CDE Detailed Report
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CRF: Family History
Displaying 1 - 8 of 8
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C06005 | Data collected date and time | DataCollDateTime | Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed | Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performe | Date information collected | 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.). |
No references available | Adult;Pediatric | Core | 3.00 | 2013-07-24 21:00:23.88 | Family History | [php] | [php_1] |
Free-Form Entry |
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| C14145 | Family history stroke youngest age value | FamHistStrokYoungAgeVal | If there is a family history of stroke, specify the youngest age an immediate family member (parent, sibling, child) suffered a stroke | If there is a family history of stroke, specify the youngest age an immediate family member (parent, sibling, child) suffered a strok | Youngest age immediate family member suffered a stroke | Numeric Values |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. Enter the youngest age to the nearest integer or choose Unknown. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Family History | [php] | [php_1] |
Free-Form Entry |
0 | 99 | year | |||||||
| C14147 | Family history coronary artery disease (CAD) youngest age value | FamHistCADYoungAgeVal | If there is a family history of coronary artery disease (CAD), specify the youngest age an immediate family member (parent, sibling, child) was diagnosed with the condition/ suffered a heart attack | If there is a family history of coronary artery disease (CAD), specify the youngest age an immediate family member (parent, sibling, child) was diagnosed with the condition/ suffered a heart attack | Youngest age immediate family member was diagnosed with condition/ suffered a heart attack | Numeric Values |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. Enter the youngest age to the nearest integer or choose Unknown. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Family History | [php] | [php_1] |
Free-Form Entry |
0 | 99 | year | |||||||
| C18678 | Family history medical condition type other text | FamHistMedclCondTypOTH | The free-text field related to 'Family history medical condition type', specifying other text. Type of medical condition or health related event for which the family history is taken | The free-text field related to 'Family history medical condition type', specifying other text. Type of medical condition or health related event for which the family history is taken | Other, specify | Alphanumeric |
This CDE should be collected along with the "Family history medical condition indicator." |
No references available | Adult;Pediatric | Supplemental | 1.10 | 2024-02-29 15:42:35.0 | Family History | [php] | [php_1] | 4000 |
Free-Form Entry |
3165585 | ||||||||
| C52569 | Brain aneurysm family member relationship text | brainAneurysmFamMemRelTxt | Specify the relationship(s) that a family member with brain aneurysm(s) has with the subject/participant | Specify the relationship(s) that a family member with brain aneurysm(s) has with the subject/participant | If YES, please indicate relationship to patient | Alphanumeric |
(i.e., grandparents, parents, siblings, children or other member) |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Family History | [php] | [php_1] | 50 |
Free-Form Entry |
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| C52570 | Subarachnoid hemorrhage family member relationship text | SAHFamMemRelTxt | Specify the relationship(s) that a family member with subarachnoid hemorrhage has with the subject/participant | Specify the relationship(s) that a family member with subarachnoid hemorrhage has with the subject/participant | If YES, please indicate relationship to patient | Alphanumeric |
(i.e., grandparents, parents, siblings, children or other member) |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Family History | [php] | [php_1] | 50 |
Free-Form Entry |
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| C00720 | Family history medical condition type | FamHistMedclCondTyp | Type of medical condition or health related event for which the family history is taken | Type of medical condition or health related event for which the family history is taken | Condition | Brain aneurysm;Stroke;Subarachnoid hemorrhage (SAH);Migraines;Coronary artery disease;Epilepsy;Dementia;Abdominal aortic aneurysm;Psychiatric illness;Multiple miscarriages;Bleeding disorder;Clotting disorder;Sudden deaths;Intracranial vascular malformation;Hereditary hemorrhagic telangiectasia (HHT);Polycystic kidney disease;Multiple endocrine neoplasia type I;Ehlers-Danlos Syndrome Type IV;Marfan Syndrome;Neurofibromatosis type 1 (NF1);Other, specify | Brain aneurysm;Stroke;Subarachnoid hemorrhage (SAH);Migraines;Coronary artery disease;Epilepsy;Dementia;Abdominal aortic aneurysm;Psychiatric illness;Multiple miscarriages;Bleeding disorder;Clotting disorder;Sudden deaths;Intracranial vascular malformation;Hereditary hemorrhagic telangiectasia (HHT);Polycystic kidney disease;Multiple endocrine neoplasia type I;Ehlers-Danlos Syndrome Type IV;Marfan Syndrome;Neurofibromatosis type 1 (NF1);Other, specify | Alphanumeric |
This CDE should be collected along with the "Family history medical condition indicator". Three of the family history condition types are Core for SAH: Stroke family history, Brain aneurysm family history, Subarachnoid hemorrhage family history. The following condiiton types are Exploratory for SAH: Migraine family history, Epilepsy family history, Dementia family history, Abdominal aortic aneurysm family history, Psychiatric illness family history, Multiple miscarriage family history, Bleeding disorder family history, Clotting disorder family history, Sudden death family history, Polycystic kidney disease family history, Multiple endocrine neoplasia type I family history, Ehlers-Danlos Syndrome Type IV family history, Marfan Syndrome family history, Neurofibromatosis family history. The remaining conditions are Supplemental for SAH. Answer for first and second degree blood relatives. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:34.0 | Family History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
3165585 | |||||||
| C00721 | Family history medical condition indicator | FamHistMedclCondInd | Indicator of whether a family member or first and second degree blood relatives of the participant has had a history of the particular medical condition or health related event | Indicator of whether a family member or first and second degree blood relatives of the participant has had a history of the particular medical condition or health related event | Has a doctor or other medical professional ever told an immediate family member (i.e., parent, sibling, child) that he/she has or has had the following | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one based on whether there is a history of the condition in a first degree family member. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:36.0 | Family History | [php] | [php_1] |
Single Pre-Defined Value Selected |
3165788 |
