CDE Detailed Report

Disease: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Sub-Domain: Laboratory Tests and Biospecimens/Biomarkers
CRF: Laboratory Tests - Immune Module

Displaying 1 - 50 of 71
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
C58186 Laboratory test lipopolyaccharide immunoglobulin negative specify text LabTestLipopolysImmunogNgSpTxt Free-text field to specify which immunoglobulin tested yielded negative laboratory test results Free-text field to specify which immunoglobulin tested yielded negative laboratory test results No (Specify whether IgA, IgM and/or IgG was found to be negative) Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C58222 Laboratory test Giardia sample type LabTestGiardiaSampleTyp Element related to the sample type used to test for Giardia Element related to the sample type used to test for Giardia Sample type Other, specify;Stool Other specify;Stool Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58197 Laboratory test parvovirus type LaboratoryTestParvovirusTyp Element related to the type of laboratory test used to test for Parvovirus Element related to the type of laboratory test used to test for Parvovirus Test type PCR;Other, specify;Unknown PCR;Other, specify;Unknown Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58233 Laboratory test autoimmune name LaboratoryTesAutoiImmunleName Name representing the autoimmunological lab test performed on body fluid(s). Test names are typically comprised of the analyte name, properties (%, Ratio, etc.), the type of body fluid tested, and any special instructions. Name representing the autoimmunological lab test performed on body fluid(s). Test names are typically comprised of the analyte name, properties (%, Ratio, etc.), the type of body fluid tested, and any special instructions. Test Anti-muscarinic receptor antibodies;Anti-beta 1 adrenergic antibodies;Anti-beta-2 adrenergic antibodies;Anti-streptolysin O antibodies;Anti-Dnase B antibodies;Antimicrobial antibodies: anti-M4 protein;Antimicrobial antibodies: anti-M3 protein;Antimicrobial antibodies: anticardiolipin antibodies;Antinuclear antibodies (ANA): IgG;Antinuclear antibodies (ANA): IgM;Rheumatoid factor (RF) antibodies: IgG;Rheumatoid factor (RF) antibodies: IgM;Cytokines: TGFbeta;Cytokines: Interleukin 6;Cytokines: Interleukin 1 beta;Cytokines: Tumor necrosis factor-alpha;Cytokines: Interferon gamma;Cytokines: Interleukin 8 Anti-muscarinic receptor antibodies;Anti-beta 1 adrenergic antibodies;Anti-beta-2 adrenergic antibodies;Anti-streptolysin O antibodies;Anti-Dnase B antibodies;Antimicrobial antibodies: anti-M4 protein;Antimicrobial antibodies: anti-M3 protein;Antimicrobial antibodies: anticardiolipin antibodies;Antinuclear antibodies (ANA): IgG;Antinuclear antibodies (ANA): IgM;Rheumatoid factor (RF) antibodies: IgG;Rheumatoid factor (RF) antibodies: IgM;Cytokines: TGFbeta;Cytokines: Interleukin 6 (IL-6);Cytokines: Interleukin 1 beta (IL-1b);Cytokines: Tumor necrosis factor-alpha (TNF-alpha);Cytokines: Interferon gamma (IFN-gamma);Cytokines: Interleukin 8 (IL-8) Alphanumeric

Autoimmunological and other immune profiling tests

Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Multiple Pre-Defined Values Selected

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C58401 Laboratory test infectious disease positive result indicator LabTestInfectDisPosRsltInd The indicator relating to whether the infectious disease laboratory test result was positive The indicator relating to whether the infectious disease laboratory test result was positive Positive result? No;Yes;Unknown No;Yes;Unknown Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

C58176 Laboratory test immunoglobulin positive indicator LabTestImmunoglPosRsltInd The indicator relating to whether the immunoglobulin laboratory test result was positive The indicator relating to whether the immunoglobulin laboratory test result was positive Positive result? No;Yes;Unknown No;Yes;Unknown Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

C58209 Laboratory test Giardia type other specify text LabTestGiardiaTypOthSpTxt Free-text field related to the other type of laboratory test used to test for Giardia Free-text field related to the other type of laboratory test used to test for Giardia Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58187 Laboratory test tick borne disease immunoglobulin G negative text LabTestTickBrnDzIgGNegTxt Free-text field to specify which tick-borne disease IgG laboratory test yielded negative results Free-text field to specify which tick-borne disease IgG laboratory test yielded negative results No (Specify which TBD were tested and found to be negative) Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C58223 Laboratory test Epstein Barr Virus sample specify text LabTestEBVSampleSpTxt Free-text field to specify other type of sample used to test for Epstein-Barr Virus (EBV) Free-text field to specify other type of sample used to test for Epstein-Barr Virus (EBV) Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58198 Laboratory test Giardia type LaboratoryTestGiardiaTyp Element related to the type of laboratory test used to test for Giardia Element related to the type of laboratory test used to test for Giardia Test type PCR;Other, specify;Unknown;Antigen PCR;Other, specify;Unknown;Antigen Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58234 Laboratory test autoimmune antibody type text LabTestAutoimmAbTYpTxt Free-text field to specify type of autoimmunological antibody laboratory test used Free-text field to specify type of autoimmunological antibody laboratory test used Specify test type Alphanumeric

e.g., ELISA, complement fixation test

Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58177 Laboratory test tick borne disease immunoglobulin M positive text LabTestTickBrnDzIgMPosTxt Free-text field to specify which tick-borne disease IgM laboratory test yielded positive results Free-text field to specify which tick-borne disease IgM laboratory test yielded positive results Yes (Specify which TBD yielded positive results) Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C58210 Laboratory test Epstein Barr Virus sample type LabTestEBVSampleTyp Element related to the sample type used to test for Epstein-Barr Virus (EBV) Element related to the sample type used to test for Epstein-Barr Virus (EBV) Sample type Serum;PBMC;Other, specify Serum;PBMC (Peripheral blood mononuclear cell);Other specify Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58188 Laboratory test tick borne disease immunoglobulin G positive text LabTestTickBrnDzIgGPosTxt Free-text field to specify which tick-borne disease IgG laboratory test yielded positive results Free-text field to specify which tick-borne disease IgG laboratory test yielded positive results Yes (Specify which TBD yielded positive results) Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C58224 Laboratory test Cytomegalovirus sample specify text LabTestCMVSampleSpTxt Free-text field to specify other type of sample used to test for Cytomegalovirus (CMV) Free-text field to specify other type of sample used to test for Cytomegalovirus (CMV) Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58199 Laboratory test Epstein Barr Virus type other specify text LaboratoryTestEBVTypOthSpTxt Free-text field related to the other type of laboratory test used to test for Epstein-barr Virus (EBV) Free-text field related to the other type of laboratory test used to test for Epstein-barr Virus (EBV) Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 500

Free-Form Entry

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C58235 Laboratory test autoimmune muscarinic receptor type text LabTestAutoimmMuscrnTYpTxt Free-text field to specify type of muscarinic receptor used in autoimmunological antibody laboratory testing Free-text field to specify type of muscarinic receptor used in autoimmunological antibody laboratory testing Specificity Alphanumeric

Which muscarinic receptor, if known

Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58178 Laboratory test tick borne disease immunoglobulin M negative text LabTestTickBrnDzIgMNegTxt Free-text field to specify which tick-borne disease IgM laboratory test yielded negative results Free-text field to specify which tick-borne disease IgM laboratory test yielded negative results No (Specify which TBD were tested and found to be negative) Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C58211 Laboratory test Cytomegalovirus sample type LabTestCMVSampleTyp Element related to the sample type used to test for Cytomegalovirus (CMV) Element related to the sample type used to test for Cytomegalovirus (CMV) Sample type Serum;PBMC;Other, specify Serum;PBMC (Peripheral blood mononuclear cell);Other specify Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58189 Laboratory test Epstein Barr Virus type LaboratoryTestEBVTyp Element related to the type of laboratory test used to test for Epstein-barr Virus (EBV) Element related to the type of laboratory test used to test for Epstein-barr Virus (EBV) Test type PCR;Other, specify;Unknown PCR;Other, specify;Unknown Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58225 Laboratory test Coxsackie B virus sample specify text LabTestCBVSampleSpTxt Free-text field to specify other type of sample used to test for Coxsackie B virus (CBV) Free-text field to specify other type of sample used to test for Coxsackie B virus (CBV) Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58200 Laboratory test Cytomegalovirus type other specify text LaboratoryTestCMVTypOthSpTxt Free-text field related to the other type of laboratory test used to test for Cytomegalovirus (CMV) Free-text field related to the other type of laboratory test used to test for Cytomegalovirus (CMV) Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 500

Free-Form Entry

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C58236 Laboratory test autoimmune isotype type text LabTestAutoimmIsotypTypTxt Free-text field to specify type of isotype used in autoimmunological antibody laboratory testing Free-text field to specify type of isotype used in autoimmunological antibody laboratory testing Isotype Alphanumeric

e.g., IgM, IgG

Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58179 Laboratory test parvovirus IgM positive strain text LabTestParvovirusIgmPosStrnTxt Free-text field to specify which strain of parvovirus yielded positive IgM laboratory test results Free-text field to specify which strain of parvovirus yielded positive IgM laboratory test results Yes (Specify which parvovirus strain yielded positive results) Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C58212 Laboratory test Coxsackie B virus sample type LabTestCBVSampleTyp Element related to the sample type used to test for Coxsackie B virus (CBV) Element related to the sample type used to test for Coxsackie B virus (CBV) Sample type Serum;PBMC;Other, specify Serum;PBMC (Peripheral blood mononuclear cell);Other specify Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58190 Laboratory test Cytomegalovirus type LaboratoryTestCMVTyp Element related to the type of laboratory test used to test for Cytomegalovirus (CMV) Element related to the type of laboratory test used to test for Cytomegalovirus (CMV) Test type PCR;Other, specify;Unknown PCR;Other, specify;Unknown Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58226 Laboratory test Human herpes virus 6 sample specify text LabTestHHV6SampleSpTxt Free-text field to specify other type of sample used to test for Human herpes virus 6 (HHV6) Free-text field to specify other type of sample used to test for Human herpes virus 6 (HHV6) Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58201 Laboratory test Coxsackie B virus type other specify text LaboratoryTestCBVTypOthSpTxt Free-text field related to the other type of laboratory test used to test for Coxsackie B virus (CBV) Free-text field related to the other type of laboratory test used to test for Coxsackie B virus (CBV) Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58237 Laboratory test immune hypersensitivity name LabTestImmHypersenName Name representing the lab test performed to assess immune system hypersensitivity Name representing the lab test performed to assess immune system hypersensitivity Test Eosinophils;Tryptase;Food-based IgG skin test;Food-based IgE skin test Eosinophils;Tryptase;Food-based IgG skin test;Food-based IgE skin test Alphanumeric

Hypersensitivity lab tests

Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Multiple Pre-Defined Values Selected

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C58180 Laboratory test parvovirus IgM negative strain text LabTestParvovirusIgMNegStrnTxt Free-text field to specify which strain of parvovirus yielded negative IgM laboratory test results Free-text field to specify which strain of parvovirus yielded negativeIgM laboratory test results No (Specify which parvovirus strains were tested and found to be negative) Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C58213 Laboratory test Human herpes virus 6 sample type LabTestHHV6SampleTyp Element related to the sample type used to test for Human herpes virus 6 (HHV6) Element related to the sample type used to test for Human herpes virus 6 (HHV6) Sample type Serum;PBMC;Other, specify Serum;PBMC (Peripheral blood mononuclear cell);Other specify Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58191 Laboratory test Coxsackie B type LaboratoryTestCBVTyp Element related to the type of laboratory test used to test for Coxsackie B (CBV) Element related to the type of laboratory test used to test for Coxsackie B (CBV) Test type PCR;Other, specify;Unknown PCR;Other, specify;Unknown Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58227 Laboratory test Echovirus sample specify text LabTestEchovirusSampleSpTxt Free-text field to specify other type of sample used to test for Echovirus Free-text field to specify other type of sample used to test for Echovirus Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C01706 Lab test result text LabTestResltTxt Result of the laboratory test Result of the laboratory test Result Alphanumeric Adult Supplemental 3.00 2013-07-25 08:54:08.2 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 4000

Free-Form Entry

2183364
C58202 Laboratory test Human herpes virus 6 type other specify text LaboratoryTestHHV6TypOthSpTxt Free-text field related to the other type of laboratory test used to test for Human herpes virus 6 (HHV6) Free-text field related to the other type of laboratory test used to test for Human herpes virus 6 (HHV6) Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58240 Laboratory test parvovirus IgG positive strain text LabTestParvovirusIgGPosStrnTxt Free-text field to specify which strain of parvovirus yielded positive IgG laboratory test results Free-text field to specify which strain of parvovirus yielded positive IgG laboratory test results Yes (Specify which parvovirus strain yielded positive IgG results) Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C58181 Laboratory test mycotoxin fungi positive text LabTestMycoFungiPosTxt Free-text field to specify which mycotoxins or fungi yielded positive laboratory test results Free-text field to specify which mycotoxins or fungi yielded positive laboratory test results Yes (Specify which mycotoxins/fungi yielded positive results) Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C58214 Laboratory test Echovirus sample type LabTestEchovirusSampleTyp Element related to the sample type used to test for Echovirus Element related to the sample type used to test for Echovirus Sample type Serum;PBMC;Other, specify Serum;PBMC (Peripheral blood mononuclear cell);Other specify Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58192 Laboratory test human herpes virus 6 type LaboratoryTestHHV6Typ Element related to the type of laboratory test used to test for human herpes virus 6 (HHV6) Element related to the type of laboratory test used to test for human herpes virus 6 (HHV6) Test type PCR;Other, specify;Unknown PCR;Other, specify;Unknown Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58228 Laboratory test Chlamydia pneumoniae sample specify text LabTestChlamPneumSampleSpTxt Free-text field to specify other type of sample used to test for Chlamydia pneumoniae Free-text field to specify other type of sample used to test for Chalmydia pneumoniae Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C01711 Lab test result unit of measure LabTestResltUoM Unit of measure for the laboratory test result Unit of measure for the laboratory test result Unit for result Alphanumeric Adult Supplemental 3.00 2013-07-25 08:54:08.2 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58203 Laboratory test Echovirus type other specify text LabTestEchovirusTypOthSpTxt Free-text field related to the other type of laboratory test used to test for Echovirus Free-text field related to the other type of laboratory test used to test for Echovirus Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58241 Laboratory test parvovirus IgG negative strain text LabTestParvovirusIgGNegStrnTxt Free-text field to specify which strain of parvovirus yielded negative IgG laboratory test results Free-text field to specify which strain of parvovirus yielded negative IgG laboratory test results No (Specify which parvovirus strains were tested and found to be negative) Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C58182 Laboratory test mycotoxin fungi negative text LabTestMycoFungiNegTxt Free-text field to specify which mycotoxins or fungi yielded negative laboratory test results Free-text field to specify which mycotoxins or fungi yielded negative laboratory test results No (Specify which mycotoxins/fungi were tested and found to be negative) Alphanumeric Adult Supplemental 3.00 2013-07-30 14:29:49.047 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

C58215 Laboratory test Chlamydia pneumoniae sample type LabTestChlamydPneumSampleTyp Element related to the sample type used to test for Chlamydia pneumoniae Element related to the sample type used to test for Chlamydia pneumoniae Sample type Serum;PBMC;Other, specify Serum;PBMC (Peripheral blood mononuclear cell);Other specify Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58193 Laboratory test Echovirus type LaboratoryTestEchovirusTyp Element related to the type of laboratory test used to test for Echovirus Element related to the type of laboratory test used to test for Echovirus Test type PCR;Other, specify;Unknown PCR;Other, specify;Unknown Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Single Pre-Defined Value Selected

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C58229 Laboratory test Mycoplasma pneumoniae sample specify text LabTestMycopPneumSampleSpTxt Free-text field to specify other type of sample used to test for Mycoplasma pneumoniae Free-text field to specify other type of sample used to test for Mycoplasma pneumoniae Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C58251 Laboratory test tick borne disease positive specify text LaboratoryTestTBDPosSpTxt Free-text field to specify which tick-borne disease test yielded positive results Free-text field to specify which tick-borne disease test yielded positive results Yes Alphanumeric

Specify which TBD yielded positive results

Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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C12779 Test assay perform date TestAssyPerfrmDate Date the confirmatory diagnostic test or assay was performed Date the confirmatory diagnostic test or assay was performed Test date Date or Date & Time Adult Supplemental 3.00 2013-07-24 21:00:23.88 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations

Free-Form Entry

C58204 Laboratory test Chlamydia pneumoniae type other specify text LabTestChlamydPneumTypOthSpTxt Free-text field related to the other type of laboratory test used to test for Chlamydia pneumoniae Free-text field related to the other type of laboratory test used to test for Chlamydia pneumoniae Other, specify: Alphanumeric Adult Supplemental 1.00 2015-02-18 00:00:00.0 Laboratory Tests - Immune Module Laboratory Tests and Biospecimens/Biomarkers Assessments and Examinations 255

Free-Form Entry

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CSV