CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Participant Characteristics
CRF: Behavioral History Short Form
Sub-Domain: Participant Characteristics
CRF: Behavioral History Short Form
7 results.
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Additional Notes (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 | Source | Form Set | Form | Field | Domain | CDASH Variable | CDASH Definition | CDASH Label | Controlled Terminology | Prompt | Essentiality | Question Text | CDASH imp guidance | SDTM IG target | csDSR | PhenX | Data Type | CRF Completion Inst | SDTMIG Target Var | SDTMIG Target Map | Codelist Name | PVs | Pre Pop Value | Query Display | List Style |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C60618 | Alcohol history status | AlcoholHxStatus | Status of the subject/participant's history of alcohol consumption. | Status of the subject/participant's history of alcohol consumption. | Alcohol history | None;Currently drink alcohol;Formerly drank alcohol | None;Currently drink alcohol;Formerly drank alcohol | Alphanumeric | Adult;Pediatric | Supplemental - Highly Recommended | 1.00 | 2021-04-29 14:08:05.0 | Behavioral History Short Form | Participant Characteristics | General Health History |
Single Pre-Defined Value Selected |
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| C60619 | Alcohol drink per week maximum count | AlcoholDrinkPerWkMaxCt | Count of alcoholic drinks per week consumed by the subject/participant in the period of his or her maximum alcohol consumption. | Count of alcoholic drinks per week consumed by the subject/participant in the period of his or her maximum alcohol consumption. | Maximum drinks/week | Numeric Values | Adult;Pediatric | Supplemental - Highly Recommended | 1.00 | 2021-04-29 14:10:51.0 | Behavioral History Short Form | Participant Characteristics | General Health History |
Free-Form Entry |
1 | alcoholic drinks per week | |||||||||||||||||||||||||||||||
| C60620 | Drug use history status | DrugUseHxStatus | Status of the subject/participant's history of drug use. | Status of the subject/participant's history of drug use. | Drug Use History | None;Current drug use;Former drug use | None;Current drug use;Former drug use | Alphanumeric | Adult;Pediatric | Supplemental - Highly Recommended | 1.00 | 2021-04-29 14:13:25.0 | Behavioral History Short Form | Participant Characteristics | General Health History |
Single Pre-Defined Value Selected |
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| C60621 | Drug illicit use type | DrugIllicitUseTyp | Type(s) of illicit drugs used by the subject/participant | Type(s) of illicit drugs used by the subject/participant | If Former or Current drug use, specify | Amphetamines;Heroin;Marijuana;Cocaine;Other, specify | Amphetamines;Heroin;Marijuana;Cocaine;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental - Highly Recommended | 1.00 | 2021-04-29 14:17:31.0 | Behavioral History Short Form | Participant Characteristics | General Health History |
Multiple Pre-Defined Values Selected |
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| C60615 | Smoking start year integer | SmokingStartYrIntg | Integer identifying the year in which the subject/participant began smoking. | Integer identifying the year in which the subject/participant began smoking. | If Current or Former smoker: Year Started: | Numeric Values | Adult;Pediatric | Core | 1.00 | 2021-04-29 13:59:09.0 | Behavioral History Short Form | Participant Characteristics | General Health History |
Free-Form Entry |
1900 | ||||||||||||||||||||||||||||||||
| C60616 | Cigarette pack per day maximum count | CigaretPckPerDayMaxCt | Count of packs per day the subject/participant smoked when he or she was smoking the most. | Count of packs per day the subject/participant smoked when he or she was smoking the most. | Maximum packs/day | Numeric Values | Adult;Pediatric | Core | 1.00 | 2021-04-29 14:03:05.0 | Behavioral History Short Form | Participant Characteristics | General Health History |
Free-Form Entry |
1 | 20 | pack per day | ||||||||||||||||||||||||||||||
| C60617 | Smoking stop year integer | SmokingStopYrIntg | Integer identifying the year in which the subject/participant stopped smoking. | Integer identifying the year in which the subject/participant stopped smoking. | Year Stopped (if Former smoker): | Numeric Values | Adult;Pediatric | Core | 1.00 | 2021-04-29 13:59:09.0 | Behavioral History Short Form | Participant Characteristics | General Health History |
Free-Form Entry |
1900 |
7 results.