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
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 Syndrom 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-Highly Recommended 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
C57590 Lung condition inactive resolved type LundCondInactResolvTyp Any lung conditions the subject has had that are no longer active or are considered resolved or cured Any lung conditions the subject has had that are no longer active or are considered resolved or cured Condition(s) no longer active/resolved Pneumonia in the past 12 weeks;Pneumonia, ever;Pleurisy;Asthma (as a child);Asthma (as an adult);Bronchitis;Emphysema;Chronic obstructive lung disease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
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
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 yea 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
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
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
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
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
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