CDE Detailed Report
Disease: system
Subdomain Name: General Health History
CRF: files
Displaying 101 - 113 of 113
Subdomain Name: General Health History
CRF: files
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
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| 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 |
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| 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 month | 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 cure | 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 |
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| 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 |
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| 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 wit | 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 |
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| 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 |
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| 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 |
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| 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 |
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| 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 |
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