CDE Detailed Report
Disease: Unruptured Cerebral Aneurysms and Subarachnoid Hemorrhage
Subdomain Name: [php]
CRF: Aneurysm History
Displaying 1 - 29 of 29
Subdomain Name: [php]
CRF: Aneurysm History
Displaying 1 - 29 of 29
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C52545 | Brain aneurysm unruptured anatomic site | BrainAneurUnrupAnatSite | Location of unruptured brain aneurysm(s) | Location of unruptured brain aneurysm(s) | Location of unruptured brain aneurysm(s) | A-comm;Basilar artery;Left ACA;Left intradural internal cerebral artery;Left MCA;Left PCA;Left vertebral artery;Other, specify;Right ACA;Right intradural internal cerebral artery;Right MCA;Right PCA;Right vertebral artery | A-comm;Basilar artery;Left ACA;Left intradural internal cerebral artery;Left MCA;Left PCA;Left vertebral artery;Other, specify;Right ACA;Right intradural internal cerebral artery;Right MCA;Right PCA;Right vertebral artery | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
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| C00701 | Tobacco use stopped age value | TobcoUseStopAgeVal | Age in years when participant/subject stopped using tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) | Age in years when participant/subject stopped using tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) | Age stopped tobacco use | Numeric Values |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 14:26:06.9 | Aneurysm History | [php] | [php_1] |
Free-Form Entry |
0 | 120 | year | 2524471 | ||||||
| C00719 | Tobacco product used type | TobcoProdctUsedTyp | Type of tobacco product (e.g., cigarettes, cigars, chewing tobacco or pipe) used by the participant/subject | Type of tobacco product (e.g., cigarettes, cigars, chewing tobacco or pipe) used by the participant/subject | Type(s) of tobacco used | Filtered cigarettes;Non-filtered cigarettes;Low tar cigarettes;Cigars;Pipes;Chewing tobacco;Other, specify | Filtered cigarettes;Non-filtered cigarettes;Low tar cigarettes;Cigars;Pipes;Chewing tobacco;Other, specify | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Aneurysm History | [php] | [php_1] |
Multiple Pre-Defined Values Selected |
3179449v1 | |||||||
| C52546 | Brain aneurysm anatomic site other text | BrainAneurUnrupAnatSiteOTH | Free-text field to specify location of unruptured brain aneurysm(s) | Free-text field to specify location of unruptured brain aneurysm(s) | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] | 255 |
Free-Form Entry |
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| C00702 | Alcohol use started age value | AlcUseStrtAgeVal | Age in years when participant/subject started ingesting alcoholic beverages, including social drinking | Age in years when participant/subject started ingesting alcoholic beverages, including social drinking | Age started drinking | Numeric Values |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 14:26:06.9 | Aneurysm History | [php] | [php_1] |
Free-Form Entry |
0 | 120 | year | 2008447 | ||||||
| C00730 | Alcohol use frequency | AlcUseFreq | The frequency of consumption of alcohol by the participant | The frequency of consumption of alcohol by the participan | How often do you have a drink containing alcohol? | Monthly or less;2 to 4 times a month;2 to 3 times a week;4 or more times a week;Unknown;Never | Monthly or less;2 to 4 times a month;2 to 3 times a week;4 or more times a week;Unknown;Never | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
Question is from the Alcohol Use Disorders Identification Test (AUDIT) - http://www.who.int/substance_abuse/activities/sbi/en/ | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
3171627 | |||||||
| C52547 | Brain aneurysm unruptured measurement | BrainAneurUnrupMeas | The size (diameter in mm) of the unruptured brain aneurysm(s) | The size (diameter in mm) of the unruptured brain aneurysm(s) | Size of unruptured brain aneurysm(s) | Numeric Values |
Diameter in mm |
Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] |
Free-Form Entry |
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| C00703 | Tobacco use started age value | TobcoUseStrtAgeVal | Age in years when participant/subject started using tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) | Age in years when participant/subject started using tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) | Age started tobacco use | Numeric Values |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 14:26:06.9 | Aneurysm History | [php] | [php_1] |
Free-Form Entry |
0 | 120 | year | 2178045 | ||||||
| C18770 | Tobacco product used other text | TobcoProdctUsedOTH | The free-text field related to 'Tobacco product used type' specifying other text. Type of tobacco product (e.g. cigarettes, cigars, chewing tobacco or pipe) used by the participant/subject | The free-text field related to 'Tobacco product used type' specifying other text. Type of tobacco product (e.g. cigarettes, cigars, chewing tobacco or pipe) used by the participant/subject | Other, specify | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | Aneurysm History | [php] | [php_1] | 4000 |
Free-Form Entry |
3170860 | ||||||||
| C52548 | Brain aneurysm unruptured days since count | BrainAneurUnrupDaysSinceCt | The number of days since having the unruptured brain aneurysm(s) | The number of days since having the unruptured brain aneurysm(s) | Number of days since having an unruptured brain aneurysm | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] |
Free-Form Entry |
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| C00704 | Alcohol drinking day average drinks consumed range | AlcDrinkingDayAvgDrinksCnsmRng | The counted number of drinks containing alcohol consumed by the participant/subject on a typical day when he/she is drinking. It is noted that the meaning of "drinks consumed" differs from one nation and culture to another, so the most common alcoholic beverages likely to be consumed will be defined as well as quantity of each that constitutes a drink (approximately 10 grams of pure ethanol). For example, one bottle of beer (330 ml at 5% ethanol), a glass of wine (140 ml at 12% ethanol), and a shot of spirits (40 ml at 40% ethanol) represent a standard drink of about 13 g of ethanol | The counted number of drinks containing alcohol consumed by the participant/subject on a typical day when he/she is drinking. It is noted that the meaning of "drinks consumed" differs from one nation and culture to another | How many alcoholic drinks do you have on a typical day when you are drinking | 1 or 2;3 or 4;5 or 6;7, 8, or 9;10 or more;Unknown | 1 or 2;3 or 4;5 or 6;7, 8, or 9;10 or more;Unknown | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
Question is from the Alcohol Use Disorders Identification Test (AUDIT) - http://www.who.int/substance_abuse/activities/sbi/en/ | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
3171647 | |||||||
| C52538 | History subarachnoid hemorrhage indicator | HisSAHInd | Indicator for whether the participant/subject has a history of subarachnoid hemorrhage | Indicator for whether the participant/subject has a history of subarachnoid hemorrhage | Do you have a history of subarachnoid hemorrhage (SAH) | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C52549 | Hypertensive episode indicator | HypertenEpisodeInd | Indicator for whether the participant/subject has experienced a hypertensive episode | Indicator for whether the participant/subject has experienced a hypertensive episode | Have you experienced a hypertensive episode? | Yes;No;Suspected;Unknown | Yes;No;Suspected;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C00705 | Alcohol current use indicator | AlcCurntUseInd | Indicator of whether the participant/subject consumed at least one alcoholic drink within the past 12 months | Indicator of whether the participant/subject consumed at least one alcoholic drink within the past 12 months | Current drinker? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. In the U.S., a single drink serving contains about 14 grams of ethanol or "pure" alcohol. Although the drinks below are different sizes, each one contains the same amount of pure alcohol and counts as a single drink: 12 oz. of beer (about %% alcohol) = 8-9 oz. of malt liquor (about 7% alcohol) = 5 oz. of wine (about 12% alcohol) = 1.5 oz. of hard liquor (about 40% alcohol) |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 14:26:06.9 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
3171540 | |||||||
| C52539 | Family history subarachnoid hemorrhage indicator | FamHisSAHInd | Indicator for whether the participant/subject has a family history of subarachnoid hemorrhage | Indicator for whether the participant/subject has a family history of subarachnoid hemorrhage | Do you have a family history of SAH? | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C52551 | Birth control use type | BirthControlTyp | Describes whether the participant/subject currently or previously uses birth control | Describes whether the participant/subject currently or previously uses birth control | Birth control use | Current user;Former user;Never used;Unknown | Current user;Former user;Never used;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C00706 | Alcohol prior use indicator | AlcPriorUseInd | Indicator of the participant's/subject's alcohol consumption prior to the past 12 months | Indicator of the participant's/subject's alcohol consumption prior to the past 12 months | Past drinker | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
3171578 | |||||||
| C52540 | Family history subarachnoid hemorrhage indeterminate indicator | FamHisSAHIndeterInd | Indicator for whether the family history for subarachnoid hemorrhage is indeterminate | Indicator for whether the family history for subarachnoid hemorrhage is indeterminate | Is your family history of SAH indeterminate? | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C52557 | Amphetamine strong desire use past three month frequency | AmphStrngDesUsePastThreeMoFreq | How often the participant/subject has had a strong desire to use amphetamine type stimulants | How often the participant/subject has had a strong desire to use amphetamine type stimulants | During the past three months, how often have you used amphetamine type stimulants? | Never;Once or twice;Monthly;Weekly;Daily or almost daily | Never;Once or twice;Monthly;Weekly;Daily or almost daily | Alphanumeric |
Speed, diet pils, ecstasy, etc. |
Adult;Pediatric | Supplemental | 1.00 | 2017-01-23 13:58:14.0 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C00707 | Alcohol consume six or more drinks frequency | AlcConsume6MoreDrinkFreq | The rate of occurrence for when the participant/subject consumes six or more drinks containing alcohol on one occasion. It is noted that the meaning of "drinks consumed" differs from one nation and culture to another, so the most common alcoholic beverages likely to be consumed will be defined as well as quantity of each that constitutes a drink (approximately 10 grams of pure ethanol). For example, one bottle of beer (330 ml at 5% ethanol), a glass of wine (140 ml at 12% ethanol), and a shot of spirits (40 ml at 40% ethanol) represent a standard drink of about 13 g of ethanol | The rate of occurrence for when the participant/subject consumes six or more drinks containing alcohol on one occasion. It is noted that the meaning of "drinks consumed" differs from one nation and culture to another | How often do you have six or more drinks on one occasion? | Never;Less than monthly;Monthly;Weekly;Daily or almost daily;Unknown | Never;Less than monthly;Monthly;Weekly;Daily or almost daily;Unknown | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
Question is from the Alcohol Use Disorders Identification Test (AUDIT) - http://www.who.int/substance_abuse/activities/sbi/en/ | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 16:35:19.49 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
3171659 | |||||||
| C52541 | Subarachnoid hemorrhage associated disorders indicator | SAHAssocDisorderInd | Indicator for whether the partici[ant/subject has associated disorders with SAH | Indicator for whether the partici[ant/subject has associated disorders with SAH | Do you have associated disorders with SAH? | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C00708 | Alcohol use related to hospitalization indicator | AlcUseRelatedHospInd | Indicator of whether the participant/subject has been hospitalized for an alcohol-related problem (i.e., esophageal varices, delirium tremens (DTs), cirrhosis and others) | Indicator of whether the participant/subject has been hospitalized for an alcohol-related problem (i.e., esophageal varices, delirium tremens (DTs), cirrhosis and others) | Have you ever been hospitalized for an alcohol-related problem | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 14:26:06.9 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
3171677 | |||||||
| C52542 | Family history brain aneurysm indicator | FamHistBrainAneurInd | Indicator for whether the participant/subject has a family history of brain aneurysms | Indicator for whether the participant/subject has a family history of brain aneurysms | Do you have a family history of brain aneurysms? | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C00709 | Tobacco cigarettes smoked daily average number | TobcoCigaretSmokedDlyAvgNum | Average number of cigarettes the participant/subject smokes daily (On the days you smoked cigarettes during the past 30 days, how many cigarettes did you smoke per day, on average?) | Average number of cigarettes the participant/subject smokes daily (On the days you smoked cigarettes during the past 30 days, how many cigarettes did you smoke per day, on average?) | Average number of cigarettes smoked per day | Less than one cigarette per day;1 cigarette per day;2 to 5 cigarettes per day;6 to 15 cigarettes per day (about 1/2 pack);16 to 25 cigarettes per day (about 1 pack);26 to 35 cigarettes per day (about 1 1/2 packs);More than 35 cigarettes per day (about 2 packs or more);Unknown | Less than one cigarette per day;1 cigarette per day;2 to 5 cigarettes per day;6 to 15 cigarettes per day (about ½ pack);16 to 25 cigarettes per day (about 1 pack);26 to 35 cigarettes per day (about 1 ½ packs);More than 35 cigarettes per day (about 2 packs or more);Unknown | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
PhenX Toolkit: https://www.phenxtoolkit.org/index.php - Protocol 1: Tobacco - 30-Day Quantity and Frequency (Adolescent Protocol) #030801 | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 14:26:06.9 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
3170853 | |||||||
| C52543 | Brain aneurysm unruptured indicator | BrainAneurUnruptInd | Indicator for whether the participant/subject has an unruptured brain aneurysm | Indicator for whether the participant/subject has an unruptured brain aneurysm | Do you have an unruptured brain aneurysm? | No;Yes;Unknown | No;Yes;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
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| C00710 | Tobacco current use indicator | TobcoUseCurntInd | Indicator for whether the participant/subject regularly uses tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) at the present time | Indicator for whether the participant/subject regularly uses tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) at the present tim | Current tobacco use? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
3170060 | |||||||
| C52544 | Brain aneurysm unruptured number | BrainAneurUnruptNum | Number of unruptured brain aneurysms the participant/usbject has | Number of unruptured brain aneurysms the participant/usbject has | Number of unruptured brain aneurysm(s) | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Aneurysm History | [php] | [php_1] |
Free-Form Entry |
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| C00700 | Alcohol use stopped age value | AlcUseStopAgeVal | Age in years when participant/subject stopped ingesting alcoholic beverages, including social drinking | Age in years when participant/subject stopped ingesting alcoholic beverages, including social drinking | Age quit drinking | Numeric Values |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-18 14:26:06.9 | Aneurysm History | [php] | [php_1] |
Free-Form Entry |
0 | 120 | year | 2008448 | ||||||
| C00711 | Tobacco prior use indicator | TobcoPriorUseInd | Indicator of the participant's/subject's past regular tobacco (e.g., cigarettes, cigars, chewing tobacco or pipe) use prior to the past 12 months | Indicator of the participant's/subject's past regular tobacco (e.g., cigarettes, cigars, chewing tobacco or pipe) use prior to the past 12 months | Past tobacco use? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
History can be obtained from participant/ subject, family member, friend, or chart/ medical record. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 7/20/2013 10:21:26 AM | Aneurysm History | [php] | [php_1] |
Single Pre-Defined Value Selected |
3170080 |
