CDE Detailed Report

Disease: content
Sub-Domain: General Health History
CRF: welcome

Displaying 1 - 50 of 55
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 / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C58301 Pneumonia type text PneumoniaTypTxt Text of type of pneumonia that the subject/participant has ever been diagnosed with. Text of type of pneumonia that the subject/participant has ever been diagnosed with. Specify type: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 11:31:35.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58368 Past surgery type PastSurgeryTyp Type of past surgery(ies) performed on subject/participant. Type of past surgery(ies) performed on subject/participant. Type of Surgery Knee arthroplasty;Coronary angioplasty/stent;Excision of disc in the spine;Hip replacement;Gall bladder removal;Colon removal (partial or total);Hysterectomy;Removal of both ovaries;Tubes tied;Vasectomy (men);Circumcision (men);Removal of adhesions in abdomen;Fracture of hip, thigh, lower leg bones;Coronary artery bypass graft (CABG);Organ transplant;Fusion of spine bones (vertebrae) Knee arthroplasty;Coronary angioplasty/stent;Excision of disc in the spine;Hip replacement;Gall bladder removal;Colon removal (partial or total);Hysterectomy;Removal of both ovaries;Tubes tied;Vasectomy (men);Circumcision (men);Removal of adhesions in abdomen;Fracture of hip, thigh, lower leg bones;Coronary artery bypass graft (CABG);Organ transplant;Fusion of spine bones (vertebrae) Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 11:51:11.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58329 Neuromuscular disorder type text NeuromuscularDisordTypeTxt Text of type of neuromuscular disorders that the subject/participant has ever been diagnosed with. Text of type of neuromuscular disorders that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 15:11:30.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58238 Past current blood disorders illness type PastCurrBloodDisordIllnessTyp Any type of past and current blood disorder(s) illnesses that the subject/participant has ever been diagnosed with. Any type of past and current blood disorder(s) illnesses that the subject/participant has ever been diagnosed with. Blood disorders Anemia requiring treatment or blood transfusions;Blood clot disorder (clots in legs, lungs);Malaria;Mononucleosis;Other bleeding disorder;Other blood disorders;Sickle cell disease;Thrombocytopenia (low platelets);Sickle cell trait Anemia requiring treatment or blood transfusions;Blood clot disorder (clots in legs, lungs);Malaria;Mononucleosis;Other bleeding disorder;Other blood disorders;Sickle cell disease;Thrombocytopenia (low platelets);Sickle cell trait Alphanumeric Adult;Pediatric Core 1.00 2018-02-06 21:34:24.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58352 Other psychosis type text OthrPsychosisTypTxt Text of type of other psychosis that the subject/participant has ever been diagnosed with. Text of type of other psychosis that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 10:03:58.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58302 Other chronic lung condition text OthrChronicLungConditnTxt Specifies other chronic lung condition not listed in the table. Specifies other chronic lung condition not listed in the table. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 10:47:11.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58370 Past surgery type indicator PastSurgeryTypInd Indicator of whether a past surgery(ies)was performed on subject/participant. Indicator of whether a past surgery(ies)was performed on subject/participant. Yes No No;Yes No;Yes Alphanumeric

Indicate whether or not the type of surgery was performed on subject/participant.

Adult;Pediatric Core 1.00 2018-02-08 11:55:54.0 Past and Current Illnesses General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58330 Muscle disease text MuscleDiseaseTxt Text specifying muscle disease that the subject/participant has ever been diagnosed with. Text specifying muscle disease that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 15:11:30.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58239 Past current cardiovascular illness type PastCurrCardiovasclrIllnessTyp Any type of past and current cardiovascular illnesses that the subject/participant has ever been diagnosed with. Any type of past and current cardiovascular illnesses that the subject/participant has ever been diagnosed with. Cardiovascular Cardiomyopathy, myocarditis;Heart attack, coronary artery disease, angina, bypass surgery, stent placement, other;Heart failure;Heart murmur;Heart rhythm problem: atrial fibrillation, pacemaker;High blood pressure (hypertension);High total or LDL (''bad'') cholesterol, or triglycerides;Irregular heart beat or palpitations;Malfunctioning heart valves;Orthostatic intolerance or POTS;Other cardiovascular conditions;Peripheral arterial disease;Very low blood pressure Cardiomyopathy, myocarditis;Heart attack, coronary artery disease, angina, bypass surgery, stent placement, other;Heart failure;Heart murmur;Heart rhythm problem: atrial fibrillation, pacemaker;High blood pressure (hypertension);High total or LDL (''bad'') cholesterol, or triglycerides;Irregular heart beat or palpitations;Malfunctioning heart valves;Orthostatic intolerance or POTS;Other cardiovascular conditions;Peripheral arterial disease;Very low blood pressure Alphanumeric Adult;Pediatric Core 1.00 2018-02-06 22:00:54.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58353 Other skin problems type text OthrSkinProblemsTypTxt Text of type of other skin problems that the subject/participant has ever been diagnosed with. Text of type of other skin problems that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 10:03:58.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58314 Past current ear nose throat condition type PastCurrEarNoseThroatCondtnTyp Any type of past and current ear, nose, and throat conditions that the subject/participant has ever been diagnosed with. Any type of past and current ear, nose, and throat conditions that the subject/participant has ever been diagnosed with. Ear/Nose/Throat conditions Bleeding gums (gingivitis);Frequent ear infections;Frequent sinus infections;Frequent throat infection (pharyngitis);Hearing Loss;Nasal allergies/rhinitis;Nasal polyps;Recurrent infections of tonsils;Tinnitus (ringing or sounds in the ears) Bleeding gums (gingivitis);Frequent ear infections;Frequent sinus infections;Frequent throat infection (pharyngitis);Hearing Loss;Nasal allergies/rhinitis;Nasal polyps;Recurrent infections of tonsils;Tinnitus (ringing or sounds in the ears) Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 11:59:12.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58372 Past surgery performed institution name PastSurgyPerformdInstitutnName Name of institution in which the subject/participant had surgery performed. Name of institution in which the subject/participant had surgery performed. Institution/City Surgery Performed Alphanumeric

Provide name of institution where surgery was performed.

Adult;Pediatric Core 1.00 2018-02-08 12:00:39.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58331 Other autoimmune disease text OthrAutoimmuneDiseaseTxt Specifies other autoimmune disease not listed in the table. Specifies other autoimmune disease not listed in the table. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 15:16:00.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58271 Past current cardiovascular heart disease type text PastCurrCardiovascHrtDisTypTxt Text of past and current cardiovascular heart disease type that the subject/participant has ever been diagnosed with. TText of past and current cardiovascular heart disease type that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-01-26 09:47:06.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58354 Other cancer type text OthrCancerTypTxt Text of type of other cancer(s) that the subject/participant has ever been diagnosed with. Text of type of other cancer(s) that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 10:03:58.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58316 Past current eye condition type PastCurrEyeConditnTyp Any type of past and current eye conditions that the subject/participant has ever been diagnosed with. Any type of past and current eye conditions that the subject/participant has ever been diagnosed with. Eye conditions Cataracts;Glaucoma;Optic neuritis;Other eye condition Cataracts;Glaucoma;Optic neuritis;Other eye condition Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 12:07:02.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58373 Past surgery performed city name PastSurgyPerformedCityName Name of city where the subject/participant had surgery performed. Name of city where the subject/participant had surgery performed. Institution/City Surgery Performed Alphanumeric

Provide name of city where surgery was performed.

Adult;Pediatric Core 1.00 2018-02-08 12:00:39.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C10559 Spontaneous miscarriage count SpontaneousMiscarriageCt Value representing the number of times the participant/subject has had miscarriages or spontaneous abortions, including all trimesters Value representing the number of times the participant/subject has had miscarriages or spontaneous abortions, including all trimesters Specify how many: Numeric Values Adult;Pediatric Core 3.00 2013-07-11 15:03:49.2 Past and Current Illnesses General Health History Participant History and Family History

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0 99
C58341 Past current psychological illness type PastCurrPsychologiclIllnessTyp Any type of past and current psychological illnesses that the subject/participant has ever been diagnosed with. Any type of past and current psychological illnesses that the subject/participant has ever been diagnosed with. Psychological Alcohol abuse/dependency;Anorexia or bulimia;Anxiety;Attention deficit disorder (ADD or ADHD);Depression;Drug Abuse;Manic depressive or bipolar disorder;Obsessive-compulsive disorder (OCD);Other type of psychosis;PTSD Alcohol abuse/dependency;Anorexia or bulimia;Anxiety;Attention deficit disorder (ADD or ADHD);Depression;Drug Abuse;Manic depressive or bipolar disorder;Obsessive-compulsive disorder (OCD);Other type of psychosis;PTSD Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 09:27:00.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58275 Past current cardiovascular cholesterol type text PastCurrCardiovasCholestTypTxt Text of past current cardiovascular cholesterol type that the subject/participant has ever been diagnosed with. Text of past current cardiovascular cholesterol type that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 10:41:31.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58355 Other sexually transmitted diseases type text OthrSexTransmitDiseasesTypTxt Any other type of past and current sexually transmitted diseases that the subject/participant has ever been diagnosed with. Any other type of past and current sexually transmitted diseases that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 10:15:53.0 Past and Current Illnesses General Health History Participant History and Family History 500

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C58317 Past current endocrine metabolic illness type PastCurrEndocrMetabIllnessTyp Any type of endocrine and metabolic illnesses that the subject/participant has ever been diagnosed with. Any type of endocrine and metabolic illnesses that the subject/participant has ever been diagnosed with. Endocrine and metabolic Diabetes (indicate if type I, type II);Hypoglycemia (low blood sugar);Metabolic syndrome or pre-diabetes;Overactive adrenal (Cushing disease);Overactive thyroid (hyperthyroidism);Overweight/obesity;Pituitary gland disorder;Thyroid nodules or cancer;Underactive adrenal (Addison disease);Underactive thyroid (hypothyroidism) Diabetes (indicate if type I, type II);Hypoglycemia (low blood sugar);Metabolic syndrome or pre-diabetes;Overactive adrenal (Cushing disease);Overactive thyroid (hyperthyroidism);Overweight/obesity;Pituitary gland disorder;Thyroid nodules or cancer;Underactive adrenal (Addison disease);Underactive thyroid (hypothyroidism) Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 12:12:23.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58374 Other surgeries performed text OthrSurgeryPerformedTxt Specifies other surgery(ies) performed on subject/participant. Specifies other surgery(ies) performed on subject/participant. List Other Surgeries: Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 12:04:07.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C11063 Parity maternal value ParityMaternalVal Number of live born children the participant's/subject's mother has delivered Number of live born children the participant's/subject's mother has delivered Specify how many: Numeric Values Adult;Pediatric Core 3.00 2013-07-10 11:37:29.993 Past and Current Illnesses General Health History Participant History and Family History

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0 99
C58343 Past current skin problems type PastCurrSkinProblemsTyp Any type of past and current skin problems that the subject/participant has ever been diagnosed with. Any type of past and current skin problems that the subject/participant has ever been diagnosed with. Skin problems Contact dermatitis;Eczema;Hives;Mastocytosis;Other skin problems;Psoriasis Contact dermatitis;Eczema;Hives;Mastocytosis;Other skin problems;Psoriasis Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 09:34:15.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58278 Other bleeding disorder text OthrBleedingDisordTxt Specifies other bleeding disorder not listed in the table. Specifies other bleeding disorder not listed in the table. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 10:47:11.0 Past and Current Illnesses General Health History Participant History and Family History 500

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C58356 Other kidney problem type text OthrKidneyProblmTypTxt Text of type of other kidney problems that the subject/participant has ever been diagnosed with. Text of type of other kidney problems that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 10:21:38.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58318 Other eye condition text OthrEyeuConditionTxt Specifies other eye condition not listed in the table. Specifies other eye condition not listed in the table. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 12:13:41.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C11065 Gravida maternal value GravidaMaternalVal Total number of times the participant's/subject's mother has been pregnant, regardless of whether these pregnancies were carried to term Total number of times the participant's/subject's mother has been pregnant, regardless of whether these pregnancies were carried to term Specify how many: Numeric Values Adult;Pediatric Core 3.00 2013-07-25 08:54:08.2 Past and Current Illnesses General Health History Participant History and Family History

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1 99
C58344 Past current tumors cancer illness type PastCurrTumorsCancIllnessTyp Any type of past and current tumors or cancer illnesses that the subject/participant has ever been diagnosed with. Any type of past and current tumors or cancer illnesses that the subject/participant has ever been diagnosed with. Tumors/Cancer Bladder cancer;Breast cancer;Colorectal cancer;Kidney cancer;Leukemia;Lung cancer;Lymphoma;Melanoma;Non-melanoma skin cancer;Other cancer(s);Prostate cancer Bladder cancer;Breast cancer;Colorectal cancer;Kidney cancer;Leukemia;Lung cancer;Lymphoma;Melanoma;Non-melanoma skin cancer;Other cancer(s);Prostate cancer Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 09:36:18.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58282 Blood clot disorder text BloodClotDisorderTxt Specifies blood clot disorder that subject/participant has ever been diagnosed with. Specifies blood clot disorder that subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 10:59:34.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58357 Other genital infections type text OthrGenitalInfectionsTypTxt Text of type of other genital infections that the subject/participant has ever been diagnosed with. Text of type of other genital infections that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 10:21:38.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58319 Past current gastrointestinal illness type PastCurrGIIllnessTyp Any type of past and current gastrointestinal illnesses that the subject/participant has ever been diagnosed with. Any type of past and current gastrointestinal illnesses that the subject/participant has ever been diagnosed with. Gastrintestinal Colitis;Celiac disease (celiac sprue);Constipation;Crohn's disease;Enteritis;Gallstones or gallbladder infection;Gastritis;Heartburn or reflux (GERD);Hepatitis (A, B or C);Irritable bowel syndrome (IBS);Liver cirrhosis;Malabsorption;Other liver disease;Pancreatitis;Stomach or duodenal ulcer;Ulcerative colitis Colitis;Celiac disease (celiac sprue);Constipation;Crohn's disease;Enteritis;Gallstones or gallbladder infection;Gastritis;Heartburn or reflux (GERD);Hepatitis (A, B or C);Irritable bowel syndrome (IBS);Liver cirrhosis;Malabsorption;Other liver disease;Pancreatitis;Stomach or duodenal ulcer;Ulcerative colitis Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 13:44:57.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C14151 Pregnancy medical terminations count PregMedTerminationCt Number of medical terminations (abortions) Number of medical terminations (abortions) Specify how many: Numeric Values Adult;Pediatric Core 3.00 2013-06-21 00:00:00.0 Past and Current Illnesses General Health History Participant History and Family History

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0 99
C58346 Past current urological condition type PastCurrUrologicalConditnTyp Any type of past and current urological conditions that the subject/participant has ever been diagnosed with. Any type of past and current urological conditions that the subject/participant has ever been diagnosed with. Urogenital conditions Genital herpes;Interstitial Cystitis;Kidney failure;Kidney or bladder stones;Other kidney problem;Other sexually transmitted diseases;Urinary tract infection Genital herpes;Interstitial Cystitis;Kidney failure;Kidney or bladder stones;Other kidney problem;Other sexually transmitted diseases;Urinary tract infection (UTI) Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 09:41:06.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58284 Other blood disorder text OtherBloodDisorderTxt Specifies other blood disorder not listed in the table. Specifies other blood disorder not listed in the table. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 10:47:11.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58359 Other gynecological condition type text OthrGynecolConditionTypTxt Text of type of other gynecological conditions that the subject/participant has ever been diagnosed with. Text of type of other gynecological conditions that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 10:21:38.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58320 Other liver disease text OthrLiverDiseaseTxt Specifies other liver disease not listed in the table. Specifies other liver disease not listed in the table. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 13:46:34.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C19096 Surgery performed date SurgPerformedDate Date of last surgical intervention Date of last surgical intervention Year(s) of Surgery Date or Date & Time

Provide year(s) when surgery was performed.

Adult;Pediatric Core 1.00 2014-05-27 15:38:10.0 Past and Current Illnesses General Health History Participant History and Family History

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C58347 Past current female only condition type PastCurrFemaleOnlyConditnTyp Any type of past and current female only conditions that the subject/participant has ever been diagnosed with. Any type of past and current female only conditions that the subject/participant has ever been diagnosed with. Female conditions only Bleeding between periods;Endometriosis;Heavy or excessive menstrual bleeding;Infertility;Irregular periods;Missing periods (other than pregnancy);Number of abortions;Number of live births;Number of miscarriages;Number of pregnancies;Other genital infections;Other gynecological conditions;Pelvic inflammatory disease;Polycystic ovary syndrome (PCOS);Premenstrual syndrome;Vaginal yeast infections Bleeding between periods;Endometriosis;Heavy or excessive menstrual bleeding;Infertility;Irregular periods;Missing periods (other than pregnancy);Number of abortions;Number of live births;Number of miscarriages;Number of pregnancies;Other genital infections;Other gynecological conditions;Pelvic inflammatory disease;Polycystic ovary syndrome (PCOS);Premenstrual syndrome;Vaginal yeast infections Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 09:43:14.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58287 Heart rhythm problem text HeartRhythmProblemTxt Specifies the heart rythym problem that the subject/participant has ever been diagnosed with. Specifies the heart rythym problem that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 11:04:22.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58361 Other male problems type text OthrMaleProblemsTypTxt Any other type of past and current male problems that the subject/participant has ever been diagnosed with Any other type of past and current male problems that the subject/participant has ever been diagnosed with Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 10:15:53.0 Past and Current Illnesses General Health History Participant History and Family History 500

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C58321 Past current neurological illness type PastCurrNeurologicalIllnessTyp Any type of past and current neurological illnesses that the subject/participant has ever been diagnosed with. Any type of past and current neurological illnesses that the subject/participant has ever been diagnosed with. Neurological Alzheimer's disease or other dementia(s);Fainting;Guillain-Barre syndrome;Loss of consciousness (not fainting);Meningitis or encephalitis;Migraine headaches;Muscle disease;Multiple sclerosis;Narcolepsy;Neuromuscular disorders: (e.g., Huntington's, amyotrophic lateral sclerosis, muscular dystrophy, myasthenia gravis);Other sleep disorder;Parkinson's disease;Peripheral neuropathy;Restless leg syndrome (RLS);Seizures, convulsions, epilepsy, pseudoseizures;Sleep apnea;Stroke or TIA (mini-stroke);Traumatic brain injury/concussion Alzheimer's disease or other dementia(s);Fainting;Guillain-Barre syndrome;Loss of consciousness (not fainting);Meningitis or encephalitis;Migraine headaches;Muscle disease;Multiple sclerosis;Narcolepsy;Neuromuscular disorders: (e.g., Huntington's, amyotrophic lateral sclerosis, muscular dystrophy, myasthenia gravis);Other sleep disorder;Parkinson's disease;Peripheral neuropathy;Restless leg syndrome (RLS);Seizures, convulsions, epilepsy, pseudoseizures;Sleep apnea;Stroke or TIA (mini-stroke);Traumatic brain injury/concussion Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 13:56:46.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58171 Condition illness indicator ConditionIllnessInd The indicator of whether the condition or illness is present as part of the past and current illness assessment The indicator of whether the condition or illness is present as part of the past and current illness assessment Condition/Illness Yes;No;Don't know;Age at Onset;Still Present? Yes;No;Don't know;Age at Onset;Still Present? Alphanumeric Adult;Pediatric Core 1.00 2018-02-05 13:09:31.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58348 Past current male only condition type PastCurrMaleOnlyConditnTyp Any type of past and current male only conditions that the subject/participant has ever been diagnosed with. Any type of past and current male only conditions that the subject/participant has ever been diagnosed with. Male condition only Epididymitis;Impotence;Other male problems;Prostate enlargement or prostatitis;Sexually transmitted diseases;Varicocele Epididymitis;Impotence;Other male problems;Prostate enlargement or prostatitis;Sexually transmitted diseases;Varicocele Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 09:45:32.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58288 Other cardiovascular condition text OthrcariovascCondtnTxt Specifies other cardiovascular conditions not listed in the table. Specifies other cardiovascular conditions not listed in the table. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 10:47:11.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58363 Immune deficiency type text ImmuneDeficiencyTypTxt Any other type of past and current immune deficiency other than HIV that the subject/participant has ever been diagnosed with. Any other type of past and current immune deficiency other than HIV that the subject/participant has ever been diagnosed with. Specify: Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 10:15:53.0 Past and Current Illnesses General Health History Participant History and Family History 255

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C58325 Past current rheumatological illness type PastCurrRheumatolIllnessTyp Any type of past and current rheumatological illnesses that the subject/participant has ever been diagnosed with. Any type of past and current rheumatological illnesses that the subject/participant has ever been diagnosed with. Rheumatological Ehlers Danlos Syndrome;Fibromyalgia or myofascial pain syndrome;Gout;Lyme disease;Multiple broken bones in the past;Neck arthritis/disc disease;Osteoarthritis;Other autoimmune disease;Polymyalgia rheumatica/temporal arteritis;Rheumatic fever;Rheumatoid arthritis;Sarcoidosis;Sjogren's syndrome;Spine arthritis/disc disease;Systemic lupus erythematosis;Temporo-mandibular joint disorder (TMJ) Ehlers Danlos Syndrome;Fibromyalgia or myofascial pain syndrome;Gout;Lyme disease;Multiple broken bones in the past;Neck arthritis/disc disease;Osteoarthritis;Other autoimmune disease;Polymyalgia rheumatica/temporal arteritis;Rheumatic fever;Rheumatoid arthritis;Sarcoidosis;Sjogren's syndrome;Spine arthritis/disc disease;Systemic lupus erythematosis;Temporo-mandibular joint disorder (TMJ) Alphanumeric Adult;Pediatric Core 1.00 2018-02-07 14:31:05.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58172 Condition illness indicator age onset value ConditionIllnessIndAgeOnseVal The value of the age of onset of indicated condition or illness as part of the past and current illness assessment The value of the age of onset of indicated condition or illness as part of the past and current illness assessment Age of Onset Numeric Values

Enter age of onset of subject/participant illness or condition.

Adult;Pediatric Core 1.00 2018-02-05 13:09:31.0 Past and Current Illnesses General Health History Participant History and Family History

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year
C58350 Past current miscellaneous illness type PastCurrMiscConditionsTyp Any type of past and current miscellaneous illnesses that the subject/participant has ever been diagnosed with. Any type of past and current miscellaneous illnesses that the subject/participant has ever been diagnosed with. Miscellaneous Anaphylaxis;Environmental hypersensitivity;HIV infection;Immune deficiency (other than HIV);Multiple chemical sensitivities (MCS);Oral herpes (cold sores);Organ transplant Anaphylaxis;Environmental hypersensitivity;HIV infection;Immune deficiency (other than HIV);Multiple chemical sensitivities (MCS);Oral herpes (cold sores);Organ transplant Alphanumeric Adult;Pediatric Core 1.00 2018-02-08 09:59:30.0 Past and Current Illnesses General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

CSV