CDE Detailed Report | NINDS Common Data Elements

Disease: Sport Related Concussion
Subdomain Name: General Health History
CRF: Migraine History

Displaying 1 - 23 of 23

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
C54382	Headache chronicity type	HeadacheChronicityTyp	The type as related to headache chronicity	The type as related to headache chronicit	Do you have intermittent or constant headache?	Intermittent;Chronic	Intermittent;Chronic	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2016-06-02 15:04:05.0	Migraine History	General Health History	Participant History and Family History		Single Pre-Defined Value Selected
C17029	Migraine Disability Assessment (MIDAS) - Headache average pain intensity scale	MIDASHdcheAvePainIntenScl	Average pain scale of the headache experienced by the participant/subject, as part of the Migraine Disability Assessment (MIDAS) Test form.	Average pain scale of the headache experienced by the participant/subject, as part of the Migraine Disability Assessment (MIDAS) Test form.	On a scale of 0-10, on average how painful were these headaches?			Numeric Values	(Where 0 = no pain at all and 10 = pain as bad as it can be). INSTRUCTIONS: Please answer the following questions about ALL your headaches you have had over the last 3 months. Write your answer in the box next to each question. Write 0 if you did not do the activity in the last 3 months. Please provide numbers; example: everyday headache = 90	Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.	Adult;Pediatric	Supplemental	3.00	2013-07-16 14:01:43.01	Migraine History	General Health History	Participant History and Family History		Free-Form Entry	0	10
C54383	Headache episode duration	HdacheEpisdDur	The element related to the duration of a headache episode	The element related to the duration of a headache episode	How long does each headache episode last?	Greater than 2 hours;Less than 2 hours	Greater than 2 hours;Less than 2 hours	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2016-06-06 08:20:12.0	Migraine History	General Health History	Participant History and Family History		Single Pre-Defined Value Selected
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	Migraine History	General Health History	Participant History and Family History	255	Free-Form Entry
C54384	Headache neurological symptom before during type	HdacheNeuroSympBefDurTyp	The element related to the type of neurological symptoms before and/or during headache	The element related to the type of neurological symptoms before and/or during headache	Do you have neurological symptoms immediately before and/or during your headache?	Visual scotoma;Visual hallucination;Weakness or numbness on one side of the body	Visual scotoma (blind or black spots);Visual hallucination (zig zag or wavy lines, colored lights or balls, shimmering patterns);Weakness or numbness on one side of the body	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2016-06-06 08:20:12.0	Migraine History	General Health History	Participant History and Family History		Single Pre-Defined Value Selected
C19247	Subject ID	SubIDNam	Subject identification ID	Subject identification ID	Site Name			Alphanumeric			Adult;Pediatric	Supplemental	1.00	2014-06-05 13:10:49.0	Migraine History	General Health History	Participant History and Family History	255	Free-Form Entry
C54385	Migraine headache pain symptom type	MigrHeadachePainSymptmTyp	The element related to the type of pain symptoms the participant/subject experiences with migraine headaches	The element related to the type of pain symptoms the participant/subject experiences with migraine headaches	Do you have any of these symptoms with headache?	Pain on one side of head only;Pain made worse by routine activity;Pain limits or restricts routine activities;Throbbing or pulsing pain sensation	Pain on one side of head only;Pain made worse by routine activity;Pain limits or restricts routine activities;Throbbing or pulsing pain sensation	Alphanumeric			Adult;Pediatric	Supplemental	3.00	2013-07-16 14:01:43.01	Migraine History	General Health History	Participant History and Family History		Multiple Pre-Defined Values Selected
C19256	Study protocol name	StudyProtocolName	Name of study protocol	Name of study protocol	Study Name/ID pre-filled			Alphanumeric			Adult;Pediatric	Supplemental	1.00	2014-06-05 16:38:14.0	Migraine History	General Health History	Participant History and Family History	4000	Free-Form Entry
C54386	Migraine headache symptom type	MigrHeadacheSymptmTyp	The element related to the type of pain symptoms the participant/subject experiences with migraine headaches	The element related to the type of pain symptoms the participant/subject experiences with migraine headaches	Do you have any of these symptoms with your headache?	Nausea/vomiting;Increased sensitivity to normal light AND sound;Pain on one side of head only;Throbbing or pulsing pain sensation;Pain limits or restricts routine activities;Pain made worse by routine activity	Nausea/vomiting;Increased sensitivity to normal light AND sound;Pain on one side of head only;Throbbing or pulsing pain sensation;Pain limits or restricts routine activities;Pain made worse by routine activity	Alphanumeric			Adult;Pediatric	Supplemental	3.00	2013-07-16 14:01:43.01	Migraine History	General Health History	Participant History and Family History		Multiple Pre-Defined Values Selected
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	Personal history of migraine headache	Yes;No	Yes;No	Alphanumeric			Adult;Pediatric	Supplemental	3.00	2013-07-15 16:08:48.687	Migraine History	General Health History	Participant History and Family History		Single Pre-Defined Value Selected
C54387	Headache prior treatment indicator	HeadachPriorTxInd	Indicator related to prior treatment for headache	Indicator related to prior treatment for headache	Prior treatment for headache?	No;Yes	No;Yes	Alphanumeric			Adult;Pediatric	Supplemental	3.00	2013-07-16 14:01:43.01	Migraine History	General Health History	Participant History and Family History		Single Pre-Defined Value Selected
C17022	Migraine Disability Assessment (MIDAS) - School work absent past three month day count	MIDASSchoWorkAbsPast3MDayCt	Number of days in the last three months the participant/subject has missed work or school because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.	Number of days in the last three months the participant/subject has missed work or school because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.	On how many days in the last 3 months did you miss work or school because of your headaches?			Numeric Values	If you're not working or going to school, just enter 0. INSTRUCTIONS: Please answer the following questions about ALL your headaches you have had over the last 3 months. Write your answer in the box next to each question. Write 0 if you did not do the activity in the last 3 months. Please provide numbers; example: everyday headache = 90	Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.	Adult;Pediatric	Supplemental	3.00	2013-07-16 14:01:43.01	Migraine History	General Health History	Participant History and Family History		Free-Form Entry			day
C54373	Headache past three month alcohol substance use unrelated indicator	HdachePstThrMoAlcSubUseUnrlInd	Indicator for whether the participant/subject has had a headache in the past three months that is unrelated to alcohol/substance use	Indicator whether participant/subject has had a headache in the past three months that is unrelated to alcohol/substance use	Have you had one or more headaches in the past 3 months, unrelated to alcohol/substance use?	No;Yes	No;Yes	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2017-02-03 15:56:09.0	Migraine History	General Health History	Participant History and Family History		Single Pre-Defined Value Selected
C54388	Migraine headache family history indicator	MigrHeadacheFamHisInd	Indicator as to whether the participant/subject has a family history of migraine headache	Indicator as to whether the participant/subject has a family history of migraine headache	Any family history of migraine headaches	Yes;No;Unknown	Yes;No;Unknown	Alphanumeric			Adult;Pediatric	Supplemental	3.00	2013-07-15 16:08:48.687	Migraine History	General Health History	Participant History and Family History		Single Pre-Defined Value Selected
C17023	Migraine Disability Assessment (MIDAS) - School work productivity reduction past three months day count	MIDASSchlWrkProRedP3MDayCt	Number of days in the last three months the participant/subject has experienced productivity reduction by half or more while at work or school because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.	Number of days in the last three months the participant/subject has experienced productivity reduction by half or more while at work or school because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.	How many days in the last 3 months was your productivity at work or school reduced by half or more because of your headaches?			Numeric Values	If you're not working or going to school. Just enter 0. (Do not include days you counted in question 1 where you missed work or school). INSTRUCTIONS: Please answer the following questions about ALL your headaches you have had over the last 3 months. Write your answer in the box next to each question. Write 0 if you did not do the activity in the last 3 months. Please provide numbers; example: everyday headache = 90	Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.	Adult;Pediatric	Supplemental	3.00	2013-07-16 14:01:43.01	Migraine History	General Health History	Participant History and Family History		Free-Form Entry			day
C54374	Headache start within two week concussion indicator	HdacheStrtWithnTwoWkConcussInd	Indicator for whether the participant/subject has had headaches that started within two weeks of concussion	Indicator for whether the participant/subject has had headaches that started within two weeks of concussion	Did headaches start within 2 weeks of concussion?	No;Yes	No;Yes	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2017-02-03 15:56:09.0	Migraine History	General Health History	Participant History and Family History		Single Pre-Defined Value Selected
C17024	Migraine Disability Assessment (MIDAS) - Household work not done past three months day count	MIDASHshldNotDoneP3MDayCt	Number of days in the last three months the participant/subject has not done household work because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.	Number of days in the last three months the participant/subject has not done household work because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.	On how many days in the last 3 months did you not do household work because of your headaches?			Numeric Values	INSTRUCTIONS: Please answer the following questions about ALL your headaches you have had over the last 3 months. Write your answer in the box next to each question. Write 0 if you did not do the activity in the last 3 months. Please provide numbers; example: everyday headache = 90	Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.	Adult;Pediatric	Supplemental	3.00	2013-07-16 14:01:43.01	Migraine History	General Health History	Participant History and Family History		Free-Form Entry			day
C54376	Brain abnormality indicator	BrainAbnormalInd	The indicator related to brain abnormalities	The indicator related to brain abnormalities	Do you have any brain abnormalities?	No;Yes	No;Yes	Alphanumeric	(unrelated to concussion)		Adult;Pediatric	Supplemental	1.00	2016-12-04 23:35:32.0	Migraine History	General Health History	Participant History and Family History		Single Pre-Defined Value Selected
C17025	Migraine Disability Assessment (MIDAS) - Household work productivity half reduction past three months day count	MIDASHshldWrkProHReP3MCt	Number of days in the last three months the participant/subject has experienced productivity reduction by half or more while doing household work because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.	Number of days in the last three months the participant/subject has experienced productivity reduction by half or more while doing household work because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.	How many days in the last 3 months was your productivity in household work reduced by hald or more because of your headaches?			Numeric Values	Do not include days you counted in question 3 where you did not do household work). INSTRUCTIONS: Please answer the following questions about ALL your headaches you have had over the last 3 months. Write your answer in the box next to each question. Write 0 if you did not do the activity in the last 3 months. Please provide numbers; example: everyday headache = 90	Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.	Adult;Pediatric	Supplemental	3.00	2013-07-16 14:01:43.01	Migraine History	General Health History	Participant History and Family History		Free-Form Entry			day
C54379	Headache daily occurrence indicator	HdacheDailyOccurInd	The indicator related to whether the participant/subject has a headache every day	The indicator related to whether the participant/subject has a headache every day	Do you have a headache every day?	No;Yes	No;Yes	Alphanumeric			Adult;Pediatric	Supplemental	1.00	2016-12-04 23:35:32.0	Migraine History	General Health History	Participant History and Family History		Single Pre-Defined Value Selected
C17026	Migraine Disability Assessment (MIDAS) - Activity missed past three months day count	MIDASActMissP3MDayCt	Number of days in the last three months the participant/subject has missed family, social, or leisure activities because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.	Number of days in the last three months the participant/subject has missed family, social, or leisure activities because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form.	On how many days in the last 3 months did you miss family, social or leisure activities because of your headaches?			Numeric Values	INSTRUCTIONS: Please answer the following questions about ALL your headaches you have had over the last 3 months. Write your answer in the box next to each question. Write 0 if you did not do the activity in the last 3 months. Please provide numbers; example: everyday headache = 90	Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved.	Adult;Pediatric	Supplemental	3.00	2013-07-16 14:01:43.01	Migraine History	General Health History	Participant History and Family History		Free-Form Entry			day
C54381	Headache pain medication more than four days week indicator	HdachPainMedMoreFourDysWkInd	Indicator for whether the participant/subject takes headache pain medication more than four days per week	Indicator for whether the participant/subject takes headache pain medication more than four days per week	Do you take over the counter or pescription pain or headache medication more than 4 days per week?	No;Yes	No;Yes	Alphanumeric			Adult;Pediatric	Supplemental	3.00	2013-07-16 14:01:43.01	Migraine History	General Health History	Participant History and Family History		Single Pre-Defined Value Selected
C17028	Migraine Disability Assessment (MIDAS) - Headache past three months day count	MIDASHdacheP3MDayCt	Count the total number of days in the past three months the participant/subject had headache, as part of the Migraine Disability Assessment (MIDAS) Test form.	Count the total number of days in the past three months the participant/subject had headache, as part of the Migraine Disability Assessment (MIDAS) Test form.	On how many days in the last 3 months did you have a headache?			Numeric Values	If a headache lasted more than 1 day, count each day. INSTRUCTIONS: Please answer the following questions about ALL your headaches you have had over the last 3 months. Write your answer in the box next to each question. Write 0 if you did not do the activity in the last 3 months. Please provide numbers; example: everyday headache = 90		Adult;Pediatric	Supplemental	3.00	2013-07-16 14:01:43.01	Migraine History	General Health History	Participant History and Family History		Free-Form Entry			day