CDE Detailed Report

Disease: content
Subdomain Name: General Health History
CRF: welcome

Displaying 1 - 13 of 13
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
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 Core 3.00 2013-06-21 00:00:00.0 Motor Development History General Health History Participant History and Family History 255

Free-Form Entry
C17493 Attention deficit disorder attention deficit hyperactivity disorder indicator AttentionDeficitADHDInd Indicator as to whether the participant/subject has or had attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) Indicator as to whether the participant/subject has or had attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) Does/did the participant/subject have Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD)? Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Motor Development History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C17494 Delay language cognitive milestone indicator DelayLangCogMilestoneInd Indicator as to whether the participant/subject has or had delayed acquisition of language or cognitive milestones, as diagnosed by a pediatrician or neurologist Indicator as to whether the participant/subject has or had delayed acquisition of language or cognitive milestones, as diagnosed by a pediatrician or neurologist Does/did the participant/subject have delayed acquisition of cognitive milestones, diagnosed by a physician? Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Motor Development History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C17496 Delay social function indicator DelaySocialFunctionInd Indicator as to whether the participant/subject has or had delayed social function Indicator as to whether the participant/subject has or had delayed social function Does/did the participant/subject have social delay? Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Motor Development History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C17497 Gait abnormal when began walking indicator GaitAbnrmlWhenBeganWalkInd Indicator as to whether the participant/subject had a gait abnormality at the time they began walking, as noted by parents or a physician Indicator as to whether or not the participant/subject had a gait abnormality at the time they began walking, as noted by parents or a physician Does/did the participant/subject have abnormality of the gait noted by parents or a physician at the time the child began walking? Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Motor Development History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C17498 Hand preference before 12 month age indicator HandPrefBefore12MoAgeInd Indicator as to whether the participant/subject had a hand preference before 12 months of age Indicator as to whether the participant/subject had a hand preference before 12 months of age Does/did the participant/subject have hand preference before 12 months of age? Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Motor Development History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C19247 Subject ID SubIDNam Subject identification ID Subject identification ID Subject ID Alphanumeric Adult;Pediatric Core 1.00 2014-06-05 13:10:49.0 Motor Development History General Health History Participant History and Family History 255

Free-Form Entry
C10615 Clinical event or milestone type ClinEvntMilestoneTyp Type of clinical event or milestone pertinent to the disease or disorder Type of clinical event or milestone pertinent to the disease or disorder Milestone Noninvasive ventilation (NIV) utilized;Loss of speech;Loss of ambulation;Percutaneous endoscopic gastrostomy (PEG)/feeding tube placement;Tracheostomy performed;Death;Walk by 17 months old;Speak his/her first words by 12 months;Speak in two word combinations by 2 years;Speak in complete sentences by 3 years;Have a cognitive/learning disability;Attend a day care group (with > 5 other children);Head control;Raise both arms above head simultaneously;Roll completely;Maintain seated position supported;Maintain seated position unsupported;Crawl- combat style;Crawl- four point;Stand with support;Cruise along furniture;Stand without support;Walk with support (hand, braces);Walk independently (without braces);Climb stairs;Roll both ways;Walk with hand held or assistive device;Walk alone (without assistive device);Reaches for object;Self feeds;Uses spoon Noninvasive ventilation (NIV) utilized;Loss of speech;Loss of ambulation;Percutaneous endoscopic gastrostomy (PEG)/feeding tube placement;Tracheostomy performed;Death;Walk by 17 months old;Speak his/her first words by 12 months;Speak in two word combinations by 2 years;Speak in complete sentences by 3 years;Have a cognitive/learning disability;Attend a day care group (with > 5 other children);Head control;Raise both arms above head simultaneously;Roll completely;Maintain seated position supported;Maintain seated position unsupported;Crawl- combat style;Crawl- four point;Stand with support;Cruise along furniture;Stand without support;Walk with support (hand, braces);Walk independently (without braces);Climb stairs;Roll both ways;Walk with hand held or assistive device;Walk alone (without assistive device);Reaches for object;Self feeds;Uses spoon Alphanumeric CF Dosman, D Andrews, KJ Goulden: Evidence-based milestone ages as a framework for developmental surveillance. Pediatr Child Health 2012; 17(10):561&#8211;568. <br />Sheldrick RC and Perrin EC: Evidence-Based Milestones for Surveillance of Cognitive, Language, and Motor Development. Academic Pediatrics 2013;13:577. Adult;Pediatric Core 3.00 2013-07-25 08:54:08.2 Motor Development History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C22884 Person obtained report type ReportObtByTyp The type indicating who the report was obtained by The type indicating who the report was obtained by Report obtained by Other, specify;Parent;Physician;Record Review;Self ;Parent;Physician;Record Review;Self Alphanumeric CF Dosman, D Andrews, KJ Goulden: Evidence-based milestone ages as a framework for developmental surveillance. Pediatr Child Health 2012;17(10):561&#8211;568.<br />Sheldrick RC and Perrin EC: Evidence-Based Milestones for Surveillance of Cognitive, Language, and Motor Development. Academic Pediatrics 2013;13:577 Adult;Pediatric Supplemental 1.00 2016-12-05 10:04:25.0 Motor Development History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C10616 Clinical event or milestone achieved indicator ClinEvntMilestoneAchvInd Indicator whether the participant/subject achieved or experienced the specific clinical event or milestone pertinent to the disease or disorder Indicator whether the participant/subject achieved or experienced the specific clinical event or milestone pertinent to the disease or disorder Achieved? Yes;No;Unknown Yes;No;Unknown Alphanumeric CF Dosman, D Andrews, KJ Goulden: Evidence-based milestone ages as a framework for developmental surveillance. Pediatr Child Health 2012; 17(10):561&#8211;568. <br />Sheldrick RC and Perrin EC: Evidence-Based Milestones for Surveillance of Cognitive, Language, and Motor Development. Academic Pediatrics 2013;13:577 Adult;Pediatric Core 3.00 2013-07-25 08:54:08.2 Motor Development History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C22886 Delay acquisition language communication milestone indicator DelAcqLanCommMilInd The indicator related to the subject having delayed acquisition of language or communication milestones, diagnosed be a physician The indicator related to the subject having delayed acquisition of language or communication milestones, diagnosed be a physicia Does/did the participant/subject have delayed acquisition of language/communication milestones, diagnosed by a physician? Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-05 12:17:59.0 Motor Development History General Health History Participant History and Family History

Single Pre-Defined Value Selected
C12658 Clinical event or milestone achieved age value ClinEvntMilstnAchvAgeVal Age when the participant/subject achieved the clinical event or milestone Age when the participant/subject achieved the clinical event or milestone Age Achieved (in months) Numeric Values CF Dosman, D Andrews, KJ Goulden: Evidence-based milestone ages as a framework for developmental surveillance. Pediatr Child Health 2012; 17(10):561&#8211;568.<br />Sheldrick RC and Perrin EC: Evidence-Based Milestones for Surveillance of Cognitive, Language, and Motor Development. Academic Pediatrics 2013;13:577. Adult;Pediatric Core 3.00 2013-07-25 08:54:08.2 Motor Development History General Health History Participant History and Family History

Free-Form Entry
C12665 Certainty of response type CertainResponsTyp Certainty of recollection of the response or information Certainty of recollection of the response or information Certainty of Response Certain/Definite;Best recollection;Unknown/Uncertain Certain/Definite;Best recollection;Unknown/Uncertain Alphanumeric CF Dosman, D Andrews, KJ Goulden: Evidence-based milestone ages as a framework for developmental surveillance. Pediatr Child Health 2012; 17(10):561&#8211;568.<br />Sheldrick RC and Perrin EC: Evidence-Based Milestones for Surveillance of Cognitive, Language, and Motor Development. Academic Pediatrics 2013;13:577. Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Motor Development History General Health History Participant History and Family History

Single Pre-Defined Value Selected
CSV