CDE Detailed Report
Disease: system
Subdomain Name: General Health History
CRF: files
Displaying 51 - 63 of 63
Subdomain Name: General Health History
CRF: files
Displaying 51 - 63 of 63
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C58303 | Bath water source other text | BathWaterSourceOthTxt | The free-text field related to 'Bath water source' specifying other text | The free-text field related to 'Bath water source' specifying other text | Other, specify: | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:34:05.0 | Exposure History | General Health History | Participant History and Family History | 16 |
Free-Form Entry |
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| C58258 | Nuclear power plant live within 300 meter indicator | NucPwrPlntLvWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of a nuclear power plant | Indicator of whether the subject/participant currently lives within 300 meters of a nuclear power plant | Nuclear power plant: | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:23:34.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58315 | Chemical biological exposure reaction grade | ChemBioExposurReactnGrade | Grade of subject/participant's reaction to the chemical or biological substance selected in 'Chemical biological exposure substance type' | Grade of subject/participant's reaction to the chemical or biological substance selected in 'Chemical biological exposure substance type' | Reaction to exposure | None, Unknown;Mild;Moderate;Severe | None, Unknown;Mild;Moderate;Severe | Alphanumeric |
Please choose 'None, Unknown' if the participant does not know if there has been an exposure |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 12:06:23.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58273 | Insect borne pathogen endemic area live within 300 meter indicator | InsBrnPthEndArLvWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) | Indicator of whether the subject/participant currently lives within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) | Area where Lyme Disease, Zika virus or other insect borne pathogens are endemic: | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:37:27.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58290 | Residence heat fuel type | ResidenceHeatFuelTyp | Type of fuel used to heat the subject/participant's residence | Type of fuel used to heat the subject/participant's residence | What type of fuel is used for heating? | Propane;Electricity;Wood;Oil;Natural gas | Propane;Electricity;Wood;Oil;Natural gas | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:10:08.0 | Exposure History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C58247 | Dump site live within 300 meter type | DmpSitLivWin300MTyp | Type of dump site that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Type of dump site that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Dump site (please specify type) | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:09:57.0 | Exposure History | General Health History | Participant History and Family History | 128 |
Free-Form Entry |
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| C58304 | Pesticide use residence indicator | PestcidUseResdncInd | Indicator of whether pesticides are used in the subject/participant's residence | Indicator of whether pesticides are used in the subject/participant's residence | Is there use of pesticides to kill bugs (e.g. bedbugs, spiders, cockroaches, ants, fleas, ticks) as sprays, collars, powders, pellets in your home/apartment/building? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:35:26.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58259 | Nuclear power plant ever live within 300 meter year range | NucPwrPlntEvrLvWin300MYrRng | Range of years during which the subject/participant lived within 300 meters of a nuclear power plant | Range of years during which the subject/participant lived within 300 meters of a nuclear power plant | Nuclear power plant: | Alphanumeric |
If you ever lived nearby, please write the years: |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:24:41.0 | Exposure History | General Health History | Participant History and Family History | 25 |
Free-Form Entry |
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| C58274 | Insect borne pathogen endemic area ever live within 300 meter year range | InsBrnPthEndArEvLvWin300MYrRng | Range of years during which the subject/participant lived within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) | Range of years during which the subject/participant lived within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) | Area where Lyme Disease, Zika virus or other insect borne pathogens are endemic | Alphanumeric |
If you ever lived nearby, please write the years. |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:39:32.0 | Exposure History | General Health History | Participant History and Family History | 25 |
Free-Form Entry |
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| C58291 | Residence test radon indicator | ResidenceTestRadonInd | Indicator of whether the subject/participant's residence has been tested for radon | Indicator of whether the subject/participant's residence has been tested for radon | Has your home or apartment building been tested for radon? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:13:19.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58248 | Pesticide spray area live within 300 meter indicator | PstcdSpryAreaLvWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of a pesticide spray area (e.g., farm, orchard, golf course) | Indicator of whether the subject/participant currently lives within 300 meters of a pesticide spray area (e.g., farm, orchard, golf course) | Areas sprayed with pesticides, e.g., farms, orchards, golf course: | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:12:31.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58305 | Pesticide residence type | PesticideResidenceTyp | Type(s) of pesticide(s) used in the subject/participant's residence | Type(s) of pesticide(s) used in the subject/participant's residence | Please specify type: | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:36:46.0 | Exposure History | General Health History | Participant History and Family History | 128 |
Free-Form Entry |
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| C58261 | Electrical tower live within 300 meter indicator | ElectrcTwrLvWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of an electrical tower | Indicator of whether the subject/participant currently lives within 300 meters of an electrical tower | Electricity towers: | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:25:24.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
