CDE Detailed Report
Subdomain Name: History of Disease/Injury Event
CRF: Medical and Family History of Headache
Displaying 1 - 13 of 13
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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
C19039 | Headache migraine other text | HdchMigranOTH | The free-text field related to 'Headache migraine type' specifying other text. Type of headache or migraine | The free-text field related to 'Headache migraine type' specifying other text. Type of headache or migraine | Other, specify | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events | 4000 |
Free-Form Entry |
||||||||||
C00721 | Family history medical condition indicator | FamHistMedclCondInd | Indicator of whether a family member or first and second degree blood relatives of the participant has had a history of the particular medical condition or health related event | Indicator of whether a family member or first and second degree blood relatives of the participant has had a history of the particular medical condition or health related event | Relative affected (first and second-degree relatives ONLY)? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:36.0 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
3165788 | ||||||||
C56045 | Headache migraine physician diagnosis medical documentation indicator | HdachMgrnPhyscnMdclDcmntatnInd | Indicator of whether the participant/subject has a physician diagnosis or medical documentation of headaches or migraines | Indicator of whether the participant/subject has a physician diagnosis or medical documentation of headaches or migraines | Physician diagnosis or medical documentation supporting diagnosis? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
|||||||||
C16005 | Headache migraine type | HeadachMigranTyp | Type of headache or migraine | Type of headache or migraine | Diagnosis | Migraine with aura;Migraine without aura;Chronic Migraine;Hemiplegic Migraine;Menstrual Headache;Tension Type Headache;Episodic Tension Type;Chronic Tension Type;Trigeminal Autonomic Cephalgias;Cluster Headache;Trigeminal Headache;Other TAC type, specify;Other primary type headache, specify;Other secondary type headache, specify | Migraine with aura;Migraine without aura;Chronic Migraine;Hemiplegic Migraine;Menstrual Headache;Tension Type Headache;Episodic Tension Type;Chronic Tension Type;Trigeminal Autonomic Cephalgias (TACS);Cluster Headache;Trigeminal Headache;Other TAC (Trigeminal Autonomic Cephalgia) type, specify;Other primary type headache, specify;Other secondary type headache, specify | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
|||||||||
C56046 | Headache migraine participant affected condition indicator | HdachMgrnPrtcpntAffctdCndtnInd | Indicator of whether the participant/subject has been affected by their condition related to headaches or migraines | Indicator of whether the participant/subject has been affected by their condition related to headaches or migraines | Participant affected by condition? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
|||||||||
C16006 | Family history first-degree physician diagnosed count | FamHist1stDegPhyscnDiagnsCt | The number of first-degree relatives with the medical condition confirmed by a physician | The number of first-degree relatives with the medical condition confirmed by a physician | Number of first degree relatives number with physician diagnosis | Numeric Values |
If there is a history of this condition in the family, indicate the total number of relatives with a history of the condition, the number of relatives affected (patient reported diagnosis), and if the number of relatives that were diagnosed by a physician. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
||||||||||
C16010 | Headache migraine diagnosis indicator | HeadachMigranDiagnsInd | Indicator of whether the participant/subject has been diagnosed with the type of headache or migraine | Indicator of whether the participant/subject has been diagnosed with the type of headache or migraine | Participant/subject diagnosed? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
If the participant/subject has a history of this condition, indicate yes. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events |
Single Pre-Defined Value Selected |
||||||||
C16019 | Family history relative first-degree affect count | FamHistReltv1stDegAffctCt | The number of first-degree relatives affected with the medical condition | The number of first-degree relatives affected with the medical conditio | Number of first degree relatives number affected | Numeric Values |
If there is a history of this condition in the family, indicate the total number of relatives with a history of the condition, the number of relatives affected (patient reported diagnosis), and if the number of relatives that were diagnosed by a physician. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
||||||||||
C16021 | Family history second-degree relative affected count | FamHistScndDegReltvAffctCt | The number of second-degree relatives affected with the medical condition | The number of second-degree relatives affected with the medical conditio | Number of second degree relatives number affected. | Numeric Values |
If there is a history of this condition in the family, indicate the total number of relatives with a history of the condition, the number of relatives affected (patient reported diagnosis), and if the number of relatives that were diagnosed by a physician. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
||||||||||
C16025 | Family history second-degree physician diagnosis count | FamHistScndDegPhyscnDiagnsCt | The number of second-degree relatives with the medical condition confirmed by a physician | The number of second-degree relatives with the medical condition confirmed by a physician | Number of second degree relatives number with physician diagnosis. | Numeric Values |
If there is a history of this condition in the family, indicate the total number of relatives with a history of the condition, the number of relatives affected (patient reported diagnosis), and if the number of relatives that were diagnosed by a physician. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events |
Free-Form Entry |
||||||||||
C16207 | Family history medical condition first-degree relative type | FamHistMedclCondFrstDegReltTyp | Relationship of the first-degree family member or ancestor with the medical condition or health related event to the participant/subject | Relationship of the first-degree family member or ancestor with the medical condition or health related event to the participant/subject | Relationship of relative(s) to participant/subject | 1;2;3;4;5;6;7;8;9;10 | Biological Mother;Biological Father;Sibling Male;Sibling Female;Non-identical or dizygotic twin Male;Non-identical or dizygotic twin Female;Identical twin Male;Identical twin Female;Full biologic child Male;Full biologic child Female | Numeric Values |
Select the relationship from the options of the family members provided in the "Name of Family Member with Condition" code list. Record more than 1 family member, if applicable. Choose all that apply. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
||||||||
C16208 | Family history medical condition second-degree relative type | FamHistMedclCondScndDegReltTyp | Relationship of the second-degree family member or ancestor with the medical condition or health related event to the participant/subject | Relationship of the second-degree family member or ancestor with the medical condition or health related event to the participant/subject | Relationship of relative(s) to participant/subject | 11;12;13;14;15;16;17;18;19;20;21;22;23;24 | Half-Sibling Male;Half-Sibling Female;Maternal Grandmother;Maternal Grandfather;Paternal Grandmother;Paternal Grandfather;Maternal Aunt;Maternal Uncle;Paternal Aunt;Paternal Uncle;Grandchild Male;Grandchild Female;Nephew;Niece | Numeric Values |
Separate multiple codes with comma |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events |
Multiple Pre-Defined Values Selected |
||||||||
C17992 | Additional comment text | AddtnalCommntTxt | Text describing any additional information about the participant or the participant's family history | Text describing any additional information about the participant or the participant's family history | Additional Comments | Alphanumeric |
Record any pertinent information regarding the participant/subject, and/or family in the comments filed. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History of Headache/Migraine | History of Disease/Injury Event | Disease/Injury Related Events | 255 |
Free-Form Entry |