CDE Detailed Report
Disease: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Subdomain Name: General Health History
CRF: Medical History - Immune Module
Displaying 1 - 50 of 113
Subdomain Name: General Health History
CRF: Medical History - Immune Module
Displaying 1 - 50 of 113
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
|||||||||||
| 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 |
|||||||||||
| 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 wit | 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 ter | 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 sectio | 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-Highly Recommended | 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 |
||||||||||
| 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 yea | 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 |
||||||||||
| 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 |
||||||||||
| 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 wel | 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 disorder | 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 wit | 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 |
|||||||||||
| C57265 | Medical history immune condition type | MedHistImmuneCondTyp | Immune condition(s) of which the participant/subject has a medical history | Immune condition(s) of which the participant/subject has a medical history | Condition | Zoster;Malignancy (cancer) affecting the immune system;Immunodeficiency syndrome(s) | Zoster;Malignancy (cancer) affecting the immune system;Immunodeficiency syndrome(s) | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:02:04.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C57880 | Infection condition inactive resolved type | InfectCondInactResolvTyp | Any type of the infections listed that are no longer active in the patient or are considered resolved or cured | Any type of the infections listed that are no longer active in the patient or are considered resolved or cure | Condition no longer active/resolved | Mononucleosis;Lyme disease, Specify type;HIV/AIDS;Fungal disease (not including skin infection);Chronic parasitic infection;Tuberculosis;Syphilis;Subacute bacterial endocarditis;Sepsis, ever;Sepsis in the past 12 weeks;Osteomyelitis;Other, specify | Mononucleosis;Lyme disease, Specify type;HIV/AIDS;Fungal disease (not including skin infection);Chronic parasitic infection;Tuberculosis;Syphilis;Subacute bacterial endocarditis;Sepsis, ever;Sepsis in the past 12 weeks;Osteomyelitis;Other, specify | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-11 13:06:25.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C57362 | ROME I criteria indicator | ROMEICritInd | The indicator relating to whether the ROME I criteria for Irritable Bowel Syndrome has been met | The indicator relating to whether the ROME I criteria for Irritable Bowel Syndrome has been me | Rome I criteria: | No;Yes | No;Yes | Alphanumeric | Adult | Supplemental-Highly Recommended | 1.00 | 2018-01-05 12:49:23.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C57716 | Skin condition medication currently indicator | SkinCondMedCurrentInd | The indicator relating to whether the subject currently takes medication for skin condition(s) | The indicator relating to whether the subject currently takes medication for skin condition(s) | Currently take medications | No;Yes | No;Yes | Alphanumeric | 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 |
||||||||||
| C57279 | Blood immune condition diagnosis year value | BldImmuneCondDiagYrVal | Year of diagnosis of a blood or immune condition | Year of diagnosis of a blood or immune condition | Year(s) of diagnosis | Numeric Values | Adult | Exploratory | 1.00 | 2018-01-05 10:18:14.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||||
| C57382 | Eye condition medication name | EyeCondMedctnName | The name of the medication(s) the subject takes for eye conditions | The name of the medication(s) the subject takes for eye conditions | Medication name(s) | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-08 08:43:05.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
|||||||||||
| C57485 | Ear nose throat condition inactive resolved type | EarNoseThroatCondInactResTyp | Element related to ear, nose, throat conditions that are considered no longer active or resolved | Element related to ear, nose, throat conditions that are considered no longer active or resolved | Condition(s) no longer active/resolved | Chronic rhinitis (runny nose);Chronic sinusitis;Chronic/repeated otitis media (ear infections);Hay fever;Impaired hearing;Easy nasal bleeding;Nasal allergies;Tonsillectomy;Other, specify;Chronically infected tonsils | Chronic rhinitis (runny nose);Chronic sinusitis;Chronic/repeated otitis media (ear infections);Hay fever;Impaired hearing;Easy nasal bleeding;Nasal allergies;Tonsillectomy;Other, specify;Chronically infected tonsils | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-08 11:20:01.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C57804 | Blood immune condition inactive resolved type | BldImmuneCondInactResolvTyp | Any type of blood and/or immune system conditions that are no longer active in the subject or are considered resolved or cured | Any type of blood and/or immune system conditions that are no longer active in the subject or are considered resolved or cure | Condition no longer active/resolved | Anemia;Sickle cell disease;Thalassemia;Hemochromatosis;Myeloproliferative disorders (myelodysplasia);Other, specify | Anemia;Sickle cell disease;Thalassemia;Hemochromatosis;Myeloproliferative disorders (myelodysplasia);Other, specify | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 16:57:15.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C57321 | Atopy allergic disorder condition diagnosis type | AtopyAllDisordrCondDiagnosTyp | The type of condition(s) that the participant/subject was diagnosed with in relation to his/her history of atopy/allergic disorders | The type of condition(s) that the participant/subject was diagnosed with in relation to his/her history of atopy/allergic disorder | Condition diagnosis | Allergic rhinitis/hay fever;Asthma;Atopic dermatitis;Hives;Mast cell activation syndrome;Other, specify | Allergic rhinitis/hay fever;Asthma;Atopic dermatitis;Hives;Mast cell activation syndrome;Other, specify | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:51:03.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C57602 | Gut condition active indicator | GutCondActInd | The indicator relating to whether the subject currently has an active gut condition | The indicator relating to whether the subject currently has an active gut condition | Condition active | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-09 11:27:55.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C57266 | Ear nose throat condition diagnosis year value | EarNoseThroatCondDiagnosYrVal | The year the subject was diagnosed with an ear, nose, throat condition | The year the subject was diagnosed with an ear, nose, throat condition | Year(s) of diagnosis | Numeric Values | Adult | Exploratory | 1.00 | 2018-01-05 10:02:54.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||||
| C57881 | Infection condition inactive resolved other text | InfectCondInactResolvOthrTxt | Text specifying an infection other than the ones already mentioned that is no longer active in the subject or is considered resolved or cured | Text specifying an infection other than the ones already mentioned that is no longer active in the subject or is considered resolved or cure | Other, specify: | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-11 13:09:26.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
|||||||||||
| C57363 | ROME II criteria type | ROMEIICritTyp | The type of condition that is required for the ROME II criteria for Irritable Bowel Syndrome to be met | The type of condition that is required for the ROME II criteria for Irritable Bowel Syndrome to be me | Abdominal distention or pain | Relieved with defecation;An onset associated with change in the form (appearance) of stool;Onset associated with change in the frequency of stool | Relieved with defecation;An onset associated with change in the form (appearance) of stool;Onset associated with change in the frequency of stool | Alphanumeric |
Of at least 12 weeks duration (not necessarily consecutive weeks) in the preceding 12 months accompanied by two of the following three features of altered bowel habits. |
Adult | Supplemental-Highly Recommended | 1.00 | 2018-01-05 12:51:04.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
|||||||||
| C57717 | Skin condition medication work well indicator | SkinCondMedWorkWellInd | The indicator relating to whether the medication(s) the subject is taking for skin condition(s) is(are) working well | The indicator relating to whether the medication(s) the subject is taking for skin condition(s) is(are) working wel | Medication(s) work well | Yes;No;Not applicable | Yes;No;Not applicable | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 11:04:35.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C57280 | Food hypersensitivity reaction onset date | FoodHypersensRxnOnsetDate | The date of onset for reaction(s) as a result of food hypersensitivity | The date of onset for reaction(s) as a result of food hypersensitivity | Date of onset | Date or Date & Time | Adult | Exploratory | 1.00 | 2018-01-05 10:19:54.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||||
| C57383 | Eye condition medication work well indicator | EyeCondMedctnWorkWellInd | The indicator relating to whether the subject's medication(s) for eye conditons is(are) working well | The indicator relating to whether the subject's medication(s) for eye conditons is(are) working wel | Medications work well | Yes;No;Not applicable | Yes;No;Not applicable | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-08 08:43:57.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C57489 | Lung condition diagnosed indicator | LungCondDiagInd | Indicator related to lung condition(s) the participant/subject has been diagnosed with | Indicator related to lung condition(s) the participant/subject has been diagnosed with | Condition diagnosed | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-08 12:33:33.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C57805 | Blood immune condition inactive resolved other text | BldImmunCondInactResolvOthrTxt | Text specifying a blood and/or immune system condition other than the ones previously mentioned that is no longer active in the subject or is considered resolved or cured | Text specifying a blood and/or immune system condition other than the ones previously mentioned that is no longer active in the subject or is considered resolved or cure | Other, specify: | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 17:00:23.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
|||||||||||
| C57323 | Atopic allergy disorder condition diagnosed information status | AllRhiHayFeverCondInfoStat | Status for atopy/allergic disorder(s) with which the participant/subject has been diagnosed | Status for atopy/allergic disorder(s) with which the participant/subject has been diagnosed | If diagnosed: | Condition active past one year;Condition currently active;Medications are taken for this condition;Medications taken daily for this condition | Condition active past one year;Condition currently active;Medications are taken for this condition;Medications taken daily for this condition | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:54:30.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C57603 | Gut condition medication past year indicator | GutCondMedPastYrInd | The indicator relating to whether the subject has taken medication for gut condition(s) in the past year | The indicator relating to whether the subject has taken medication for gut condition(s) in the past year | Take medications | No;Yes | No;Yes | Alphanumeric |
In the past year |
Adult | Exploratory | 1.00 | 2018-01-09 11:28:54.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
|||||||||
| C57267 | Medical history Immunodeficiency syndrome name text | MedHistImmunodefSyndNameTxt | The name of the immunodeficiency syndrome(s) the subject has as medical history of | The name of the immunodeficiency syndrome(s) the subject has as medical history of | Name of syndrome: | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:04:11.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
|||||||||||
| C57882 | Immune disorder treatment received indicator | ImmDisordrTreatmtRecInd | Indicator related to whether treatments were received for any immune disorders | Indicator related to whether treatments were received for any immune disorders | Treatments received for any immune disorders? | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-11 13:10:35.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C57364 | ROME II criteria indicator | ROMEIICritInd | The indicator relating to whether the ROME II criteria for Irritable Bowel Syndrome has been met | The indicator relating to whether the ROME II criteria for Irritable Bowel Syndrome has been me | Rome II criteria: | No;Yes | No;Yes | Alphanumeric | Adult | Supplemental-Highly Recommended | 1.00 | 2018-01-05 12:53:38.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C57766 | Skin condition inactive resolved type | SkinCondInactResolvTyp | Any type of the aforementioned skin conditions that are no longer active in the subject or are considered resolved or cured | Any type of the aforementioned skin conditions that are no longer active in the subject or are considered resolved or cure | Condition no longer active/resolved | 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 12:36:57.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C57281 | Infection condition diagnosis year value | InfectCondDiagYrVal | The year of diagnosis of infections | The year of diagnosis of infections | Year(s) of diagnosis | Numeric Values | Adult | Exploratory | 1.00 | 2018-01-05 10:20:57.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||||
| C57414 | Eye condition inactive resolved type | EyeCondInactResolvTyp | Element related to eye conditions that are considered no longer active or resolved | Element related to eye conditions that are considered no longer active or resolved | Condition no longer active/resolved | 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 09:14:39.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C57494 | Lung condition active indicator | LungCondActInd | The indicator relating to lung condition(s) that are active | The indicator relating to lung condition(s) that are active | Condition(s) active | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-08 13:54:58.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C00314 | Medical history taken date and time | MedclHistTakenDateTime | Date (and time, if applicable and known) the participant's medical history was taken | Date (and time, if applicable and known) the participant 's medical history was taken | Date history taken: | Date or Date & Time | Adult | Exploratory | 3.20 | 2024-02-29 15:42:39.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Free-Form Entry |
2179659 | |||||||||||
| C57806 | Infection diagnosis type | InfecDiagnosTyp | Any type of the infections listed that the subject has ever been diagnosed with | Any type of the infections listed that the subject has ever been diagnosed wit | Condition diagnosed | Mononucleosis;Lyme disease, Specify type;HIV/AIDS;Fungal disease (not including skin infection);Chronic parasitic infection;Tuberculosis;Syphilis;Subacute bacterial endocarditis;Sepsis, ever;Sepsis in the past 12 weeks;Osteomyelitis;Other, specify | Mononucleosis;Lyme disease, Specify type;HIV/AIDS;Fungal disease (not including skin infection);Chronic parasitic infection;Tuberculosis;Syphilis;Subacute bacterial endocarditis;Sepsis, ever;Sepsis in the past 12 weeks;Osteomyelitis;Other, specify | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-11 08:32:59.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C57325 | Atopic allergic disorder condition medication name | AtopicAllergDsrdrCondMedName | The name(s) of the medication(s) being taken for the participant/subject's atopy/allergic disorder condition | The name(s) of the medication(s) being taken for the participant/subject's atopy/allergic disorder condition | Medication(s) name(s) | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:57:24.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
|||||||||||
| C57605 | Gut condition medication current indicator | GutCondMedCurrentInd | The indicator relating to whether the subject currently takes medication for gut conditions | The indicator relating to whether the subject currently takes medication for gut conditions | Currently take medications | No;Yes | No;Yes | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-09 11:28:54.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C57268 | Medical history immune symptom onset text | MedHistImmSymptmOnsetTxt | Text describing symptoms at onset the participant/subject experienced for immune conditions as part of medical history | Text describing symptoms at onset the participant/subject experienced for immune conditions as part of medical history | Symptoms at onset | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:05:04.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
|||||||||||
| C57957 | Immune symptom onset current type | ImmSymptmOnsetCurrTyp | Whether the types of general immune/infectious symptom(s) that the subject experienced at onset (within first month of illness) are being currently experienced | Whether the types of general immune/infectious symptom(s) that the subject experienced at onset (within first month of illness) are being currently experience | If yes, are any of those symptoms current? | 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 |
|||||||||
| C57365 | ROME III criteria type | ROMEIIICritTyp | The type of ROME II Diagnostic Criteria for Irritable Bowel Syndrome that needs to be met | The type of ROME II Diagnostic Criteria for Irritable Bowel Syndrome that needs to be me | Recurrent abdominal pain for discomfort at least three days per month and two or more of the following symptoms: | Improvement with defecation;An onset associated with change in the form (appearance) of stool;Onset associated with change in the frequency of stool | Improvement with defecation;An onset associated with change in the form (appearance) of stool;Onset associated with change in the frequency of stool | Alphanumeric | Adult | Supplemental-Highly Recommended | 1.00 | 2018-01-05 12:55:19.0 | Medical History - Immune Module | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C57767 | Skin condition inactive resolved other text | SkinCondInactResolvOthrTxt | Text specifying another skin condition that is no longer active in the subject or is considered resolved or cured | Text specifying another skin condition that is no longer active in the subject or is considered resolved or cure | Other, specify: | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-10 12:38:48.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
|||||||||||
| C57282 | Adverse reaction drug type text | AdvRxnDrugTypTxt | Free-text field to describe the type of adverse reaction the participant/subject has from a drug | Free-text field to describe the type of adverse reaction the participant/subject has from a drug | Reaction | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:19:54.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
