CDE Detailed Report | NINDS Common Data Elements

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	External Id caDSR
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
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
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
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
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
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
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
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
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
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
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
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