CDE Detailed Report
Subdomain Name: General Health History
CRF: welcome
Displaying 1 - 39 of 39
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 |
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C17988 | Relative first degree decease count unknown indicator | Reltv1stDegDecCntUnknownInd | Indicator of the unknown number of deceased first-degree relatives | Indicator of the unknown number of deceased first-degree relatives | Number deceased | Unknown | Unknown | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C00313 | Medical history condition SNOMED CT code | MedclHistCondSNOMEDCTCode | Systematized Nomenclature Of Medicine Clinical Terms (SNOMED CT) code for medical condition/disease reported by the participant/subject | Systematized Nomenclature Of Medicine Clinical Terms (SNOMED CT) code for medical condition/disease reported by the participant/subject | Condition | Alphanumeric |
Code each of the medical/family history conditions using SNOMED CT |
SNOMED CT Codes (http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html) | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Medical and Family History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C56021 | Sibling decease count | SiblingDeceaseCt | The total number of deceased siblings that the subject has | The total number of deceased siblings that the subject ha | Number deceased | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-05 13:01:45.0 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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C16003 | Relative second degree decease count | ReltvScndDegDeceasCt | The number of the participant/subject second-degree deceased relatives | The number of the participant/subject second-degree deceased relatives | Number deceased | Numeric Values |
Provide the number of first/second degree relatives. The participant/subject should refer to the Name of Family Member with Condition" code list to provide any information on each of family member that he/she has knowledge of. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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C17989 | Relative second degree total count unknown indicator | ReltvSecDegTotlCntUnknownInd | Indicator of the unknown total number of second-degree relatives | Indicator of the unknown total number of second-degree relatives | How many total number of second-degree relatives do you have? | Unknown | Unknown | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C00720 | Family history medical condition type | FamHistMedclCondTyp | Type of medical condition or health related event for which the family history is taken | Type of medical condition or health related event for which the family history is taken | Condition | Cancer;Heart disease;Acute coronary syndrome;Hypertension;Hypotension;Dyslipidemia;Mitral valve prolapse;Patent-Foramen Ovale (PFO)/Right-left shunt (RLS);Cerebral aneurysm;Intracerebral hemorrhage;Ischemic Stroke;Extracranial aneurysm;Coronary vascular disease;Periphereal vascular disease;Reynaud's Syndrome;Diabetes mellitus;Gastroparesis;Irritable bowel syndrome (IBS);Thyroid condition;Obesity;Painful bladder;Interstitial Cystitis;Endometriosis;Polycystic ovary syndrome;(Pre)eclampsia;Emotional/Verbal abuse;Physical abuse;Sexual abuse;Allerg(ies);Asthma;Eczema;Systemic lupus erythematosus (SLE);Arthritis;Fibromyalgia;Muscle disease;Autism;Alzheimer's disease;Amyotrophic lateral sclerosis (ALS);Ataxia;Chronic ataxia;Dementia;Dystonia;Epilepsy;Memory loss;Developmental delays;Multiple sclerosis;Restless leg syndrome (RLS);Tourette syndrome;Traumatic brain injury;Tremor;Vertigo;Anxiety;Bi-polar disorder;Depression;Obsessive-compulsive disorder (OCD);Post traumatic stress disorder (PTSD);Schizophrenia;Suicide or suicide attempt;Alcohol use disorder;Illicit substance use disorder;Prescription use disorder;Anorexia;Bulimia;Binge eating;Insomnia;Sleep apnea;Narcolepsy;Other Immunological Disorders, specify:;Other neurological disorder, specify;Other Sleep condition, specify;Other, specify | Cancer;Heart disease;Acute coronary syndrome;Hypertension;Hypotension;Dyslipidemia;Mitral valve prolapse;Patent-Foramen Ovale (PFO)/Right-left shunt (RLS);Cerebral aneurysm;Intracerebral hemorrhage;Ischemic Stroke;Extracranial aneurysm;Coronary vascular disease;Periphereal vascular disease;Reynaud's Syndrome;Diabetes mellitus;Gastroparesis;Irritable bowel syndrome (IBS);Thyroid condition;Obesity;Painful bladder;Interstitial Cystitis;Endometriosis;Polycystic ovary syndrome;(Pre)eclampsia;Emotional/Verbal abuse;Physical abuse;Sexual abuse;Allerg(ies);Asthma;Eczema;Systemic lupus erythematosus (SLE);Arthritis;Fibromyalgia;Muscle disease;Autism;Alzheimer's disease;Amyotrophic lateral sclerosis (ALS);Ataxia;Chronic ataxia;Dementia;Dystonia;Epilepsy;Memory loss;Developmental delays;Multiple sclerosis;Restless leg syndrome (RLS);Tourette syndrome;Traumatic brain injury;Tremor;Vertigo;Anxiety;Bi-polar disorder;Depression;Obsessive-compulsive disorder (OCD);Post traumatic stress disorder (PTSD);Schizophrenia;Suicide or suicide attempt;Alcohol use disorder;Illicit substance use disorder;Prescription use disorder;Anorexia;Bulimia;Binge eating;Insomnia;Sleep apnea;Narcolepsy;Other Immunological Disorders, specify:;Other neurological disorder, (specify);Other Sleep condition, specify;Other, specify | Alphanumeric |
Comorbid conditions Musculo-Skeletal, Arthritis – if type of arthritis known, specify type in comments section Psychiatric, Depression – if type of depression known, specify type in comments section If a family member has a diagnosis or condition not listed, specify the diagnosis and/or condition under the "Other, specify" fields. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:34.0 | Medical and Family History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
3165585 | |||||||
C56022 | Sibling decease count unknown indicator | SiblingDeceaseCtUnkInd | The indicator relating to whether or not the subject knows how many deceased siblings he/she has | The indicator relating to whether or not the subject knows how many deceased siblings he/she ha | Number deceased | Unknown | Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-05 13:02:42.0 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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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 | 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 | General Health History | Participant History and Family History |
Free-Form Entry |
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C17990 | Relative second degree live count unknown indicator | ReltvSecDegLivCntUnknownInd | Indicator of the unknown number of living second-degree relatives | Indicator of the unknown number of living second-degree relatives | Number alive | Unknown | Unknown | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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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 | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
First and second-degree relatives ONLY |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-02-29 15:42:36.0 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
3165788 | |||||||
C56023 | Sibling decease primary cause text | SiblingDeceasePrimCauseTxt | Text describing the primary cause of the subject's sibling's death | Text describing the primary cause of the subject's sibling's deat | Primary cause of death | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-05 13:07:18.0 | Medical and Family History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C16012 | Medical history condition diagnosis indicator | MedclHistCondDiagnsInd | Indicator of whether the participant has been diagnosed with the medical condition/disease | Indicator of whether the participant has been diagnosed with the medical condition/disease | 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 | 3.10 | 2024-02-29 15:42:42.0 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C17991 | Relative second degree decease count unknown indicator | ReltvSecDegDecCntUnknownInd | Indicator of the unknown number of deceased second-degree relatives | Indicator of the unknown number of deceased second-degree relatives | Number deceased | Unknown | Unknown | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C08087 | Sibling death age value | SiblingDeathAgeVal | Age of sibling when he/she died | Age of sibling when he/she died | Age at death | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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C56024 | Relative second degree decease death age value | RelSecondDegDecDeathAgeVal | Value representing the age of the subject's second-degree relative at their time of death | Value representing the age of the subject's second-degree relative at their time of deat | Age at death | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-05 12:57:31.0 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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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 | 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 | General Health History | Participant History and Family History |
Free-Form Entry |
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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 | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C08147 | Data source | DataSource | Source of the data provided on the case report form | Source of the data provided on the case report form | Source from which medical and family history obtained? | Participant/subject;Family, specify relation;Unknown | Participant/subject;Family, specify relation;Unknown | Alphanumeric |
Choose all that apply |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:46:24.96 | Medical and Family History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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C56025 | Relative second degree decease primary cause text | RelSecondDegDecPrimCauseTxt | Text describing the primary cause of the subject's second-degree relative's death | Text describing the primary cause of the subject's second-degree relative's deat | Primary cause of death | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-05 12:58:52.0 | Medical and Family History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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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 | Numeric Values |
Affected' is defined as patient reported diagnosis. Answer this question for each medical condition. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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C18666 | Body system category other text | BodySysCatOTH | The free-text field related to 'Body system category', specifying other text. Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured | The free-text field related to 'Body system category', specifying other text. Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured | Other, specify | Alphanumeric |
Each body system is pre-populated on the case report form. |
Review of Symptoms from Centers for Medicare and Medicaid Services https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/eval_mgmt_serv_guide-ICN006764.pdf | Adult;Pediatric | Supplemental | 1.10 | 2023-11-07 08:40:35.0 | Medical and Family History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
2002895 | ||||||||
C10813 | Adopted indicator | AdoptedInd | Indicator of whether the participant was adopted | Indicator of whether the participant was adopted | Are you adopted? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.10 | 2024-02-29 15:42:33.0 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C56028 | Sibling count | SiblingCt | The total number of siblings the subject has | The total number of siblings the subject has | How many siblings do you have? | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-05 13:18:48.0 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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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 | Numeric Values |
Answer this question for each medical condition. Choose one. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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C18678 | Family history medical condition type other text | FamHistMedclCondTypOTH | The free-text field related to 'Family history medical condition type', specifying other text. Type of medical condition or health related event for which the family history is taken | The free-text field related to 'Family history medical condition type', specifying other text. Type of medical condition or health related event for which the family history is taken | Other, specify | Alphanumeric |
Comorbid conditions Musculo-Skeletal, Arthritis – if type of arthritis known, specify type in comments section Psychiatric, Depression – if type of depression known, specify type in comments section If a family member has a diagnosis or condition not listed, specify the diagnosis and/or condition under the "Other, specify" fields. |
No references available | Adult;Pediatric | Supplemental | 1.10 | 2024-02-29 15:42:35.0 | Medical and Family History | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
3165585 | ||||||||
C15997 | Relative first degree total count | Reltv1stDegTotlCt | Count of the total number of first-degree relatives the participant/subject has | Count of the total number of first-degree relatives the participant/subject has | How many total number of first-degree relatives do you have? | Numeric Values |
This number can be calculated with informant after enumerating relatives of each type provided in the 'Name of Family Member with Condition" code list. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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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 first-degree realtive(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 | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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C56017 | Relative first degree decease death age value | RelFirstDegDecDeathAgeVal | Value representing the age of the subject's first-degree relative at their time of death | Value representing the age of the subject's first-degree relative at their time of deat | Age at death | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-05 12:57:31.0 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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C15998 | Relative first degree live count | Reltv1stDegLivCt | The total number of the participant/subject first-degree living relatives | The total number of the participant/subject first-degree living relatives | Number alive | Numeric Values |
Provide the number of first/second degree relatives. The participant/subject should refer to the Name of Family Member with Condition" code list to provide any information on each of family member that he/she has knowledge of. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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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 second-degree 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 |
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 | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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C56018 | Relative first degree decease primary cause text | RelFirstDegDecPrimCauseTxt | Text describing the primary cause of the subject's first-degree relative's death | Text describing the primary cause of the subject's first-degree relative's deat | Primary cause of death | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-05 12:58:52.0 | Medical and Family History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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C15999 | Relative first degree decease count | Reltv1stDegDeceasCt | The total number of the participant/subject first-degree deceased relatives | The total number of the participant/subject first-degree deceased relatives | Number deceased | Numeric Values |
Provide the number of first/second degree relatives. The participant/subject should refer to the Name of Family Member with Condition" code list to provide any information on each of family member that he/she has knowledge of. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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C17986 | Relative first degree total count unknown indicator | Reltv1stDegTotCntUnknownInd | Indicator of the unknown total number of first-degree relatives | Indicator of the unknown total number of first-degree relatives the participant/subject has | How many total number of first-degree relatives do you have? | Unknown | Unknown | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C56019 | Sibling live count | SiblingLiveCt | The total number of alive siblings that the subject has | The total number of alive siblings that the subject ha | Number alive | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2017-06-05 13:01:45.0 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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C16001 | Relative second degree total count | ReltvScndDegTotlCt | The total number of the participant/subject second-degree relatives | The total number of the participant/subject second-degree relatives | How many total number of second-degree relatives do you have? | Numeric Values |
This number can be calculated with informant after enumerating relatives of each type provided in the 'Name of Family Member with Condition" code list. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |
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C17987 | Relative first degree live count unknown indicator | Reltv1stDegLivCtUnknownInd | Indicator of the unknown number of living first-degree relatives | Indicator of the unknown number of living first-degree relatives | Number alive | Unknown | Unknown | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C00312 | Body system category | BodySysCat | Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured interview and physical examination of all the body systems | Category or grouping used in the comprehensive assessment of a participant/subject, which includes a subjective history taking component as well as an objective based structured interview and physical examination of all the body system | Condition | Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify: | Allergic/Immunologic;Cardiovascular;Constitutional symptoms (e.g., fever, weight loss);Dermatological;Ears, Nose, Mouth, Throat;Endocrine;Eyes;Gastrointestinal;Gastrointestinal/Abdominal;Genitourinary;Gynecologic/Urologic/ Renal;Hematologic/Lymphatic;Hepatobiliary;Integumentary (skin and/or breast);Musculoskeletal;Musculoskeletal (separate from ALS exam);Neurological;Neurologic/CNS;Neurological (separate from ALS exam);Oncologic;Psychiatric;Pulmonary;Respiratory;Other, specify: | Alphanumeric |
Each body system is pre-populated on the case report form. |
Review of Symptoms from Centers for Medicare and Medicaid Services https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/eval_mgmt_serv_guide-ICN006764.pdf | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
2002895 | |||||||
C56020 | Sibling live count unknown indicator | SiblingLiveCtUnkInd | The indicator relating to whether or not the subject knows how many living siblings he/she has | The indicator relating to whether or not the subject knows how many living siblings he/she ha | Number alive | Unknown | Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2017-06-05 13:02:42.0 | Medical and Family History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C16002 | Relative second degree live count | ReltvScndDegLivCt | The total number of the participant/subject second-degree living relatives | The total number of the participant/subject second-degree living relatives | Number alive | Numeric Values |
Provide the number of first/second degree relatives. The participant/subject should refer to the Name of Family Member with Condition" code list to provide any information on each of family member that he/she has knowledge of. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Medical and Family History | General Health History | Participant History and Family History |
Free-Form Entry |