CDE Detailed Report
Disease: content
Subdomain Name: General Health History
CRF: welcome
Displaying 1 - 29 of 29
Subdomain Name: General Health History
CRF: welcome
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C16008 | Birth control indicator | BirthControlInd | Indicates if participant uses birth control | Indicates if participant uses birth control | Was birth control being used? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16023 | Pregnancy prior history births pre-term count | PregPriorHistBirthPretermCt | Count of the total number of pregnancies the participant/subject carried for less than a full term (< 37 weeks) | Count of the total number of pregnancies the participant/subject carried for less than a full term (< 37 weeks) | Pre-term (< 37 weeks) births | Numeric Values |
No additional Instructions |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Free-Form Entry |
0 | 30 | ||||||||
| C19040 | Prenatal testing other text | PrenatalTestOTH | The free-text field related to 'Prenatal testing type' specifying other text. The type of prenatal testing that was performed for the current pregnancy | The free-text field related to 'Prenatal testing type' specifying other text. The type of prenatal testing that was performed for the current pregnancy | Other, specify | Alphanumeric |
Record the date for each prenatal test performed and the results |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
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| C16009 | Birth control last used date and time | BirthControlLastUsedDateTime | Date (and time, if applicable and known) birth control was last used | Date birth control was last used | Last date birth control used | 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.). |
ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Free-Form Entry |
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| C16024 | Pregnancy prior history birth defect indicator | PregPriorHistBirthDefectInd | Indicator of whether a birth defect occurred in any of the participant/subject's previous pregnancies | Indicator of whether a birth defect occurred in any of the participant/subject's previous pregnancies | Did a birth defect occur in any previous pregnancy? | Yes, specify;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C19044 | Pregnancy prior history toxic exposure other text | PregPriorHistToxExposOTH | The free-text field related to 'Pregnancy prior history toxic exposure type' specifying other text. Type of any substances or radiation potentially harmful to the embryo or fetus to which the participant/subject has ever been exposed during pregnancy | The free-text field related to 'Pregnancy prior history toxic exposure type' specifying other text. Type of any substances or radiation potentially harmful to the embryo or fetus to which the participant/subject has ever been exposed during pregnancy | Other, specify | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
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| C16011 | Pregnancy confirmed date and time | PregConfirmDateTime | Date the participant/subject's current pregnancy was confirmed | Date the participant/subject's current pregnancy was confirmed | Date pregnancy confirmed | 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.). |
ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Free-Form Entry |
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| C16026 | Pregnancy prior history loss indicator | PregPriorHistLossInd | Indicator of whether a miscarriage (<= 20 weeks) or stillbirth (> 20 weeks) occurred in any previous pregnancy | Indicator of whether a miscarriage (<= 20 weeks) or stillbirth (> 20 weeks) occurred in any previous pregnancy | Did a miscarriage (<= 20 weeks) or stillbirth (> 20 weeks) occur in any previous pregnancy? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C55934 | Pregnancy prior history births count | PrgnncyPrrHstryBrthCt | Count of the total number of pregnancies, either full-term or pre-term, that the patient/subject has been through | Count of the total number of pregnancies, either full-term or pre-term, that the patient/subject has been throug | Number of prior pregnancies: | Numeric Values |
No additional instructions |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2017-06-02 16:08:22.0 | Pregnancy Information | General Health History | Participant History and Family History |
Free-Form Entry |
0 | 30 | weeks | |||||||
| C16013 | Pregnancy estimated delivery date ultrasound based indicator | PregDelEstDateUltrasndInd | Indicator of whether the estimated delivery date is based on an ultrasound examination | Indicator of whether the estimated delivery date is based on an ultrasound examination | Was the EDD based on an ultrasound? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16027 | Pregnancy prior history loss week count | PregPriorHistLossWeekCt | Number of the week of pregnancy during which the stillbirth or miscarriage occurred | Number of the week of pregnancy during which the stillbirth or miscarriage occurred | If Yes in what week of pregnancy did the miscarriage or stillbirth occur? Week(s) | Numeric Values |
Record in weeks |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Free-Form Entry |
1 | 45 | week | |||||||
| C16014 | Pregnancy prenatal testing performed indicator | PregPrenatalTestPerfInd | Indicator of whether prenatal testing was performed for the current pregnancy | Indicator of whether prenatal testing was performed for the current pregnancy | Was prenatal testing performed? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
If yes, please complete the following questions regarding prenatal testing |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16028 | Pregnancy prior history toxic exposure type | PregPriorHistToxExposTyp | Type of any substances or radiation potentially harmful to the embryo or fetus to which the participant/subject has ever been exposed during pregnancy | Type of any substances or radiation potentially harmful to the embryo or fetus to which the participant/subject has ever been exposed during pregnancy | Has the participant/subject ever had exposure to any of the following during pregnancy? | Concurrent medications;Teratogens;Smoking;Exposure to X-ray;Alcohol;Other, specify | Concurrent medications;Teratogens;Smoking;Exposure to X-ray;Alcohol;Other, specify | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C16015 | Prenatal testing type | PrenatalTestTyp | The type of prenatal testing that was performed for the current pregnancy | The type of prenatal testing that was performed for the current pregnancy | If Yes, please complete the following questions regarding prenatal testing: | Ultrasound;Amniocentesis;Screening for neural tube defects;Screening for gestational diabetes before or at 28 weeks;Screening for asymptomatic bacteriuria before or at 16 weeks gestation;Hepatitis B specific antigen screening at first visit;HIV screening at first visit;Group B streptococcus screening (GBS) at 35 to 37 weeks;Maternal serum alpha fetoprotein;Other, specify | Ultrasound;Amniocentesis;Screening for neural tube defects;Screening for gestational diabetes before or at 28 weeks;Screening for asymptomatic bacteriuria before or at 16 weeks gestation;Hepatitis B specific antigen screening at first visit;HIV screening at first visit;Group B streptococcus screening (GBS) at 35 to 37 weeks;Maternal serum alpha fetoprotein;Other, specify | Alphanumeric |
Record the date for each prenatal test performed and the results |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16173 | Pregnancy estimate delivery date and time | PregEstDeliveryDateTime | The date and time (if applicable) the participant is estimated to deliver the pregnancy | The date and time (if applicable) the participant is estimated to deliver the pregnancy | Estimated delivery date EDD | 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.). |
ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm | Adult;Pediatric | Supplemental | 3.10 | 2024-02-02 11:48:32.0 | Pregnancy Information | General Health History | Participant History and Family History |
Free-Form Entry |
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| C16016 | Prenatal testing date and time | PrenatalTestDateTime | Date the selected prenatal testing type was performed for the current pregnancy | Date the selected pregnancy prenatal testing type was performed for the current pregnancy | Dates of testing | 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 | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Free-Form Entry |
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| C16175 | Menstrual period last date | MenstrualPeriodLastDate | Date of the participant's last menstrual period | Date of the participant's last menstrual period | Date of last menstrual period | 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.). |
ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm | Adult;Pediatric | Supplemental | 3.10 | 2024-02-02 12:18:50.0 | Pregnancy Information | General Health History | Participant History and Family History |
Free-Form Entry |
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| C06005 | Data collected date and time | DataCollDateTime | Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed | Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performe | Date pregnancy information obtained | 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.). |
ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 21:00:23.88 | Pregnancy Information | General Health History | Participant History and Family History |
Free-Form Entry |
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| C16017 | Prenatal testing result | PrenatalTestReslt | Results of the selected prenatal testing type | Results of the selected prenatal testing type | Results of Test | Alphanumeric |
To be answered for each prenatal test performed. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C17993 | Prenatal test text | PrenatalTestTxt | Text notes of any comments regarding the selected prenatal testing type | Text notes of any comments regarding the selected prenatal testing type | Comments | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C10556 | Pregnant ever indicator | PregEverInd | Indicator as to whether or not the participant/subject has every been pregnant, both term and not to term | Indicator as to whether or not the participant/subject has every been pregnant, both term and not to term | Has the participant/subject ever been pregnant? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
If No or Unknown, stop |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16018 | Pregnancy complication indicator | PregComplicationInd | Indicator of whether the participant/subject had complications during the pregnancy | Indicator of whether the participant/subject had complications during the pregnancy | Did/Has the participant subject experienced any complications during the pregnancy? | Yes, specify;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. If yes, specify the complication(s). |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17994 | Pregnancy complication text | PregComplicationTxt | Text specifying any complications the participant/subject experienced during this pregnancy | Text specifying any complications the participant/subject experienced during this pregnancy | If yes specify | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C10981 | Birth control method type | BirthCntrlMethdTyp | The participant's method of birth control | The participant's method of birth control | If Yes, indicate all forms of contraception used (choose all that apply) | Oral contraceptives – combined pill;Oral contraceptives – progestin-only pill;Transdermal patch;Shot/injection;Vaginal ring;Implantable devices with hormone;Abstinence;None of these | Oral contraceptives – combined pill;Oral contraceptives – progestin-only pill;Transdermal patch;Shot/injection;Vaginal ring;Implantable devices with hormone;Abstinence;None of these | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-03-18 15:21:17.0 | Pregnancy Information | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C16020 | Pregnancy infection illness indicator | PregInfectnIllnessInd | Indicator of whether there were any infections/illnesses that occurred during this pregnancy | Indicator of whether there were any infections/illnesses that occurred during this pregnancy | Did/Has the participant subject experienced any infections or illnesses during the pregnancy? | Yes, specify;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. If yes, specify the infection or illness. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17995 | Pregnancy infection illness text | PregInfectnIllnessTxt | Text specifying any infections or illnesses the participant/subject experienced during this pregnancy | Text specifying any infections or illnesses the participant/subject experienced during this pregnancy | If yes specify | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C15624 | Pregnancy indicator | PregInd | Indicates if the participant/subject is currently pregnant | Indicates if the participant/subject is currently pregnant | Is the participant/subject pregnant? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
If No or Unknown skip to Pregnant ever indicator |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C16022 | Pregnancy prior history births full-term count | PregPriorHistBirthFulltermCt | Count of the total number of pregnancies the participant/subject has carried for a full term (>= 37 weeks) | Count of the total number of pregnancies the participant/subject has carried to a full term (>= 37 weeks) | Full term (>= 37 weeks) births | Numeric Values |
No additional Instructions |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History |
Free-Form Entry |
0 | 30 | ||||||||
| C17996 | Pregnancy prior history birth defect text | PregPriorHistBirthDefectTxt | Text of any comments about any birth defects that occurred during the participant/subject's previous pregnancies | Text of any comments about any birth defects that occurred during the participant/subject's previous pregnancies | If Yes specify birth defect | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy Information | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
