CDE Detailed Report

Disease: Cerebral Palsy
Sub-Domain: 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 / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C17482 Diabetes mellitus indicator EndocrineHistDiabetesMellInd Indicator as to whether the participant/subject has diabetes mellitus (type I or type II) Indicator as to whether the participant/subject has diabetes mellitus (type I or type II) Diabetes mellitus (type I or type II) 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
C22658 Medical history bronchiectasis indicator MedHistBronInd Indicator of whether the participant/subject has been diagnosed with brochiectasis Indicator of whether the participant/subject has been diagnosed with brochiectasis Bronchiectasis Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:30:05.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C22669 Medical history recurrent urinary tract infect MedHistRecUrnTrctInfInd Indicator of whether participant/subject has/had recurrent urinary tract infections Indicator of whether participant/subject has/had recurrent urinary tract infections Recurrent urinary tract infections Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:36:34.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
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;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
C19058 Psychiatric history psychotic diagnosis other text PsychHistPsychoticDiagnosOTH The free-text field related to 'Psychiatric history psychotic diagnosis type' specifying other text. Type of psychotic disorder the participant/subject has been diagnosed with, if any The free-text field related to 'Psychiatric history psychotic diagnosis type' specifying other text. Type of psychotic disorder the participant/subject has been diagnosed with, if any Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Medical History General Health History Participant History and Family History 4000

Free-Form Entry
C00319 Medical history condition ongoing indicator MedclHistCondOngoingInd Indicator of whether a medical condition/disease experienced by the participant/subject is ongoing Indicator of whether a medical condition/disease experienced by the participant/subject is ongoing Ongoing? Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose Yes or No to indicate if the medical condition/disease is still present.

 Adult;Pediatric Core 3.00 2013-07-24 11:38:01.2 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected

 2736881
C10506 Genetic diagnosis established indicator GeneticDiagnosEstablishedInd Whether a genetic diagnosis for the disease/disorder was established Whether a genetic diagnosis for the disease/disorder was established Genetic diagnoses established Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-14 03:55:23.71 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C22680 Medical history checkup recommend interval complete indicator MedHistChckRecIntInd Indicator of whether or not checkups were completed at recommended intervals Indicator of whether or not checkups were completed at recommended intervals Checkups at recommended intervals Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:44:16.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C17471 Cardiovascular history arrhythmia supraventricular tachycardia indicator CardioHistArrhythSupraTachInd Indicator as to whether the participant/subject has or had a cardiac arrhythmia in the form of supraventricular tachycardia Indicator as to whether the participant/subject has or had a cardiac arrhythmia in the form of supraventricular tachycardia Supraventricular tachycardia 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
C22647 Medical history high myopia indicator MedHistHghMyopInd Indicator of whether the participant/subject has been affected by high myopia Indicator of whether the participant/subject has been affected by high myopia High myopia Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:22:55.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C10556 Pregnant ever indicator PregEverInd Indicator as to whether or not the participant/subject has every been pregnant, both term and not to term Indicator as to whether or not the participant/subject has every been pregnant, both term and not to term Pregnant ever (female participants) Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C17483 Psychiatric history clinical anxiety diagnosis indicator PsychHistClinAnxietyDiagnosInd Indicator as to whether the participant/subject has had an anxiety diagnosis Indicator as to whether the participant/subject has had an anxiety diagnosi Anxiety disorder diagnosis 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
C22659 Medical history restrictive airway disease indicator MedHistRestAirDsInd Indicator of whether the participant has been diagnosed with restrictive airway disease Indicator of whether the participant has been diagnosed with restrictive airway disease Restrictive airway disease Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:30:36.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C22670 Medical history Perinatal neurological event indicator MedHistPerNeurEvntInd Indicator of whether participant had a perinatal neurological event Indicator of whether participant had a perinatal neurological event Perinatal neurological event Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:37:58.0 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C17461 Cancer history type text CancerHistTypTxt Text description of the type of cancer the participant/subject was or is diagnosed with Text description of the type of cancer the participant/subject was or is diagnosed wit Type of cancer diagnosed with Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Medical History General Health History Participant History and Family History 255

Free-Form Entry
C19078 Cardiovascular history cardiac surgery other text CardioHistCardSurgOTH The free-text field related to 'Cardiovascular history cardiac surgery type' specifying other text. Type of cardiac surgery or mechanical intervention the participant/subject underwent The free-text field related to 'Cardiovascular history cardiac surgery type' specifying other text. Type of cardiac surgery or mechanical intervention the participant/subject underwent Other, specify Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Medical History General Health History Participant History and Family History 4000

Free-Form Entry
C00321 Medical history for body system indicator MedclHistBodySysInd Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body system Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body syste 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 for each body system.

 Adult;Pediatric Core 3.00 2013-07-22 16:57:17.79 Medical History General Health History Participant History and Family History

Single Pre-Defined Value Selected
CSV