CDE Detailed Report
Disease: Unruptured Cerebral Aneurysms and Subarachnoid Hemorrhage
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CRF: Medical History
Displaying 1 - 50 of 54
Subdomain Name: [php]
CRF: Medical History
Displaying 1 - 50 of 54
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C00322 | Medical history condition text | MedclHistCondTxt | Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history | Verbatim text for the medical condition/disease reported by the participant/subject or documented in the medical record as part of medical history | Medical history condition | Alphanumeric |
Record one Medical History term per line. Make sure to record if the following events are in the medical history which are Core items: Any stroke; Ischemic stroke; Hemorrhagic stroke; Hemorrhagic stroke type; 4) Transient ischemic attack (TIA); Carotid stenosis; Epilepsy/ Seizure disorder; Central nervous system infection; Dementia; Head trauma; Head trauma type; Atrial fibrillation (AF)/ flutter; Rheumatic heart disease |
SNOMED CT Codes (http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html) | Adult;Pediatric | Core | 3.00 | 2013-07-25 08:54:08.2 | Medical History | [php] | [php_1] | 4000 |
Free-Form Entry |
2003874 | ||||||||
| C52692 | Hypertension past teatment text | HypertensPastTreatTxt | The free-text field related to past treatment used for hypertension | The free-text field related to past treatment used for hypertension | past treatment for hypertension: | Alphanumeric | Adult;Pediatric | Exploratory | 3.00 | 2013-07-20 10:21:25.65 | Medical History | [php] | [php_1] | 500 |
Free-Form Entry |
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| C52706 | Mitochondrial encephalomyopathy lactic acidosis stroke like episodes indicator | MELASInd | The indicator related to whether the participant/subject has or had mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) | The indicator related to whether the participant/subject has or had mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) | If YES, do you have/have you had Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric |
Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes - MELAS |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C19058 | Psychiatric history psychotic diagnosis other text | PsychHistPsychoticDiagnosOTH | The free-text field related to 'Psychiatric history psychotic diagnosis type' specifying other text. Type of psychotic disorder the participant/subject has been diagnosed with, if any | The free-text field related to 'Psychiatric history psychotic diagnosis type' specifying other text. Type of psychotic disorder the participant/subject has been diagnosed with, if any | Other, specify: | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | [php] | [php_1] | 4000 |
Free-Form Entry |
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| C52605 | Medical history carotid artery stenting anatomic site | MedHistCarotArtStentAnatSite | The element related to the location of carotid artery stenting the participant/subject has had | The element related to the location of carotid artery stenting the participant/subject has had | If YES, indicate location | Left side;Right side;Both;Unknown | Left side;Right side;Both;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 14:49:56.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C06246 | Medical history condition type | MedHistCondTyp | Type of pre-specified medical condition/disease asked about when collecting the medical history from the participant or found documented in the medical record | Type of pre-specified medical condition/disease asked about when collecting the medical history from the participant/subject or found documented in the medical record | Has a doctor or other medical professional ever told you that you have or have had the following? | None;Unknown (any cardiovascular disorder);Cardiac pacemaker;Other cardiac disorders, specify;Hypertension;Hypotension;Orthostatic hypotension;Deep vein thrombosis;Neuropathy (alcoholic, diabetic, and others);Myocardial infarction;Stroke;Family history of cardiovascular disease;Other, specify:;Cardiac surgery, specify;Hemorrhagic stroke;Unruptured aneurysm;Dural sinus thrombosis/cerebral venous thrombosis;Ischemic Stroke;Transient Ischemic Attack (TIA);Arteriovenous malformation;Cavernous malformation;Transient monocular blindness;Migraines;Carotid stenosis;Carotid endarterectomy;Carotid artery stenting;Seizure episode;Epilepsy/Seizures;Meningitis;Dementia;Depression;Depressive disorder diagnosis;Current clinical anxiety;Anxiety Disorder;Psychotic Disorder/Schizophrenia;Atrial fibrillation/flutter;Coronary artery disease;Diabetes mellitus;Hypercholesterolemia;Cancer;Bleeding disorder;Sleep apnea;Hemorrhoids;Moyamoya Syndrome;Neurofibromatosis type 1 (NF1);Inborn errors of metabolism;Mitochondrial disease;Hereditary hemorrhagic telangiectasia (HHT);Ehlers-Danlos Syndrome Type IV;Marfan Syndrome;Fibromuscular dysplasia;Central nervous system infection;Head trauma;Neck trauma;Rheumatic heart disease;Angina;Valvular heart disease;Coronary stent or PTCA;Congestive heart failure;Congenital heart disease;Cardiac catheterization;Peripheral arterial disease;Aortic or thoracic aneurysm;Hypertriglyceridemia;Infection within two weeks;Dental disease;Sickle cell anemia;Hypercoagulable disorder;Lupus;Other connective tissue disease;Renal (kidney) failure;Nephrotic syndrome;Chronic liver failure;Iron deficiency/anemia;Inflammatory bowel disease;Down Syndrome;Sturge-Weber Syndrome;Coarctation of the aorta;Alpha 1-antitrypsin deficiency;Pheochromocytoma | None;Unknown (any cardiovascular disorder);Cardiac pacemaker;Other cardiac disorders, specify;Hypertension;Hypotension;Orthostatic hypotension;Deep vein thrombosis;Neuropathy (alcoholic, diabetic, and others);Myocardial infarction;Stroke;Family history of cardiovascular disease;Other, specify:;Cardiac surgery, specify;Hemorrhagic stroke;Unruptured aneurysm;Dural sinus thrombosis/cerebral venous thrombosis;Ischemic Stroke;Transient Ischemic Attack (TIA);Arteriovenous malformation (AVM);Cavernous malformation;Transient monocular blindness;Migraines;Carotid stenosis;Carotid endarterectomy (CEA);Carotid artery stenting (CAS);Seizure episode;Epilepsy/Seizures;Meningitis;Dementia;Depression;Depressive disorder diagnosis;Current clinical anxiety;Anxiety Disorder;Psychotic Disorder/Schizophrenia;Atrial fibrillation/flutter;Coronary artery disease;Diabetes mellitus;Hypercholesterolemia;Cancer;Bleeding disorder;Sleep apnea;Hemorrhoids;Moyamoya Syndrome;Neurofibromatosis type 1 (NF1);Inborn errors of metabolism;Mitochondrial disease;Hereditary hemorrhagic telangiectasia (HHT);Ehlers-Danlos Syndrome Type IV;Marfan Syndrome;Fibromuscular dysplasia;Central nervous system infection;Head trauma;Neck trauma;Rheumatic heart disease;Angina;Valvular heart disease;Coronary stent or PTCA;Congestive heart failure;Congenital heart disease;Cardiac catheterization;Peripheral arterial disease;Aortic or thoracic aneurysm;Hypertriglyceridemia;Infection within two weeks;Dental disease;Sickle cell anemia;Hypercoagulable disorder;Lupus;Other connective tissue disease;Renal (kidney) failure;Nephrotic syndrome;Chronic liver failure;Iron deficiency/anemia;Inflammatory bowel disease;Down Syndrome;Sturge-Weber Syndrome;Coarctation of the aorta;Alpha 1-antitrypsin deficiency;Pheochromocytoma | Alphanumeric |
Core elements for SAH studies: Stroke, Unruptued aneurysm, Hypertension; Supplementa; - Highly Recommended elements: Transient ischemic attack, Arteriovenous malformation; Exploratory elements: Dural sinys thrombosis/cerebral venous thrombosis, carotid stenosis, carotid endarterectomy, carotid artery stenting, seizure episode, epilepsy/seizure disprder, central nervous system infection, meningitis, dementia, current clinical depression, depressive disorder diagnosis, current clinical anxiety, anxiety disorder diagnosis, psychotic disorder, head trauma, neck trauma, atrial fibrillation/flutter, rheumatic heart disease, coronary artery disease, myocardial infarction, angina, valvular heart disease, cardiac surgery, coronary stent or PTCA, Congestive heart failure, Congential heart disease, Cardiac catheterization, peripheral arterial disease, hypertriglyceridemia, cancer, sickle cell anemia, hypercoagulable disorder, lupus, other connective disease, sleep apnea, nephrotic syndrome, chronic liver failure, iron deficiency/anemia, inflammatory bowel disease, hemorrhoids, Moyamoya disease, Down Syndrome, Neurofibromatosis type I, Sturge-Weber Syndrome, inborn errors of metabolism, mitochondrial disease, hereditary hemorrhagic telangiectasia, fibromuscular dysplasia, coarctation or the aorta, Alphai-antitrypsin deficiency, pheochromocytoma, menarche, menopause |
Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:40.0 | Medical History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
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| C52693 | High cholesterol treatment type | HighCholesTreatTyp | Type of treatment for high blood cholesterol | Type of treatment for high blood cholesterol | If YES, indicate treatment(s) | Diet;None;Statins;Other medicines | Diet;None;Statins;Other medicines | Alphanumeric |
Choose all that apply |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-11 15:03:49.2 | Medical History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
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| C52709 | Menopause begin age value | MenopauseBeginAgeVal | The age at which menopause began for the participant/subject | The age at which menopause began for the participant/subject | Age: | Numeric Values | Adult | Exploratory | 3.00 | 2013-06-11 00:00:00.0 | Medical History | [php] | [php_1] |
Free-Form Entry |
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| C19078 | Cardiovascular history cardiac surgery other text | CardioHistCardSurgOTH | The free-text field related to 'Cardiovascular history cardiac surgery type' specifying other text. Type of cardiac surgery or mechanical intervention the participant/subject underwent | The free-text field related to 'Cardiovascular history cardiac surgery type' specifying other text. Type of cardiac surgery or mechanical intervention the participant/subject underwent | Other, specify: | Alphanumeric | Adult;Pediatric | Exploratory | 3.00 | 2013-07-15 16:08:48.687 | Medical History | [php] | [php_1] | 4000 |
Free-Form Entry |
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| C52617 | Head trauma result type | HdTrmResTyp | The element related to the result of head trauma | The element related to the result of head trauma | If YES, indicate if head trauma resulted in any of the following | Loss of consciousness > 30 minutes;Post traumatic amnesia > 24 hours;Abnormal brain imaging findings;None of the above | Loss of consciousness > 30 minutes;Post traumatic amnesia > 24 hours;Abnormal brain imaging findings;None of the above | Alphanumeric |
Choose all that apply |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Medical History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
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| C10539 | Diabetes first diagnosis age value | DiabetFrstDiagnosisAgeVal | Value representing the age, in years, at which the participant was first diagnosed with diabetes mellitus | Value representing the age, in years, at which the participant was first diagnosed with diabetes mellitus | Age diabetes first diagnosed: | Numeric Values |
years |
Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:41:16.0 | Medical History | [php] | [php_1] |
Free-Form Entry |
year | ||||||||||
| C52695 | Cancer diagnosis type | CancerDiagTyp | The element related to the type of cancer diagnosis the participant/subject has or had | The element related to the type of cancer diagnosis the participant/subject has or had | Type(s) of cancer | Brain;Breast;Colorectal;Endometrial;Esophagus;Prostate;Renal;Skin;Other specify;Lung | Brain;Breast;Colorectal;Endometrial;Esophagus;Prostate;Renal;Skin;Other specify;Lung | Alphanumeric | Adult;Pediatric | Exploratory | 3.00 | 2013-07-15 16:08:48.687 | Medical History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
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| C52710 | Menarche begin age value | MenarcheBeginAgeVal | The age at which menarche began for the participant/subject | The age at which menarche began for the participant/subject | Age: | Numeric Values | Adult;Pediatric | Exploratory | 3.00 | 2013-06-11 00:00:00.0 | Medical History | [php] | [php_1] |
Free-Form Entry |
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| C22679 | Medical history first depressive episode diagnosis age value | MedHistFrstDepEpDiagAgeVal | Value of a participant's/subject's age when first depressive episode was diagnosed | Value of a participant's/subject's age when first depressive episode was diagnosed | If YES, age experienced first depressive episode/diagnosed with depression | Numeric Values |
years |
Adult;Pediatric | Supplemental | 1.00 | 2016-07-27 11:43:54.0 | Medical History | [php] | [php_1] |
Free-Form Entry |
year | ||||||||||
| C00312 | Body system category | BodySysCat | 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 interview and physical examination of all the body systems | 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 interview and physical examination of all the body system | Body System | Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify: | Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify: | Alphanumeric |
Record the appropriate body system for each line of medical history. |
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 | Core | 3.00 | 2013-07-25 08:54:08.2 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
2002895 | |||||||
| C52618 | Medical history neck trauma recency rate | MedHistNeckTraumaRecenRt | The element related to the recency of neck trauma | The element related to the recency of neck trauma | If YES, indicate recency: | < 8 days before current stroke/TIA;8 days - 4 weeks ago;> 4 weeks ago;Unknown | < 8 days before current stroke/TIA;8 days - 4 weeks ago;> 4 weeks ago;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 13:49:14.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C52696 | Infection within two weeks type | InfectionWthnTwoWksTyp | The element related to the type of infection(s) within the last two weeks the participant/subject has had | The element related to the type of infection(s) within the last two weeks the participant/subject has had | If YES, indicate type(s) | Otitis media;Respiratory infection;Urinary tract infection;Cellulitis;Sepsis;Mastoiditis;Viral gastroenteritis;Fever lasting > 48 hours;Other infection, specify: | Otitis media;Respiratory infection;Urinary tract infection (UTI);Cellulitis;Sepsis;Mastoiditis;Viral gastroenteritis;Fever lasting > 48 hours;Other infection, specify: | Alphanumeric |
Choose all that apply |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-17 09:26:36.973 | Medical History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
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| C10541 | Diabetes treatment type | DiabetTreatTyp | Type of treatment the participant/subject is receiving or has received for diabetes mellitus | Type of treatment the participant/subject is receiving or has received for diabetes mellitus | Treatment for diabetes | Diet;Oral medication;Insulin;None | Diet;Oral medication;Insulin;None | Alphanumeric |
Choose all that apply |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-11 15:03:49.2 | Medical History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
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| C52597 | Medical history ischemic stroke range | MedHistIschemicStrokeRng | The element related to the number of ischemic strokes the participant/subject has had | The element related to the number of ischemic strokes the participant/subject has had | Number of ischemic strokes | >= 2;1;None;Unknown | >= 2;1;None;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 13:49:14.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C00313 | Medical history condition SNOMED CT code | MedclHistCondSNOMEDCTCode | Systematized Nomenclature Of Medicine Clinical Terms (SNOMED CT) code for medical condition/disease reported by the participant/subject | Systematized Nomenclature Of Medicine Clinical Terms (SNOMED CT) code for medical condition/disease reported by the participant/subject | Medical History Term | Alphanumeric |
Code each of the medical history conditions using SNOMED CT |
SNOMED CT Codes (http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html) | Adult;Pediatric | Core | 3.00 | 2013-07-25 08:54:08.2 | Medical History | [php] | [php_1] | 255 |
Free-Form Entry |
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| C52619 | Medical history atrial fibrillation other cause indicator | MedHistAtrlFibOthCauseInd | The indicator related to other cause of atrial fibrillation | The indicator related to other cause of atrial fibrillation | Other cause of AF | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric |
AF: atrial fibrillation |
Adult;Pediatric | Exploratory | 1.00 | 2017-01-27 08:23:58.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C52697 | Infection within two weeks other text | InfectionWthnTwoWksOTH | The free-text field related to the type of infection(s) within the last two weeks the participant/subject has had | The free-text field related to the type of infection(s) within the last two weeks the participant/subject has had | Other infection, specify: | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-17 09:26:36.973 | Medical History | [php] | [php_1] | 255 |
Free-Form Entry |
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| C10543 | Cancer head or neck radiation treatment indicator | CancerHeadNeckRadiatTreatInd | Indicator as to whether the participant's/subject's cancer is or was treated with head or neck radiation | Indicator as to whether the participant's/subject's cancer is or was treated with head or neck radiatio | Did you receive head or neck radiation to treat the cancer? | Yes;No/Not documented;Unknown | Yes;No/Not documented;Unknown | Alphanumeric | Adult;Pediatric | Exploratory | 3.00 | 2013-07-11 15:03:49.2 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C52598 | Medical history ischemic stroke recency rate | MedHistIschemicStrokeRecenRt | The element related to the recency of ischemic strokes the participant/subject has had | The element related to the recency of ischemic strokes the participant/subject has had | Recency of ischemic strokes | < 3 mos ago;>= 3 mos ago;Unknown | < 3 mos ago;>= 3 mos ago;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 13:49:14.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| 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.). |
No references available | Adult;Pediatric | Core | 3.20 | 2024-02-29 15:42:39.0 | Medical History | [php] | [php_1] |
Free-Form Entry |
2179659 | |||||||||
| C52620 | Medical history atrial fibrillation other cause text | MedHistAtrlFibOthCauseTxt | The free-text field related to other cause of atrial fibrillation | The free-text field related to other cause of atrial fibrillation | If YES, specify other cause | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2017-01-27 08:23:58.0 | Medical History | [php] | [php_1] | 255 |
Free-Form Entry |
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| C52698 | Dental disease type text | DentalDisTypTxt | The free-text field to specify the type of dental disease | The free-text field to specify the type of dental disease | If YES, specify type: | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-17 09:26:36.973 | Medical History | [php] | [php_1] | 255 |
Free-Form Entry |
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| C17473 | Cardiovascular history cardiac surgery date | CardioHistCardSurgDate | Date of most recent cardiac surgery or mechanical intervention performed on the participant/subject | Date of most recent cardiac surgery or mechanical intervention performed on the participant/subject | Date of most recent cardiac surgery: | Date or Date & Time | Adult;Pediatric | Exploratory | 3.00 | 2013-07-15 16:08:48.687 | Medical History | [php] | [php_1] |
Free-Form Entry |
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| C52599 | Medical history hemorrhagic stroke type | MedHistHemorrStrokeTyp | The element related to the type of hemorrhagic stroke the participant/subject has had | The element related to the type of hemorrhagic stroke the participant/subject has had | If YES, indicate type(s) | Intracerebral hemorrhage (ICH);Subarachnoid hemorrhage (SAH);Hemorrhage unspecified;Unknown | Intracerebral hemorrhage (ICH);Subarachnoid hemorrhage (SAH);Hemorrhage unspecified;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 14:10:41.0 | Medical History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
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| 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. |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:42:39.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
3145578 | |||||||
| C52621 | Medical history artificial valve type | MedHistArtificialVlvTyp | The element related to the type of artificial valve | The element related to the type of artificial valve | If YES, indicate type: | Biological/tissue valve;Mechanical/non-tissue valve;Valvuloplast;Unknown type of valve | Biological/tissue valve;Mechanical/non-tissue valve;Valvuloplast;Unknown type of valve | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2017-01-27 08:34:45.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C52699 | Sickle cell anemia blood transfusion treatment indicator | SickleCellAnemBloodTransfInd | The indicator related to whether blood transfusions are used for treatment for sickle cell anemia | The indicator related to whether blood transfusions are used for treatment for sickle cell anemia | If YES, are blood transfusions used for treatment? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C17475 | Cardiovascular history cardiac surgery type | CardioHistCardSurgTyp | Type of cardiac surgery or mechanical intervention the participant/subject underwent | Type of cardiac surgery or mechanical intervention the participant/subject underwent | Indicate type(s) | Coronary artery bypass graft;Cardiac valve surgery, including non-open surgery;Pacemaker;Implantable cardiac defibrillator;Other, specify | Coronary artery bypass graft (CABG);Cardiac valve surgery, including non-open surgery (i.e. percutaneous valvuloplasty);Pacemaker;Implantable cardiac defibrillator;Other, specify | Alphanumeric | Adult;Pediatric | Exploratory | 3.00 | 2013-07-15 16:08:48.687 | Medical History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
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| C52600 | Medical history transient ischemic attack range | MedHistTIARng | The element related to the number of transient ischemic attacks (TIAs) the participant/subject has had | The element related to the number of transient ischemic attacks (TIAs) the participant/subject has had | Number of TIAs | None;1;2-10;> 10;Unknown | None;1;2-10;> 10;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 14:29:36.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C00316 | Medical history condition end date and time | MedclHistCondEndDateTime | Date (and time, if applicable and known) for the end of an event in the participant's medical history | Date (and time, if applicable and known) for the end of an event in the participant's medical history | End Date | Date or Date & Time |
Record the date (and time) the medical condition/disease stopped. For surgeries, start and stop dates will most likely be the same date. 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 | Exploratory | 3.10 | 2024-02-29 15:42:44.0 | Medical History | [php] | [php_1] |
Free-Form Entry |
3145557 | |||||||||
| C52622 | Medical history cardiac catheterization recency rate | MedHistCardCathRecenRt | The element related to the recency of cardiac catheterization the participant/subject has had | The element related to the recency of cardiac catheterization the participant/subject has had | If YES, indicate recency: | <= 2 weeks;> 2 weeks ago;Unknown | <= 2 weeks;> 2 weeks ago;Unknown | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2017-01-26 13:49:14.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C52700 | Hypercoagulable disorder type text | HypercoagDisrdrTypeTxt | The free-text field related to the type of hypercoagulable disorder | The free-text field related to the type of hypercoagulable disorder | If YES, specify type: | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | Medical History | [php] | [php_1] | 255 |
Free-Form Entry |
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| C17480 | Diabetes mellitus complications type | EndocrineHistDiabMellCompliTyp | Type(s) of complications related to diabetes mellitus the participant/subject has experienced or is experiencing | Type(s) of complications related to diabetes mellitus the participant/subject has experienced or is experiencing | Complicaitons of diabetes | Nephropathy;Neuropathy;Retinopathy;Other, specify;None | Nephropathy;Neuropathy;Retinopathy;Other, specify;None | Alphanumeric |
Choose all that apply |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
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| C52601 | Medical history transient ischemic attack recency rate | MedHistTIARecenRt | The element related to the recency of transient ischemic attacks (TIAs) the participant/subject has had | The element related to the recency of transient ischemic attacks (TIAs) the participant/subject has had | Recency of TIA | < 24 hours ago;24h - 7d ago;7d - 3 mos ago;> 3 mos ago | < 24 hours ago;24h - 7d ago;7d - 3 mos ago;> 3 mos ago | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 14:29:36.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C00317 | Medical history condition start date and time | MedclHistCondStrtDateTime | Date (and time, if applicable and known) for the start of an event in the participant's medical history | Date (and time, if applicable and known) for the start of an event in the participant's medical history | Start Date | 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 | Exploratory | 3.10 | 2024-02-29 15:42:43.0 | Medical History | [php] | [php_1] |
Free-Form Entry |
2543596 | |||||||||
| C52623 | Aortic thoracic aneurysm specify text | AorticThorAneurSpTxt | The free-text field related to the type of aortic or thoracic aneurysm | The free-text field related to the type of aortic or thoracic aneurysm | If YES, specify type: | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 13:49:14.0 | Medical History | [php] | [php_1] | 255 |
Free-Form Entry |
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| C52701 | Bleeding disorder type text | BleedDisorderTypeTxt | Free-text field related to the type of bleeding disorder | Free-text field related to the type of bleeding disorder | If YES, specify type: | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-10-13 12:39:16.0 | Medical History | [php] | [php_1] | 255 |
Free-Form Entry |
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| C17488 | Psychiatric history psychotic diagnosis type | PsychHistPsychoticDiagnosTyp | Type of psychotic disorder the participant/subject has been diagnosed with, if any | Type of psychotic disorder the participant/subject has been diagnosed with, if any | If YES, indicate type(s) | Schizophrenia;Bipolar disorder;Depression with psychotic features;Dementia with psychotic ideation;Other, specify | Schizophrenia;Bipolar disorder;Depression with psychotic features;Dementia with psychotic ideation;Other, specify | Alphanumeric |
Choose all that apply |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Medical History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
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| C52602 | Medical history migraine aura indicator | MedHistMigrAuraInd | The indicator related to the participant/subject having migraine(s) with aura | The indicator related to the participant/subject having migraine(s) with aura | If YES, migraine(s) with aura | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 14:49:56.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C00319 | Medical history condition ongoing indicator | MedclHistCondOngoingInd | Indicator of whether a medical condition/disease experienced by the participant is ongoing | Indicator of whether a medical condition/disease experienced by the participant is ongoing | Ongoing? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose Yes or No to indicate if the medical condition/disease is still present. |
No references available | Adult;Pediatric | Exploratory | 4.00 | 2024-02-29 15:42:44.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
2736881 | |||||||
| C52624 | Hypertension first diagnosed age value | HypertensFirstDiagAgeVal | Free-text field related to the age hypertension was first diagnosed | Free-text field related to the age hypertension was first diagnosed | If YES, age hypertension first diagnosed: | Alphanumeric |
years |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Medical History | [php] | [php_1] | 255 |
Free-Form Entry |
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| C52702 | Connective tissue disease other type text | ConnTissDisTypTxt | The free-text field related to other type of connective tissue disease | The free-text field related to other type of connective tissue disease | If YES, specify type: | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-10-19 12:03:19.0 | Medical History | [php] | [php_1] | 255 |
Free-Form Entry |
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| 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 |
Record the appropriate body system for each line of medical history. |
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 | [php] | [php_1] | 4000 |
Free-Form Entry |
2002895 | ||||||||
| C52603 | Medical history migraine active last year indicator | MedHistMigrActivLstYrInd | The indicator related to the participant/subject having had an active migraine within the last year | The indicator related to the participant/subject having had an active migraine within the last year | Active migraine within last year? | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-01-26 14:49:56.0 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C00321 | Medical history for body system indicator | MedclHistBodySysInd | Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body system | Indicator of whether the participant/subject has a history of medical problems/conditions for the specific body syste | 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 for each body system. |
No references available | Adult;Pediatric | Exploratory | 3.00 | 2013-07-22 16:57:17.79 | Medical History | [php] | [php_1] |
Single Pre-Defined Value Selected |
