CDE Detailed Report
Disease: Myalgic Encephalomyelitis%2FChronic Fatigue Syndrome
Subdomain Name: General Health History
CRF: Medical History - Immune Module
Displaying 101 - 113 of 113
Subdomain Name: General Health History
CRF: Medical History - Immune Module
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 |
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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 |
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C57308 | Food hypersensitivity component other text | FoodHyperCompOthrTxt | Text describing another food component to which the subject has hypersensitivity | Text describing another food component to which the subject has hypersensitivity | Other, specify: | Alphanumeric | Adult | Exploratory | 1.00 | 2018-01-05 10:38:04.0 | Medical History - Immune Module | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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