CDE Detailed Report
Disease: Sport Related Concussion
Subdomain Name: General Health History
CRF: Participant and Family Psychological History
Displaying 1 - 13 of 13
Subdomain Name: 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 / 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 disorde | Learning disorder | No;Yes | No;Yes | Alphanumeric |
e.g., Dyslexia, Language Processing Disorder, Visual Perceptual/Visual Motor Deficit) |
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 |
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| 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 disorde | 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 |
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| 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 disorde | 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 |
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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 | 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 |
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| 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 |
