ID

43760

Beskrivning

NINDS Common Data Elements (General Health History Friedreich's Ataxia) Used from the National Institute of Neurological Disorders and Stroke Common Data Elements (https://www.commondataelements.ninds.nih.gov/) References: Grinnon ST, Miller K, Marler JR, Lu Y, Stout A, Odenkirchen J, Kunitz S. National Institute of Neurological Disorders and Stroke Common Data Element Project - approach and methods. Clin Trials. 2012;9(3):322-9.

Länk

https://www.commondataelements.ninds.nih.gov/

Nyckelord

  1. 2016-04-29 2016-04-29 -
  2. 2021-09-20 2021-09-20 -
Uppladdad den

20 september 2021

DOI

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Creative Commons BY-NC 3.0

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NINDS CDE General Health History Friedreich's Ataxia

General Health History

  1. StudyEvent: ODM
    1. General Health History
Behavioral History
Beskrivning

Behavioral History

Date of evaluation
Beskrivning

Assessment Date

Datatyp

date

Alias
UMLS CUI [1]
C2985720
Study ID
Beskrivning

Study ID

Datatyp

text

Alias
UMLS CUI [1]
C2826693
Study site name
Beskrivning

Study site

Datatyp

text

Alias
UMLS CUI [1]
C2825164
Subject ID
Beskrivning

Subject ID

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Current tobacco use?
Beskrivning

Regular use of cigarettes, cigars, chewing tobacco or pipes within past year

Datatyp

integer

Alias
UMLS CUI [1]
C1519384
Past tobacco use?
Beskrivning

Regular use of cigarettes, cigars, chewing tobacco or pipes prior to the past year

Datatyp

integer

Alias
UMLS CUI [1]
C1519384
Age started tobacco use
Beskrivning

Age started tobacco use

Datatyp

integer

Måttenheter
  • yrs
Alias
UMLS CUI [1]
C2827019
yrs
Age stopped tobacco use
Beskrivning

Age stopped tobacco use

Datatyp

integer

Måttenheter
  • yrs
Alias
UMLS CUI [1]
C2827008
yrs
Ongoing tobacco use
Beskrivning

Ongoing tobacco use

Datatyp

boolean

Alias
UMLS CUI [1]
C0154517
Type(s) of tobacco used
Beskrivning

Choose all that apply

Datatyp

integer

Alias
UMLS CUI [1]
C3166496
Type of tobacco used: if other type, please specify
Beskrivning

Tobacco use type

Datatyp

text

Alias
UMLS CUI [1]
C3166496
Average number of cigarettes smoked per day
Beskrivning

Skip if cigarettes is NOT an answer in prior Q

Datatyp

integer

Alias
UMLS CUI [1]
C1608325
Current drinker?
Beskrivning

Consumed at least one drink within past year

Datatyp

integer

Alias
UMLS CUI [1]
C0552479
Past drinker?
Beskrivning

Consumed at least one drink prior to the past year

Datatyp

integer

Alias
UMLS CUI [1]
C0552479
Age started drinking
Beskrivning

Age started drinking

Datatyp

integer

Måttenheter
  • yrs
Alias
UMLS CUI [1]
C2827019
yrs
Age quit drinking
Beskrivning

Age quit drinking

Datatyp

integer

Måttenheter
  • yrs
Alias
UMLS CUI [1]
C2827008
yrs
Ongoing use
Beskrivning

Ongoing use

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0038586
UMLS CUI [1,2]
C0549178
How often do you have a drink containing alcohol?
Beskrivning

In the U.S., a single drink serving contains about 14 grams of ethanol or "pure" alcohol.12 ounces of beer equals 8-9 ounces of malt liquor. 8-9 ounces of malt liquor equals 5 ounces of wine. 5 ounces of wine equals 1.5 ounces of hard liquor.

Datatyp

integer

Alias
UMLS CUI [1]
C2826656
How many alcoholic drinks do you have on a typical day when you are drinking?
Beskrivning

Number of drinks

Datatyp

integer

Alias
UMLS CUI [1]
C0551555
How often do you have six or more drinks on one occasion?
Beskrivning

Amount of drinks

Datatyp

integer

Alias
UMLS CUI [1]
C3698589
Have you ever been hospitalized for an alcohol-related problem?
Beskrivning

(e.g., esophageal varices, delirium tremens (DTs), cirrhosis, etc.)

Datatyp

integer

Alias
UMLS CUI [1,1]
C0184666
UMLS CUI [1,2]
C0848950
Current drug user?
Beskrivning

Use of any illicit drug within the past year

Datatyp

integer

Alias
UMLS CUI [1]
C0038586
Current drug user: if yes, please specify illicit drug type(s) used
Beskrivning

Choose all that apply

Datatyp

integer

Alias
UMLS CUI [1]
C0038586
Current user: if other illicit drug(s), please specify
Beskrivning

Drug use history

Datatyp

text

Alias
UMLS CUI [1]
C0038586
Family History
Beskrivning

Family History

Does the participants first degree blood relative have a history of Ataxia
Beskrivning

Family history of Ataxia

Datatyp

integer

Alias
UMLS CUI [1,1]
C0004134
UMLS CUI [1,2]
C0241889
Relationship of Family Member to Participant/ Subject (Choose all that apply)
Beskrivning

Relationship

Datatyp

integer

Alias
UMLS CUI [1]
C0015608
Does the participant/subject’s first degree blood relatives have a history of Cardiomyopathy?
Beskrivning

Family history of Cardiomyopathy

Datatyp

integer

Alias
UMLS CUI [1,1]
C0241889
UMLS CUI [1,2]
C0878544
Relationship of Family Member to Participant/ Subject (Choose all that apply)
Beskrivning

Relationship

Datatyp

integer

Alias
UMLS CUI [1]
C0015608
Does the participant/subject’s first degree blood relatives have a history of Diabetes mellitus
Beskrivning

Family history of diabetes mellitus

Datatyp

integer

Alias
UMLS CUI [1,1]
C0241889
UMLS CUI [1,2]
C0011849
Relationship of Family Member to Participant/ Subject (Choose all that apply)
Beskrivning

Relationship

Datatyp

integer

Alias
UMLS CUI [1]
C0015608
Does the participant/subject’s first degree blood relatives have a history of Friedreich’s Ataxia
Beskrivning

Family History of Friedreich’s Ataxia

Datatyp

integer

Alias
UMLS CUI [1,1]
C0241889
UMLS CUI [1,2]
C0016719
Relationship of Family Member to Participant/ Subject (Choose all that apply)
Beskrivning

Relationship

Datatyp

integer

Alias
UMLS CUI [1]
C0015608
Does the participant/subject’s first degree blood relatives have a history of Mitochondrial Disease
Beskrivning

Family History of Mitochondrial Disease

Datatyp

integer

Alias
UMLS CUI [1,1]
C0241889
UMLS CUI [1,2]
C0751651
Relationship of Family Member to Participant/ Subject (Choose all that apply)
Beskrivning

Relationship

Datatyp

integer

Alias
UMLS CUI [1]
C0015608
History Data Source and Reliability
Beskrivning

History Data Source and Reliability

Indicate how the medical/family history information was obtained
Beskrivning

Choose all that apply

Datatyp

integer

Alias
UMLS CUI [1]
C0683836
If other information source, please specify
Beskrivning

Information source

Datatyp

text

Alias
UMLS CUI [1]
C0683836
If the medical/ family history information was not obtained from the participant/subject, indicate the reason(s) the information were obtained from alternate source(s
Beskrivning

Reason for alternate information source

Datatyp

integer

Alias
UMLS CUI [1,1]
C0683836
UMLS CUI [1,2]
C0566251
If other reason for alternate information source, please specify
Beskrivning

Reason for alternate information source

Datatyp

text

Alias
UMLS CUI [1,1]
C0683836
UMLS CUI [1,2]
C0566251
Overall assessment of the reliability of the medical/family history information obtained:
Beskrivning

Reliability

Datatyp

integer

Alias
UMLS CUI [1]
C0035036
Medical history
Beskrivning

Medical history

Date Medical History Taken
Beskrivning

Date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Have you experienced problems with constitutional symptoms in the past?
Beskrivning

Constitutional symptoms (e.g., fever, weight loss)

Datatyp

boolean

Alias
UMLS CUI [1]
C0009812
Please specify the constitutional symptom you experienced. If there´s more than one, please describe one be one.
Beskrivning

Constitutional symptoms (e.g., fever, weight loss...)Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description

Datatyp

text

Alias
UMLS CUI [1]
C0009812
Start date of constitutional symptom
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of constitutional symptom
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your eyes in the past?
Beskrivning

Eye problems

Datatyp

boolean

Alias
UMLS CUI [1]
C0262477
Please specify the eye problems you experienced. If there´s more than one, please describe one be one.
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description

Datatyp

text

Alias
UMLS CUI [1]
C0262477
Start date of eye problems
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of eye problems
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced ENT or mouth problems in the past?
Beskrivning

Otorhinolaryngologic conditions

Datatyp

boolean

Alias
UMLS CUI [1]
C0029896
Please specify the otorhinolaryngologic conditions or problems with your mouth you experienced. If there´s more than one, please describe one be one.
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description

Datatyp

text

Alias
UMLS CUI [1]
C0029896
Start date of your ENT or mouth problems
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of your ENT or mouth problems
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your cardiovascular system in the past?
Beskrivning

Cardiovascular diseases

Datatyp

boolean

Alias
UMLS CUI [1]
C0007222
Please specify the problems you experienced with your cardiovascular system. If there´s more than one, describe it one by one.
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0007222
Start date of your cardiovascular problems
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of your cardiovascular problems
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced respiratory problems in the past?
Beskrivning

Respiratory disorders

Datatyp

boolean

Alias
UMLS CUI [1]
C0035204
Please specify the respiratory problems you experienced. If there´s more than one, describe it one by one.
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0035204
Start date of your respiratory problems
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of your respiratory problems
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced gastrointestinal problems in the past?
Beskrivning

Gastrointestinal system

Datatyp

boolean

Alias
UMLS CUI [1]
C0012240
Please specify the gastrointestinal problem you experienced. If there´s more than one, describe it one by one
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0012240
Start date of your gastrointestinal problems
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of your gastrointestinal problems
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your genitourinary system in the past?
Beskrivning

Genitourinary system

Datatyp

boolean

Alias
UMLS CUI [1]
C0042066
Please specify the problems with your genitourinary system. If there´s more than one, describe it one by one.
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0042066
Start date of your genitourinary problems
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of your genitourinary problems
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with musculoskeletal system in the past?
Beskrivning

Musculoskeletal system

Datatyp

boolean

Alias
UMLS CUI [1]
C0026860
Please specify the problem with your musculoskeletal system. If there´s more than one, describe it one by one.
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0026860
Start date of your musculoskeletal problem
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of your musculoskeletal problem
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your skin or your breast in the past?
Beskrivning

Integumentary system

Datatyp

boolean

Alias
UMLS CUI [1]
C0037267
Please specify the problems with your integumentary system you experienced. If there´s more than one, describe it one by one.
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0037267
Start date of your problems with the integumentary system
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of your problems with the integumentary system
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced neurological problems with in the past?
Beskrivning

Neurological problems

Datatyp

boolean

Alias
UMLS CUI [1]
C0221571
Please specify the neurological problems you experienced. If there´s more than one, please describe it one be one.
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0221571
Start date of the neurological problem
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of the neurological problem
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your mental health in the past?
Beskrivning

Mental disorders

Datatyp

boolean

Alias
UMLS CUI [1]
C0004936
Please specify the mental problem you experienced. If there´s more than one, please describe it one by one.
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0004936
Start date of your mental illness
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of your mental illness
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your endocrine system in the past?
Beskrivning

Endocrine system diseases

Datatyp

boolean

Alias
UMLS CUI [1]
C0014130
Please specify the endocrine system disease you experienced. If there´s more than one,please describe it one by one
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0014130
Start date of the endocrine system disease
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of the endocrine system disease
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with diseases of blood and bloodforming organs in the past?
Beskrivning

Hematological disease

Datatyp

boolean

Alias
UMLS CUI [1]
C0018939
Please specify the disease of blood and bloodforming organs you experienced. If there´s more than one,please describe it one by one.
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0018939
Start date of your problems with the blood or bloodforming system
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of the problems with your blood or bloodforming system
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with lymphatic diseases in the past?
Beskrivning

Lymphatic disease

Datatyp

boolean

Alias
UMLS CUI [1]
C0024228
Please specify the problem with your lymphatic system you experienced. If there´s more than one, please describe it one by one
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0024228
Start date of your problems with the lymphatic system
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of your problems with the lymphatic system
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with allergies in the past?
Beskrivning

Allergies

Datatyp

boolean

Alias
UMLS CUI [1]
C0020517
Please specify the allergy you experienced. If there´s more than one, please describe it one by one.
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0020517
Start date of the allergy
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of the allergy
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the allergy persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your immune system in the past?
Beskrivning

Immunologic diseases

Datatyp

boolean

Alias
UMLS CUI [1]
C0021053
Please specify the problem with your immune system you experienced. If there´s more than one, please desribe it one by one
Beskrivning

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Datatyp

text

Alias
UMLS CUI [1]
C0021053
Start date of your problems with the immune system
Beskrivning

Start date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
End date of the problems with your immune system
Beskrivning

End date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Beskrivning

Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C0549178
Cardiac condition
Beskrivning

Cardiovascular History

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0007222
Arrhythmia
Beskrivning

Cardiocascular history

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0007222
If cardiac arrhythmia is present,please specify type
Beskrivning

Select all that apply

Datatyp

integer

Alias
UMLS CUI [1]
C0003811
If other Type of cardiac arrhythmia, please specify
Beskrivning

Arrhythmia

Datatyp

text

Alias
UMLS CUI [1]
C0003811
Type of cardiac arrhythmia is unknown
Beskrivning

Arrhythmia

Datatyp

boolean

Alias
UMLS CUI [1]
C0003811
Heart failure
Beskrivning

Cardiovascular history

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0007222
Ischemia heart disease
Beskrivning

Cardiovascular history

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0007222
Abnormal echocardiogram
Beskrivning

Cardiovascular history

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0007222
If abnormal echocardiogram,LVH?
Beskrivning

Abnormal echocardiogram

Datatyp

integer

Alias
UMLS CUI [1]
C0476369
If abnormal echocardiogram: decreased LV function
Beskrivning

Abnormal echocardiogram

Datatyp

integer

Alias
UMLS CUI [1]
C0476369
If other abnormal echocardiogram, please specify
Beskrivning

Abnormal echocardiogram

Datatyp

text

Alias
UMLS CUI [1]
C0476369
Cardiac surgery/mechanical intervention
Beskrivning

Cardiovascular history

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0007222
If Cardiac surgery/mechanical intervention,please specify
Beskrivning

Select all that apply

Datatyp

integer

Alias
UMLS CUI [1,1]
C0018821
UMLS CUI [1,2]
C0581396
Date of most recent surgery
Beskrivning

Cardiac surgery/mechanical intervention

Datatyp

date

Alias
UMLS CUI [1,1]
C0018821
UMLS CUI [1,2]
C0581396
Congenital heart disease
Beskrivning

Cardiovascular history

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0007222
Diabetes mellitus (type I or type II)?
Beskrivning

Endocrine history

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0014130
Diabetes mellitus:If yes
Beskrivning

Diabetes mellitus

Datatyp

integer

Alias
UMLS CUI [1]
C0011849
Diabetes mellitus age at diagnosis
Beskrivning

Diabetes mellitus age at diagnosis

Datatyp

integer

Måttenheter
  • yrs
Alias
UMLS CUI [1,1]
C0011849
UMLS CUI [1,2]
C1828181
yrs
Diabetes mellitus complications
Beskrivning

Select all that apply

Datatyp

integer

Alias
UMLS CUI [1,1]
C0011849
UMLS CUI [1,2]
C0009566
Diabetes mellitus: other complications,please specify
Beskrivning

Diabetes mellitus complications

Datatyp

text

Alias
UMLS CUI [1,1]
C0011849
UMLS CUI [1,2]
C0009566
Indicate the treatments taken for diabetes
Beskrivning

Select all that apply

Datatyp

integer

Alias
UMLS CUI [1,1]
C0011849
UMLS CUI [1,2]
C0087111
Clinical depression within the past year
Beskrivning

Psychiatric history

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0004936
Depressive disorder diagnosis
Beskrivning

Depressive disorder diagnosis

Datatyp

integer

Alias
UMLS CUI [1]
C0011581
Age at which participant/subject experienced first depressive episode or was first diagnosed with depression, whichever is earlier (years):
Beskrivning

Age at diagnosis/onset

Datatyp

integer

Måttenheter
  • yrs
Alias
UMLS CUI [1,1]
C1828181
UMLS CUI [1,2]
C0150907
yrs
Clinical anxiety within the past year
Beskrivning

Psychiatric History

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0004936
Anxiety disorder diagnosis
Beskrivning

Anxiety disorder diagnosis

Datatyp

integer

Alias
UMLS CUI [1]
C0003469
Psychotic disorder diagnosis
Beskrivning

Psychiatric history

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0004936
Psychotic disorder diagnosis: If Yes, choose all disorders that apply
Beskrivning

Psychotic disorder diagnosis

Datatyp

integer

Alias
UMLS CUI [1]
C0033975
If other psychotic disorder diagnosis,please specify
Beskrivning

Psychotic disorder diagnosis

Datatyp

text

Alias
UMLS CUI [1]
C0033975
Cancer
Beskrivning

Miscellaneous History

Datatyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0205395
Cancer diagnosis:if yes, please specify type of cancer diagnosed with
Beskrivning

Cancer diagnosis

Datatyp

text

Alias
UMLS CUI [1]
C0920688
Cancer diagnosis: treated with head or neck radiation?
Beskrivning

Cancer diagnosis

Datatyp

integer

Alias
UMLS CUI [1]
C0920688
Pediatric Developmental History
Beskrivning

Pediatric Developmental History

Does/did the participant/ subject have ADHD/ADD?
Beskrivning

ADHD/ADD

Datatyp

integer

Alias
UMLS CUI [1,1]
C1263846
UMLS CUI [1,2]
C0041671
Does/did the participant/ subject have delayed acquisition of language/cognitive milestones, diagnosed by a pediatrician or neurologist?
Beskrivning

Delayed acquisition of language/cognitive milestones

Datatyp

integer

Alias
UMLS CUI [1,1]
C0023012
UMLS CUI [1,2]
C1959866
Does/did the participant/ subject have delayed acquisition of motor milestones, diagnosed by a pediatrician or neurologist?
Beskrivning

Delayed acquisition of motor milestones

Datatyp

integer

Alias
UMLS CUI [1]
C1854301
Does/did the participant/ subject have social delay?
Beskrivning

Social delay

Datatyp

integer

Alias
UMLS CUI [1]
C3840125
Does/did the participant/ subject have hand preference before 12 months of age?
Beskrivning

Early hand preference

Datatyp

integer

Alias
UMLS CUI [1,1]
C0422881
UMLS CUI [1,2]
C0517081
Does/did the participant/ subject have abnormality of the gait noted by parents or a physician at the time the child began walking?
Beskrivning

Abnormality of the gait

Datatyp

integer

Alias
UMLS CUI [1,1]
C0575081
UMLS CUI [1,2]
C0599196
Does/did the participant/ subject have special education?
Beskrivning

Special education

Datatyp

integer

Alias
UMLS CUI [1]
C0013649
School placement
Beskrivning

School placement

Datatyp

integer

Alias
UMLS CUI [1]
C0455002
If other school placement, please specify
Beskrivning

School placement

Datatyp

text

Alias
UMLS CUI [1]
C0455002
Does/did the participant/subject receive any specialized therapies and services?
Beskrivning

Specialized therapies and services

Datatyp

integer

Alias
UMLS CUI [1]
C0013649
Did the patient receive speech therapy?
Beskrivning

Specialized therapies and services

Datatyp

boolean

Alias
UMLS CUI [1]
C0037831
Did the patient receive Occupational Therapy?
Beskrivning

Specialized therapies and services

Datatyp

boolean

Alias
UMLS CUI [1]
C1318464
Did the patient receive Physical Therapy?
Beskrivning

Specialized therapies and services

Datatyp

boolean

Alias
UMLS CUI [1]
C0949766
Did the patient receive Sensory Integration
Beskrivning

Specialized therapies and services

Datatyp

boolean

Alias
UMLS CUI [1]
C0695560
Did the patient receive Social Skills Training
Beskrivning

Specialized therapies and services

Datatyp

boolean

Alias
UMLS CUI [1]
C0150777
Did the patient receive Adaptive Physical Education
Beskrivning

Specialized therapies and services

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0031805
UMLS CUI [1,2]
C0814282
Did the patient receive Behavior Support Plan
Beskrivning

Specialized therapies and services

Datatyp

boolean

Alias
UMLS CUI [1]
C0150143
Did the patient receive Crisis Management Plan
Beskrivning

Specialized therapies and services

Datatyp

boolean

Alias
UMLS CUI [1]
C1443432
If patient received other specialized therapies and services, please specify
Beskrivning

Specialized therapies and services

Datatyp

text

Alias
UMLS CUI [1]
C0013649
Pregnancy History
Beskrivning

Pregnancy History

Does participant/ subject have a history of prior pregnancy? (both term and not to term)
Beskrivning

Prior pregnancy

Datatyp

integer

Alias
UMLS CUI [1]
C0032967
Number of pregnancies
Beskrivning

Number of pregnancies

Datatyp

integer

Alias
UMLS CUI [1]
C0422807
Year of last delivery or miscarriage
Beskrivning

Date of last delivery or miscarriage

Datatyp

integer

Måttenheter
  • year
Alias
UMLS CUI [1,1]
C3262384
UMLS CUI [1,2]
C0000786
year
Number of miscarriages
Beskrivning

Number of miscarriages

Datatyp

integer

Alias
UMLS CUI [1]
C0429916
Prenatal and Perinatal History
Beskrivning

Prenatal and Perinatal History

Mother’s age at the time she gave birth to the participant/subject
Beskrivning

Mother’s age at the time she gave birth

Datatyp

integer

Måttenheter
  • yrs
Alias
UMLS CUI [1]
C2136466
yrs
Number of live born children the participant/subject’s mother has delivered
Beskrivning

Number of live born children

Datatyp

integer

Alias
UMLS CUI [1]
C0425981
Total number of times the participant/subject’s mother has been pregnant, regardless of whether these pregnancies were carried to term
Beskrivning

(A current pregnancy, if any, is included in this count)

Datatyp

integer

Alias
UMLS CUI [1]
C3812254
Previous pregnancy loss
Beskrivning

Previous pregnancy loss

Datatyp

integer

Alias
UMLS CUI [1]
C0687675
Preeclampsia during pregnancy of the participant/subject?
Beskrivning

Preeclampsia is defined as a physician diagnosis of either preeclampsia or pregnancy-induced hypertension

Datatyp

integer

Alias
UMLS CUI [1]
C0032914
Another hypertensive disorder during pregnancy of the participant/subject?
Beskrivning

Hypertensive disorder during pregnancy

Datatyp

integer

Alias
UMLS CUI [1,1]
C0020538
UMLS CUI [1,2]
C0032962
Oligohydramnios
Beskrivning

condition in pregnancy characterized by a deficiency of amniotic fluid

Datatyp

integer

Alias
UMLS CUI [1]
C0079924
Gestational onset diabetes during pregnancy of the participant/subject?
Beskrivning

Gestational onset diabetes

Datatyp

integer

Alias
UMLS CUI [1]
C0085207
Fever during delivery of participant/subject?
Beskrivning

Fever during delivery

Datatyp

integer

Alias
UMLS CUI [1]
C1389671
Prolonged rupture of membraines (i.e., > 24 hours) during delivery of participant/subject?
Beskrivning

Prolonged rupture of membraines

Datatyp

integer

Alias
UMLS CUI [1]
C0405050
Second stage of labor more than two hours?
Beskrivning

Prolonged second stage of labor

Datatyp

integer

Alias
UMLS CUI [1]
C0157266
Meconium staining of the amniotic fluid?
Beskrivning

Meconium staining

Datatyp

integer

Alias
UMLS CUI [1]
C0426209
Birth weight
Beskrivning

pounds/ounces OR grams

Datatyp

float

Alias
UMLS CUI [1]
C0005612
Gestational Age at Birth
Beskrivning

Gestational Age at Birth

Datatyp

float

Måttenheter
  • weeks
Alias
UMLS CUI [1]
C0456129
weeks
APGAR 5 Minute score
Beskrivning

APGAR

Datatyp

integer

Alias
UMLS CUI [1]
C0003533
APGAR 10 Minute score
Beskrivning

APGAR

Datatyp

integer

Alias
UMLS CUI [1]
C0003533
Mode of delivery of the neonate
Beskrivning

Mode of delivery

Datatyp

integer

Alias
UMLS CUI [1]
C1555567
Route of delivery of the neonate
Beskrivning

Route of delivery

Datatyp

integer

Alias
UMLS CUI [1]
C3656414
If Caesarean section, timing of procedure
Beskrivning

Caesarean section

Datatyp

integer

Alias
UMLS CUI [1]
C0007876
Delivery modality type of the neonate
Beskrivning

Presentation at delivery

Datatyp

integer

Alias
UMLS CUI [1]
C2114311
Instrument(s) used to assist with the delivery of the participant/subject?
Beskrivning

Assisted delivery

Datatyp

integer

Alias
UMLS CUI [1]
C0877233
Resuscitation of the participant/subject at delivery?
Beskrivning

Resuscitation of newborn

Datatyp

integer

Alias
UMLS CUI [1]
C0374651
Intravascular catheter placed in newborn period?
Beskrivning

Intravascular catheter

Datatyp

integer

Alias
UMLS CUI [1]
C0179777
Placenta sent for pathology?
Beskrivning

Placenta sent for pathology

Datatyp

integer

Alias
UMLS CUI [1,1]
C0032043
UMLS CUI [1,2]
C0444061
Placental abnormalities?
Beskrivning

Placental abnormalities

Datatyp

integer

Alias
UMLS CUI [1]
C1306893
Cord abnormalities?
Beskrivning

Cord abnormalities include tight nuchal cord, umbilical cord knot, and body cord.

Datatyp

integer

Alias
UMLS CUI [1]
C0266785
Fetal heart rate abnormality?
Beskrivning

Fetal heart rate abnormalities are considered present if a treating physician noted repetitive or prolonged late decelerations, fetal bradycardia, nonreassuring fetal heart tracing, or fetal distress according to electronic fetal heart rate monitoring

Datatyp

integer

Alias
UMLS CUI [1]
C0695245
Decreased fetal movement?
Beskrivning

Decreased fetal movement refers to a maternal report of decreased fetal movement before labor or decreased fetal movement during a nonstress test

Datatyp

integer

Alias
UMLS CUI [1]
C0235659
Chorioamnionitis
Beskrivning

Chorioamnionitis is defined as a maternal temperature of at least 37.8 degrees C [100.4 degrees F] or a physician diagnosis of chorioamnionitis according to clinical symptoms alone

Datatyp

integer

Alias
UMLS CUI [1]
C0008495
Other pregnancy/delivery risk factors
Beskrivning

Pregnancy/delivery risk factors

Datatyp

integer

Alias
UMLS CUI [1,1]
C0242786
UMLS CUI [1,2]
C1171158

Similar models

General Health History

  1. StudyEvent: ODM
    1. General Health History
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Behavioral History
Assessment Date
Item
Date of evaluation
date
C2985720 (UMLS CUI [1])
Study ID
Item
Study ID
text
C2826693 (UMLS CUI [1])
Study site
Item
Study site name
text
C2825164 (UMLS CUI [1])
Subject ID
Item
Subject ID
text
C2348585 (UMLS CUI [1])
Item
Current tobacco use?
integer
C1519384 (UMLS CUI [1])
Code List
Current tobacco use?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Past tobacco use?
integer
C1519384 (UMLS CUI [1])
Code List
Past tobacco use?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Age started tobacco use
Item
Age started tobacco use
integer
C2827019 (UMLS CUI [1])
Age stopped tobacco use
Item
Age stopped tobacco use
integer
C2827008 (UMLS CUI [1])
Ongoing tobacco use
Item
Ongoing tobacco use
boolean
C0154517 (UMLS CUI [1])
Item
Type(s) of tobacco used
integer
C3166496 (UMLS CUI [1])
Code List
Type(s) of tobacco used
CL Item
Filtered cigarettes(Answer next Q) (1)
CL Item
Cigars (2)
CL Item
Other, specify (3)
CL Item
Non-filtered cigarettes(Answer next Q) (4)
CL Item
Pipes (5)
CL Item
Low tar cigarettes(Answer next Q) (6)
CL Item
Chewing tobacco (7)
Tobacco use type
Item
Type of tobacco used: if other type, please specify
text
C3166496 (UMLS CUI [1])
Item
Average number of cigarettes smoked per day
integer
C1608325 (UMLS CUI [1])
Code List
Average number of cigarettes smoked per day
CL Item
Less than one cigarette per day (1)
CL Item
1 cigarette per day (2)
CL Item
2 to 5 cigarettes per day (3)
CL Item
6 to 15 cigarettes per day(about ½ pack) (4)
CL Item
16 to 25 cigarettes per day (about 1 pack) (5)
CL Item
26 to 35 cigarettes per day (about 1 ½ packs) (6)
CL Item
More than 35 cigarettes per day (about 2 packs or more) (7)
CL Item
Unknown (8)
Item
Current drinker?
integer
C0552479 (UMLS CUI [1])
Code List
Current drinker?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Past drinker?
integer
C0552479 (UMLS CUI [1])
Code List
Past drinker?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Age started drinking
Item
Age started drinking
integer
C2827019 (UMLS CUI [1])
Age quit drinking
Item
Age quit drinking
integer
C2827008 (UMLS CUI [1])
Ongoing use
Item
Ongoing use
boolean
C0038586 (UMLS CUI [1,1])
C0549178 (UMLS CUI [1,2])
Item
How often do you have a drink containing alcohol?
integer
C2826656 (UMLS CUI [1])
Code List
How often do you have a drink containing alcohol?
CL Item
Monthly or less  (1)
CL Item
2 - 4 times/ month  (2)
CL Item
2 - 3 times/ week  (3)
CL Item
4 or more times/ week (4)
CL Item
Unknown(Skip if Question 1 and Question 2 are both NO) (5)
Item
How many alcoholic drinks do you have on a typical day when you are drinking?
integer
C0551555 (UMLS CUI [1])
Code List
How many alcoholic drinks do you have on a typical day when you are drinking?
CL Item
1 or 2  (1)
CL Item
3 or 4  (2)
CL Item
5 or 6  (3)
CL Item
7, 8, or 9  (4)
CL Item
10 or more (5)
CL Item
Unknown (Skip if Q1 and Q2 are both NO) (6)
Item
How often do you have six or more drinks on one occasion?
integer
C3698589 (UMLS CUI [1])
Code List
How often do you have six or more drinks on one occasion?
CL Item
Never  (1)
CL Item
Less than monthly  (2)
CL Item
Monthly  (3)
CL Item
Weekly  (4)
CL Item
Daily or almost daily (5)
CL Item
Unknown (6)
Item
Have you ever been hospitalized for an alcohol-related problem?
integer
C0184666 (UMLS CUI [1,1])
C0848950 (UMLS CUI [1,2])
Code List
Have you ever been hospitalized for an alcohol-related problem?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Current drug user?
integer
C0038586 (UMLS CUI [1])
Code List
Current drug user?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Current drug user: if yes, please specify illicit drug type(s) used
integer
C0038586 (UMLS CUI [1])
Code List
Current drug user: if yes, please specify illicit drug type(s) used
CL Item
Sedatives (e.g., sleeping pills, barbiturates, Seconal, Quaaludes, or Chloral Hydrate) (1)
CL Item
Tranquilizers or anti-anxiety drugs (e.g., Valium®, Librium, muscle relaxants, or Zanax) (2)
CL Item
Painkillers (e.g., Codeine, Darvon, Percodan, Dilaudid, or Demerol) (3)
CL Item
Stimulants (e.g., Preludin, Benzedrine, Methadrine, uppers, or speed) (4)
CL Item
Marijuana, hash, THC, or grass (5)
CL Item
Cocaine or crack (6)
CL Item
Hallucinogens (e.g., Ecstasy, LSD, mescaline, psilocybin, PCP, angel dust, or peyote) (7)
CL Item
Inhalants or Solvents (e.g., amyl nitrate, nitrous oxide, glue, tolune, or gasoline) (8)
CL Item
Heroin (9)
CL Item
Other, specify: (e.g., Methadone, Elavil, steroids,Thorazine, or Haldol) (10)
Drug use history
Item
Current user: if other illicit drug(s), please specify
text
C0038586 (UMLS CUI [1])
Item Group
Family History
Item
Does the participants first degree blood relative have a history of Ataxia
integer
C0004134 (UMLS CUI [1,1])
C0241889 (UMLS CUI [1,2])
Code List
Does the participants first degree blood relative have a history of Ataxia
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Relationship of Family Member to Participant/ Subject (Choose all that apply)
integer
C0015608 (UMLS CUI [1])
Code List
Relationship of Family Member to Participant/ Subject (Choose all that apply)
CL Item
Mother  (1)
CL Item
Father  (2)
CL Item
Sibling (3)
CL Item
Half-Sibling (4)
CL Item
Child (5)
Item
Does the participant/subject’s first degree blood relatives have a history of Cardiomyopathy?
integer
C0241889 (UMLS CUI [1,1])
C0878544 (UMLS CUI [1,2])
Code List
Does the participant/subject’s first degree blood relatives have a history of Cardiomyopathy?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Relationship of Family Member to Participant/ Subject (Choose all that apply)
integer
C0015608 (UMLS CUI [1])
Code List
Relationship of Family Member to Participant/ Subject (Choose all that apply)
CL Item
Mother  (1)
CL Item
Father  (2)
CL Item
Sibling (3)
CL Item
Half-Sibling (4)
CL Item
Child (5)
Item
Does the participant/subject’s first degree blood relatives have a history of Diabetes mellitus
integer
C0241889 (UMLS CUI [1,1])
C0011849 (UMLS CUI [1,2])
Code List
Does the participant/subject’s first degree blood relatives have a history of Diabetes mellitus
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Relationship of Family Member to Participant/ Subject (Choose all that apply)
integer
C0015608 (UMLS CUI [1])
Code List
Relationship of Family Member to Participant/ Subject (Choose all that apply)
CL Item
Mother  (1)
CL Item
Father  (2)
CL Item
Sibling (3)
CL Item
Half-Sibling (4)
CL Item
Child (5)
Item
Does the participant/subject’s first degree blood relatives have a history of Friedreich’s Ataxia
integer
C0241889 (UMLS CUI [1,1])
C0016719 (UMLS CUI [1,2])
Code List
Does the participant/subject’s first degree blood relatives have a history of Friedreich’s Ataxia
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Relationship of Family Member to Participant/ Subject (Choose all that apply)
integer
C0015608 (UMLS CUI [1])
Code List
Relationship of Family Member to Participant/ Subject (Choose all that apply)
CL Item
Mother  (1)
CL Item
Father  (2)
CL Item
Sibling (3)
CL Item
Half-Sibling (4)
CL Item
Child (5)
Item
Does the participant/subject’s first degree blood relatives have a history of Mitochondrial Disease
integer
C0241889 (UMLS CUI [1,1])
C0751651 (UMLS CUI [1,2])
Code List
Does the participant/subject’s first degree blood relatives have a history of Mitochondrial Disease
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Relationship of Family Member to Participant/ Subject (Choose all that apply)
integer
C0015608 (UMLS CUI [1])
Code List
Relationship of Family Member to Participant/ Subject (Choose all that apply)
CL Item
Mother  (1)
CL Item
Father  (2)
CL Item
Sibling (3)
CL Item
Half-Sibling (4)
CL Item
Child (5)
Item Group
History Data Source and Reliability
Item
Indicate how the medical/family history information was obtained
integer
C0683836 (UMLS CUI [1])
Code List
Indicate how the medical/family history information was obtained
CL Item
Participant/Subject (1)
CL Item
Family, specify relation: (2)
CL Item
Friend (3)
CL Item
Physician (4)
CL Item
Chart/Medical record (5)
CL Item
Other, specify (6)
Information source
Item
If other information source, please specify
text
C0683836 (UMLS CUI [1])
Item
If the medical/ family history information was not obtained from the participant/subject, indicate the reason(s) the information were obtained from alternate source(s
integer
C0683836 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Code List
If the medical/ family history information was not obtained from the participant/subject, indicate the reason(s) the information were obtained from alternate source(s
CL Item
Dementia (1)
CL Item
Aphasia (2)
CL Item
Other cognitive impairment (3)
CL Item
Not fluent in examiner’s language (4)
CL Item
Poor historian (5)
CL Item
Too young (6)
CL Item
Other, specify (7)
Reason for alternate information source
Item
If other reason for alternate information source, please specify
text
C0683836 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Item
Overall assessment of the reliability of the medical/family history information obtained:
integer
C0035036 (UMLS CUI [1])
Code List
Overall assessment of the reliability of the medical/family history information obtained:
CL Item
Definitely reliable  (1)
CL Item
Probably reliable  (2)
CL Item
Not reliable (3)
Item Group
Medical history
Date
Item
Date Medical History Taken
date
C0011008 (UMLS CUI [1])
Constitutional symptoms
Item
Have you experienced problems with constitutional symptoms in the past?
boolean
C0009812 (UMLS CUI [1])
Constitutional symptoms
Item
Please specify the constitutional symptom you experienced. If there´s more than one, please describe one be one.
text
C0009812 (UMLS CUI [1])
Start date
Item
Start date of constitutional symptom
date
C0011008 (UMLS CUI [1])
End date
Item
End date of constitutional symptom
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Eye problems
Item
Have you experienced problems with your eyes in the past?
boolean
C0262477 (UMLS CUI [1])
Eye problems
Item
Please specify the eye problems you experienced. If there´s more than one, please describe one be one.
text
C0262477 (UMLS CUI [1])
Start date
Item
Start date of eye problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of eye problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Otorhinolaryngologic conditions
Item
Have you experienced ENT or mouth problems in the past?
boolean
C0029896 (UMLS CUI [1])
Otorhinolaryngologic conditions
Item
Please specify the otorhinolaryngologic conditions or problems with your mouth you experienced. If there´s more than one, please describe one be one.
text
C0029896 (UMLS CUI [1])
Start date
Item
Start date of your ENT or mouth problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your ENT or mouth problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Cardiovascular diseases
Item
Have you experienced problems with your cardiovascular system in the past?
boolean
C0007222 (UMLS CUI [1])
Cardiovascular Diseases
Item
Please specify the problems you experienced with your cardiovascular system. If there´s more than one, describe it one by one.
text
C0007222 (UMLS CUI [1])
Start date
Item
Start date of your cardiovascular problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your cardiovascular problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Respiratory disorders
Item
Have you experienced respiratory problems in the past?
boolean
C0035204 (UMLS CUI [1])
Respiration disorders
Item
Please specify the respiratory problems you experienced. If there´s more than one, describe it one by one.
text
C0035204 (UMLS CUI [1])
Start date
Item
Start date of your respiratory problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your respiratory problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Gastrointestinal system
Item
Have you experienced gastrointestinal problems in the past?
boolean
C0012240 (UMLS CUI [1])
Gastrointestinal system
Item
Please specify the gastrointestinal problem you experienced. If there´s more than one, describe it one by one
text
C0012240 (UMLS CUI [1])
Start date
Item
Start date of your gastrointestinal problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your gastrointestinal problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Genitourinary system
Item
Have you experienced problems with your genitourinary system in the past?
boolean
C0042066 (UMLS CUI [1])
Genitourinary system
Item
Please specify the problems with your genitourinary system. If there´s more than one, describe it one by one.
text
C0042066 (UMLS CUI [1])
Start date
Item
Start date of your genitourinary problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your genitourinary problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Musculoskeletal system
Item
Have you experienced problems with musculoskeletal system in the past?
boolean
C0026860 (UMLS CUI [1])
Musculoskeletal System
Item
Please specify the problem with your musculoskeletal system. If there´s more than one, describe it one by one.
text
C0026860 (UMLS CUI [1])
Start date
Item
Start date of your musculoskeletal problem
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your musculoskeletal problem
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Integumentary system
Item
Have you experienced problems with your skin or your breast in the past?
boolean
C0037267 (UMLS CUI [1])
Integumentary system
Item
Please specify the problems with your integumentary system you experienced. If there´s more than one, describe it one by one.
text
C0037267 (UMLS CUI [1])
Start date
Item
Start date of your problems with the integumentary system
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your problems with the integumentary system
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Neurological problems
Item
Have you experienced neurological problems with in the past?
boolean
C0221571 (UMLS CUI [1])
Neurological problems
Item
Please specify the neurological problems you experienced. If there´s more than one, please describe it one be one.
text
C0221571 (UMLS CUI [1])
Start date
Item
Start date of the neurological problem
date
C0011008 (UMLS CUI [1])
End date
Item
End date of the neurological problem
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Mental disorders
Item
Have you experienced problems with your mental health in the past?
boolean
C0004936 (UMLS CUI [1])
Mental disorders
Item
Please specify the mental problem you experienced. If there´s more than one, please describe it one by one.
text
C0004936 (UMLS CUI [1])
Start date
Item
Start date of your mental illness
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your mental illness
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Endocrine system diseases
Item
Have you experienced problems with your endocrine system in the past?
boolean
C0014130 (UMLS CUI [1])
Endocrine system diseases
Item
Please specify the endocrine system disease you experienced. If there´s more than one,please describe it one by one
text
C0014130 (UMLS CUI [1])
Start date
Item
Start date of the endocrine system disease
date
C0011008 (UMLS CUI [1])
End date
Item
End date of the endocrine system disease
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Hematological disease
Item
Have you experienced problems with diseases of blood and bloodforming organs in the past?
boolean
C0018939 (UMLS CUI [1])
Hematological disease
Item
Please specify the disease of blood and bloodforming organs you experienced. If there´s more than one,please describe it one by one.
text
C0018939 (UMLS CUI [1])
Start date
Item
Start date of your problems with the blood or bloodforming system
date
C0011008 (UMLS CUI [1])
End date
Item
End date of the problems with your blood or bloodforming system
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Lymphatic disease
Item
Have you experienced problems with lymphatic diseases in the past?
boolean
C0024228 (UMLS CUI [1])
Lymphatic disease
Item
Please specify the problem with your lymphatic system you experienced. If there´s more than one, please describe it one by one
text
C0024228 (UMLS CUI [1])
Start date
Item
Start date of your problems with the lymphatic system
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your problems with the lymphatic system
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Allergies
Item
Have you experienced problems with allergies in the past?
boolean
C0020517 (UMLS CUI [1])
Allergies
Item
Please specify the allergy you experienced. If there´s more than one, please describe it one by one.
text
C0020517 (UMLS CUI [1])
Start date
Item
Start date of the allergy
date
C0011008 (UMLS CUI [1])
End date
Item
End date of the allergy
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the allergy persistent?
boolean
C0549178 (UMLS CUI [1])
Immunologic diseases
Item
Have you experienced problems with your immune system in the past?
boolean
C0021053 (UMLS CUI [1])
Immunologic diseases
Item
Please specify the problem with your immune system you experienced. If there´s more than one, please desribe it one by one
text
C0021053 (UMLS CUI [1])
Start date
Item
Start date of your problems with the immune system
date
C0011008 (UMLS CUI [1])
End date
Item
End date of the problems with your immune system
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Item
Cardiac condition
integer
C0262926 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
Code List
Cardiac condition
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Arrhythmia
integer
C0262926 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
Code List
Arrhythmia
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
If cardiac arrhythmia is present,please specify type
integer
C0003811 (UMLS CUI [1])
Code List
If cardiac arrhythmia is present,please specify type
CL Item
Atrial fibrillation (1)
CL Item
Atrial flutter (2)
CL Item
Supraventricular tachycardia (3)
CL Item
Ventricular tachycardia (4)
CL Item
Bradycardia (5)
CL Item
Other, specify (6)
Arrhythmia
Item
If other Type of cardiac arrhythmia, please specify
text
C0003811 (UMLS CUI [1])
Arrhythmia
Item
Type of cardiac arrhythmia is unknown
boolean
C0003811 (UMLS CUI [1])
Item
Heart failure
integer
C0262926 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
Code List
Heart failure
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Ischemia heart disease
integer
C0262926 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
Code List
Ischemia heart disease
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Abnormal echocardiogram
integer
C0262926 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
Code List
Abnormal echocardiogram
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
If abnormal echocardiogram,LVH?
integer
C0476369 (UMLS CUI [1])
Code List
If abnormal echocardiogram,LVH?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
If abnormal echocardiogram: decreased LV function
integer
C0476369 (UMLS CUI [1])
Code List
If abnormal echocardiogram: decreased LV function
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Abnormal echocardiogram
Item
If other abnormal echocardiogram, please specify
text
C0476369 (UMLS CUI [1])
Item
Cardiac surgery/mechanical intervention
integer
C0262926 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
Code List
Cardiac surgery/mechanical intervention
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
If Cardiac surgery/mechanical intervention,please specify
integer
C0018821 (UMLS CUI [1,1])
C0581396 (UMLS CUI [1,2])
Code List
If Cardiac surgery/mechanical intervention,please specify
CL Item
Coronary artery bypass graft (CABG) (1)
CL Item
Cardiac valve surgery, including non-open surgery (i.e., percutaneous valvuloplasty) (2)
CL Item
Pacemaker (3)
CL Item
Implantable cardic defibrillator  (4)
CL Item
Other, specify (5)
Cardiac surgery/mechanical intervention
Item
Date of most recent surgery
date
C0018821 (UMLS CUI [1,1])
C0581396 (UMLS CUI [1,2])
Item
Congenital heart disease
integer
C0262926 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
Code List
Congenital heart disease
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Diabetes mellitus (type I or type II)?
integer
C0262926 (UMLS CUI [1,1])
C0014130 (UMLS CUI [1,2])
Code List
Diabetes mellitus (type I or type II)?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Diabetes mellitus:If yes
integer
C0011849 (UMLS CUI [1])
Code List
Diabetes mellitus:If yes
CL Item
Type I (1)
CL Item
Type II (2)
Diabetes mellitus age at diagnosis
Item
Diabetes mellitus age at diagnosis
integer
C0011849 (UMLS CUI [1,1])
C1828181 (UMLS CUI [1,2])
Item
Diabetes mellitus complications
integer
C0011849 (UMLS CUI [1,1])
C0009566 (UMLS CUI [1,2])
Code List
Diabetes mellitus complications
CL Item
Nephropathy (1)
CL Item
Neuropathy (2)
CL Item
Retinopathy (3)
CL Item
Other, specify (4)
CL Item
None (5)
Diabetes mellitus complications
Item
Diabetes mellitus: other complications,please specify
text
C0011849 (UMLS CUI [1,1])
C0009566 (UMLS CUI [1,2])
Item
Indicate the treatments taken for diabetes
integer
C0011849 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
Code List
Indicate the treatments taken for diabetes
CL Item
Diet (1)
CL Item
Oral medication (2)
CL Item
Insulin (3)
CL Item
None (4)
Item
Clinical depression within the past year
integer
C0262926 (UMLS CUI [1,1])
C0004936 (UMLS CUI [1,2])
Code List
Clinical depression within the past year
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Depressive disorder diagnosis
integer
C0011581 (UMLS CUI [1])
Code List
Depressive disorder diagnosis
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Age at diagnosis/onset
Item
Age at which participant/subject experienced first depressive episode or was first diagnosed with depression, whichever is earlier (years):
integer
C1828181 (UMLS CUI [1,1])
C0150907 (UMLS CUI [1,2])
Item
Clinical anxiety within the past year
integer
C0262926 (UMLS CUI [1,1])
C0004936 (UMLS CUI [1,2])
Code List
Clinical anxiety within the past year
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Anxiety disorder diagnosis
integer
C0003469 (UMLS CUI [1])
Code List
Anxiety disorder diagnosis
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Psychotic disorder diagnosis
integer
C0262926 (UMLS CUI [1,1])
C0004936 (UMLS CUI [1,2])
Code List
Psychotic disorder diagnosis
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Psychotic disorder diagnosis: If Yes, choose all disorders that apply
integer
C0033975 (UMLS CUI [1])
Code List
Psychotic disorder diagnosis: If Yes, choose all disorders that apply
CL Item
Schizophrenia (1)
CL Item
Bipolar disorder (2)
CL Item
Depression with psychotic features (3)
CL Item
Dementia with psychotic ideation (4)
CL Item
Other, specify (5)
Psychotic disorder diagnosis
Item
If other psychotic disorder diagnosis,please specify
text
C0033975 (UMLS CUI [1])
Item
Cancer
integer
C0262926 (UMLS CUI [1,1])
C0205395 (UMLS CUI [1,2])
Code List
Cancer
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Cancer diagnosis
Item
Cancer diagnosis:if yes, please specify type of cancer diagnosed with
text
C0920688 (UMLS CUI [1])
Item
Cancer diagnosis: treated with head or neck radiation?
integer
C0920688 (UMLS CUI [1])
Code List
Cancer diagnosis: treated with head or neck radiation?
CL Item
Yes (1)
CL Item
No/Not documented (2)
CL Item
Unknown (3)
Item Group
Pediatric Developmental History
Item
Does/did the participant/ subject have ADHD/ADD?
integer
C1263846 (UMLS CUI [1,1])
C0041671 (UMLS CUI [1,2])
Code List
Does/did the participant/ subject have ADHD/ADD?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Does/did the participant/ subject have delayed acquisition of language/cognitive milestones, diagnosed by a pediatrician or neurologist?
integer
C0023012 (UMLS CUI [1,1])
C1959866 (UMLS CUI [1,2])
Code List
Does/did the participant/ subject have delayed acquisition of language/cognitive milestones, diagnosed by a pediatrician or neurologist?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Does/did the participant/ subject have delayed acquisition of motor milestones, diagnosed by a pediatrician or neurologist?
integer
C1854301 (UMLS CUI [1])
Code List
Does/did the participant/ subject have delayed acquisition of motor milestones, diagnosed by a pediatrician or neurologist?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Does/did the participant/ subject have social delay?
integer
C3840125 (UMLS CUI [1])
Code List
Does/did the participant/ subject have social delay?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Does/did the participant/ subject have hand preference before 12 months of age?
integer
C0422881 (UMLS CUI [1,1])
C0517081 (UMLS CUI [1,2])
Code List
Does/did the participant/ subject have hand preference before 12 months of age?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Does/did the participant/ subject have abnormality of the gait noted by parents or a physician at the time the child began walking?
integer
C0575081 (UMLS CUI [1,1])
C0599196 (UMLS CUI [1,2])
Code List
Does/did the participant/ subject have abnormality of the gait noted by parents or a physician at the time the child began walking?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Does/did the participant/ subject have special education?
integer
C0013649 (UMLS CUI [1])
Code List
Does/did the participant/ subject have special education?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
School placement
integer
C0455002 (UMLS CUI [1])
Code List
School placement
CL Item
Full-time regular education without aide (1)
CL Item
Full-time regular education with one to one aide (2)
CL Item
Regular education with pull-out for certain areas (3)
CL Item
Special education w/ minimal inclusion (e.g., lunch) (4)
CL Item
Full-time special education with no inclusion (5)
CL Item
Special (MR/DD) school (6)
CL Item
Home-school (7)
CL Item
Not in school (8)
CL Item
Other, specify (9)
School placement
Item
If other school placement, please specify
text
C0455002 (UMLS CUI [1])
Item
Does/did the participant/subject receive any specialized therapies and services?
integer
C0013649 (UMLS CUI [1])
Code List
Does/did the participant/subject receive any specialized therapies and services?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Specialized therapies and services
Item
Did the patient receive speech therapy?
boolean
C0037831 (UMLS CUI [1])
Specialized therapies and services
Item
Did the patient receive Occupational Therapy?
boolean
C1318464 (UMLS CUI [1])
Specialized therapies and services
Item
Did the patient receive Physical Therapy?
boolean
C0949766 (UMLS CUI [1])
Specialized therapies and services
Item
Did the patient receive Sensory Integration
boolean
C0695560 (UMLS CUI [1])
Specialized therapies and services
Item
Did the patient receive Social Skills Training
boolean
C0150777 (UMLS CUI [1])
Specialized therapies and services
Item
Did the patient receive Adaptive Physical Education
boolean
C0031805 (UMLS CUI [1,1])
C0814282 (UMLS CUI [1,2])
Specialized therapies and services
Item
Did the patient receive Behavior Support Plan
boolean
C0150143 (UMLS CUI [1])
Specialized therapies and services
Item
Did the patient receive Crisis Management Plan
boolean
C1443432 (UMLS CUI [1])
Specialized therapies and services
Item
If patient received other specialized therapies and services, please specify
text
C0013649 (UMLS CUI [1])
Item Group
Pregnancy History
Item
Does participant/ subject have a history of prior pregnancy? (both term and not to term)
integer
C0032967 (UMLS CUI [1])
Code List
Does participant/ subject have a history of prior pregnancy? (both term and not to term)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Number of pregnancies
Item
Number of pregnancies
integer
C0422807 (UMLS CUI [1])
Date of last delivery or miscarriage
Item
Year of last delivery or miscarriage
integer
C3262384 (UMLS CUI [1,1])
C0000786 (UMLS CUI [1,2])
Number of miscarriages
Item
Number of miscarriages
integer
C0429916 (UMLS CUI [1])
Item Group
Prenatal and Perinatal History
Mother’s age at the time she gave birth
Item
Mother’s age at the time she gave birth to the participant/subject
integer
C2136466 (UMLS CUI [1])
Number of live born children
Item
Number of live born children the participant/subject’s mother has delivered
integer
C0425981 (UMLS CUI [1])
Number of pregnancies
Item
Total number of times the participant/subject’s mother has been pregnant, regardless of whether these pregnancies were carried to term
integer
C3812254 (UMLS CUI [1])
Item
Previous pregnancy loss
integer
C0687675 (UMLS CUI [1])
Code List
Previous pregnancy loss
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Preeclampsia during pregnancy of the participant/subject?
integer
C0032914 (UMLS CUI [1])
Code List
Preeclampsia during pregnancy of the participant/subject?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Another hypertensive disorder during pregnancy of the participant/subject?
integer
C0020538 (UMLS CUI [1,1])
C0032962 (UMLS CUI [1,2])
Code List
Another hypertensive disorder during pregnancy of the participant/subject?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Oligohydramnios
integer
C0079924 (UMLS CUI [1])
Code List
Oligohydramnios
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Gestational onset diabetes during pregnancy of the participant/subject?
integer
C0085207 (UMLS CUI [1])
Code List
Gestational onset diabetes during pregnancy of the participant/subject?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Fever during delivery of participant/subject?
integer
C1389671 (UMLS CUI [1])
Code List
Fever during delivery of participant/subject?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Prolonged rupture of membraines (i.e., > 24 hours) during delivery of participant/subject?
integer
C0405050 (UMLS CUI [1])
Code List
Prolonged rupture of membraines (i.e., > 24 hours) during delivery of participant/subject?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Second stage of labor more than two hours?
integer
C0157266 (UMLS CUI [1])
Code List
Second stage of labor more than two hours?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Meconium staining of the amniotic fluid?
integer
C0426209 (UMLS CUI [1])
Code List
Meconium staining of the amniotic fluid?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Birth weight
Item
Birth weight
float
C0005612 (UMLS CUI [1])
Gestational Age at Birth
Item
Gestational Age at Birth
float
C0456129 (UMLS CUI [1])
Item
APGAR 5 Minute score
integer
C0003533 (UMLS CUI [1])
Code List
APGAR 5 Minute score
CL Item
0 (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
CL Item
10 (10)
Item
APGAR 10 Minute score
integer
C0003533 (UMLS CUI [1])
Code List
APGAR 10 Minute score
CL Item
0 (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
CL Item
10 (10)
Item
Mode of delivery of the neonate
integer
C1555567 (UMLS CUI [1])
Code List
Mode of delivery of the neonate
CL Item
Spontaneous  (1)
CL Item
Induced  (2)
CL Item
Unknown (3)
Item
Route of delivery of the neonate
integer
C3656414 (UMLS CUI [1])
Code List
Route of delivery of the neonate
CL Item
Vaginal (1)
CL Item
Caesarean (2)
Item
If Caesarean section, timing of procedure
integer
C0007876 (UMLS CUI [1])
Code List
If Caesarean section, timing of procedure
CL Item
Emergency  (1)
CL Item
Elective  (2)
CL Item
Unknown (3)
Item
Delivery modality type of the neonate
integer
C2114311 (UMLS CUI [1])
Code List
Delivery modality type of the neonate
CL Item
Breech  (1)
CL Item
Cephalic  (2)
CL Item
Unknown (3)
Item
Instrument(s) used to assist with the delivery of the participant/subject?
integer
C0877233 (UMLS CUI [1])
Code List
Instrument(s) used to assist with the delivery of the participant/subject?
CL Item
None  (1)
CL Item
Vaccum  (2)
CL Item
Forceps  (3)
CL Item
Vaccum and Forceps  (4)
CL Item
Unknown (5)
Item
Resuscitation of the participant/subject at delivery?
integer
C0374651 (UMLS CUI [1])
Code List
Resuscitation of the participant/subject at delivery?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Intravascular catheter placed in newborn period?
integer
C0179777 (UMLS CUI [1])
Code List
Intravascular catheter placed in newborn period?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Placenta sent for pathology?
integer
C0032043 (UMLS CUI [1,1])
C0444061 (UMLS CUI [1,2])
Code List
Placenta sent for pathology?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Placental abnormalities?
integer
C1306893 (UMLS CUI [1])
Code List
Placental abnormalities?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Cord abnormalities?
integer
C0266785 (UMLS CUI [1])
Code List
Cord abnormalities?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Fetal heart rate abnormality?
integer
C0695245 (UMLS CUI [1])
Code List
Fetal heart rate abnormality?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Decreased fetal movement?
integer
C0235659 (UMLS CUI [1])
Code List
Decreased fetal movement?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Chorioamnionitis
integer
C0008495 (UMLS CUI [1])
Code List
Chorioamnionitis
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Other pregnancy/delivery risk factors
integer
C0242786 (UMLS CUI [1,1])
C1171158 (UMLS CUI [1,2])
Code List
Other pregnancy/delivery risk factors
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)

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