Sub-Domain: Participant Characteristics
CRF: Surgical History
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 |
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C21669 | Surgical or therapeutic procedure ICD-10-CM other text | SurgTherapuProcICD10CMOTH | The free-text field related to 'Surgical or therapeutic procedure ICD-10-CM code' specifying other text. Code from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for the selected surgical procedure | The free-text field related to 'Surgical or therapeutic procedure ICD-10-CM code' specifying other text. Code from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for the selected surgical procedure | Other, specify | Alphanumeric |
Record a reason for each surgery. If the data will be shared, code each surgical procedure using ICD-10-CM. |
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): http://www.cdc.gov/nchs/icd/icd10cm.htm#icd2016 | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | Surgical History | Participant Characteristics | General Health History | 4000 |
Free-Form Entry |
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C05105 | Surgical or therapeutic procedure end date and time | SurgTherapuProcEndDateTime | Date on which the surgical or therapeutic procedure ended | Date on which the surgical or therapeutic procedure ended | Discharge Date (MM/YYYY) or Age (approximate) | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 21:00:23.88 | Surgical History | Participant Characteristics | General Health History |
Free-Form Entry |
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C05106 | Surgical or therapeutic procedure start date and time | SurgTherapuProcStartDateTime | Date (and time, if applicable and known) on which the surgical or therapeutic procedure started | Date (and time, if applicable and known) on which the surgical or therapeutic procedure started | Admission Date (MM/YYYY) or Age (approximate) | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Surgical History | Participant Characteristics | General Health History |
Free-Form Entry |
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C08018 | Surgery age value | SurgAgeVal | Age of the participant/subject at the time of the selected surgical procedure | Age of the participant/subject at the time of the selected surgical procedure | Admission Date (MM/YYYY) or Age (approximate) Discharge Date (MM/YYYY) or Age (approximate) | Numeric Values |
This value can be captured in years or months. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | Surgical History | Participant Characteristics | General Health History |
Free-Form Entry |
0 | 99 | |||||||||||||||||||||||||||||
C08020 | Surgery reason indication type | SurgRsnIndTyp | Reason participant/subject is in need of surgery | Reason participant/subject is in need of surgery | Reason | Trauma;Cardiomyopathy/Arrhythmia/Cardiac Device Implantation;Tracheostomy;Other, specify | Trauma;Cardiomyopathy/Arrhythmia/Cardiac Device Implantation;Tracheostomy;Other, specify | Alphanumeric |
Record a reason for each surgery. If the data will be shared, code each surgical procedure using ICD-9-CM. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 21:00:23.88 | Surgical History | Participant Characteristics | General Health History |
Single Pre-Defined Value Selected |
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C12671 | Surgery lifetime total count | SurgLftmeTotCt | Total number of surgeries the participant/subject has undergone in his/her lifetime | Total number of surgeries the participant/subject has undergone in his/her lifetime | Total Number of surgeries in lifetime | Numeric Values |
No additional instructions |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:36:20.083 | Surgical History | Participant Characteristics | General Health History |
Free-Form Entry |
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C12672 | Surgical or therapeutic procedure ventilated indicator | SurgTherapProcedVntltdInd | Whether the participant/subject was ventilated during the surgical or therapeutic procedure | Whether the participant/subject was ventilated during the surgical or therapeutic procedure | Ventilated During Surgery? | Yes;No | Yes;No | Alphanumeric |
Choose one. Answer for each surgical procedure in the medical history. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:36:20.083 | Surgical History | Participant Characteristics | General Health History |
Single Pre-Defined Value Selected |
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C18759 | Surgery reason indication other text | SurgRsnIndOTH | The free-text field related to 'Surgery reason indication type' specifying other text. Reason participant/subject is in need of surgery | The free-text field related to 'Surgery reason indication type' specifying other text. Reason participant/subject is in need of surgery | Other, specify | Alphanumeric |
Record a reason for each surgery. If the data will be shared, code each surgical procedure using ICD-9-CM. |
No references available | Adult;Pediatric | Supplemental | 1.00 | 2014-05-27 13:34:46.0 | Surgical History | Participant Characteristics | General Health History | 4000 |
Free-Form Entry |
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C21668 | ICD-10-CM code | SurgTherapuProcICD10CMCode | Code from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-10-CM) for the selected surgical procedure | Code from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-10-CM) for the selected surgical procedure | Reason | Alphanumeric |
Record a reason for each surgery. If the data will be shared, code each surgical procedure using ICD-10-CM. |
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): http://www.cdc.gov/nchs/icd/icd10cm.htm#icd2016 | Adult;Pediatric | Supplemental | 1.00 | 2013-08-28 16:08:00.453 | Surgical History | Participant Characteristics | General Health History |
Multiple Pre-Defined Values Selected |