnosis of stroke/transient ischemic attack (TIA) for imaging positive | Stroke/TIA | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 3.00 | 2013-06-21 00:00:00.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21872 | Medical history visual impairment indicator | MedHistVisImpairmntInd | The indicator related to personal medical history of visual impairment or legally blind | The indicator related to personal medical history of visual impairment or legally blin | Visual Impairment/Legally Blind | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 1.00 | 2016-06-06 10:53:36.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21885 | Pain general leg indicator | PainGenLegInd | The indicator relating to general leg pain | The indicator relating to general leg pai | Leg pain, in general? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 1.00 | 2016-06-06 11:08:50.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17460 | Cancer history indicator | CancerHistInd | Indicator as to whether the participant/subject has or had cancer | Indicator as to whether the participant/subject has or had cance | Cancer | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21873 | Medical history hearing deficit indicator | MedHistHeaDefInd | The indicator related to personal medical history of hearing deficit or use of hearing aid | The indicator related to personal medical history of hearing deficit or use of hearing ai | Hearing deficit/use of hearing aid | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 1.00 | 2016-06-06 10:55:07.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21886 | Injury Head Indicator | InjHeadInd | The indicator relating to traumatic head injury | The indicator relating to traumatic head injur | Head injury? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 1.00 | 2016-06-06 11:10:17.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C18150 | Thyroid disease indicator | ThyrdDiseasInd | Indicator for thyroid disease | Indicator for thyroid disease | Thyroid Disease | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-17 09:26:36.973 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21874 | Medical history paraplegia quadriplegia indicator | MedHistParQuadInd | The indicator related to personal medical history of paraplegia/quadriplegia | The indicator related to personal medical history of paraplegia/quadriplegi | Paraplegia/Quadriplegia | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 1.00 | 2016-06-06 10:56:04.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21887 | Injury whiplash indicator | InjWhiInd | The indicator relating to injury in the form of whiplash | The indicator relating to injury in the form of whiplas | Whiplash injury? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 1.00 | 2016-06-06 11:11:25.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C18793 | Medical history condition other text | MedHistCondOTH | The free-text field related to 'Medical history condition type', specifying other text. Pre-specified medical condition/disease asked about when collecting the medical history from the participant or found documented in the medical record | The free-text field related to 'Medical history condition type', specifying other text. Pre-specified medical condition/disease asked about when collecting the medical history from the participant or found documented in the medical record | Other, specify: | Alphanumeric | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:42:42.0 | Past History (on intake) | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C21875 | Surgical history cardiac bypass stent indicator | SurgHistCarBypSteInd | The indicator related to surgical history of cardiac bypass/stent | The indicator related to surgical history of cardiac bypass/sten | Cardiac Bypass/Stent | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 10:57:14.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21888 | Injury fall head neck indicator | InjFallHeadNeckInd | The indicator relating to injury in the form of the patient falling on their head or neck | The indicator relating to injury in the form of the patient falling on their head or nec | Fall on head/back? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 1.00 | 2016-06-06 11:12:33.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C19500 | Assessment performed date | AssessmentPerformedDate | The date of assessment of the examination being performed | The date of assessment of the examination being performed | Date of Intake | Date or Date & Time | Adult;Pediatric | Supplemental | 1.00 | 2014-06-18 08:10:12.0 | Past History (on intake) | General Health History | Participant History and Family History |
Free-Form Entry |
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| C21876 | Surgical history pacemaker indicator | SurgHistPacId | The indicator related to surgical history of a pacemaker | The indicator related to surgical history of a pacemake | Pacemaker | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 10:58:13.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21889 | Medical history claustrophobic indicator | MedHistClaInd | The indicator relating to personal medical history of claustrophobia | The indicator relating to personal medical history of claustrophobi | Are you claustrophobic? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2016-06-06 11:13:45.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C19761 | Medical history glaucoma diagnosis indicator | MedHistGlcmaDiagInd | Indicator of history of Glaucoma | Indicator of history of Glaucoma | Glaucoma | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21877 | Surgical history defibrillator indicator | SurgHistDefInd | The indicator related to surgical history of using a defibrillator | The indicator related to surgical history of using a defibrillato | Defibrillator | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 10:59:27.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C21890 | Medical history test sedation require indicator | MedHistTestSedReqInd | The indicator relating to the requirement of sedation for testing | The indicator relating to the requirement of sedation for testin | Do you require sedation for testing? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2016-06-06 11:15:21.0 | Past History (on intake) | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
