CDE Detailed Report

Disease: Cerebral Palsy
Subdomain Name: General Health History
CRF: Medical History

Displaying 101 - 117 of 117
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
C19856 Medical history gastrostomy tube since last visit indicator MedHistGtubeSLVInd Indicator of Gtube placed since last study visit Indicator of Gtube placed since last study visit Gastrostomy tube No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-06 00:00:00.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C06192 Fecal incontinence past three month average frequency FclInctPstThrMoAvgFreq Average frequency of incontinence to solid or liquid stools within the last three months. Fecal incontinence is defined as involuntary passage of stools Average frequency of incontinence to solid or liquid stools within the last three months. Fecal incontinence is defined as involuntary passage of stool Fecal incontinence past three month average frequency Never;Not applicable;Less than once per month;Not every day but at least once per week;Not every week but at least once per month;Once every month;One episode per day;Two or more episodes per day;Unknown Never;Not applicable;Less than once per month;Not every day but at least once per week;Not every week but at least once per month;Once every month;One episode per day;Two or more episodes per day;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-17 09:26:36.973 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C22676 Medical history disruptive behavior disorder indicator MedHistDisrpBehDisInd Indicator of whether participant/subject has disruptive behavior disorder Indicator of whether participant/subject has disruptive behavior disorder Disruptive behavior disorder Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:41:51.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C17478 Cardiovascular history heart failure indicator CardioHistHeartFailureInd Indicator as to whether the participant/subject has ever experienced heart failure Indicator as to whether the participant/subject has ever experienced heart failure Heart failure Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C22655 Medical history respiratory distress syndrome indicator MedHistRespDstSyndInd Indicator of whether the participant/subject has been diagnosed with respiratory distress syndrome Indicator of whether the participant/subject has been diagnosed with respiratory distress syndrome Respiratory distress syndrome Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:28:37.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C10522 Speech affected by disease indicator SpchAffectDisInd The indicator of whether the disease/disorder has affected the participant's/subject's speech The indicator of whether the disease/disorder has affected the participant's/subject's speech Is speech affected? Yes;No;Unknown History reported and/or confirmed in medical record;History NOT reported and NOT confirmed in medical record;History reported as unknown or could not be collected Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-11 15:03:49.2 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C14536 Seizure diagnosis method type SeizDiagnosMethdTyp Describes how the diagnosis of seizure was established Describes how the diagnosis of seizure was establishe Seizure diagnosis method type Clinical manifestations;EEG;Unknown Clinical manifestations;EEG;Not documented or Cannot be determined Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Medical History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected
C18862 Death location other text DeathLoctnOTH The free-text field related to 'Death location type' specifying other text. Type of location where the participant/subject died The free-text field related to 'Death location type' specifying other text. Type of location where the participant/subject died Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Medical History General Health History Participant History and Family History 4000

Free-Form Entry
C00315 Medical history global assessment indicator MedclHistGlobalAssmtInd Indicator of whether the participant has a history of any medical problems/conditions Indicator of whether the participant has a history of any medical problems/conditions Does the participant/subject have a history of any medical problems/conditions in the following body systems Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one. If this question is answered NO then the rest of the form is blank. If the question is answered YES then the medical history for at least one body system should be recorded.

 Adult;Pediatric Core 3.10 2024-02-29 15:42:39.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

 3145578
C22666 Medical history oropharyngeal dysphagia indicator MedHistOrphDysInd Indicator of whether the participant/subject has/had oropharyngeal dysphagia Indicator of whether the participant/subject has/had oropharyngeal dysphagia Oropharyngeal dysphagia Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:34:45.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C17468 Cardiovascular history arrhythmia bradycardia indicator CardioHistArrhythBradycardInd Indicator as to whether the participant/subject has or had a cardiac arrhythmia in the form of bradycardia Indicator as to whether the participant/subject has or had a cardiac arrhythmia in the form of bradycardia Bradycardia Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C22469 Medical history tuberculosis condition indicator MedHisTBCondInd The indicator related to medical history of the condition tuberculosis (TB) The indicator related to medical history of the condition tuberculosis (TB Cerebral visual impairment Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-06-10 15:58:46.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C06316 Menstruation scale MenstruationScale Scale for how the female participant's menstruation is affected by the spinal cord injury Scale for how the female participant's menstruation is affected by the spinal cord injur Sexual dysfunction indicator Normal;Reduced/altered;Unknown;Not applicable (For female);Not applicable (Patient male) Refers to no change in duration, frequency or quantity of menstrual flow and no change in subjective experience or symptoms of menstruation after the spinal cord lesion;i.e. Menstruation has been initiated, though partially impaired or changed. This refers to a change in the duration, frequency or amount of menstrual blood flow after spinal cord lesion. It can also refer to a change in the quality of sensations or other autonomic phenomena associated with menses;Means the impact of the spinal cord lesion on menstruation is unknown;Means the woman was not menstruating at the time of spinal cord lesion, thus there is not an impact on menstruation; Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-17 09:26:36.973 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C22677 Medical history self injurious behavior disorder MedHistSlfInjBehDisInd Indicator of whether participant/subject has self-injurious behavior disorder Indicator of whether participant/subject has self-injurious behavior disorder Self-injurious behavior disorder Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:42:28.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C17479 Cardiovascular history ischemia heart disease indicator CardioHistIschHeartDiseaseInd Indicator as to whether the participant/subject has or had ischemia heart disease Indicator as to whether the participant/subject has or had ischemia heart disease Ischemia heart disease Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C22656 Medical history bronchopulmonary dysplasia indicator MedHistBrncplmDyspInd Indicator of whether the participant/subject has been diagnosed with bronchopulmonary dysplasia Indicator of whether the participant/subject has been diagnosed with bronchopulmonary dysplasia Bronchopulmonary dysplasia Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:29:03.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C10539 Diabetes first diagnosis age value DiabetFrstDiagnosisAgeVal Value representing the age, in years, at which the participant was first diagnosed with diabetes mellitus Value representing the age, in years, at which the participant was first diagnosed with diabetes mellitus Indicate age when diabetes was first diagnosed (years) Numeric Values Adult;Pediatric Supplemental 3.10 2024-02-29 15:41:16.0 Medical History General Health History Participant History and Family History

Free-Form Entry

 year
CSV