CDE Detailed Report
Subdomain Name: General Health History
CRF: welcome
Displaying 1 - 50 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 |
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C06020 | Urinary incontinence past three months indicator | UrinIncntPstThreeMoInd | Indicator of involuntary urine leakage (incontinence) within the last three months. Urinary incontinence is defined by International Continence Society (Abrams et al. 2002) as the complaint of any involuntary leakage of urine | Indicator of involuntary urine leakage (incontinence) within the last three months. Urinary incontinence is defined by International Continence Society (Abrams et al. 2002) as the complaint of any involuntary leakage of urin | Urinary incontinence past three months frequency | No;Yes;Not applicable;Unknown | No;Yes;Not applicable;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 |
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C22675 | Medical history oppositional defiance indicator | MedHIstOppDefInd | Indicator of whether participant/subject displays oppositional defiance | Indicator of whether participant/subject displays oppositional defiance | Oppositional defiance | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:41:22.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C17466 | Cardiovascular history arrhythmia atrial fibrillation indicator | CardioHistArrhythAtrialFibInd | Indicator as to whether the participant/subject has or had a cardiac arrhythmia in the form of atrial fibrillation | Indicator as to whether the participant/subject has or had a cardiac arrhythmia in the form of atrial fibrillation | Atrial Fibrillation | 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 |
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C19836 | Pain anatomic site text | PainAntmicSiteTxt | Anatomic Site of body pain | Anatomic Site of body pain | If yes, where | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-05 00:00:00.0 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C22654 | Medical history respiratory support type | MedHistRespSuppTyp | Type of respiratory support utilized by a participant/subject | Type of respiratory support utilized by a participant/subject | If yes, indicate type | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:27:42.0 | Medical History | General Health History | Participant History and Family History | 500 |
Free-Form Entry |
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C10521 | Hearing affected by disease indicator | HearAffectDisInd | The indicator of whether the disease/disorder has affected the participant's/subject's hearing | The indicator of whether the disease/disorder has affected the participant's/subject's hearing | Is hearing 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 |
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C17477 | Cardiovascular history congenital heart disease indicator | CardioHistCongHeartDiseaseInd | Indicator as to whether the participant/subject has or had a congenital heart disease | Indicator as to whether the participant/subject has or had a congenital heart disease | Congenital 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 |
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C00314 | Medical history taken date and time | MedclHistTakenDateTime | Date (and time, if applicable and known) the participant's medical history was taken | Date (and time, if applicable and known) the participant 's medical history was taken | Date Medical History Taken | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
Adult;Pediatric | Core | 3.20 | 2024-02-29 15:42:39.0 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
2179659 | ||||||||||
C22665 | Medical history chronic constipation indicator | MedHIstChrnConsInd | Indicator of whether the participant/subject has/had chronic constipation | Indicator of whether the participant/subject has/had chronic constipation | Chronic constipation | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:34:16.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C14130 | Seizure focal classification type | SeizFocClassTyp | The type of focal epileptic seizures, considered to originate within networks limited to one hemisphere, which may be discretely localized or more widely distributed, and may originate in subcortical structures, experience by the participant/subject | The type of focal epileptic seizures, considered to originate within networks limited to one hemisphere, which may be discretely localized or more widely distributed, and may originate in subcortical structures, experience by the participant/subjec | Seizure focal classification type | Without impairment of consciousness or responsiveness;With observable motor or autonomic components;Involving subjective sensory or psychic phenomena only;With impairment of consciousness or responsiveness;Evolving to a bilateral, convulsive seizure | Without impairment of consciousness or responsiveness;Without impairment of consciousness or responsiveness-With observable motor or autonomic components (roughly corresponds to the concept of "simple partial seizure");Without impairment of consciousness or responsiveness-Involving subjective sensory or psychic phenomena only (corresponds to the concept of "aura");With impairment of consciousness or responsiveness (roughly corresponds to the concept of "complex partial seizure");Evolving to a bilateral, convulsive seizure (involving tonic, clonic, or tonic and clonic components replaces the term "secondarily generalized seizure") | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-08-28 16:08:00.453 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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C18666 | Body system category other text | BodySysCatOTH | The free-text field related to 'Body system category', specifying other text. Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured | The free-text field related to 'Body system category', specifying other text. Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured | Other, specify | Alphanumeric | Review of Symptoms from Centers for Medicare and Medicaid Services https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/eval_mgmt_serv_guide-ICN006764.pdf | Adult;Pediatric | Supplemental | 1.10 | 2023-11-07 08:40:35.0 | Medical History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
2002895 | |||||||||
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 |
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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 |
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C17467 | Cardiovascular history arrhythmia atrial flutter indicator | CardioHistArrhythAtrialFlutInd | Indicator as to whether the participant/subject has or had a cardiac arrhythmia in the form of atrial flutter | Indicator as to whether the participant/subject has or had a cardiac arrhythmia in the form of atrial flutter | Atrial Flutter | 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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 | |||||||||||
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 |
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C00316 | Medical history condition end date and time | MedclHistCondEndDateTime | Date (and time, if applicable and known) for the end of an event in the participant's medical history | Date (and time, if applicable and known) for the end of an event in the participant's medical history | End Date | Date or Date & Time |
"Record the date (and time) the medical condition/disease stopped. For surgeries, start and stop dates will most likely be the same date. Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.)." |
Adult;Pediatric | Core | 3.10 | 2024-02-29 15:42:44.0 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
3145557 | ||||||||||
C22667 | Medical history sialorrhea indicator | MedHistSiaInd | Indicator of whether the participant/subject has/ had sialorrhea | Indicator of whether the participant/subject has/ had sialorrhea | Sialorrhea | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:35:18.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C14543 | Genetic disorder type | GeneticDisTyp | Whether the participant/subject has a known single gene disorder | Whether the participant/subject has a known single gene disorder | Genetic disorder type | No known single gene disorder;Mendelian;Mitochondrial;Other, specify | No known single gene disorder;Mendelian;Mitochondrial;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C18961 | Genetic disorder other text | GeneticDisOTH | The free-text field related to 'Genetic disorder type' specifying other text. Whether the participant/subject has a known single gene disorder | The free-text field related to 'Genetic disorder type' specifying other text. Whether the participant/subject has a known single gene disorder | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Medical History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
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C22478 | Attention deficit hyperactivity disorder indicator | AttDefHyperDisInd | The indicator related to the disorders of attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) | The indicator related to the disorders of attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD | Attention Deficit Hyperactivity Disorder (ADHD) | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-10 16:30:55.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C06358 | Diabetes mellitus type | DiabetesMellitusTyp | Type of diabetes mellitus | Type of diabetes mellitus | If Yes, Indicate type | Type 1;Type 2 | Type 1;Type 2 | Alphanumeric | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:41:20.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C22678 | Medical history aggressive behavior disorder indicator | MedHistAggBehDisInd | Indicator of whether participant/subject has aggressive behavior disorder | Indicator of whether participant/subject has aggressive behavior disorder | Aggressive behavior disorder | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:42:52.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C17469 | Cardiovascular history arrhythmia indicator | CardioHistArrhythInd | Indicator as to whether the participant/subject has or had a cardiac arrhythmia | Indicator as to whether the participant/subject has or had a cardiac arrhythmia | Arrhythmia | 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 |
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C22657 | Medical history recurrent pneumonia indicator | MedHistReccPneInd | Indicator of whether the participant/subject has been diagnosed with recurrent pneumonia | Indicator of whether the participant/subject has been diagnosed with recurrent pneumonia | Recurrent pneumonia | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:29:37.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C10541 | Diabetes treatment type | DiabetTreatTyp | Type of treatment the participant/subject is receiving or has received for diabetes mellitus | Type of treatment the participant/subject is receiving or has received for diabetes mellitus | Indicate the treatments taken for diabetes (Choose all that apply) | Diet;Oral medication;Insulin;None | Diet;Oral medication;Insulin;None | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-11 15:03:49.2 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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C17480 | Diabetes mellitus complications type | EndocrineHistDiabMellCompliTyp | Type(s) of complications related to diabetes mellitus the participant/subject has experienced or is experiencing | Type(s) of complications related to diabetes mellitus the participant/subject has experienced or is experiencing | Indicate the complications of diabetes (choose all that apply) | Nephropathy;Neuropathy;Retinopathy;Other, specify;None | Nephropathy;Neuropathy;Retinopathy;Other, specify;None | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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C00317 | Medical history condition start date and time | MedclHistCondStrtDateTime | Date (and time, if applicable and known) for the start of an event in the participant's medical history | Date (and time, if applicable and known) for the start of an event in the participant's medical history | Start Date | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
Adult;Pediatric | Core | 3.10 | 2024-02-29 15:42:43.0 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
2543596 | ||||||||||
C22668 | Medical history neurogenic detrusor indicator | MedHistNeurDetrusInd | Indicator of whether participant/subject has a neurogenic detrusor | Indicator of whether participant/subject has a neurogenic detrusor | Neurogenic detrusor, detrusor sphincter dyssernigia | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:36:08.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C17402 | Site name | SiteName | The name of the site for the study | The name of the site for the study | Site Name | Alphanumeric | Adult;Pediatric | Supplemental-Highly Recommended | 3.00 | 2013-06-21 00:00:00.0 | Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C19057 | Diabetes mellitus complications other text | EndocrineHistDiabMellCompliOTH | The free-text field related to 'Diabetes mellitus complications type' specifying other text. Type(s) of complications related to diabetes mellitus the participant/subject has experienced or is experiencing | The free-text field related to 'Diabetes mellitus complications type' specifying other text. Type(s) of complications related to diabetes mellitus the participant/subject has experienced or is experiencing | 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 |
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C22646 | Medical history retinopathy of prematurity indicator | MedHistRetinPremInd | Indicator of whether the participant/subject has been affected by Retinopathy of prematurity | Indicator of whether the participant/subject has been affected by Retinopathy of prematurity | Retinopathy of prematurity | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:22:09.0 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C08177 | Hemorrhage indicator | HemrrhgInd | Indicator of the presence of cerebral hemorrhages, regardless of size in any region of the brain | Indicator of the presence of cerebral hemorrhages, regardless of size in any region of the brain | Presence of cerebral hemorrhages, regardless of size in any region of the brain | Yes;No;Unknown;Not assessed | Yes;No;Unknown;Not assessed | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C22679 | Medical history first depressive episode diagnosis age value | MedHistFrstDepEpDiagAgeVal | Value of a participant's/subject's age when first depressive episode was diagnosed | Value of a participant's/subject's age when first depressive episode was diagnosed | Age at which participant/subject experienced first depressive episode or was first diagnosed with depression, whoever is earlier (years) | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:43:54.0 | Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
year | |||||||||||
C17470 | Cardiovascular history arrhythmia other text | CardioHistArrhythOtherTxt | Text description of any cardiac arrhythmia the participant/subject has or had in a form other than atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia, or bradycardia | Text description of any cardiac arrhythmia the participant/subject has or had in a form other than atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia, or bradycardia | 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 | 255 |
Free-Form Entry |
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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 |
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C10543 | Cancer head or neck radiation treatment indicator | CancerHeadNeckRadiatTreatInd | Indicator as to whether the participant's/subject's cancer is or was treated with head or neck radiation | Indicator as to whether the participant's/subject's cancer is or was treated with head or neck radiatio | Treated with head or neck radiation | Yes;No/Not documented;Unknown | Yes;No/Not documented;Unknown | 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 |