CDE Detailed Report
Disease: cookie-policy
Sub-Domain: Participant Characteristics
CRF:
Sub-Domain: Participant Characteristics
CRF:
5 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 |
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C19500 | Assessment performed date | AssessmentPerformedDate | The date of assessment of the examination being performed. | The date of assessment of the examination being performed. | Date of Interview/Examination/Bioassay (MM/DD/YYYY): | Date or Date & Time | Adult;Pediatric | Proposed | 1.00 | 2014-06-18 08:10:12.0 | PhenX Toolkit: Ethnicity Data Collection Worksheet | Participant Characteristics | Demographics |
Free-Form Entry |
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C59281 | Hispanic latino spanish origin code | HspncLtnSpnshOriginCode | Code indicating whether a person is of Hispanic, Latino or Spanish origin. | Code indicating whether a person is of Hispanic, Latino or Spanish origin. | Do you consider yourself to be Hispanic, Latino, or of Spanish origin? | 1;2;7;9 | Yes;No;Refused;Don't know | Alphanumeric | Adult;Pediatric | Proposed | 1.00 | 2019-03-28 17:26:08.0 | PhenX Toolkit: Ethnicity Data Collection Worksheet | Participant Characteristics | Demographics |
Single Pre-Defined Value Selected |
PhenX | Core Tier 1 | Ethnicity | 1 | |||||||||||||||||||||||||||
C59282 | Ancestry code | AncestryCode | Code indicating where the subject/participant's ancestors came from. | Code indicating where the subject/participant's ancestors came from. | READ IF NECESSARY: Where do your ancestors come from? | Puerto Rican;Cuban or Cuban American;Dominican Republic;Mexican or Mexican American;Central or South American;Other Latin American;Other Hispanic or Latino | Puerto Rican;Cuban or Cuban American;Dominican Republic;Mexican or Mexican American;Central or South American;Other Latin American;Other Hispanic or Latino | Alphanumeric | Adult;Pediatric | Proposed | 1.00 | 2019-03-28 17:40:33.0 | PhenX Toolkit: Ethnicity Data Collection Worksheet | Participant Characteristics | Demographics |
Multiple Pre-Defined Values Selected |
PhenX | Core Tier 2 | Ethnicity | 2 | |||||||||||||||||||||||||||
C59283 | Ancestor country code | AncestorCountryCode | Code indicating subject or participant's ancestor country of origin. | Code indicating subject or participant's ancestor country of origin. |
Please give the number of the group that represents your Hispanic/Latino or Spanish origin or ancestry. Please select 1 or more of these categories. PROBE: Where do your ancestors come from? |
10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30;31;32;33;34;35;36;40;41;77;99 | Mexican;Puerto Rican;Cuban;Dominican Republic;Costa Rican;Guatemalan;Honduran;Nicaraguan;Panamanian;Salvadoran;Other Central American;Argentinean;Bolivian;Chilean;Colombian;Ecuadorian;Paraguayan;Peruvian;Uruguayan;Venezuelan;Other South American;Filipino;Spaniard;Spanish;Spanish American;Hispano/Hispana;Hispanic/Latino;Other Hispanic/Latino (specificy);Chicano;Refused;Don't know | Alphanumeric | Adult;Pediatric | Proposed | 1.00 | 2019-03-28 17:51:24.0 | PhenX Toolkit: Ethnicity Data Collection Worksheet | Participant Characteristics | Demographics |
Multiple Pre-Defined Values Selected |
PhenX | Core Tier 1 | Ethnicity | 3 | |||||||||||||||||||||||||||
C59284 | Specific Hispanic Latino type | SpecificHispanicLatinoTyp | Type indicating the specific Hispanic/Latino ancestry if not otherwise listed. | Type indicating the specific Hispanic/Latino ancestry if not otherwise listed. | If 'Other Hispanic/Latino', please specify: | Alphanumeric | Adult;Pediatric | Proposed | 1.00 | 2019-03-28 18:33:20.0 | PhenX Toolkit: Ethnicity Data Collection Worksheet | Participant Characteristics | Demographics | 255 |
Free-Form Entry |
PhenX | Core Tier 1 | Ethnicity | n/a |
5 results.