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Description
Value Range
Notes
Data Structures with shared data
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ACE Subject Medical History

ace_subjmedhist

01

ACE Subject Medical History

Download Definition as
Download Submission Template as
Files
PDF file iconACE Subject Medical History Form.pdf
URLs
Element NameData TypeSizeRequiredDescriptionValue RangeNotes
subjectkeyGUIDRequiredThe NDAR Global Unique Identifier (GUID) for research subjectNDAR*
src_subject_idString20RequiredSubject ID how it's defined in lab/project
interview_ageIntegerRequiredAge in months at the time of the interview/test/sampling/imaging.0 :: 1260Age 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 was completed. MM/DD/YYYYRequired field
genderString20RequiredSex of the subjectM;FM = Male; F = Female
comments_miscString4,000RecommendedMiscellaneous comments on study, interview, methodology relevant to this form data
data_derivedIntegerRequiredData Derived From1::41 = Physical examination; 2 = Medical record; 3 = Both; 4=Parental report
diag_aofcIntegerRecommendedAge of First Concern(in months)0 :: 1200
devel_concernString10RecommendedDevelopmental 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_diagnosismadebyString50RecommendedDiagnosis made byPhysician;Psychologist;Other; NKNK = Not known
preg_complicString10RequiredComplications during pregnancy?Yes; No; NKNK = Not known
preg_dxdrugString10RequiredUsed prescription medications during pregnancy?
Yes; No; NK
NK = Not known
full_termString10RequiredFull-term delivery? 37-42 weeks
Yes; No; NK
NK = Not known
info_gestString50RecommendedNo. 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_langString10RecommendedCurrent speech/language. Verbal?Yes; No; NKNK = Not known
verb_wordsIntegerRecommendedIf 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_devdelayString50RecommendedDevelopmental Delay
Yes;No; NK
NK = Not known
school_perfIntegerRecommendedSchool Performance1::41 = 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)
rx_behavString10RequiredPrescription medications for behavioral concernsYes; No; NKNK = Not known
rx_physString10RequiredPrescription medications for physical health concernsYes; No; NKNK = Not known
otc_medString10RequiredOver-the-counter medicationsYes; No; NKNK = Not known
ds_medString10RequiredDietary supplementsYes; No; NKNK = Not known
gastro_spec_dietString50RequiredDoes subject have a special diet?Yes; No; NKNK = Not known
rev_headmeningitisString50RecommendedMeningitisYes; No; NK; NSNK= Not known; NS = Not sure
rev_headmeningitisageIntegerRecommendedMeningitis: Age(in months)0 :: 1200
rev_headmeningitisorgString255RecommendedMeningitis: Organism
rev_headencephalitisString50RecommendedEncephalitis
Yes; No; NK; NS
NK= Not known; NS = Not sure
rev_headencephalitisageIntegerRecommendedEncephalitis: Age(in months)0 :: 1200
rev_headencephalitisorgString255RecommendedEncephalitis: Organism
rev_headfebseizString50RecommendedFebrile Seizures
Yes; No; NK; NS
NK= Not known; NS = Not sure
rev_headfebseizagesString255RecommendedFebrile Seizures: Age(S)
rev_headseizureString50RequiredSeizuresYes; No; NK; NSNK= Not known; NS = Not sure
rev_headseizureonsetString255RecommendedSeizures: Onset
rev_headseizurecontrolString50RequiredSeizures: Controlled
Yes;No;NK
NK = Not known
fhxcpString5RequiredCerebral Palsy
Yes;No; NK
NK = Not known
hist_traumaString10RecommendedHistory of head trauma
Yes; No; NK; NS
NK= Not known; NS = Not sure
rev_headimagestudyString50RecommendedImaging Studies
Yes;No;NK
NK = Not known
rev_headimagestudytypeString50RecommendedImaging Studies: TypeUS;CT;MR;PET;EEG; MR; any combinations of these types
rev_headimagestudyresultString255RecommendedImaging Studies: ResultsNormal; Abnormal
vis_blindString10RecommendedSignificant visual loss or congenital blindnessYes; No; NKNK = Not known
rev_eartestString50RecommendedHearing Testing:
Yes;No;NK
NK = Not known
rev_eartestagesString255RecommendedHearing Testing: Age(S)
rev_eartestresultString50RecommendedHearing Testing: ResultNormal;Abnormal;Unknown
hear_lossString10RequiredDeafness or significant hearing loss
Yes;No;NK
NK = Not known
othmem_hearingcorString50RecommendedHearing corrected?
Yes;No
rev_earrecuotitisString50RequiredRecurrent Otitis Media
Yes; No; NK; NS
NK= Not known; NS = Not sure
rev_earrecuotitisyearIntegerRecommendedRecurrent Otitis Media: #Year
rev_earrecuotitisageIntegerRecommendedRecurrent Otitis Media: Age of Onset(in months)0 :: 1200
rev_earpetubeString50RecommendedPE Tubes
Yes;No;NK
NK = Not known
rev_mouthcleftlipString50RecommendedIs there a cleft lip and/or cleft palate?
Yes;No;NK
NK = Not known
rev_mouthcleftpalateString50RecommendedCleft Palate
Yes;No;NK
NK = Not known
rev_teethdentalabString50RecommendedDental abnormalities
Yes;No;NK
NK = Not known
rev_neckspinalabString50RecommendedSpinal abnormalities
Yes;No;NK
NK = Not known
rev_skinbirthmarkString50RecommendedBirthmarks (e.g., cafe-au-lait spots, white spots)
Yes;No;NK
NK = Not known
rev_skineczemaString50RecommendedEczema
Yes;No;NK
NK = Not known
rev_skinabcessesString50RequiredSkin Infections/Abcesses
Yes;No;NK
NK = Not known
rev_pulbreathabString50RecommendedAbnormal Breathing
Yes;No;NK
NK = Not known
rev_pulasthmaString50RequiredAsthma
Yes;No;NK
NK = Not known
rev_lungString10RecommendedLung diseaseYes;No;NKNK = Not known
rev_cardiomalfuncString50RequiredCardiac Malformation
Yes;No;NK
NK = Not known
rev_cardiocyanosisString50RecommendedCyanosis
Yes;No;NK
NK = Not known
rev_rythmString10RecommendedAbnormal rhythm or heart rateYes;No;NKNK = Not known
rev_gastrodysphagiaString50RecommendedDysphagia
Yes;No;NK
NK = Not known
rev_gastrorefluxString50RequiredReflux
Yes; No; NK; NS
NK= Not known; NS = Not sure
rev_gastrorefluxmedString50RequiredReflux: Medication Required
Yes;No;NK
NK = Not known
rev_gastrootherString50RecommendedOther feeding difficulties
Yes;No;NK
NK = Not known
rev_endoprecociousString50RecommendedPrecocious Puberty
Yes;No;NK
NK = Not known
rev_endoprecociousageIntegerRecommendedPrecocious Puberty: Age(in months)0 :: 1200
rev_endohypothyroidismString50RequiredHypothyroidism
Yes;No;NK
NK = Not known
rev_endohyperthyroidismString50RequiredHyperthyroidism
Yes;No;NK
NK = Not known
rev_endodiabetesString50RequiredDiabetes
Yes;No;NK
NK = Not known
rev_endodiabetestypeString50RequiredDiabetes: TypeI;II;999
rev_endohypoglycemiaString50RecommendedHypoglycemia
Yes;No;NK
NK = Not known
rev_hemanemiaString50RecommendedAnemia
Yes;No;NK
NK = Not known
rev_hembleeddisorderString50RecommendedBleeding disorder
Yes;No;NK
NK = Not known
rev_immunorecurinfectionString50RequiredRecurrent Infections((>2 pneum or sinus infect/yr, >8 OM /yr, absesses))
Yes;No;NK
NK = Not known
rev_immunoigdeficiencyString50RecommendedIg Deficiency
Yes;No;NK
NK = Not known
rev_immunocellimmunedefString50RecommendedCell Mediated Immune Def.
Yes;No;NK
NK = Not known
rev_immunoenvallergyString50RequiredEnvironmental Allergies
Yes;No;NK
NK = Not known
rev_immunomedallergyString50RequiredMedication Allergies
Yes;No;NK;NA
NK = Not known; NA=Not Applicable
rev_immunoimmunizationString50RecommendedImmunizations
Up to date;Behind;None;NK
NK = 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_confString10RecommendedIf check above, is the genetic disorder confirmed by a physician-ordered genetic analysisYes;No;NKNK = Not known
othmem_bipolarString50RecommendedBipolar disorder (Manic/depression)
Yes;No; NK
NK = Not known
othmem_depressionString50RecommendedDepression
Yes;No; NK
NK = Not known
othmem_anxietyString50RecommendedAnxiety disorder
Yes;No; NK
NK = Not known
cfmh_othr_ocdIntegerRecommendedObsessive compulsive disorder1;0; -90 = No; 1 = Yes; -9 = Not known
othmem_schizophreniaString50RecommendedSchizophrenia
Yes;No; NK
NK = Not known
othmem_selfinjString50RecommendedSelf-injuring behavior
Yes;No; NK
NK = Not known
othmem_adhdString50RecommendedAttention deficit hyperactivity disorder (ADHD)
Yes;No; NK
NK = Not known
othmem_eatingdisString50RecommendedEating disorder. Bulimia, Anorexia, other
Yes;No; NK
NK = Not known
othmem_eatingdis_typeString100RecommendedIf yes, specify type
sleep_patString10RecommendedDisrupted sleep patternsYes;No;NKNK = Not known
touretString10RequiredTourette Syndrome
Yes; No; NK; NS
NK= Not known; NS = Not sure
Data Structure

This page displays the data structure defined for the measure identified in the title and structure short name. The table below displays a list of data elements in this structure (also called variables) and the following information:

  • Element Name: This is the standard element name
  • Data Type: Which type of data this element is, e.g. String, Float, File location.
  • Size: If applicable, the character limit of this element
  • Required: This column displays whether the element is Required for valid submissions, Recommended for valid submissions, Conditional on other elements, or Optional
  • Description: A basic description
  • Value Range: Which values can appear validly in this element (case sensitive for strings)
  • Notes: Expanded description or notes on coding of values
  • Aliases: A list of currently supported Aliases (alternate element names)
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Please email the The NDA Help Desk with any questions.

Distribution for DataStructure: ace_subjmedhist01 and Element:
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