CDE Detailed Report

Disease: Sport Related Concussion
Sub-Domain: General Health History
CRF: Participant and Family Psychological History

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 / 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
C52416 ADD ADHD medication perscription indicator ADDADHDMedPerscInd The indicator relating to whether or not the participant or the participant's family has been perscribed ADD or ADHD medication The indicator relating to whether or not the participant or the participant's family has been perscribed ADD or ADHD medication Are you currently perscribed ADD/ADHD medication? No;Yes No;Yes Alphanumeric

See Medication CRF for more information

Adult;Pediatric Supplemental 1.00 2017-01-18 12:03:41.0 Participant and Family Psychological History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C52417 Learning disorder indicator LearnDisorderInd The indicator relating to whether or not the participant or the participant's family have a learning disorder. The indicator relating to whether or not the participant or the participant's family have a learning disorder. Learning disorder No;Yes No;Yes Alphanumeric

e.g., Dyslexia, Language Processing Disorder, Visual Perceptual/Visual Motor Deficit)
Does not include ADD/ADHD.

Adult;Pediatric Supplemental 1.00 2017-01-18 12:05:05.0 Participant and Family Psychological History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C52418 Sleep disorder indicator SleepDisorderInd The indicator relating to whether or not the participant or the participant's family have a sleep disorder. The indicator relating to whether or not the participant or the participant's family have a sleep disorder. Sleep disorder No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-18 12:05:05.0 Participant and Family Psychological History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00713 Drug or substance current illicit use indicator DrgSubstCurrntIllicitUseInd Indicator of participant's/subject's use of illegal drugs, prescription or over-the-counter drugs in the past year for purposes other than those for which they are meant to be used, or in large amounts Indicator of participant's/subject's use of illegal drugs, prescription or over-the-counter drugs in the past year for purposes other than those for which they are meant to be used, or in large amounts Substance Abuse Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Participant and Family Psychological History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3171724
C52419 Eating disorder indicator EatingDisorderInd The indicator relating to whether or not the participant or the participant's family have an eating disorder. The indicator relating to whether or not the participant or the participant's family have an eating disorder. Eating disorder No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-18 12:05:05.0 Participant and Family Psychological History General Health History Participant History and Family History

Single Pre-Defined Value Selected

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 3.00 2013-06-21 00:00:00.0 Participant and Family Psychological History General Health History Participant History and Family History 255

Free-Form Entry

C52421 Seizure disorder indicator SeizureDisorderInd The indicator relating to whether or not the participant has a seizure disorder The indicator relating to whether or not the participant has a seizure disorder Seizure Disorder No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-18 12:05:05.0 Participant and Family Psychological 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 Supplemental 1.00 2014-06-05 13:10:49.0 Participant and Family Psychological History General Health History Participant History and Family History 255

Free-Form Entry

C22673 Medical history autism indicator MedHistAutInd Indicator of whether participant/subject has Autism Indicator of whether participant/subject has Autism Autism/Asperger's Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:40:25.0 Participant and Family Psychological History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C22674 Medical history obsessive compulsive disorder indicator MedHistOCDInd Indicator of whether participant/subject has Obsessive Compulsive Disorder (OCD) Indicator of whether participant/subject has Obsessive Compulsive Disorder (OCD) OCD Yes;No Yes;No Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-27 11:40:50.0 Participant and Family Psychological History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C52413 Typical sleep hour number TypicalSleepHrNum The typical number of hours of sleep that the subject gets every night The typical number of hours of sleep that the subject gets every night Typical Number of Hours of Sleep Numeric Values Adult;Pediatric Supplemental 1.00 2016-12-22 14:31:13.0 Participant and Family Psychological History General Health History Participant History and Family History

Free-Form Entry

0 24 Hour
C52414 Psychiatric disorder diagnosis type PsychDisDiagnosTyp The type of diagnosis the participant/family member was diagnoses with The type of diagnosis the participant/family member was diagnoses with Psychiatric Disorder Diagnosis Mood Disorder/Depression/Bipolar;Anxiety Disorder;Somatoform Disorder;Personality Disorder;Psychotic Disorder/Schizophrenia;Alcohol Abuse;Drug Abuse;PTSD;Unknown Mood Disorder/Depression/Bipolar;Anxiety Disorder;Somatoform Disorder;Personality Disorder;Psychotic Disorder/Schizophrenia;Alcohol Abuse;Drug Abuse;PTSD;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-18 11:57:57.0 Participant and Family Psychological History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C52415 ADD ADHD indicator ADDADHDInd The indicator relating to whether or not the participant or the participant's family have ADD or ADHD The indicator relating to whether or not the participant or the participant's family have ADD or ADHD ADD/ADHD No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2017-01-18 12:02:04.0 Participant and Family Psychological History General Health History Participant History and Family History

Single Pre-Defined Value Selected

CSV