CDE Detailed Report
Disease: Sport Related Concussion
Subdomain Name: General Health History
CRF: Personal Medical History
Displaying 1 - 42 of 42
Subdomain Name: General Health History
CRF: Personal Medical History
Displaying 1 - 42 of 42
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C53073 | Headache indicator text | HeadacheIndicatorTxt | Text related to participant/subject medical history of headache | Text related to participant/subject medical history of headache | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C55572 | Arthritis indicator text | ArthritisIndicatorTxt | Text relating to participant/subject medical history of arthritis | Text relating to participant/subject medical history of arthritis | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 14:44:15.0 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C19256 | Study protocol name | StudyProtocolName | Name of study protocol | Name of study protocol | Study Name/ID | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2014-06-05 16:38:14.0 | Personal Medical History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
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| C53061 | Developmental disorder type other text | DevelopmntlDisordrOtherTypeTxt | The free-text field related to 'Developmental disorder type' specifying other text | The free-text field related to 'Developmental disorder type' specifying other text | Other specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.10 | 2018-07-30 00:00:00.0 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C53076 | Migraine headache ability limitation indicator | MigraineHeadacheAbilLimitInd | Indicator as to whether the participant/subject migraine headache limits activities of daily life | Indicator as to whether the participant/subject migraine headache limits activites of daily life | If yes, was your ability to work, study, or do what you wanted to do limited? | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C55574 | Major cv risk type | MajorCvRiskTyp | Type of major cv risk the participant/subject has | Type of major cv risk the participant/subject has | Major CV risk | HTN;CAD/MI;PVD | Hypertension;Coronary artery disease/Myocardial infarction;Peripheral vascular disease | Alphanumeric | Adult;Pediatric | Supplemental | 2.00 | 2019-07-03 15:25:34.0 | Personal Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C53042 | Neonatal intensive care unit (NICU) indicator | NICUInd | Indicator of whether the participant/subject has a medical history of being in the Neonatal Intensive Care Unit (NICU) at birth | Indicator of whether the participant/subject has a medical history of being in the Neonatal Intensive Care Unit (NICU) at birt | NICU (Neonatal Intensive Care Unit) at Birth | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 13:40:30.0 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53062 | Diabetes mellitus medical history indicator | DiabetesMellMedHistInd | Indicator as to whether the participant/subject has a medical history of diabetes mellitus (type I or type II) | Indicator as to whether the participant/subject has a medical history of diabetes mellitus (type I or type II) | Diabetes | Yes;No | Yes;No | Alphanumeric |
Choose one |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53077 | Migraine headache light indicator | MigraineHeadacheLightInd | Indicator as to whether light bothers participant/subject when experiencing a migraine headache | Indicator as to whether light bothers participant/subject when experiencing a migraine headache | If yes, did light bother you (more than when you don't have a headache)? | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C55575 | Neurological disorder indicator | NeuroDisorderInd | Indicator as to whether the participant/subject has a neurological disorder | Indicator as to whether the participant/subject has a neurological disorder | Neurological Disorder | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-12 16:07:02.0 | Personal Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C53043 | Developmental disorder indicator | DevelopmenatlDisorderInd | Indicator of whether the participant/subject has a medical history of a developmental disorder | Indicator of whether the participant/subject has a medical history of a developmental disorde | Other developmental disorder | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 13:45:43.0 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53063 | Confusion indicator | ConfusionInd | Indicator as to whether the participant/subject has a medical history of confusion | Indicator as to whether the participant/subject has a medical history of confusion | Confusion | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53078 | Migraine headache illness indicator | MigraineHeadacheIllnessInd | Indicator as to whether participant/subject experiences illness when having a migraine headache | Indicator as to whether participant/subject experiences illness when having a migraine headache | If yes, did you get nauseous or sick to your stomach? | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C55576 | Neurological disorder indicator text | NeuroDisorderIndTxt | Text relating to whether the participant/subject has a neurological disorder | Ttext relating to whether the participant/subject has a neurological disorder | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-12 16:07:02.0 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C53045 | Developmental disorder type | DevelopmentallDisorderTyp | Type of developmental disorder of the participant/subject | Type of developmental disorder of the participant/subjec | Check all that apply | ADD;HD;LD;Other specify | ADD;HD;LD;Other specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.10 | 2018-07-30 00:00:00.0 | Personal Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C53064 | Diabetes mellitus indicator text | DiabetesMellIndTxt | Text related to participant/subject medical history of diabetes mellitus (type I or type II) | Text related to participant/subject medical history of diabetes mellitus (type I or type II) | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C53079 | General anesthesia indicator | GeneralAnesthesiaInd | Indicator as to whether participant/subject has a medical history of general anesthesia | Indicator as to whether participant/subject has a medical history of general anesthesia | General Anesthesia | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C55662 | Major CV risk type text | MajorCVRiskTypeTxt | Text regarding type of cardiovascular risk type | Text regarding type of cardiovascular risk typ | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-22 15:38:02.0 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C53049 | Traumatic brain injury indicator | TraumaticBrainInjuryInd | Indicator of whether participant/subject has medical history of traumatic brain injury | Indicator of whether participant/subject has medical history of traumatic brain injur | Moderate/Severe Traumatic Brain injury | Yes;No | Yes;No | Alphanumeric |
This does NOT include concussions |
Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 14:01:00.0 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53065 | Confusion indicator text | ConfusionIndicatorTxt | Text related to participant/subject medical history of confusion | Text related to participant/subject medical history of confusion | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C53080 | General anesthesia indicator count | GeneralAnesthesiaIndCt | Count of the number of times participant/subject has had general anesthesia | Count of the number of times participant/subject has had general anesthesia | If yes, how many times? | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History |
Free-Form Entry |
0 | 100 | ||||||||||
| C53050 | Vision problem indicator | VisionProblemInd | Indicator of whether participant/subject has medical history of a vision problem | Indicator of whether participant/subject has medical history of a vision proble | Vision Problems (other than need for glasses/contacts) | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 14:01:00.0 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53066 | Memory difficulty indicator | MemoryDifficultyInd | Indicator as to whether the participant/subject has medical history of memory difficulty | Indicator as to whether the participant/subject has a medical history of memory difficulty | Memory Difficulties | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53081 | Headache past three months indicator | HeadachePstThreeMoInd | Indicator whether participant/subject has had headache in the past three months | Indicator whether participant/subject has had headache in the past three months | Have you had one or more headaches (unrelated to alcohol/substance use) in the past 3 months? | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 15:56:09.0 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08113 | Born prematurely indicator | BornPrematurInd | Indicator of whether the participant was informed by a physician or family member that they were born prematurely | Indicator of whether the participant was informed by a physician or family member that they were born prematurely | Premature birth | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 4.2 | 2024-01-08 14:51:28.0 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53052 | Hearing problem indicator | HearingProblemInd | Indicator of whether participant/subject has medical history of a hearing problem | Indicator of whether participant/subject has medical history of a hearing proble | Hearing Problems | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 14:01:00.0 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53067 | Memory difficulty indicator text | MemoryDifficultyIndTxt | Text related to participant/subject medical history of memory difficulty | Text related to participant/subject medical history of memory difficulty | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C53088 | Meningitis indicator text | MeningitisIndTxt | Text related to participant/subject medical history of meningitis | Text related to participant/subject medical history of meningitis | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C08114 | Meningitis or encephalitis history indicator | MengtisEncphtisHistInd | Indicator of whether the participant/subject has ever had meningitis or encephalitis (brain infection) diagnosed by a physician | Indicator of whether the participant/subject has ever had meningitis or encephalitis (brain infection) diagnosed by a physician | Meningitis | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53057 | Vision problem indicator text | VisionProblemIndicatorTxt | Text relating to participant/subject medical history of a vision problem | Text relating to participant/subject medical history of a vision proble | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 14:01:00.0 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C53069 | Balance disorder indicator | BalanceDisorderInd | Indicator as to whether the participant/subject has a medical history of a balance disorder | Indicator as to whether the participant/subject has a medical history of a balance disorder | Balance Disorder | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C55544 | Other Medical Problems indicator | OtherMedProbInd | Indicator as to whether the participant/subject hasother medical problems | Indicator as to whether the participant/subject hasother medical problems | Other medical problems | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-12 13:54:21.0 | Personal Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C15936 | Headache history indicator | HeadachHistInd | Indicates whether participant/subject suffers from headaches | Indicates whether participant/subject suffers from headaches | Headache (Non-Migraine) | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53058 | Hearing problem indicator text | HearingProblemIndicatorTxt | Text relating to participant/subject medical history of a hearing problem | Text relating to participant/subject medical history of a hearing proble | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 14:01:00.0 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C53070 | Balance disorder indicator text | BalanceDisorderIndTxt | Text related to participant/subject medical history of a balance disorder | Text related to participant/subject medical history of a balance disorder | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C55557 | Other medical problem indicator text | OtherMedProbIndicatorTxt | Text relating to participant/subject's other medical problems | Text relating to participant/subject's other medical problems | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 14:01:00.0 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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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 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C53059 | Stroke indicator | StrokeInd | Indicator of whether participant/subject has a medical history of stroke | Indicator of whether participant/subject has a medical history of strok | Stroke | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 14:44:15.0 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C53072 | Migraine headache indicator | MigraineHeadacheInd | Indicator as to whether the participant/subject has a medical history of migraine headache | Indicator as to whether the participant/subject has a medical history of migraine headache | Migraine Headaches | Yes;No | Yes;No | Alphanumeric |
Choose one. |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-15 16:08:48.687 | Personal Medical History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C55568 | Arthritis Indicator | ArthritisInd | Indicator as to whether the participant/subject has been diagnosed with arthritis | Indicator as to whether the participant/subject has been diagnosed with arthritis | Arthritis | Yes;No | Yes;No | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-05-12 16:07:02.0 | Personal Medical History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| 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 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C53060 | Stroke indicator text | StrokeIndicatorTxt | Text relating to participant/subject medical history of stroke | Text relating to participant/subject medical history of strok | Comment | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-02-03 14:44:15.0 | Personal Medical History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
