CDE Detailed Report

Disease: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Sub-Domain: General Health History
CRF: Medical History - Immune Module

Displaying 1 - 50 of 113
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (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 / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C57372 Medical history eye condition type MedHistEyeCondTyp The type of any eye conditions that the subject has ever had. The type of any eye conditions that the subject has ever had. Condition diagnosed: Optic neuritis;Uveitis or scleritis;Dry eye;Eye infections;Sjogren's syndrome;Other, specify Optic neuritis;Uveitis or scleritis;Dry eye;Eye infections;Sjogren's syndrome;Other, specify Alphanumeric

Check any eye condtiions if you were ever diagnosed

Adult Exploratory 1.00 2018-01-05 14:17:55.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57709 Gut condition inactive resolved type GutCondInactResolvTyp Any type of gut condition that is no longer active in the subject or is considered resolved or cured. Any type of gut condition that is no longer active in the subject or is considered resolved or cured. Condition(s) no longer active/resolved Peptic ulcer;Hiatus hernia;Hepatitis A;Hepatitis B;Hepatitis C;Hepatitis, type unspecified;Gall bladder disease;Liver disease;Cirrhosis;Chronic pancreatitis;Pancreatitis;Celiac disease;Irritable bowel syndrome;Crohn's disease;Colorectal cancer;Ulcerative colitis;Other, specify Peptic ulcer;Hiatus hernia;Hepatitis A;Hepatitis B;Hepatitis C;Hepatitis, type unspecified;Gall bladder disease;Liver disease;Cirrhosis;Chronic pancreatitis;Pancreatitis;Celiac disease;Irritable bowel syndrome;Crohn's disease;Colorectal cancer;Ulcerative colitis;Other, specify Alphanumeric Adult Exploratory 1.00 2018-01-10 10:03:15.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57271 Medical history immune diagnosis year text MedHistImmDiagYrTxt Year of diagnosis for immune condition(s) the participant/subject has as part of medical history Year of diagnosis for immune condition(s) the participant/subject has as part of medical history Year of diagnosis Alphanumeric Adult Exploratory 1.00 2018-01-05 10:08:32.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C58435 Eye condition inactive resolved other text EyeCondInactResolvOthTxt Free-text field to describe other eye conditions that are considered no longer active or resolved Free-text field to describe other eye conditions that are considered no longer active or resolved Other, specify: Alphanumeric Adult Exploratory 1.00 2018-01-08 09:14:39.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57419 Ear nose throat condition active indicator EarNoseThroatCondActInd The indicator relating to whether the subject currently has an active ear, nose, throat condition The indicator relating to whether the subject currently has an active ear, nose, throat condition Condition active No;Yes No;Yes Alphanumeric Adult Exploratory 1.00 2018-01-08 09:28:44.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57770 Blood immune condition medication past year indicator BldImmuneMedPastYrInd The indicator relating to whether the subject has taken medication for blood or immune conditions in the past year The indicator relating to whether the subject has taken medication for blood or immune conditions in the past year Take medication No;Yes No;Yes Alphanumeric

In the past year

Adult Exploratory 1.00 2018-01-10 13:00:12.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57312 Adverse drug reaction indicator AdvDrugRxnInd The indicator relating to whether the subject experiences reactions to adverse drugs. The indicator relating to whether the subject experiences reactions to adverse drugs. Adverse drug reactions No;Yes No;Yes Alphanumeric

If yes, specify

Adult Exploratory 1.00 2018-01-05 10:41:26.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57499 Lung condition medication work well indicator LungCondMedWorkWellInd The indicator relating to whether the medication(s) the subject is taking for lung condition(s) is(are) working The indicator relating to whether the medication(s) the subject is taking for lung condition(s) is(are) working Medications work well Yes;No;Not applicable Yes;No;Not applicable Alphanumeric Adult Exploratory 1.00 2018-01-08 14:06:42.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57261 Immune symptom onset type ImmSymptmOnsetTyp The type of general immune/infectious symptom(s) that the subject experienced at onset (within first month of illness). The type of general immune/infectious symptom(s) that the subject experienced at onset (within first month of illness). At onset (within first month of illness), did participant/subject experience of the following? Fever;Chills;Night sweats;Sore throats;Swollen/tender glands;Rashes;N/V/D;Arthalgia/arthritis;Mouth ulcers;History of autoimmune disease;Family history of autoimmune disease (biological relatives only, if applicable) Fever;Chills;Night sweats;Sore throats;Swollen/tender glands;Rashes;N/V/D;Arthalgia/arthritis;Mouth ulcers;History of autoimmune disease;Family history of autoimmune disease (biological relatives only, if applicable) Alphanumeric

Check all that apply

Adult Core 1.00 2018-01-05 09:23:33.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57810 Infection condition medication past year indicator InfectCondMedPastYrInd The indicator relating to whether the subject has taken medication for infections in the past year The indicator relating to whether the subject has taken medication for infections in the past year Take medications No;Yes No;Yes Alphanumeric

In the past year

Adult Exploratory 1.00 2018-01-11 08:46:57.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57346 Vaccine unusual received year text VaccUnusualRecYrTxt The year(s) the participant/subject received unusual vaccine(s) The year(s) the participant/subject received unusual vaccine(s) Year(s) Received Alphanumeric Adult Exploratory 1.00 2018-01-05 11:21:44.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57373 Medical history eye condition other text MedHistEyeCondOthrTxt Text describing another eye condition the subject has a medical history of. Text describing another eye condition the subject has a medical history of. Other, specify: Alphanumeric Adult Exploratory 1.00 2018-01-05 14:20:56.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57711 Skin condition diagnosis type SkinCondDiagnosTyp Any type of the skin conditions listed that the subject has ever been diagnosed with. Any type of the skin conditions listed that the subject has ever been diagnosed with. Condition diagnosed Psoriasis;Eczema;Dermatomyositis;Contact dermatitis;Vasculitis;Zoster;Other allergic skin reactions;Other, specify;Hives Psoriasis;Eczema;Dermatomyositis;Contact dermatitis;Vasculitis;Zoster;Other allergic skin reactions;Other, specify;Hives Alphanumeric Adult Exploratory 1.00 2018-01-10 10:09:26.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57273 Gut condition diagnosis year value GutCondDiagnosYrVal The year that the subject was diagnosed with gut condition(s) The year that the subject was diagnosed with gut condition(s) Year(s) of diagnosis Numeric Values Adult Exploratory 1.00 2018-01-05 10:09:40.0 Medical History - Immune Module General Health History Participant History and Family History

Free-Form Entry

C58436 Lung condition inactive resolved other text LundCondInactResolvOthTxt Free-text field to specify any other lung conditions the subject has had that are no longer active or are considered resolved or cured Free-text field to specify any other lung conditions the subject has had that are no longer active or are considered resolved or cured Other, specify: Alphanumeric Adult Exploratory 1.00 2018-01-09 09:29:41.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57420 Ear nose throat condition medication past year indicator EarNoseThroatCondMedPastYrInd The indicator relating to whether the subject has taken medication for an ear, nose, throat condition in the past year. The indicator relating to whether the subject has taken medication for an ear, nose, throat condition in the past year. Take medications No;Yes No;Yes Alphanumeric

In the past year

Adult Exploratory 1.00 2018-01-08 09:30:14.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57772 Blood immune condition medication currently indicator BldImmuneMedCurrentInd The indicator relating to whether the subject takes medication for blood or immune conditions daily The indicator relating to whether the subject takes medication for blood or immune conditions daily Currently take medication(s) No;Yes No;Yes Alphanumeric Adult Exploratory 1.00 2018-01-10 13:00:12.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57313 Adverse reaction drug name AdverseRxnDrugName The name of the drug to which the participant/subject has an adverse reaction The name of the drug to which the participant/subject has an adverse reaction Drug name Alphanumeric Adult Exploratory 1.00 2018-01-05 10:42:39.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57584 Ear nose throat condition diagnosed other specify text EarNoseThroatCondDiagOthSpTxt Free-text field related to describe other ear, nose, throat conditions with which the participant/subject has been diagnosed Free-text field related to describe other ear, nose, throat conditions with which the participant/subject has been diagnosed Other, specify: Alphanumeric Adult Exploratory 1.00 2018-01-09 09:23:51.0 Medical History - Immune Module General Health History Participant History and Family History 500

Free-Form Entry

C57262 Antibiotic long term repeated history indication text AntibLngTermRepHistIndicTxt Free-text field to describe the indication for which the participant/subject has had a history of long-term or repeated use Free-text field to describe the indication for which the participant/subject has had a history of long-term or repeated use Indication: Alphanumeric Adult Exploratory 1.00 2018-01-05 09:42:20.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57812 Infection condition medication currently indicator InfectCondMedCurrentInd The indicator relating to whether the subject takes medication for infections daily The indicator relating to whether the subject takes medication for infections daily Currently take medications No;Yes No;Yes Alphanumeric Adult Exploratory 1.00 2018-01-11 08:46:57.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57358 ROME I criteria type ROMEICritTyp The type of ROME I criteria for Irritable Bowel Syndrome that has continuously or recurrently occurred for at least 3 months. The type of ROME I criteria for Irritable Bowel Syndrome that has continuously or recurrently occurred for at least 3 months. At least three months of continuous or recurrent symptoms: Abdominal pain or dscomfort;Two or more of the following, on at least one-fourth of occasions or days Abdominal pain or dscomfort;Two or more of the following, on at least one-fourth of occasions or days Alphanumeric Adult Supplemental-Highly Recommended 1.00 2018-01-05 12:11:14.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57378 Eye condition active indicator EyeCondActiveInd The indicator relating to whether the subject currently has an eye condition The indicator relating to whether the subject currently has an eye condition Condition active Optic neuritis;Uveitis or scleritis;Dry eye;Eye infections;Sjogren's syndrome;Other, specify Optic neuritis;Uveitis or scleritis;Dry eye;Eye infections;Sjogren's syndrome;Other, specify Alphanumeric Adult Exploratory 1.00 2018-01-08 08:39:13.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57712 Skin condition diagnosis other text SkinCondDiagnosOthrTxt Text specifying another skin condition the subject has ever been diagnosed with. Text specifying another skin condition the subject has ever been diagnosed with. Other, specify: Alphanumeric Adult Exploratory 1.00 2018-01-10 10:37:03.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57274 Food hypersensitivity indicator FoodHypersensInd The indicator relating to whether the subject has food hypersensitivity The indicator relating to whether the subject has food hypersensitivity Food hypersensitivity No;Yes No;Yes Alphanumeric Adult Exploratory 1.00 2018-01-05 10:10:39.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58437 Gut condition inactive resolved other text GutCondInactResolvOthTxt Free-text field to describe other type of gut condition that is no longer active in the subject or is considered resolved or cured. Free-text field to describe other type of gut condition that is no longer active in the subject or is considered resolved or cured. Other, specify: Alphanumeric Adult Exploratory 1.00 2018-01-10 10:03:15.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57422 Ear nose throat condition medication current indicator EarNoseThroatCondMedCurrInd The indicator relating to whether the subject currently takes medication for an ear, nose, throat condition The indicator relating to whether the subject currently takes medication for an ear, nose, throat condition Currently take medications No;Yes No;Yes Alphanumeric Adult Exploratory 1.00 2018-01-08 09:30:14.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57773 Blood immune condition medication name BldImmuneMedName The name of any medication(s) the subject is taking for blood or immune conditions The name of any medication(s) the subject is taking for blood or immune conditions Medication name(s) Alphanumeric Adult Exploratory 1.00 2018-01-10 13:02:30.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57315 Adverse reaction drug route text AdverseRxnDrugRouteTxt Free-text field to describe the route used for a drug which causes an adverse reaction for the participant/subject Free-text field to describe the route used for a drug which causes an adverse reaction for the participant/subject Route Alphanumeric Adult Exploratory 1.00 2018-01-05 10:45:43.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57590 Lung condition inactive resolved type LundCondInactResolvTyp Any lung conditions the subject has had that are no longer active or are considered resolved or cured Any lung conditions the subject has had that are no longer active or are considered resolved or cured Condition(s) no longer active/resolved Pneumonia in the past 12 weeks;Pneumonia, ever;Pleurisy;Asthma (as a child);Asthma (as an adult);Bronchitis;Emphysema;Chronic obstructive lung disease (COPD or COLD);Chronic restrictive lung disease;Silicosis;Asbestosis;Other, specify Pneumonia in the past 12 weeks;Pneumonia, ever;Pleurisy;Asthma (as a child);Asthma (as an adult);Bronchitis;Emphysema;Chronic obstructive lung disease (COPD or COLD);Chronic restrictive lung disease;Silicosis;Asbestosis;Other, specify Alphanumeric Adult Exploratory 1.00 2018-01-09 09:29:41.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57263 Antibiotic long term repeated history name AntibLongTermRepHistName The name of the antibiotic(s) that the subject has a history of using repeatedly or long term The name of the antibiotic(s) that the subject has a history of using repeatedly or long term If yes, what antibiotic(s): Alphanumeric Adult Exploratory 1.00 2018-01-05 09:56:26.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57813 Infection condition medication name InfectCondMedName The name of the medication(s) the subject is taking for infections The name of the medication(s) the subject is taking for infections Medication name(s) Alphanumeric Adult Exploratory 1.00 2018-01-11 08:51:25.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57359 ROME I criteria abdominal pain discomfort type ROMEICritAbPainDiscomfrtTyp The type of abdominal pain or discomfort that the subject might be experiencing in relation to the ROME I criteria for Irritable Bowel Syndrome. The type of abdominal pain or discomfort that the subject might be experiencing in relation to the ROME I criteria for Irritable Bowel Syndrome. Abdominal pain or discomfort that is: Relieved with defecation;Associated with a change in consistency of stool;Associated with a change in frequency of stool Relieved with defecation;Associated with a change in consistency of stool;Associated with a change in frequency of stool Alphanumeric Adult Supplemental 1.00 2018-01-05 12:15:40.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57379 Eye condition medication past year indicator EyeCondMedPastYrInd The indicator relating to whether the subject has taken medications for eye conditions in the past year. The indicator relating to whether the subject has taken medications for eye conditions in the past year. Take Medications Optic neuritis;Uveitis or scleritis;Dry eye;Eye infections;Sjogren's syndrome;Other, specify Optic neuritis;Uveitis or scleritis;Dry eye;Eye infections;Sjogren's syndrome;Other, specify Alphanumeric

Medications taken in the last year

Adult Exploratory 1.00 2018-01-08 08:40:14.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57713 Skin condition active indicator SkinCondActInd The indicator relating to whether the subject currently has active skin condition(s) The indicator relating to whether the subject currently has active skin condition(s) Condition(s) active No;Yes No;Yes Alphanumeric Adult Exploratory 1.00 2018-01-10 10:44:02.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57275 Food hypersensitivity component type FoodHypersensCompTyp The food component(s) to which the subject has a hypersensitivity The food component(s) to which the subject has a hypersensitivity Have hypersensitivity? Lactose;Gluten (any intolerance);Gluten (celiac disease);Milk protein;Alcohol;Eggs;Sugar/Fructose;Caffeine;Nuts;Chocolate;Aspartame;Other, specify Lactose;Gluten (any intolerance);Gluten (celiac disease);Milk protein;Alcohol;Eggs;Sugar/Fructose;Caffeine;Nuts;Chocolate;Aspartame;Other, specify Alphanumeric Adult Exploratory 1.00 2018-01-05 10:12:01.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57423 Ear nose throat condition medication name EarNoseThroatCondMedName The name of the medication(s) the subject is taking for an ear, nose, throat condition The name of the medication(s) the subject is taking for an ear, nose, throat condition Medication name(s) Alphanumeric Adult Exploratory 1.00 2018-01-08 09:38:14.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57774 Blood immune condition medication work well indicator BldImmuneMedWorkWellInd The indicator relating to whether the medication(s) the subject is taking for blood or immune conditions is (are) working well The indicator relating to whether the medication(s) the subject is taking for blood or immune conditions is (are) working well Medications work well Yes;No;Not applicable Yes;No;Not applicable Alphanumeric Adult Exploratory 1.00 2018-01-10 13:02:58.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57316 Adverse reaction drug receive year text AdverseRxnDrugYrTxt Free-text field to indicate the year(s) the participant/subject has received a drug which causes an adverse reaction Free-text field to indicate the year(s) the participant/subject has received a drug which causes an adverse reaction Year(s) received Alphanumeric Adult Exploratory 1.00 2018-01-05 10:46:28.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57595 Gut condition diagnosis type GutCondDiagnosTyp Any gut conditions the subject has ever been diagnosed with. Any gut conditions the subject has ever been diagnosed with. Condition diagnosed Peptic ulcer;Hiatus hernia;Hepatitis A;Hepatitis B;Hepatitis C;Hepatitis, type unspecified;Gall bladder disease;Liver disease;Cirrhosis;Chronic pancreatitis;Pancreatitis;Celiac disease;Irritable bowel syndrome;Crohn's disease;Colorectal cancer;Ulcerative colitis;Other, specify Peptic ulcer;Hiatus hernia;Hepatitis A;Hepatitis B;Hepatitis C;Hepatitis, type unspecified;Gall bladder disease;Liver disease;Cirrhosis;Chronic pancreatitis;Pancreatitis;Celiac disease;Irritable bowel syndrome;Crohn's disease;Colorectal cancer;Ulcerative colitis;Other, specify Alphanumeric Adult Exploratory 1.00 2018-01-09 10:24:06.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57264 Antibiotic long term repeated history use year text AntibLongTermRepHistUseYrTxt The year(s) that the subject has used antibiotics repeatedly or long term. The year(s) that the subject has used antibiotics repeatedly or long term. When (year(s)): Alphanumeric Adult Exploratory 1.00 2018-01-05 09:57:29.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57814 Infection condition medication work well indicator InfectCondMedWorkWellInd The indicator relating to whether the medication(s) the subject is taking for infections is (are) working well The indicator relating to whether the medication(s) the subject is taking for infections is (are) working well Medications work well Yes;No;Not applicable Yes;No;Not applicable Alphanumeric Adult Exploratory 1.00 2018-01-11 08:54:19.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57361 ROME I criteria PLUS type ROMEICritPLUSTyp The ROME I criteria that requires two or more of the following conditions under the PLUS section. The ROME I criteria that requires two or more of the following conditions under the PLUS section. Two or more of the following, on at least one-fourth of occassions or days: Altered stool form (lumpy and hard, or loose and watery);Altered stool passage (straining, urgency, or a feeling of incomplete evacuatioin);Altered stool freuqency (for research purposes, ''altered'' may be defined as more than three bowel movements each day or fewer than three bowel movements each week);Passage of mucus;Bloating or feeling of abdominal Altered stool form (lumpy and hard, or loose and watery);Altered stool passage (straining, urgency, or a feeling of incomplete evacuatioin);Altered stool freuqency (for research purposes, ''altered'' may be defined as more than three bowel movements each day or fewer than three bowel movements each week);Passage of mucus;Bloating or feeling of abdominal Alphanumeric Adult Supplemental 1.00 2018-01-05 12:45:19.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57381 Eye condition medication current indicator EyeCondMedctnCurrentInd The indicator relating to whether the subject currently takes medication for eye conditions The indicator relating to whether the subject currently takes medication for eye conditions Currently take medications Optic neuritis;Uveitis or scleritis;Dry eye;Eye infections;Sjogren's syndrome;Other, specify Optic neuritis;Uveitis or scleritis;Dry eye;Eye infections;Sjogren's syndrome;Other, specify Alphanumeric Adult Exploratory 1.00 2018-01-08 08:40:14.0 Medical History - Immune Module General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C57714 Skin condition medication past year indicator SkinCondMedPastYrInd The indicator relating to whether the subject has taken medication for skin condition(s) in the past year. The indicator relating to whether the subject has taken medication for skin condition(s) in the past year. Take medications No;Yes No;Yes Alphanumeric

In the past year

Adult Exploratory 1.00 2018-01-10 11:02:19.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57277 Food component hypersensitivity reaction type text FoodCompHypersRxnTypTxt Free-text field describing the reaction the participant/subject has as a result of a food component hypersensitivity Free-text field describing the reaction the participant/subject has as a result of a food component hypersensitivity Reaction Alphanumeric

Hives, vomiting, other

Adult Exploratory 1.00 2018-01-05 10:16:42.0 Medical History - Immune Module General Health History Participant History and Family History 500

Free-Form Entry

C57424 Ear nose throat condition medication work well indicator EarNoseThroatMedWorkWellInd The indicator relating to whether the medication(s) the subject is taking for ear, nose, throat condition(s) is(are) working well. The indicator relating to whether the medication(s) the subject is taking for ear, nose, throat condition(s) is(are) working well. Medication(s) work well Yes;No;Not applicable Yes;No;Not applicable Alphanumeric Adult Exploratory 1.00 2018-01-08 09:39:58.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57780 Blood immune condition active indicator BldImmuneCondActInd The indicator relating to whether the subject currently has an active blood or immune condition The indicator relating to whether the subject currently has an active blood or immune condition Condition active No;Yes No;Yes Alphanumeric Adult Exploratory 1.00 2018-01-10 13:27:49.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57319 Atopy allergic disorder history indicator AtopyAllDisordrHistInd The indicator relating to whether the participant/subject has a history of atopy/allergic disorders. The indicator relating to whether the participant/subject has a history of atopy/allergic disorders. History of atopy/allergic disorders No;Yes No;Yes Alphanumeric Adult Exploratory 1.00 2018-01-05 10:49:14.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57601 Gut condition diagnosis other text GutCondDiagnosOthrTxt Text specifying another gut condition that the subject has ever been diagnosed with. Text specifying another gut condition that the subject has ever been diagnosed with. Other, specify: Alphanumeric Adult Exploratory 1.00 2018-01-09 11:23:28.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

CSV