NDAABCDCCFOAINIAAADAAMP SCZHEALNBBPEC

Data Structure

ACE Subject Medical History

Version 015975 Shared Subjects
Short Name: ace_subjmedhist01
Categories: Med History

ACE Subject Medical History

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Definition
Submission Template

A Collection's submission must be cumulative.

124 Elements

Name
Type
Required
Description
Value Range
Notes
subjectkeyGUIDRequiredThe NDAR Global Unique Identifier (GUID) for research subjectNDAR*
src_subject_idStringRequiredSubject ID how it's defined in lab/project
interview_ageIntegerRequiredAge in months at the time of the interview/test/sampling/imaging.0::1440Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month.
interview_dateDateRequiredDate on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY
sexStringRequiredSex of subject at birthM;F; O; NRM = Male; F = Female; O=Other; NR = Not reported
comments_miscStringRecommendedMiscellaneous comments on study, interview, methodology relevant to this form data
data_derivedIntegerRequiredData Derived From1::4; 9991 = Physical examination; 2 = Medical record; 3 = Both; 4=Parental report; 999=missing
diag_aofcIntegerRecommendedAge of First Concern(in months)0 :: 1200; -999
devel_concernStringRecommendedDevelopmental concern1 = Cognitive/learning; 2 = Behavior; 3 = Hearing; 4 = Motor; 5 = Language; 6= all
aut_diagIntegerRequiredAutism-related diagnosis1::4;9991 = Autism; 2 = Autism Spectrum Disorder; 3 = Asperger syndrome; 4 = PDD-NOS
diag_ageatdiagIntegerRecommendedAge at diagnosis(in months)0 :: 1200
diag_diagnosismadebyStringRecommendedDiagnosis made byPhysician;Psychologist;Other; NKNK = Not known
preg_complicStringRequiredComplications during pregnancy?Yes; No; NKNK = Not known
preg_dxdrugStringRequiredUsed prescription medications during pregnancy?Yes; No; NKNK = Not known
full_termStringRequiredFull-term delivery? 37-42 weeksYes; No; NKNK = Not known
info_gestStringRecommendedNo. Weeks Gestation (G.A.)
birth_weight_lbsFloatRecommendedBirth weight pounds
ldnb_lgthinFloatRecommendedWhat was the babys length at birth(inches)-1 = Not known
ldnb_hosptotalbabydayFloatRecommendedHow many days total did this baby stay in the hospital (after delivery up until discharge, including the neonatal ICU) (days)0 :: 365
earlydev_walkIntegerRecommendedAge when first walked unaided (in months)995 = Still not reached; 996 = N/K, but apparently normal; 997 = N/K, but apparently delayed; 998 = N/A; 999 = N/K or not asked
ad016IntegerRecommendedAge of first single words (months)994 = Milestone not reached; 996 = N/K, but apparently normal; 997 = N/K, but apparently delayed; 998 = N/A; 999 = N/K or not asked
age_3wordIntegerRecommendedAge at 3-word sentences (in months)
current_langStringRecommendedCurrent speech/language. Verbal?Yes; No; NKNK = Not known
verb_wordsIntegerRecommended"If yes, how many words?"1::41 = <10 Single words; 2 = Speaks in 10 or more single words; 3 = Speaks in 2 word combinations; 4 = Speaks in 3 or more word combinations
othmem_devdelayStringRecommendedDevelopmental DelayYes;No; NKNK = Not known
school_perfIntegerRecommendedSchool Performance1::4; -9991 = Below grade level; 2 = At grade level; 3 = Above grade level; 4 = Mixed (at or above grade level in some areas and below grade level in other areas); -999 = milestone not reached
rx_behavStringRequiredPrescription medications for behavioral concernsYes; No; NKNK = Not known
rx_physStringRequiredPrescription medications for physical health concernsYes; No; NKNK = Not known
otc_medStringRequiredOver-the-counter medicationsYes; No; NKNK = Not known
ds_medStringRequiredDietary supplementsYes; No; NKNK = Not known
gastro_spec_dietStringRequiredDoes subject have a special diet?Yes; No; NKNK = Not known
rev_headmeningitisStringRecommendedMeningitisYes; No; NK; NSNK= Not known; NS = Not sure
rev_headmeningitisageIntegerRecommendedMeningitis: Age(in months)0 :: 1200
rev_headmeningitisorgStringRecommendedMeningitis: Organism
rev_headencephalitisStringRecommendedEncephalitisYes; No; NK; NSNK= Not known; NS = Not sure
rev_headencephalitisageIntegerRecommendedEncephalitis: Age(in months)0 :: 1200
rev_headencephalitisorgStringRecommendedEncephalitis: Organism
rev_headfebseizStringRecommendedFebrile SeizuresYes; No; NK; NSNK= Not known; NS = Not sure
rev_headfebseizagesStringRecommendedFebrile Seizures: Age(S)
rev_headseizureStringRequiredSeizuresYes; No; NK; NSNK= Not known; NS = Not sure
rev_headseizureonsetStringRecommendedSeizures: Onset
rev_headseizurecontrolStringRequiredSeizures: ControlledYes;No;NKNK = Not known
fhxcpStringRequiredCerebral PalsyYes;No; NKNK = Not known
hist_traumaStringRecommendedHistory of head traumaYes; No; NK; NSNK= Not known; NS = Not sure
rev_headimagestudyStringRecommendedImaging StudiesYes;No;NKNK = Not known
rev_headimagestudytypeStringRecommendedImaging Studies: TypeUS;CT;MR;PET;EEG; MR; any combinations of these types
rev_headimagestudyresultStringRecommendedImaging Studies: ResultsNormal; Abnormal
vis_blindStringRecommendedSignificant visual loss or congenital blindnessYes; No; NKNK = Not known
rev_eartestStringRecommendedHearing Testing:Yes;No;NKNK = Not known
rev_eartestagesStringRecommendedHearing Testing: Age(S)
rev_eartestresultStringRecommendedHearing Testing: ResultNormal;Abnormal;Unknown
hear_lossStringRequiredDeafness or significant hearing lossYes;No;NKNK = Not known
othmem_hearingcorStringRecommendedHearing corrected?Yes;No; NKNK = Not known
rev_earrecuotitisStringRequiredRecurrent Otitis MediaYes; No; NK; NSNK= Not known; NS = Not sure
rev_earrecuotitisyearIntegerRecommendedRecurrent Otitis Media: #Year
rev_earrecuotitisageIntegerRecommendedRecurrent Otitis Media: Age of Onset(in months)0 :: 1200
rev_earpetubeStringRecommendedPE TubesYes;No;NKNK = Not known
rev_mouthcleftlipStringRecommendedIs there a cleft lip and/or cleft palate?Yes;No;NKNK = Not known
rev_mouthcleftpalateStringRecommendedCleft PalateYes;No;NKNK = Not known
rev_teethdentalabStringRecommendedDental abnormalitiesYes;No;NKNK = Not known
rev_neckspinalabStringRecommendedSpinal abnormalitiesYes;No;NKNK = Not known
rev_skinbirthmarkStringRecommendedBirthmarks (e.g., cafe-au-lait spots, white spots)Yes;No;NKNK = Not known
rev_skineczemaStringRecommendedEczemaYes;No;NKNK = Not known
rev_skinabcessesStringRequiredSkin Infections/AbcessesYes;No;NKNK = Not known
rev_pulbreathabStringRecommendedAbnormal BreathingYes;No;NKNK = Not known
rev_pulasthmaStringRequiredAsthmaYes;No;NKNK = Not known
rev_lungStringRecommendedLung diseaseYes;No;NKNK = Not known
rev_cardiomalfuncStringRequiredCardiac MalformationYes;No;NKNK = Not known
rev_cardiocyanosisStringRecommendedCyanosisYes;No;NKNK = Not known
rev_rythmStringRecommendedAbnormal rhythm or heart rateYes;No;NKNK = Not known
rev_gastrodysphagiaStringRecommendedDysphagiaYes;No;NKNK = Not known
rev_gastrorefluxStringRequiredRefluxYes; No; NK; NSNK= Not known; NS = Not sure
rev_gastrorefluxmedStringRequiredReflux: Medication RequiredYes;No;NKNK = Not known
rev_gastrootherStringRecommendedOther feeding difficultiesYes;No;NKNK = Not known
rev_endoprecociousStringRecommendedPrecocious PubertyYes;No;NKNK = Not known
rev_endoprecociousageIntegerRecommendedPrecocious Puberty: Age(in months)0 :: 1200
rev_endohypothyroidismStringRequiredHypothyroidismYes;No;NKNK = Not known
rev_endohyperthyroidismStringRequiredHyperthyroidismYes;No;NKNK = Not known
rev_endodiabetesStringRequiredDiabetesYes;No;NKNK = Not known
rev_endodiabetestypeStringRequiredDiabetes: TypeI;II;NA
rev_endohypoglycemiaStringRecommendedHypoglycemiaYes;No;NKNK = Not known
rev_hemanemiaStringRecommendedAnemiaYes;No;NKNK = Not known
rev_hembleeddisorderStringRecommendedBleeding disorderYes;No;NKNK = Not known
rev_immunorecurinfectionStringRequiredRecurrent Infections((>2 pneum or sinus infect/yr, >8 OM /yr, absesses))Yes;No;NKNK = Not known
rev_immunoigdeficiencyStringRecommendedIg DeficiencyYes;No;NKNK = Not known
rev_immunocellimmunedefStringRecommendedCell Mediated Immune Def.Yes;No;NKNK = Not known
rev_immunoenvallergyStringRequiredEnvironmental AllergiesYes;No;NKNK = Not known
rev_immunomedallergyStringRequiredMedication AllergiesYes;No;NK;NANK = Not known; NA=Not Applicable
rev_immunoimmunizationStringRecommendedImmunizationsUp to date;Behind;None;NKNK = Not known
gen_disIntegerRequiredDoes the study subject have any of the following genetic disorders?1::5;9991 = Rett syndrome; 2 = Down syndrome; 3 = Tuberous Sclerosis Complex; 4 = Fragile X syndrome; 5 = Neurofibromatosis I
gen_dis_confStringRecommended"If check above, is the genetic disorder confirmed by a physician-ordered genetic analysis"Yes;No;NKNK = Not known
othmem_bipolarStringRecommendedBipolar disorder (Manic/depression)Yes;No; NKNK = Not known
othmem_depressionStringRecommendedDepressionYes;No; NKNK = Not known
othmem_anxietyStringRecommendedAnxiety disorderYes;No; NKNK = Not known
cfmh_othr_ocdIntegerRecommendedObsessive compulsive disorder1;0; -90 = No; 1 = Yes; -9 = Not known
othmem_schizophreniaStringRecommendedSchizophreniaYes;No; NKNK = Not known
othmem_selfinjStringRecommendedSelf-injuring behaviorYes;No; NKNK = Not known
othmem_adhdStringRecommendedAttention deficit hyperactivity disorder (ADHD)Yes;No; NKNK = Not known
othmem_eatingdisStringRecommendedEating disorder. Bulimia, Anorexia, otherYes;No; NKNK = Not known
othmem_eatingdis_typeStringRecommendedIf yes, specify type
sleep_patStringRecommendedDisrupted sleep patternsYes;No;NKNK = Not known
touretStringRequiredTourette SyndromeYes; No; NK; NSNK= Not known; NS = Not sure
birth_weight_ozFloatRecommendedBirth weight ounces
cfmh_othr_autismIntegerRecommendedAutism1;00 = No; 1 = Yes
cfmh_othr_pddnosIntegerRecommendedAutism Spectrum Disorder0::20 = No; 1 = Yes; 2 = Cannot be ruled out
cfmh_othr_aspergersIntegerRecommendedAsperger's Syndrome1;00 = No; 1 = Yes
aut_diag_pddnosIntegerRecommendedPervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)0;10 = No; 1 = Yes
aut_diag_otherIntegerRecommendedAutism-related diagnosis - Other0; 10 = No; 1 = Yes
diag_diagnosismadeby_aIntegerRecommendedDiagnosis made by - Physician0;10 = No; 1 = Yes
diag_diagnosismadeby_bIntegerRecommendedDiagnosis made by - Psychologist0;10 = No; 1 = Yes
diag_diagnosismadeby_cIntegerRecommendedDiagnosis made by - Other0;10 = No; 1 = Yes
diag_diagnosismadeby_dIntegerRecommendedDiagnosis made by - Not Known0;10 = No; 1 = Yes
hhb_med_yn_dt1IntegerRecommendedDiabetes Type 10;1;-900;-3000= No; 1= Yes; -900 = Missing; -300 = N/A
hhb_med_yn_dt2IntegerRecommendedDiabetes Type 20;1;-900;-3000= No; 1= Yes; -900 = Missing; -300 = N/A
rev_endodiabetestype_cIntegerRecommendedDiabetes Type - Not Known0;10 = No; 1 = Yes
rev_immunoimmunization_aIntegerRecommendedImmunizations - Not Known0;10 = No; 1 = Yes
rev_immunoimmunization_bIntegerRecommendedImmunizations - Up to date0;10 = No; 1 = Yes
rev_immunoimmunization_cIntegerRecommendedImmunizations - Behind0;10 = No; 1 = Yes
rev_immunoimmunization_dIntegerRecommendedImmunizations - None0;10 = No; 1 = Yes
cfmh_othr_rettsIntegerRecommendedRett's Syndrome1;00 = No; 1 = Yes
cfmh_othr_downssyndIntegerRecommendedDown's Syndrome1;00 = No; 1 = Yes
cfmh_othr_tubersclIntegerRecommendedTuberous Sclerosis1;00 = No; 1 = Yes
cfmh_othr_fragilexIntegerRecommendedFragile X1;00 = No; 1 = Yes
neurofibromatosisIntegerRecommendedNeurofibromatosis I0;10 = No; 1 = Yes