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Xformpusher
CDASH VariableOrderQuestion TextPromptCRF Completion InstructionsTypeSDTMIG Target VariableSDTMIG Target MappingControlled Terminology Code List NamePermissible ValuesPre-Populated ValueQuery DisplayList StyleHidden
MHYN1Has the subject had any medical conditions or events?Any Medical HistoryIndicate if the subject experienced any medical conditions or events. If Yes, include the appropriate details where indicated on the CRF.TextN/A
(NY)Yes; No

radioMHCAT2What was the category of the medical history?Medical History CategoryIf collected on the CRF, the sponsor provides instructions to ensure the data is entered as intended.TextMHCATSponsor Defined
promptMHSPID3What is the medical condition or event identifier?MH NumberSponsor-Defined CRF Completion InstructionsTextMHSPID






MHTERM4What is the medical condition or event term?Medical History TermRecord all relevant medical conditions or events, as defined in the protocol. Record only one medical condition or event per line. Ensure that the medical conditions or events listed on the Medical History page do not meet any of the exclusion criteria.TextMHTERM






MHSTDAT5What was the medical condition or event start date?Start DateRecord the start date of the medical event or condition using this format (DD-MON-YYYY).DateMHSTDTC



prompt

MHONGO6Is the medical condition or event ongoing?OngoingRecord the medical condition or event as ongoing (Yes) if it has not ended at the time of data collection; the end date should be left blank.TextMHENRF/  MHENRTPT
(NY)Yes; No

radio
MHENDAT7What was the medical condition or event end date?End DateRecord the end date of the medical event or condition using this format (DD-MON-YYYY).DateMHENDTC



prompt

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Rows 1-3:MHCAT indicates that these data were collected on the General Medical History CRF, and MHSCAT indicates the body system for which the event was collected. The reported events were coded using a standard dictionary. MHDECOD and MHBODSYS display the preferred term and body system assigned through the coding process. MHENRTPT was populated based on the response to the "Ongoing" question on the General Medical History CRF. MHENTPT displays the reference date for MHENRTPT, that is, the date the information was collected. If "Yes" was specified for Ongoing, MHENRTPT = "ONGOING"; if "No" was checked, MHENRTPT = "BEFORE". See Section 4.4.7, Use of Relative Timing Variables, for further guidance.
Rows 4-5:MHCAT indicates that these data were collected on the Cardiac Medical History CRF. Because 2 kinds of start date were collected for congestive heart failure, there are 2 records for this event, with start dates of MHEVDTYP = "SYMPTOM ONSET" and MHEVDTYP = "DIAGNOSIS". The sponsor grouped these 2 records using the MHGRPID value "CHF".
Dataset2
RowSTUDYIDDOMAINUSUBJIDMHSEQMHGRPIDMHTERMMHDECODMHEVDTYPMHCATMHSCATMHBODSYSMHSTDTCMHENRTPTMHENTPT
1ABC123MH1231011ASTHMAAsthma
GENERAL MEDICAL HISTORYRESPIRATORYRespiratory system disorders
ONGOING2004-09-18
2ABC123MH1231012FREQUENT HEADACHESHeadache
GENERAL MEDICAL HISTORYCNSCentral and peripheral nervous system disorders
ONGOING2004-09-18
3ABC123MH1231013BROKEN LEGBone fracture
GENERAL MEDICAL HISTORYOTHERMusculoskeletal system disorders
BEFORE2004-09-18
4ABC123MH1231014CHFCONGESTIVE HEART FAILURECardiac failure congestiveSYMPTOM ONSETCARDIAC MEDICAL HISTORY
Cardiac disorders2004-09-17

5ABC123MH1231015CHFCONGESTIVE HEART FAILURECardiac failure congestiveDIAGNOSISCARDIAC MEDICAL HISTORY
Cardiac disorders2004-09-19