CDE Detailed Report

Disease: content
Subdomain Name: General Health History
CRF: welcome

Displaying 101 - 113 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
C57418 Lung condition diagnosed other text LungCondDiagOthrTxt Text specifying other lung condition(s) the subject has ever been diagnosed with Text specifying other lung condition(s) the subject has ever been diagnosed with Other, specify: Alphanumeric Adult Exploratory 1.00 2018-01-08 09:27:04.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57769 Blood immune condition diagnosis other text BldImmuneCondDiagnosOthrTxt Text specifying a blood and/or immune system condition other than the ones previously mentioned that the subject has ever been diagnosed with Text specifying a blood and/or immune system condition other than the ones previously mentioned that the subject has ever been diagnosed wit Other, specify: Alphanumeric Adult Exploratory 1.00 2018-01-10 12:58:27.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57809 Infection condition active indicator InfectCondActInd The indicator relating to whether the subject currently has an infection The indicator relating to whether the subject currently has an infection Condition active No;Yes No;Yes Alphanumeric Adult Exploratory 1.00 2018-01-11 08:43:34.0 Medical History - Immune Module General Health History Participant History and Family History

Single Pre-Defined Value Selected

C57345 Vaccine unusual history name VaccUnusualHistName The name of unusual vaccine(s) that the participant/subject has taken The name of unusual vaccine(s) that the participant/subject has taken Vaccine Name Alphanumeric Adult Exploratory 1.00 2018-01-05 11:20:50.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C57498 Lung condition medication name LungCondMedName The name of any medication(s) the subject is taking for lung condition(s) The name of any medication(s) the subject is taking for lung condition(s) Medication name(s) Alphanumeric Adult Exploratory 1.00 2018-01-08 14:05:21.0 Medical History - Immune Module General Health History Participant History and Family History 255

Free-Form Entry

C19256 Study protocol name StudyProtocolName Name of study protocol Name of study protocol Study name/ID Alphanumeric Adult Exploratory 1.00 2014-06-05 16:38:14.0 Medical History - Immune Module General Health History Participant History and Family History 4000

Free-Form Entry

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

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 ha 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 cure 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

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 drug 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

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

CSV