|
subjectkey |
GUID |
|
Required |
The NDAR Global Unique Identifier (GUID) for research subject |
NDAR*
|
|
guid |
|
src_subject_id |
String |
20
|
Required |
Subject ID how it's defined in lab/project |
|
|
aid, bid, id, patid, pid, randid, record_id, subject_id, subjectid, subjectnumber |
|
interview_date |
Date |
|
Required |
Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY |
|
|
co_doa, datacollecteddate, intvdate, med_history_date, med_hx_visit_date, v1_pe_date, visit_date |
|
interview_age |
Integer |
|
Required |
Age in months at the time of the interview/test/sampling/imaging. |
0::1440
|
Age 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.
|
intvage, v1_pe_age |
|
sex |
String |
20
|
Required |
Sex of subject at birth |
|
M = Male; F = Female; O=Other; NR = Not reported
|
gender |
Query
|
relationship |
Integer |
|
Recommended |
Relationship of respondent to individual |
|
1 = Biological mom; 2 = Biological dad; 3 = Grandparent; 4 = Special education (sped) teacher; 5 = General education teacher; 6 = Occupational therapist; 7 = Speech and language therapist; 8 = Behavioral therapist; 9 = Paraprofessional; 10 = Aide; 11 = Principal; 12 = Administrator; 14 = Content teacher; 15 = Parent center director; 16 = Self; 17=Adoptive mother; 18=Adoptive father; 19=Foster mother; 20 = Foster father; 21=Grandmother; 22=Grandfather; 23=Step-mother; 24 = Step-father; 25=Aunt; 26=Uncle; 28=Both parents;31= Grandmother from mother side; 32= Grandfather from mother side; 33= Grandmother from father side; 34= Grandfather from father side; 36= Brother; 37= Sister; 38= Cousin; 39= female caregiver; 40=male caregiver; 41=Female child; 42=Male child; 43=Spouse/Mate; 44=Friend; 45=Parent; 46=Significant other; 47=Sibling; 48=Son/Daughter; 49=Son-in-law/Daughter-in law; 50=Other Relative; 51=Paid caregiver; 52=Friends; 53=Roommate; 54=Supervisor; 55=mother's boyfriend; 56=other parental figure; 57=Summary; 58=counselor ; 59 = other female relative; 60 = other male relative; 61 = non-relative ; 62=Maternal Aunt; 63=Maternal Uncle; 64=Maternal Cousin; 65 = Paternal Aunt; 66=Paternal Uncle; 67=Paternal Cousin ; 68=Biological/Adoptive Mother and Grandmother; 69=Biological/Adoptive Mother and Stepmother and Grandmother; 70=Biological/Adoptive Mother and Grandmother and Foster Father; 71=Biological/Adoptive Mother and Stepmother and Foster Mother; 72=Biological/Adoptive Mother and Foster Mother; 73=Biological/Adoptive Mother and Biological/Adoptive Father; 74=Biological/Adoptive Mother and Stepmother and Biological/Adoptive Father; 75=Biological/Adoptive Mother and Other; 76=Biological/Adoptive Mother and Stepmother and Stepfather; 77=Biological/Adoptive Mother and Stepfather; 78=Biological/Adoptive Mother and Grandfather; 79=Biological/Adoptive Mother and Stepmother and Foster Father; 80=Biological/Adoptive Mother and Stepmother; 81=Guardian, female; 82=Other female; 83=Guardian, male; 84=Other male; 85=Other/Grandparent/Nanny; 86 = Mother, Father, Guardian; 87 = Daughter, son, grandchild; 88 = Professional (e.g., social worker, nurse, therapist, psychiatrist, or group home staff); -999=Missing; 89 = Biological parent; 90=Other; 91 = Stepparent; 92 = Adoptive parent; 93 = Foster parent; 94 = Co-worker
|
RESPREL |
|
respondent_other_specify |
String |
50
|
Recommended |
Respondent: Other (specify) |
|
|
RESPREL_SP |
Query
|
age_concern |
Integer |
|
Recommended |
Age of first developmental concern (months) |
0 :: 1200
|
|
DIAG_AOFC, agedevelopconcernsmon |
Query
|
devel_concern_cog |
Integer |
|
Recommended |
2. Developmental concerns (check all that apply): (choice=Cognitive/learning) |
0;1
|
0=Unchecked; 1=Checked
|
developconcernscheck_cognitivele |
Query
|
devel_concern_beh |
Integer |
|
Recommended |
2. Developmental concerns (check all that apply): (choice=Behavior) |
0;1
|
0=Unchecked; 1=Checked
|
developconcernscheck_behavior |
Query
|
devel_concern_hear |
Integer |
|
Recommended |
2. Developmental concerns (check all that apply): (choice=Hearing) |
0;1
|
0=Unchecked; 1=Checked
|
developconcernscheck_hearing |
Query
|
devel_concern_mot |
Integer |
|
Recommended |
2. Developmental concerns (check all that apply): (choice=Motor) |
0;1
|
0=Unchecked; 1=Checked
|
developconcernscheck_motor |
Query
|
devel_concern_lang |
Integer |
|
Recommended |
2. Developmental concerns (check all that apply): (choice=Language) |
0;1
|
0=Unchecked; 1=Checked
|
developconcernscheck_language |
Query
|
aut_diag |
Integer |
|
Required |
Autism-related diagnosis |
1::4;999
|
1 = Autism; 2 = Autism Spectrum Disorder; 3 = Asperger syndrome; 4 = PDD-NOS
|
autismrelateddiagche, diagnosis |
Query
|
diag_diagnosismadeby |
String |
50
|
Recommended |
Diagnosis made by |
Physician;Psychologist;Other; NK
|
NK = Not known
|
diagmadeby, diagnosismadeby |
Query
|
diagnosis_other |
String |
20
|
Recommended |
Did the subject recieve another diagnosis? |
Yes; No; Don't Know (DK); Not Applicable (N/A)
|
|
OTHDIAGYN, developconcernscheck_other |
|
diagnosis_other_specify |
String |
500
|
Recommended |
What other diagnoses has the participant had? |
|
|
OTHDIAGSP, autismrelateddiagotherspec, developconcernsother |
Query
|
othdiagy |
Integer |
|
Recommended |
other diagnosis Years |
|
|
|
Query
|
othdiagm |
Integer |
|
Recommended |
other diagnosis Months |
|
|
|
Query
|
othdiag_age |
Integer |
|
Recommended |
Age at other diagnosis months |
|
|
|
Query
|
preg_complic |
String |
10
|
Required |
Complications during pregnancy? |
|
NK = Not known
|
cmedhx8 |
|
preg_comp_note |
String |
300
|
Recommended |
Note regarding complications during pregnancy |
|
|
PGCOMPLSP |
Query
|
preg_dxdrug |
String |
10
|
Required |
Used prescription medications during pregnancy? |
|
NK = Not known
|
|
|
any_medication_preg |
String |
200
|
Recommended |
was the mother given any medication during pregnancy |
|
|
PGMEDSSP |
Query
|
pgart |
Integer |
|
Recommended |
9. Used Assisted Reproductive Technology (ART)? |
0::2
|
|
|
|
pgartsp |
String |
200
|
Recommended |
ART Used: Please Describe |
|
|
|
Query
|
preg_age_mom |
Integer |
|
Recommended |
Age of mother at the time of birth |
|
In years; 999=Unknown
|
MAGEATBRTH, cmedhx1 |
Query
|
preg_age_dad |
Integer |
|
Recommended |
Age of father at the time of birth |
|
In years; 999=Unknown
|
FAGEATBRTH |
Query
|
birth_weight_lbs |
Float |
|
Recommended |
Birth weight pounds |
|
|
BIRTH_WEIGHT_LBS, cmedhx7a |
Query
|
birth_weight_oz |
Float |
|
Recommended |
Birth weight ounces |
|
|
BWOZ, cmedhx7b |
Query
|
bwnk_2 |
Integer |
|
Recommended |
Birth weight not Known or Not Available (choice=NK) |
0;1
|
0=Unchecked; 1=Checked
|
|
Query
|
ldnb_lgthin |
Float |
|
Recommended |
What was the babys length at birth(inches) |
|
-1 = Not known
|
|
Query
|
blnk_2 |
Integer |
|
Recommended |
Birth length not Known or Not Available (choice=NK) |
0;1
|
0=Unchecked; 1=Checked
|
|
Query
|
full_term |
String |
10
|
Required |
Full-term delivery? 37-42 weeks |
|
NK = Not known
|
|
|
info_gest |
String |
50
|
Recommended |
No. Weeks Gestation (G.A.) |
|
|
|
Query
|
ldnb_hosptotalmom |
Float |
|
Recommended |
How many days did the mom stay in the hospital after birth |
|
|
|
Query
|
walk10_age |
Integer |
|
Recommended |
Walking 10 steps - age |
0 :: 1200
|
|
p7902devhistagewalkingmonth |
Query
|
ad016 |
Integer |
|
Recommended |
Age 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
|
p7902devhistagefirstwordsmonth |
Query
|
age_3word |
Integer |
|
Recommended |
Age at 3-word sentences (in months) |
|
|
p7902devhistagefirst3wordsente2 |
Query
|
current_lang |
String |
10
|
Recommended |
Current speech/language. Verbal? |
Yes; No; NK
|
NK = Not known
|
|
Query
|
verb_words |
Integer |
|
Recommended |
If yes, how many words? |
1::4
|
1 = <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
|
|
Query
|
intellig |
Integer |
|
Recommended |
20. Is your childs speech intelligible to you? |
0::2
|
0=No; 1= Yes; 2=Sometimes
|
|
Query
|
intelligoth |
Integer |
|
Recommended |
21. Is your childs speech intelligible to other people? |
0::2
|
0=No; 1= Yes; 2=Sometimes
|
|
Query
|
aac |
Integer |
|
Recommended |
22. Does your child use an augmentative communication device? |
0::2
|
0=No; 1=Yes; 2=NK
|
|
Query
|
aac_pecs |
Integer |
|
Recommended |
What type of AAC does your child use? (choice=PECS) |
0;1
|
0=Unchecked; 1=Checked
|
|
Query
|
aac_ipad |
Integer |
|
Recommended |
What type of AAC does your child use? (choice=iPad single words) |
0;1
|
0=Unchecked; 1=Checked
|
|
Query
|
aac_spgen |
Integer |
|
Recommended |
What type of AAC does your child use? (choice=Speech generating device) |
0;1
|
0=Unchecked; 1=Checked
|
|
Query
|
aacoth |
Integer |
|
Recommended |
What type of AAC does your child use? (choice=Other type) |
0;1
|
0=Unchecked; 1=Checked
|
|
|
speechdevsp |
String |
200
|
Recommended |
Please describe speech generating device: |
|
|
|
|
speechdevoth |
String |
200
|
Recommended |
Please describe other AAC type: |
|
|
|
Query
|
aacfreq |
Integer |
|
Recommended |
How often does your child use the AAC? |
1::5
|
1=Frequently; 2=Sometimes in different contexts; 3=Only at home; 4=Only at school; 5=Rarely
|
|
Query
|
child_devdelay |
String |
50
|
Recommended |
Does (did) the Child have a Developmental Delay? |
|
|
DELAY |
Query
|
rx_behav |
String |
10
|
Required |
Prescription medications for behavioral concerns |
|
NK = Not known
|
|
Query
|
rx_phys |
String |
10
|
Required |
Prescription medications for physical health concerns |
|
NK = Not known
|
|
Query
|
otc_med |
String |
10
|
Required |
Over-the-counter medications |
|
NK = Not known
|
|
Query
|
ds_med |
String |
10
|
Required |
Dietary supplements |
|
NK = Not known
|
|
|
ds_medsp |
String |
200
|
Recommended |
Dietary Supplements: Please Describe |
|
|
|
Query
|
gastro_spec_diet |
String |
50
|
Required |
Does subject have a special diet? |
|
NK = Not known
|
|
|
specialdiet_current_desc |
String |
1,000
|
Recommended |
Special diet - Describe |
|
|
GASTRO_SPEC_SP |
Query
|
specialdiet_past |
String |
6
|
Recommended |
taking special diets in the past? |
TRUE;FALSE; NK
|
|
SPDIETP |
|
spdietphowlong |
String |
50
|
Recommended |
Special Diet in the Past: How Long |
|
|
|
|
spdietpsp |
String |
100
|
Recommended |
Special Diet in the Past: Please Describe |
|
|
|
Query
|
weight_std |
Float |
|
Recommended |
Weight - Standard Unit |
|
-1 = Not known; 999 = Missing
|
CHWGT, dx20_in, weight |
Query
|
fs_v2_height_feet |
Integer |
|
Recommended |
How tall is the subject now (feet)? |
|
|
CHHGTF |
Query
|
fs_v2_height_inches |
Float |
|
Recommended |
How tall is the subject now (inches)? |
|
|
CHHGTI |
Query
|
hosp_med |
Integer |
|
Recommended |
32. Has your child ever been hospitalized for: (choice=Medical) |
0;1
|
0=Unchecked; 1=Checked
|
|
Query
|
hosp_beh |
Integer |
|
Recommended |
32. Has your child ever been hospitalized for: (choice=Behavioral) |
0;1
|
0=Unchecked; 1=Checked
|
|
Query
|
hosp_mh |
Integer |
|
Recommended |
32. Has your child ever been hospitalized for: (choice=Mental Health) |
0;1
|
0=Unchecked; 1=Checked
|
|
Query
|
hospagem |
Integer |
|
Recommended |
At what ages has your child been hospitalized for medical concerns? |
|
|
|
|
hosplngthm |
String |
50
|
Recommended |
For how long: |
|
|
|
Query
|
hospageb |
Integer |
|
Recommended |
At what ages has your child been hospitalized for behavioral concerns? |
|
|
|
|
hosplngthb |
String |
50
|
Recommended |
For how long: |
|
|
|
Query
|
hospagemh |
Integer |
|
Recommended |
At what ages has your child been hospitalized for mental health concerns? |
|
|
|
|
hosplngthmh |
String |
50
|
Recommended |
For how long: |
|
|
|
Query
|
child_retts |
String |
50
|
Required |
Does the Child have Rett's Syndrome? |
|
999=NA/missing
|
GEN_DIS_RETT |
Query
|
child_downssynd |
String |
50
|
Required |
Does (did) the Child have Down's Syndrome? |
|
999=NA/missing
|
GEN_DIS_DOWN |
Query
|
child_tuberscl |
String |
50
|
Required |
Does (did) the Child have Tuberous Sclerosis? |
|
NK= Not known; NS = Not sure
|
GEN_DIS_TUB, q26 |
Query
|
child_fragilex |
String |
50
|
Required |
Does (did) the Child have Fragile X? |
|
999=NA/missing
|
GEN_DIS_FRAGX |
Query
|
fhi_df_nfib_chd |
Integer |
|
Required |
Family History: Neurofibromatosis Child |
0;1;999
|
0=Unchecked; 1=Checked
|
GEN_DIS_NEUROF |
Query
|
child_geneticdis |
String |
50
|
Recommended |
Does (did) the Child have a Genetic Disorder? |
|
NK= Not known; NS = Not sure
|
GEN_DIS_OTHGEN |
Query
|
gen_dis_conf_rett |
Integer |
|
Recommended |
Is the Rett Syndrome confirmed by a physician-ordered genetic analysis? |
0::2
|
0=No; 1=Yes; 2=NK
|
|
Query
|
gen_dis_conf_down |
Integer |
|
Recommended |
Is the Down Syndrome confirmed by a physician-ordered genetic analysis? |
0::2
|
0=No; 1=Yes; 2=NK
|
|
Query
|
gen_dis_conf_tub |
Integer |
|
Recommended |
Is the Tuberous Sclerosis Complex confirmed by a physician-ordered genetic analysis? |
0::2
|
0=No; 1=Yes; 2=NK
|
|
Query
|
gen_dis_conf_fragx |
Integer |
|
Recommended |
Is the Fragile X Syndrome confirmed by a physician-ordered genetic analysis? |
0::2
|
0=No; 1=Yes; 2=NK
|
|
Query
|
gen_dis_conf_neurof |
Integer |
|
Recommended |
Is the Neurofibromatosis I confirmed by a physician-ordered genetic analysis? |
0::2
|
0=No; 1=Yes; 2=NK
|
|
|
child_geneticdis_cmt |
String |
255
|
Recommended |
Specify Child's Genetic Disorder |
|
|
GEN_DISOTH |
Query
|
rev_headmeningitis |
String |
50
|
Recommended |
Meningitis |
Yes; No; NK; NS
|
NK= Not known; NS = Not sure
|
|
Query
|
meningitisy |
Integer |
|
Recommended |
Meningitis Years |
|
|
|
Query
|
meningitism |
Integer |
|
Recommended |
Meningitis Months |
|
|
|
Query
|
rev_headmeningitisage |
Integer |
|
Recommended |
Meningitis: Age(in months) |
0 :: 1200
|
|
|
|
rev_headmeningitisorg |
String |
255
|
Recommended |
Meningitis: Organism |
|
|
|
Query
|
rev_headencephalitis |
String |
50
|
Recommended |
Encephalitis |
|
NK= Not known; NS = Not sure
|
|
Query
|
encephalitisy |
Integer |
|
Recommended |
Encephalitis Years |
|
|
|
Query
|
encephalitism |
Integer |
|
Recommended |
Encephalitis Months |
|
|
|
Query
|
rev_headencephalitisage |
Integer |
|
Recommended |
Encephalitis: Age(in months) |
0 :: 1200
|
|
|
|
rev_headencephalitisorg |
String |
255
|
Recommended |
Encephalitis: Organism |
|
|
|
Query
|
rev_headfebseiz |
String |
50
|
Recommended |
Febrile Seizures |
|
NK= Not known; NS = Not sure
|
|
|
rev_headfebseizages |
String |
255
|
Recommended |
Febrile Seizures: Age(S) |
|
|
|
Query
|
rev_headseizure |
String |
50
|
Required |
Seizures |
|
NK= Not known; NS = Not sure
|
neuro_psych_seizures, seizure |
|
rev_headseizureonset |
String |
255
|
Recommended |
Seizures: Onset |
|
|
|
Query
|
rev_headseizurecontrol |
String |
50
|
Required |
Seizures: Controlled |
|
NK = Not known
|
|
|
nfebseizhow |
String |
100
|
Recommended |
How are the seizures controlled? |
|
|
|
Query
|
fhxcp |
String |
5
|
Required |
Cerebral Palsy |
|
NK = Not known
|
|
Query
|
hist_trauma |
String |
10
|
Recommended |
History of head trauma |
|
NK= Not known; NS = Not sure
|
dukemed_headtrauma |
Query
|
rev_headimagestudy |
String |
50
|
Recommended |
Imaging Studies |
|
NK = Not known
|
|
Query
|
headimage_us |
Integer |
|
Recommended |
Head imaging type (choice=Ultrasound) |
0;1
|
0=Unchecked; 1=Checked
|
|
Query
|
ctscanofbrain |
String |
10
|
Recommended |
Did the subject take a CT scan of brain? |
|
NK = Not known
|
HEADIMAGE_CT |
Query
|
mribrainscan |
String |
10
|
Recommended |
Did the subject take an MRI scan of brain? |
|
NK = Not known
|
HEADIMAGE_MR, mri001 |
Query
|
diag_pet |
String |
50
|
Recommended |
PET scan |
|
NK= Not known; NS = Not sure
|
HEADIMAGE_PET, pet001 |
Query
|
diag_eeg |
String |
50
|
Recommended |
EEG |
|
|
HEADIMAGE_EEG, eeg_conducted |
Query
|
usres |
Integer |
|
Recommended |
Results: Ultrasound |
1;2
|
1=Normal; 2=Abnormal
|
|
Query
|
ctscanresult |
Integer |
|
Recommended |
Details of MRI/CT scan result(s) |
1;2;3
|
1 = Normal; 2 = Abnormal; 3 = Unknown
|
CTRES |
Query
|
mriscanresults |
Integer |
|
Recommended |
Details of the brain MRI result(s) |
1;2;3
|
1 = Normal; 2 = Abnormal; 3 = Unknown
|
MRRES |
Query
|
petres |
Integer |
|
Recommended |
Results: PET scan |
1::3
|
1=Normal; 2=Abnormal; 3= Not Sure
|
|
Query
|
eegresults |
Integer |
|
Recommended |
Details of the EEG result(s) |
1;2;3
|
1 = Normal; 2 = Abnormal; 3 = Unknown
|
EEGRES |
|
braincomm |
String |
250
|
Recommended |
Brain imaging comments |
|
|
mri003 |
Query
|
vis_blind |
String |
10
|
Recommended |
Significant visual loss or congenital blindness |
Yes; No; NK
|
NK = Not known
|
VISCORR |
Query
|
weareyeglasses |
Integer |
|
Recommended |
Does (did) the Child wear Glasses/lenses? |
0;1;2
|
0 = No; 1 = Yes; 2 = Unknown
|
EYESCOMM |
|
rev_eyeoter |
String |
255
|
Recommended |
Eyes Other/Comments: |
|
|
eyes |
Query
|
rev_eartest |
String |
50
|
Recommended |
Hearing Testing: |
|
NK = Not known
|
|
|
rev_eartestages |
String |
255
|
Recommended |
Hearing Testing: Age(S) |
|
|
|
Query
|
rev_eartestresult |
String |
50
|
Recommended |
Hearing Testing: Result |
Normal;Abnormal;Unknown
|
|
|
Query
|
hear_loss |
String |
10
|
Required |
Deafness or significant hearing loss |
|
NK = Not known
|
|
Query
|
othmem_hearingcor |
String |
50
|
Recommended |
Hearing corrected? |
|
NK = Not known
|
|
Query
|
hearcorry |
Integer |
|
Recommended |
Hearing corrected Years |
|
|
|
Query
|
hearcorrm |
Integer |
|
Recommended |
Hearing corrected Months |
|
|
|
Query
|
hearcorrage |
Integer |
|
Recommended |
Age of hearing correction (months) |
|
|
|
Query
|
rev_earrecuotitis |
String |
50
|
Required |
Recurrent Otitis Media |
|
NK= Not known; NS = Not sure
|
|
Query
|
rev_earrecuotitisyear |
Integer |
|
Recommended |
Recurrent Otitis Media: #Year |
|
|
|
Query
|
recuotitisy |
Integer |
|
Recommended |
Recurrent otitis Years |
|
|
|
Query
|
recuotitism |
Integer |
|
Recommended |
Recurrent otitis Months |
|
|
|
Query
|
rev_earrecuotitisage |
Integer |
|
Recommended |
Recurrent Otitis Media: Age of Onset(in months) |
0 :: 1200
|
|
|
Query
|
rev_earpetube |
String |
50
|
Recommended |
PE Tubes |
|
NK = Not known
|
EAR_PETUBE |
|
rev_earother |
String |
255
|
Recommended |
Ears Other/Comments |
|
|
EARCOMM, ears, gen_med_ent_info |
Query
|
rev_mouthcleptlip |
Integer |
|
Recommended |
48. Cleft lip |
|
|
|
Query
|
rev_mouthcleptpalate |
Integer |
|
Recommended |
49. Cleft Palate |
0;1
|
0=No; 1=Yes
|
|
Query
|
feed_swallow_problem |
String |
10
|
Recommended |
Has the participant demonstrated any feeding or swallowing problems? |
|
|
SWALLOW |
Query
|
rev_mouthspeechdiff |
String |
50
|
Recommended |
Speech Difficulties |
|
NK = Not known
|
SPEECH |
|
mouthcomm |
String |
100
|
Recommended |
Other/Comments |
|
|
|
Query
|
rev_teethdentalab |
String |
50
|
Recommended |
Dental abnormalities |
|
NK = Not known
|
|
|
rev_teethdentalabdesc |
String |
255
|
Recommended |
Dental abnormalities: Describe |
|
|
DENTCOMM |
Query
|
rev_neckspinalab |
String |
50
|
Recommended |
Spinal abnormalities |
|
NK = Not known
|
|
|
rev_neckother |
String |
255
|
Recommended |
Other/Comments |
|
|
NECKCOMM |
Query
|
rev_skinbirthmark |
String |
50
|
Recommended |
Birthmarks (e.g., cafe-au-lait spots, white spots) |
|
NK = Not known
|
|
Query
|
rev_skineczema |
String |
50
|
Recommended |
Eczema |
|
NK = Not known
|
|
Query
|
rev_skinabcesses |
String |
50
|
Required |
Skin Infections/Abcesses |
|
NK = Not known
|
|
|
rev_skinother |
String |
255
|
Recommended |
Skin Other/Comments |
|
|
SKINCOMM |
Query
|
rev_pulbreathab |
String |
50
|
Recommended |
Abnormal Breathing |
|
NK = Not known
|
|
Query
|
rev_pulasthma |
String |
50
|
Required |
Asthma |
|
NK = Not known
|
|
Query
|
rev_lung |
String |
10
|
Recommended |
Lung disease |
Yes;No;NK
|
NK = Not known
|
|
|
rev_pulother |
String |
255
|
Recommended |
Pulmonary Other/Comments |
|
|
PULMCOMM, respiratory |
Query
|
rev_cardiomalfunc |
String |
50
|
Required |
Cardiac Malformation |
|
NK = Not known
|
|
Query
|
rev_cardiocyanosis |
String |
50
|
Recommended |
Cyanosis |
|
NK = Not known
|
|
Query
|
rev_rythm |
String |
10
|
Recommended |
Abnormal rhythm or heart rate |
Yes;No;NK
|
NK = Not known
|
|
|
rev_cardioother |
String |
255
|
Recommended |
Cardiac Other/Comments |
|
|
CARDIOCOMM, cardiac_detail |
Query
|
rev_gastrodysphagia |
String |
50
|
Recommended |
Dysphagia |
|
NK = Not known
|
|
Query
|
rev_gastroreflux |
String |
50
|
Required |
Reflux |
|
NK= Not known; NS = Not sure
|
|
Query
|
rev_gastrorefluxmed |
String |
50
|
Required |
Reflux: Medication Required |
|
NK = Not known
|
|
Query
|
rev_gastroother |
String |
50
|
Recommended |
Other feeding difficulties |
|
NK = Not known
|
|
|
rev_gastroothercom |
String |
255
|
Recommended |
Gastro Other/comments |
|
|
GASTROCOMM, gastrointestinal |
Query
|
rev_endoprecocious |
String |
50
|
Recommended |
Precocious Puberty |
|
NK = Not known
|
|
Query
|
endoprecociousy |
Integer |
|
Recommended |
Early puberty Years |
|
|
|
Query
|
endoprecociousm |
Integer |
|
Recommended |
Early puberty Months |
|
|
|
Query
|
rev_endoprecociousage |
Integer |
|
Recommended |
Precocious Puberty: Age(in months) |
0 :: 1200
|
|
|
Query
|
rev_endohypothyroidism |
String |
50
|
Required |
Hypothyroidism |
|
NK = Not known
|
mhxa24_1 |
Query
|
rev_endohyperthyroidism |
String |
50
|
Required |
Hyperthyroidism |
|
NK = Not known
|
|
Query
|
rev_endodiabetes |
String |
50
|
Required |
Diabetes |
|
NK = Not known
|
mhxa2 |
Query
|
rev_endodiabetestype |
String |
50
|
Required |
Diabetes: Type |
|
|
persmedhx38 |
Query
|
rev_endohypoglycemia |
String |
50
|
Recommended |
Hypoglycemia |
|
NK = Not known
|
|
|
rev_endoother |
String |
255
|
Recommended |
Endo Other/comments |
|
|
ENDOCOMM |
Query
|
rev_hemanemia |
String |
50
|
Recommended |
Anemia |
|
NK = Not known
|
|
Query
|
rev_hembleeddisorder |
String |
50
|
Recommended |
Bleeding disorder |
|
NK = Not known
|
|
|
hemacomm |
String |
100
|
Recommended |
Hematology Other/Comments |
|
|
|
Query
|
rev_immunorecurinfectio |
Integer |
|
Recommended |
73. Recurrent infections (>2 pneumonia or sinus infections/yr, >8 OM /yr, abscesses) |
0;1;-9
|
0=No;1=Yes;-9=Unknown
|
gen_med_sinus |
Query
|
rev_immunoigdeficiency |
String |
50
|
Recommended |
Ig Deficiency |
|
NK = Not known
|
|
Query
|
rev_immunocellimmunedef |
String |
50
|
Recommended |
Cell Mediated Immune Def. |
|
NK = Not known
|
|
Query
|
rev_immunoenvallergy |
String |
50
|
Required |
Environmental Allergies |
|
NK = Not known
|
|
Query
|
rev_immunomedallergy |
String |
50
|
Required |
Medication Allergies |
|
NK = Not known; NA=Not Applicable
|
cmedhx13, med_074 |
Query
|
rev_immunoimmunization |
String |
50
|
Recommended |
Immunizations |
|
NK = Not known
|
cmedhx14 |
Query
|
othmem_bipolar |
String |
50
|
Recommended |
Bipolar disorder (Manic/depression) |
|
NK = Not known
|
neuro_psych_bipolar |
Query
|
othmem_depression |
String |
50
|
Recommended |
Depression |
|
NK = Not known
|
|
Query
|
othmem_anxiety |
String |
50
|
Recommended |
Anxiety disorder |
|
NK = Not known
|
|
Query
|
cfmh_othr_ocd |
Integer |
|
Recommended |
Obsessive compulsive disorder |
1;0; -9
|
0 = No; 1 = Yes; -9 = Not known
|
|
Query
|
othmem_schizophrenia |
String |
50
|
Recommended |
Schizophrenia |
|
NK = Not known
|
|
Query
|
othmem_selfinj |
String |
50
|
Recommended |
Self-injuring behavior |
|
NK = Not known
|
|
Query
|
othmem_adhd |
String |
50
|
Recommended |
Attention deficit hyperactivity disorder (ADHD) |
|
NK = Not known
|
|
Query
|
othmem_eatingdis |
String |
50
|
Recommended |
Eating disorder. Bulimia, Anorexia, other |
|
NK = Not known
|
neuro_psych_ed |
|
othmem_eatingdis_type |
String |
100
|
Recommended |
If yes, specify type |
|
|
|
Query
|
sleep_pat |
String |
10
|
Recommended |
Disrupted sleep patterns |
Yes;No;NK
|
NK = Not known
|
|
Query
|
touret |
String |
10
|
Required |
Tourette Syndrome |
|
NK= Not known; NS = Not sure
|
|
|
mhcomm |
String |
100
|
Recommended |
Mental Health Other/Comments |
|
|
neuro_psych_psych |
Query
|
data_derived |
Integer |
|
Recommended |
Data Derived From |
1::4; 999
|
1 = Physical examination; 2 = Medical record; 3 = Both; 4=Parental report; 999=missing
|
|
Query
|
mhx001aa |
Integer |
|
Recommended |
History of: Allergies - Drugs |
1;2; 9
|
1=No; 2=Yes; 9=not evaluated
|
allergy, mhx01a |
|
mhx001ab |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Allergies - Drugs |
|
|
mhx01b |
Query
|
mhx001ba |
Integer |
|
Recommended |
History of: Allergies - Other |
1::3;9
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
allergies_diagnosis_past_o, mhxs_q09a, q09c |
|
mhx001b |
String |
250
|
Recommended |
Allergies. Other (Specify:) |
|
|
allergies_ms |
|
mhx001bb |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Allergies - Other |
|
|
|
Query
|
mhx002a |
Integer |
|
Recommended |
History of:Sensitivity to study medication(s) |
1;2;9
|
1=No; 2=Yes;9=not evaluated
|
|
|
mhx002b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Sensitivity to study medication(s) |
|
|
|
Query
|
q19_a5 |
Integer |
|
Recommended |
HEENT (includes thryroid) |
0; 1; -7; -8; -9; 999
|
Field should not be left blank. If missing, please use -7,8, -9.
|
mhx003a, mhx02a, mhxa24, mhxa27_1 |
|
mhx003b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: HEENT disorder |
|
|
mhx02b |
Query
|
mhx004a |
Integer |
|
Recommended |
History of: Cardiovascular disorder |
1::3;9
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
cardio, cardiovascular_diagnosis_p, gen_med_cardiac, mhx03a, mhxa25, mhxa28_1, mhxs_q03a, q03c |
|
mhx004b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Cardiovascular disorder |
|
|
mhx03b |
Query
|
mhx005a |
Integer |
|
Recommended |
History of: Renal disorder |
1::3;9
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
mhx04a, mhxa11, mhxs_q12a, q12a, renal_diagnosis_past_or_cu, renalgen |
|
mhx005b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Renal disorder |
|
|
mhx04b |
Query
|
mhx006a |
Integer |
|
Recommended |
History of: Hepatic disorder |
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
hepatic, hepatic_diagnosis_past_or, med_042, mhx05a, mhxa9, mhxs_q13a, q13a |
|
mhx006b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Hepatic disorder |
|
|
mhx05b |
Query
|
mhx007aa |
Integer |
|
Recommended |
History of: Pulmonary disorder |
1::3;9
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
mhx06a, mhxs_q02a |
|
mhx007ab |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Pulmonary disorder |
|
|
mhx06b |
Query
|
w1_m_cu_asthma |
Integer |
|
Recommended |
health at interview - has a history of asthma |
0;1; -888; -999
|
0 = No; 1 = Yes; -999 = missing; -888 = not applicable
|
mhx007ba |
|
mhx007bb |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: History of Asthma |
|
|
|
Query
|
mhx008a |
Integer |
|
Recommended |
History of: Gastrointestinal disorder |
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
dukemed_gastro, gastrint, gastrointestinal_diagnosis, med_040, mhx07a, mhxa8, mhxs_q05a, q05c |
|
mhx008b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Gastrointestinal disorder |
|
|
mhx007b, mhx07b |
Query
|
mhx009a |
Integer |
|
Recommended |
History of: Musculoskeletal disorder |
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
med_052, mhx08a, mhxs_q07a, muscular, musculo_skeletal_diagnosis, q07c |
|
mhx009b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Musculoskeletal disorder |
|
|
mhx08b |
Query
|
mhx010a |
Integer |
|
Recommended |
History of: Neurologic disorder |
1::3;9
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
central_nervous_system_pas, dukemed_cpd, mhx09a, mhxa4, mhxs_q10a, q10c |
|
mhx010b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Neurologic disorder |
|
|
mhx09b |
Query
|
mhx011a |
Integer |
|
Recommended |
History of: Ophthalmologic disorder |
1::3;9
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
mhxs_q11a, q11a |
|
mhx011b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Ophthalmologic disorder |
|
|
|
Query
|
mhx012a |
Integer |
|
Recommended |
History of: Psychiatric disorder |
1;2
|
1=No; 2=Yes
|
|
|
mhx012b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Psychiatric disorder |
|
|
|
Query
|
mhx013a |
Integer |
|
Recommended |
History of: Dermatologic disorder |
1::3;9
|
1=No; 2=Yes;9=not evaluated
|
dermat, dermotological_diagnosis_p, mhx10a, mhxa13a |
|
mhx013b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Dermatologic disorder |
|
|
mhx10b |
Query
|
medhx_metsynd |
Integer |
|
Recommended |
Metabolic Syndrome |
0::2; -9
|
0 = No; 1 = Yes; 2 = Not sure; -9 = missing/not reported
|
dukemed_metabolic, mhx014a, mhx11a |
|
mhx014b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Metabolic disorder |
|
|
mhx11b |
Query
|
mhx015a |
Integer |
|
Recommended |
History of: Hematologic disorder |
|
1=No; 2=Yes;9=not evaluated
|
med_057, mhx12a, mhxa15 |
|
mhx015b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Hematologic disorder |
|
|
mhx12b |
Query
|
mhx016a |
Integer |
|
Recommended |
History of: Endocrine disorder |
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
dukemed_endo, endocrin, endrocrinine_metabolite_di, med_027, mhx13a, mhxa23_1, mhxs_q04a |
|
mhx016b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Endocrine disorder |
|
|
mhx13b |
Query
|
mhx017a |
Integer |
|
Recommended |
History of: Genitourinary disorder |
1::3;9
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
mhx14a, mhxs_q06a, q06c |
|
mhx017b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Genitourinary disorder |
|
|
mhx14b |
Query
|
mhx018a |
Integer |
|
Recommended |
History of: Reproductive System disorder |
1;2;9
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
|
|
mhx018b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Reproductive disorder |
|
|
|
Query
|
mhx019a |
Integer |
|
Recommended |
History of: Infectious Disease |
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
med_063, mhx15a, mhxa18 |
|
mhx019b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Infectious Disease |
|
|
mhx15b |
Query
|
mhx020a |
Integer |
|
Recommended |
History of: Other 1 |
1::3;9
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
mhxa25_1, mhxs_q15a, other_history_past_or_curr, othergen |
|
mhx020 |
String |
250
|
Recommended |
Specify Other History 1 |
|
|
mhx016, mhxs_q15b, other_history |
|
mhx020b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Other |
|
|
|
Query
|
mhx021a |
Integer |
|
Recommended |
History of: Other 2 |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
mhx16a, mhxs_q16a |
|
mhx021 |
String |
250
|
Recommended |
Specify Other History 2 |
|
|
mhx16, mhxs_q16b |
|
mhx021b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Other |
|
|
mhx16b |
|
site |
String |
101
|
Recommended |
Site |
|
Study Site
|
asite, mhxs_site_x, site_uid, siteid |
Query
|
visit |
String |
60
|
Recommended |
Visit name |
|
|
int1, interval, mhxs_interval, visit_name, wave |
Query
|
daysrz |
Integer |
|
Recommended |
days since randomization |
|
|
mdga0b, mhxa0b, visitdt |
Query
|
fseqno |
Integer |
|
Recommended |
Sequence Number |
0::999
|
The FSEQNO variable in the ADJ form has a special interpretation compared to other forms.
For example, ADJ FSEQNO of '1' can be thought of as being '001', FSEQNO of '2' can be thought of as
being '002', and FSEQNO of '3' can be thought of as being '003'.
The first digit of FSEQNO relates to the corresponding ENF sequence number at that visit and the third
digit relates to the specific adjudicator who completed the adjudication form.
|
|
|
version_form |
String |
121
|
Recommended |
Form used/assessment name |
|
|
form_name, vers |
Query
|
baseline_k_006 |
Integer |
|
Recommended |
Stroke |
0;1; -888; -999
|
0=No; 1=Yes; -888=Not Applicable; -999=Missing;
|
mdga1, med_006, mhxa1a, neuro_psych_stroke, stroke_tia, stroke_yn |
Query
|
mhxa1b |
Integer |
|
Recommended |
Date crisis resolved (physician determination): |
|
|
mdga2_a |
Query
|
mhxa1c |
Integer |
|
Recommended |
Coronary artery disease |
0;1; -9
|
0=No; 1=Yes; -9 =NK
|
mdga3, med_010 |
Query
|
mhxa1d |
Integer |
|
Recommended |
Angina |
0;1;-9
|
0=No; 1=Yes; -9 = Not applicable or Missing
|
mdga4, med_012 |
Query
|
mhxa1e |
Integer |
|
Recommended |
Heart attack/ myocardial infarction |
0;1;9;-9
|
0=No; 1=Yes; 9=not evaluated; -9=unknown
|
mdga5, med_014 |
Query
|
mhxa1f |
Integer |
|
Recommended |
Peripheral vascular disease |
0;1
|
0=No; 1=Yes
|
mdga6, med_016 |
Query
|
mhxa1g |
Integer |
|
Recommended |
Abdominal aortic aneurysm |
0;1
|
0=No; 1=Yes
|
mdga7, med_018 |
Query
|
mhxa1h |
Integer |
|
Recommended |
Congestive heart failure |
0;1;8
|
1=Yes;0= No;8=Don't Know
|
mdga8, med_020 |
Query
|
quesmoth_probhighbp |
String |
50
|
Recommended |
Hypertension (High blood pressure) |
|
|
dx3, mdga9, med_022, mhxa1i |
Query
|
mhxa2a |
Integer |
|
Recommended |
If yes, Is the patient now prescribed insulin? |
0;1;999
|
0=No; 1=Yes;999= legitimiately skipped
|
med_024 |
Query
|
mhxa2b |
Integer |
|
Recommended |
If yes, Is the patient now prescribed an oral hypoglycemic agent? |
0;1;999
|
0=No; 1=Yes;999= legitimiately skipped
|
med_025 |
Query
|
baseline_k_004 |
Integer |
|
Recommended |
HIV |
|
0=No; 1=Yes; -888=Not Applicable; -999=Missing;
|
dukemed_hivaid, mdga17, med_026, mhxa3 |
Query
|
mhxa5 |
Integer |
|
Recommended |
Eyes |
0;1
|
0=No; 1=Yes
|
med_031 |
Query
|
mdga2 |
Integer |
|
Recommended |
Eye, Ears, Nose or Throat |
0;1
|
1=Yes; 0=No
|
eyesnose, gen_med_ent, med_033, mhxa6 |
Query
|
mhxa7a |
Integer |
|
Recommended |
Chronic Obstructive Pulmonary Disease |
0;1;-9
|
0=No; 1=Yes; -9 = missing/not reported
|
copd, dukemed_pulm, mdga14a, med_036 |
Query
|
mhxa7b |
Integer |
|
Recommended |
Other pulmonary disease |
0;1
|
0=No; 1=Yes
|
mdga15, med_038 |
Query
|
hepat |
Integer |
|
Recommended |
Hepatitis |
1;0;-7; -9
|
0=No; 1=Yes;-7=Refused; -9 =unknown
|
mdga19, med_044, mhxa10 |
Query
|
medhx_genital |
Integer |
|
Recommended |
Genital Problems |
0::2
|
0 = No, 1 = Yes, 2 = Not sure
|
mhxa12 |
Query
|
mhxa14a |
Integer |
|
Recommended |
Musculoskeletal: Osteoarthritis |
0;1
|
0=No; 1=Yes
|
med_053 |
Query
|
mhxa14b |
Integer |
|
Recommended |
Musculoskeletal: Osteoporosis |
0;1
|
0=No; 1=Yes
|
mdga16, med_055 |
Query
|
mhxa16 |
Integer |
|
Recommended |
Immune System (include allergies) |
0;1
|
0=No; 1=Yes
|
med_059 |
Query
|
mhxa17 |
Integer |
|
Recommended |
Other Sexually Transmitted Diseases |
0;1
|
0=No; 1=Yes
|
mdga18, med_061 |
Query
|
baseline_k_003 |
Integer |
|
Recommended |
Cancer |
|
0=No; 1=Yes; -888=Not Applicable; -999=Missing;
|
dukemed_cancer, med_065, mhxa19 |
Query
|
medhx_surg |
Integer |
|
Recommended |
Major Surgeries? |
0::2
|
0 = No, 1 = Yes, 2 = Not sure
|
med_067, mhxa20, surgery |
Query
|
q21_5f |
Integer |
|
Recommended |
Other major illness or injury |
0; 1; -7; -8; -9; 999
|
Field should not be left blank. If missing, please use -7, 8, -9.
|
mdga20, med_069, mhxa21 |
Query
|
hysterec |
Integer |
|
Recommended |
hysterectomy |
0;1;-7; 888; 999
|
0=No; 1=Yes; -7=Refused; 888=N/A; 999=missing data
|
hysterec_yn, med_071, mhxa22 |
Query
|
mhxa22a |
Integer |
|
Recommended |
If Yes, with oophorectomy? (Y/N/U) |
0;1;2;999
|
0=No; 1=Yes; 2= Unknown;999= legitimiately skipped
|
|
Query
|
mxha17 |
String |
20
|
Recommended |
General Appearance/Skin |
|
A=Abnormal; N=Normal
|
med_146, mhxa23, mhxa26_1 |
Query
|
mxha20 |
String |
20
|
Recommended |
Chest |
|
A=Abnormal; N=Normal
|
med_140, mhxa26, mhxa29_1 |
Query
|
mhxa27 |
Integer |
|
Recommended |
Abdominal |
0;1
|
0=Abnormal; 1=Normal
|
mhxa30 |
Query
|
mxha22 |
String |
20
|
Recommended |
Extremities/Joints |
A;N
|
A=Abnormal; N=Normal
|
mhxa28, mhxa31 |
Query
|
mhxa29 |
Integer |
|
Recommended |
Neurological |
0;1
|
0=Abnormal; 1=Normal
|
mhxa32 |
Query
|
mdga10 |
Integer |
|
Recommended |
Diagnosed with: Hyperlipidemia |
0;1; -9
|
0=No; 1=Yes; -9=unknown
|
|
Query
|
mdga11a |
Integer |
|
Recommended |
Diagnosed with: Other heart disease |
0;1
|
0=No; 1=Yes
|
heart_disease |
Query
|
mdga12 |
Integer |
|
Recommended |
Diagnosed with: Diabetes Type I (insulin dependent) |
0;1
|
0=No; 1=Yes
|
|
Query
|
mdga13 |
Integer |
|
Recommended |
Diagnosed with: Diabetes Type II |
0;1
|
0=No; 1=Yes
|
|
|
mdga20a |
String |
150
|
Recommended |
Medical Illness 1 |
|
|
|
|
mdga20b |
String |
150
|
Recommended |
Medical Illness 2 |
|
|
|
|
mdga20c |
String |
150
|
Recommended |
Medical Illness 3 |
|
|
|
|
mdga20d |
String |
150
|
Recommended |
Medical Illness 4 |
|
|
|
|
mdga20e |
String |
150
|
Recommended |
Medical Illness 5 |
|
|
|
|
mdga20f |
String |
150
|
Recommended |
Medical Illness 6 |
|
|
|
Query
|
ch20prob |
Float |
|
Recommended |
10 Year Probability Of CHD |
|
|
|
|
study |
String |
100
|
Recommended |
Study; The code for each individual study |
|
|
mhxs_studyid, studyid |
Query
|
completed |
Integer |
|
Recommended |
Checks if completed |
0::3
|
0=No; 1=Yes; 2=Yes, lost; 3=Unverified
|
formcomp, frmcomp |
Query
|
subtrial_name |
Integer |
|
Recommended |
Name of subtrial |
1::3
|
1=Crossover; 2=Guanfacine; 3= Open Label MPH
|
|
Query
|
mhalldre |
Integer |
|
Recommended |
Allergies Drugs |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
|
Query
|
mhallote |
Integer |
|
Recommended |
Allergies Other |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
mhx001a, q09a |
Query
|
mhsensme |
Integer |
|
Recommended |
Sensitivity to study medication(s) |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
|
Query
|
mhheente |
Integer |
|
Recommended |
HEENT Disorder |
1::4;-9;9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown;4=Yes; 9=not evaluated
|
|
Query
|
mhcardie |
Integer |
|
Recommended |
Cardiovascular Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
q03a |
Query
|
mhrenale |
Integer |
|
Recommended |
Renal Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
q12c |
Query
|
mhhepate |
Integer |
|
Recommended |
Hepatic Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
q13c |
Query
|
mhpulmne |
Integer |
|
Recommended |
Pulmonary Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
|
Query
|
mhasthme |
Integer |
|
Recommended |
History of Asthma |
1::4;-9;9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown;4=Yes; 9=not evaluated
|
|
Query
|
mhgastre |
Integer |
|
Recommended |
Gastrointestinal Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
gen_med_gastro, mhx007a, q05a |
Query
|
mhmusske |
Integer |
|
Recommended |
Musculoskeletal Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
gen_med_muscoskeletal, q07a |
Query
|
mhneuroe |
Integer |
|
Recommended |
Neurologic Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
q10a |
Query
|
mhophthe |
Integer |
|
Recommended |
Ophthalmologic Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
q11c |
Query
|
mhpsyche |
Integer |
|
Recommended |
Psychiatric Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
|
Query
|
mhdermae |
Integer |
|
Recommended |
Dermatologic Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
|
Query
|
mhmetabe |
Integer |
|
Recommended |
Metabolic Disorder |
1::4;-9;9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown;4=Yes; 9=not evaluated
|
q01c, q25 |
Query
|
mhhemate |
Integer |
|
Recommended |
Hematologic Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
|
Query
|
mhendoce |
Integer |
|
Recommended |
Endocrine Disorder |
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
gen_med_endocrine, q04a |
Query
|
mhgenure |
Integer |
|
Recommended |
Genitourinary Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
gen_med_kidney, q06a |
Query
|
mhreproe |
Integer |
|
Recommended |
Reproductive System Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
|
Query
|
mhinfece |
Integer |
|
Recommended |
Infectious Disease |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
|
Query
|
mhothr1 |
Integer |
|
Recommended |
Other 1 |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
|
Query
|
mhothr2 |
Integer |
|
Recommended |
Other 2 |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
|
Query
|
mhsur |
Integer |
|
Recommended |
Any surgeries |
0;1
|
0=No; 1=Yes
|
|
Query
|
mhsur1e |
Integer |
|
Recommended |
Major Surgery 1 |
1::3; -9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown
|
gen_med_surgery |
Query
|
mhsur2e |
Integer |
|
Recommended |
Major Surgery 2 |
1::3; -9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown
|
|
Query
|
mhsur3e |
Integer |
|
Recommended |
Major Surgery 3 |
1::3; -9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown
|
|
Query
|
mhsur4e |
Integer |
|
Recommended |
Major Surgery 4 |
1::3; -9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown
|
|
Query
|
mhsur5e |
Integer |
|
Recommended |
Major Surgery 5 |
1::3; -9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown
|
|
Query
|
mhpbirth |
Integer |
|
Recommended |
Other condition premature birth |
1;2
|
1=Yes 2=No
|
cmedhx6 |
Query
|
mhcoord |
Integer |
|
Recommended |
Other condition coordination problem |
1;2
|
1=Yes 2=No
|
|
Query
|
mhspeech |
Integer |
|
Recommended |
Other condition speech delay |
1;2
|
1=Yes 2=No
|
|
Query
|
mhlang |
Integer |
|
Recommended |
Other condition language difficulty |
1;2
|
1=Yes 2=No
|
|
Query
|
mhlearn |
Integer |
|
Recommended |
Other condition learning disability |
1;2; -9
|
1=Yes 2=No; -9=NK
|
|
Query
|
mhsur1dt |
Integer |
|
Recommended |
Major Surgery 1 Date in days from the randomization date (MHSUR1DT = Date of surgery - randomization date) |
|
Date of the surgery was assumed to be 15th of the month
|
|
Query
|
mhsur2dt |
Integer |
|
Recommended |
Major Surgery 2 Date in days from the randomization date (MHSUR2DT = Date of surgery - randomization date) |
|
Date of the surgery was assumed to be 15th of the month
|
|
Query
|
mhsur3dt |
Integer |
|
Recommended |
Major Surgery 3 Date in days from the randomization date (MHSUR3DT = Date of surgery - randomization date) |
|
Date of the surgery was assumed to be 15th of the month
|
|
Query
|
mhsur4dt |
Integer |
|
Recommended |
Major Surgery 4 Date in days from the randomization date (MHSUR4DT = Date of surgery - randomization date) |
|
Date of the surgery was assumed to be 15th of the month
|
|
Query
|
mhsur5dt |
Integer |
|
Recommended |
Major Surgery 5 Date in days from the randomization date (MHSUR5DT = Date of surgery - randomization date) |
|
Date of the surgery was assumed to be 15th of the month
|
|
|
session_id |
String |
20
|
Recommended |
session ID/screening ID |
|
|
screeningid |
|
medhxevt |
String |
250
|
Recommended |
Medical history Event |
|
|
|
|
medhxdsc |
String |
250
|
Recommended |
Medical history event Description |
|
|
|
|
medhxmth |
String |
30
|
Recommended |
Medical History event Month |
|
|
|
Query
|
medhxyr |
Integer |
|
Recommended |
Medical History event Year |
|
|
|
Query
|
medhxprs |
Integer |
|
Recommended |
Medical history event Currently Present? |
1;2
|
1=Yes; 2=No
|
|
Query
|
nervsys |
Integer |
|
Recommended |
Nervous system disorders (other than MD) |
0;1
|
0=No;1=Yes
|
|
Query
|
medhx_respprob |
Integer |
|
Recommended |
Respiratory Problems |
0::2
|
0 = No, 1 = Yes, 2 = Not sure
|
gen_med_respiratory, med_035, other_resp, respir |
Query
|
lymph |
Integer |
|
Recommended |
Hematopoietic-Lymphatic disorders |
0;1
|
0=No;1=Yes
|
|
Query
|
malig |
Integer |
|
Recommended |
Malignancy |
0;1
|
0=No;1=Yes
|
|
Query
|
scrn09b |
Integer |
|
Recommended |
Alcohol abuse |
0;1
|
0=No; 1=Yes
|
alcabuse, neuro_psych_substance |
Query
|
curalc |
Integer |
|
Recommended |
Current alcohol use |
0;1
|
0=No;1=Yes
|
alcohol |
Query
|
curalcfr |
Integer |
|
Recommended |
Current alcohol use frequency |
1::5
|
1=Occasional (<1 drink/week); 2=Occasional (1-2 drinks/week); 3=Occasional (?3 drinks/week); 4=Most days of the week (1-2 drinks/day); 5= Most days of the week (?3 drinks/day)
|
alcohol_2 |
Query
|
ysua |
Integer |
|
Recommended |
Abuse. Other drug abuse/dependence. Diagnosis for other substance abuse |
0 :: 1
|
0 = Absent; 1 = Present
|
subsbuse |
Query
|
male |
Integer |
|
Recommended |
Is the subject male? |
0;1
|
0=No;1=Yes
|
|
Query
|
menopaus |
Integer |
|
Recommended |
Depression from menopause |
0;1
|
0=No;1=Yes
|
|
Query
|
rlhqlql |
Integer |
|
Recommended |
Patient's status is childbearing potential |
|
1=No; 2=Yes; 9=unknown
|
childbr |
Query
|
contrcep |
Integer |
|
Recommended |
Any contraception use |
0;1
|
0=No;1=Yes
|
current_contraceptives |
Query
|
age1stmp |
Integer |
|
Recommended |
first menstrual period |
|
999= NA
|
mensage |
Query
|
numpreg |
Integer |
|
Recommended |
number of pregnancies |
|
|
pregnum |
Query
|
lbirth |
Integer |
|
Recommended |
Live births |
|
|
livebrth |
Query
|
miscar |
Integer |
|
Recommended |
Number of miscarriages |
|
|
mscarnum |
Query
|
abort |
Integer |
|
Recommended |
Abortions |
|
|
abortnum |
Query
|
oralcntr |
Integer |
|
Recommended |
Has the patient ever taken oral contraceptives |
0;1
|
0=No;1=Yes
|
|
Query
|
postpart |
Integer |
|
Recommended |
Postpartum |
1;0;-7
|
0=No; 1=Yes;-7=Refused
|
postprtm |
Query
|
useoral |
Integer |
|
Recommended |
Depression from oral contraceptives |
0;1
|
0=No;1=Yes
|
|
Query
|
pms |
Integer |
|
Recommended |
Depression from PMS |
0;1
|
0=No;1=Yes
|
|
Query
|
menostas |
Integer |
|
Recommended |
Menopause status |
1::3
|
1=Post-menopausal (natural or surgical); 2=Peri-menopausal; 3=Pre-menopausal
|
|
Query
|
mnpsage |
Integer |
|
Recommended |
Age of menopause (Years) |
|
|
menoage |
Query
|
estrogen |
Integer |
|
Recommended |
hormone replacement therapy |
0;1;-7
|
0=No; 1=Yes; -7=Refused
|
takehorm |
Query
|
menscaus |
Integer |
|
Recommended |
Menopause due to: |
1::3
|
1=Natural; 2=Surgery (ovaries removed); 3=Chemotherapy or radiation
|
|
Query
|
agelast |
Integer |
|
Recommended |
Age of last normal menstrual period |
|
|
|
Query
|
me3 |
Integer |
|
Recommended |
Did the patient have a hysterectomy? |
0;1
|
0=No; 1=Yes
|
posthyst |
Query
|
regmense |
Integer |
|
Recommended |
Regular menstrual periods |
0;1; 999
|
0=No;1=Yes; 999=NA
|
regular_periods |
Query
|
mensdays |
Integer |
|
Recommended |
Average menstrual cycle length |
|
|
|
Query
|
condom |
Integer |
|
Recommended |
BC: Condom |
0;1
|
0=No;1=Yes
|
|
Query
|
spermcd |
Integer |
|
Recommended |
BC: Spermicide |
0;1
|
0=No;1=Yes
|
|
Query
|
bcp |
Integer |
|
Recommended |
Oral Birth Control Pill |
0;1
|
0=No; 1=Yes
|
brthcntrl |
Query
|
iud |
Integer |
|
Recommended |
Use of IUD |
0;1
|
0=No;1=Yes
|
|
Query
|
implant |
Integer |
|
Recommended |
BC: Implant |
0;1
|
0=No;1=Yes
|
|
Query
|
tuballig |
Integer |
|
Recommended |
BC: Tubal ligation |
0;1
|
0=No;1=Yes
|
|
Query
|
controth |
Integer |
|
Recommended |
Use of other birth control |
0;1
|
0=No;1=Yes
|
|
Query
|
lasatmense |
Integer |
|
Recommended |
Premenopause last menstrual date |
|
|
|
Query
|
mpdatm |
Integer |
|
Recommended |
Date of last menstrual period |
|
|
begin_last_period, mensesdt |
Query
|
phase |
Integer |
|
Recommended |
Phase |
|
9 =follow up
|
|
Query
|
days_baseline |
Integer |
|
Recommended |
Days since baseline |
|
|
date, lof |
Query
|
week |
Float |
|
Recommended |
Week in level/study |
|
99=week 10-week 14
|
|
|
midihist_002a |
String |
250
|
Recommended |
Allergies- Other Specified |
|
|
mhxs_q09b |
|
midihist_003a |
String |
250
|
Recommended |
HEENT Disorder explain or describe |
|
|
|
|
midihist_013a |
String |
250
|
Recommended |
Hepatic Disorder describe |
|
|
hepatic, mhxs_q13b |
|
midihist_012a |
String |
250
|
Recommended |
Renal Disorder describe |
|
|
mhxs_q12b, renal_gento_urinary |
|
midihist_014a |
String |
250
|
Recommended |
Pulmonary Disorder describe |
|
|
mhxs_q02b |
|
midihist_015a |
String |
250
|
Recommended |
Gastrointestinal Disorder describe |
|
|
gen_med_gastro_info, mhxs_q05b |
|
midihist_016a |
String |
250
|
Recommended |
Musculoskeletal Disorder describe |
|
|
gen_med_muscoskeletal_info, mhxs_q07b, mhxs_q08b, musculo_skeletal |
|
midihist_017a |
String |
250
|
Recommended |
Neurologic Disorder describe |
|
|
central_nervous_sustem, mhxs_q10b |
|
midihist_018a |
String |
250
|
Recommended |
Dermatologic Disorder describe |
|
|
dermotological |
|
midihist_020a |
String |
250
|
Recommended |
Hemotologic Disorder describe |
|
|
gen_med_blood_info |
|
endocmt |
String |
250
|
Recommended |
Endocrine/Diabetes comments |
|
|
endrocrinine_metabolite, gen_med_endocrine_info, mhxs_q04b |
|
midihist_025a |
String |
250
|
Recommended |
Genitourinary Disorder describe |
|
|
gen_med_kidney_info, mhxs_q06b |
|
midihist_026a |
String |
250
|
Recommended |
Infectious Disease describe |
|
|
|
|
midihist_040a |
String |
250
|
Recommended |
Other medical history 1 describe |
|
|
|
|
mhx003b_1 |
String |
250
|
Recommended |
Explain Cardiovascular disorder history |
|
|
cardiovascular, mhxs_q03b |
|
mhx011b_1 |
String |
250
|
Recommended |
Explain Metabolic disorder history |
|
|
mhxs_q01b |
|
lab020 |
Date |
|
Recommended |
Date of PI/clinician signature |
|
|
date_con_review_inves_1, mhx017 |
Query
|
fmri001 |
Integer |
|
Recommended |
Was a Bold fMRI performed on this subject? |
0;1;-9
|
0=No; 1=Yes; -9=Unknown
|
|
|
fmri002 |
Date |
|
Recommended |
When was the Bold fMRI performed? |
|
|
|
|
fmri003 |
String |
200
|
Recommended |
fMRI comments |
|
|
|
Query
|
mrs001 |
Integer |
|
Recommended |
Was a Glx MRS performed on this subject? |
0;1;-9
|
0=No; 1=Yes; -9=Unknown
|
|
|
mrs002 |
Date |
|
Recommended |
When was the Glx MRS performed? |
|
|
|
|
mrs003 |
String |
200
|
Recommended |
Glx MRS: Comments |
|
|
|
Query
|
visday |
Integer |
|
Recommended |
Number of days from study baseline to date of visit |
|
|
daymedhxc |
Query
|
respondent |
String |
20
|
Recommended |
Respondent |
|
|
nfmedhxc |
|
respond_detail_oth_spec |
String |
255
|
Recommended |
Respondent details |
|
|
infrmoth, respiratory_detail |
Query
|
fh07 |
Integer |
|
Recommended |
7. Subject adopted |
0;1;9
|
|
adopted |
Query
|
cmedhx3 |
Integer |
|
Recommended |
Take any medications other than vitamins and iron? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx9 |
Integer |
|
Recommended |
Did the baby have any other trouble? (Jaundice, infections, other?) |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx10 |
Integer |
|
Recommended |
How many days did the baby stay in the hospital after birth? |
|
|
|
Query
|
daycmedh11a |
Integer |
|
Recommended |
Study Day of last medical exam |
|
|
|
Query
|
cmedhx14a |
Integer |
|
Recommended |
Any bad reactions to immunizations? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx18 |
Integer |
|
Recommended |
Are any current medications taken regularly? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx19 |
Integer |
|
Recommended |
Are there any past medications which were taken regularly? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx20 |
Integer |
|
Recommended |
Any operations? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx21 |
Integer |
|
Recommended |
Has your child had frequent ear infections? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx25 |
Integer |
|
Recommended |
Is there asthma, recurrent cough or any lung problems? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx27 |
Integer |
|
Recommended |
Any problems with urination? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx28 |
Integer |
|
Recommended |
Any problems with diarrhea or constipation? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx29 |
Integer |
|
Recommended |
Have there been any convulsions or other problems with the nervous system? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx30 |
Integer |
|
Recommended |
Any eczema, hives, or other skin conditions? |
0;1
|
0 = No;1 = Yes
|
med_050, skin_yn |
Query
|
cmedhx31 |
Integer |
|
Recommended |
Has your child ever been anemic? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx34 |
Integer |
|
Recommended |
Any hormonal problems? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx37 |
Integer |
|
Recommended |
Any history of physical and/or sexual abuse? |
0;1
|
0 = No;1 = Yes
|
|
Query
|
cmedhx38 |
Integer |
|
Recommended |
Any other medical problems? |
0;1;-9
|
0=No; 1=Yes; -9 = missing/not reported
|
dukemed_other |
|
illness_pregnancy |
String |
200
|
Recommended |
did the mother experience any illnesses during pregnancy |
|
Yes; No
|
cmedhx2 |
Query
|
presmed_alcohol |
String |
50
|
Recommended |
In this pregnancy, did the birth mother do any of the following activities - Drink alcohol |
|
999 = Don't Know
|
cmedhx4 |
Query
|
presmed_smoke |
String |
50
|
Recommended |
In this pregnancy, did the birth mother do any of the following activities - Smoke cigarettes or other tobacco products |
|
999=NA/missing
|
cmedhx5 |
Query
|
height_std |
Float |
|
Recommended |
Height - Standard Unit |
|
-1 = Not known; 999 = Missing
|
height |
Query
|
othmem_foodallergy |
String |
50
|
Recommended |
Food Allergy |
|
|
cmedhx13a, med_076 |
Query
|
hi_81e |
Integer |
|
Recommended |
Past two years. Bee or Insect Sting Allergies |
0;1
|
0=No; 1=Yes
|
cmedhx13b |
|
hospitalizations |
String |
200
|
Recommended |
has the subject had any hospitalisations |
|
|
cmedhx15, p7902devhisthospitalizations |
Query
|
tc9 |
Integer |
|
Recommended |
Life threatening illness and/or serious injury |
1;2;-99;77;88
|
1= Yes; 2= No; -99= NA; 77= Refused ; 88= Missing
|
cmedhx16 |
Query
|
edihea |
Integer |
|
Recommended |
Head injury |
|
0 = No; 1 = Possible; 2 = Definite; 9 = Not answered/Not evaluated; -999= Don't know/Missing Data
|
cmedhx17, neuro_psych_tbi |
Query
|
visionproblems |
Integer |
|
Recommended |
Vision: Does (did) the subject have Vision/eye problems? |
|
0 = No/False; 1 = Yes/True; 2 = Unknown
|
cmedhx22 |
Query
|
q17_b11 |
Integer |
|
Recommended |
Any problem with mouth lips or teeth |
-7;-8;-9;0;1
|
Field should not be left blank. If missing please use -78 -9.
|
cmedhx23 |
Query
|
wk_sore_throat |
Integer |
|
Recommended |
42. Sore throat |
0;1
|
No = 0; Yes = 1;
|
cmedhx24 |
Query
|
q17_b14 |
Integer |
|
Recommended |
Has she/he ever been to a doctor for any of these things…Problems with Heart /Problemas del corazón |
0::2
|
0 = No, 1 = Yes, 2 = Not sure//Now I'd like to ask you about your child's use of health services during the past year and throughout his/her whole life.
|
cmedhx26 |
Query
|
medhx_kidur |
Integer |
|
Recommended |
Kidney/Urinary Problems |
0::2; -9
|
0 = No; 1 = Yes; 2 = Not sure; -9 = missing/not reported
|
cmedhx32, dukemed_kidney, kidney_yn, med_046 |
Query
|
elig_18 |
Integer |
|
Recommended |
Liver disease |
0;1
|
0=No; 1=Yes
|
cmedhx33 |
Query
|
cfmh_othr_migraine |
Integer |
|
Recommended |
Migraine headaches |
0;1; -9
|
0 = No; 1 = Yes; -9=unknown
|
cmedhx35, dukemed_headaches, dx14, migraine_yn |
Query
|
medhx_sleep_prob |
String |
50
|
Recommended |
Does subject have sleep problems? |
|
|
cmedhx36 |
Query
|
chronic2 |
Integer |
|
Recommended |
Type of chronic illness - Asthma |
1;2
|
1=no; 2=yes
|
dx1 |
Query
|
diabetes |
Integer |
|
Recommended |
Diabetes, or problems with blood sugar levels, if so are you insulin dependant |
1::4;999
|
1 = No; 2 = Yes, in the past; 3 = Yes, currently; 4 = Under doctor's care now
|
dx2 |
Query
|
medcon_dx4 |
Integer |
|
Recommended |
Arthritis or rheumatism |
0;1
|
0=No; 1=Yes
|
dx4 |
Query
|
medcon_dx5 |
Integer |
|
Recommended |
Cancer diagnosed within the last 3 years |
0;1
|
0=No; 1=Yes
|
dx5 |
Query
|
medcon_dx6 |
Integer |
|
Recommended |
A neurological condition, such as epilepsy, convulsions, fainting spells, or Parkinsons disease |
0;1
|
0=No; 1=Yes
|
dx6, med_029 |
Query
|
medcon_dx7 |
Integer |
|
Recommended |
Stroke or major paralysis (inability to use arms or walk) |
0;1
|
0=No; 1=Yes
|
dx7 |
Query
|
baseline_k_002 |
Integer |
|
Recommended |
Heart disease or heart attack |
|
0=No; 1=Yes; -888=Not Applicable; -999=Missing;
|
dukemed_heart, dx8, heartatk_yn |
Query
|
medcon_dx9 |
Integer |
|
Recommended |
Back problems including disk or spine |
0;1
|
0=No; 1=Yes
|
dx9 |
Query
|
scq_05 |
Integer |
|
Recommended |
Ulcer or Stomach Disease |
0;1
|
0=No; 1=Yes
|
dx10, ulcer_yn |
Query
|
medcon_dx11 |
Integer |
|
Recommended |
Chronic inflamed bowel, enteritis, or colitis |
0;1
|
0=No; 1=Yes
|
dx11 |
Query
|
cfmh_othr_thyroiddis |
Integer |
|
Recommended |
Thyroid Disease |
1;0; -9
|
0 = No; 1 = Yes; -9=Unknown
|
dx12 |
Query
|
medcon_dx13 |
Integer |
|
Recommended |
Kidney failure |
0;1
|
0=No; 1=Yes
|
dx13 |
Query
|
medcon_dx15 |
Integer |
|
Recommended |
Do you have trouble seeing even with glasses or contact lenses |
0;1
|
0=No; 1=Yes
|
dx15 |
Query
|
medcon_dx16 |
Integer |
|
Recommended |
Not including asthma, has a doctor told you that you have chronic lung disease such as chronic bronchitis or emphysema? |
0;1
|
0=No; 1=Yes
|
dx16 |
Query
|
medcon_dx17 |
Integer |
|
Recommended |
Do you have a physical disability such as a loss of an arm or leg, or loss of your eyesight or hearing or a birth defect that limits your ability to do daily activities? |
0;1
|
0=No; 1=Yes
|
dx17 |
Query
|
dusa1a |
Integer |
|
Recommended |
If yes, on average, how many cigarettes per day have you smoked in the past 7 days? |
0::100; 999
|
999= Legitimately skipped
|
dx18 |
Query
|
cig_smoking1_100 |
Integer |
|
Recommended |
Have you smoked at least 100 cigarettes in your entire life? PX030601_Cigarette_Smoking_100 |
1;2;97
|
1=Yes; 2=No; 97=Don't Know/Refused
|
dx18a |
Query
|
weight_met |
Float |
|
Recommended |
Weight - Metric Unit |
|
999 = Missing; -999 = No Data
|
dx19, med_104 |
Query
|
medcon_dx21 |
Integer |
|
Recommended |
How often do you get physical exercise, either on your job or in a recreational activity? |
1::4
|
1=regularly; 2= occasionally; 3= seldom; 4= never
|
dx21 |
Query
|
clinicid |
Integer |
|
Recommended |
Clinic ID |
|
|
aclinic |
Query
|
interv |
Integer |
|
Recommended |
Intervention Status |
0;1
|
1=ITV, intervention; 0=TAU, treatment as usual
|
|
Query
|
tchronds |
Integer |
|
Recommended |
Number of major chronic medical conditions |
|
|
|
Query
|
rchronds |
Float |
|
Recommended |
square root of total chronic diseases |
|
|
|
Query
|
chronds3 |
Integer |
|
Recommended |
major chronic medical conditions |
|
1=none;2=one;3=two or more
|
|
Query
|
chron0 |
Integer |
|
Recommended |
no major chronic medical conditions |
0;1
|
0=No;1=Yes
|
|
Query
|
chron1 |
Integer |
|
Recommended |
1 major chronic medical condition |
0;1
|
0=No;1=Yes
|
|
Query
|
chron2 |
Integer |
|
Recommended |
2 or more major chronic medical conditions |
0;1
|
0=No;1=Yes
|
|
|
date_updated |
Date |
|
Recommended |
Date record updated |
|
|
edit_date |
Query
|
mhxa1b_1 |
Integer |
|
Recommended |
Cardiovascular Disorders: Transient Ischemic Attacks, TIAs |
0;1;-9
|
0=No;1=Yes; -9 = Not applicable or Missing
|
med_008 |
Query
|
mhxa33 |
String |
2
|
Recommended |
Other illness/disease |
A;N
|
A=Abnormal; N=Normal
|
|
Query
|
mhxs_q01a |
Integer |
|
Recommended |
Metabolic History |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
q01a |
Query
|
mhxs_q08a |
Integer |
|
Recommended |
Skin/Appendages History |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
q08c |
Query
|
mhxs_q01c |
Integer |
|
Recommended |
Metabolic Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q02c |
Integer |
|
Recommended |
Respiratory/Pulmonary Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q03c |
Integer |
|
Recommended |
Cardiovascular Disease Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q04c |
Integer |
|
Recommended |
Endocrinological System Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q05c |
Integer |
|
Recommended |
Gastrointestinal System Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q06c |
Integer |
|
Recommended |
Genitourinary/Reproductive Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q07c |
Integer |
|
Recommended |
Musculoskeletal System Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q08c |
Integer |
|
Recommended |
Skin/Appendages Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q09c |
Integer |
|
Recommended |
Allergies Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q10c |
Integer |
|
Recommended |
Neurological System Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q11c |
Integer |
|
Recommended |
Ophthalmologic Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q12c |
Integer |
|
Recommended |
Renal Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q13c |
Integer |
|
Recommended |
Hepatic Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
mhxs_q14c |
Integer |
|
Recommended |
Hematopoietic System Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
|
mhxs_q11b |
String |
250
|
Recommended |
Ophthalmologic Description |
|
|
|
Query
|
mhxs_q14a |
Integer |
|
Recommended |
Hematopoietic System History |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
hematopoietic_lymphatic_di, q14a |
|
mhxs_q14b |
String |
250
|
Recommended |
Hematopoietic System Description |
|
|
hematopoietic_lymphatic |
|
mhxs_q15 |
String |
45
|
Recommended |
Other 1 Name |
|
|
gen_med_other |
Query
|
mhxs_q15c |
Integer |
|
Recommended |
Other 1 Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
gen_med_other_info |
|
mhxs_q16 |
String |
45
|
Recommended |
Other 2 Name |
|
|
|
Query
|
mhxs_q16c |
Integer |
|
Recommended |
Other 2 Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
|
mhxs_q17 |
String |
30
|
Recommended |
Other 3 Name |
|
|
|
Query
|
mhxs_q17a |
Integer |
|
Recommended |
Other 3 History |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
|
|
mhxs_q17b |
String |
250
|
Recommended |
Other 3 Description |
|
|
|
Query
|
mhxs_q17c |
Integer |
|
Recommended |
Other 3 Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
|
mhxs_q18 |
String |
30
|
Recommended |
Other 4 Name |
|
|
|
Query
|
mhxs_q18a |
Integer |
|
Recommended |
Other 4 History |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
|
|
mhxs_q18b |
String |
250
|
Recommended |
Other 4 Description |
|
|
|
Query
|
mhxs_q18c |
Integer |
|
Recommended |
Other 4 Significance |
1;2
|
1= Yes, significant; 2= Not signifiant
|
|
Query
|
visitday |
Integer |
|
Recommended |
day of visit |
|
|
mhxs_visitdat_x, studyday |
Query
|
medhisx_q02a |
Integer |
|
Recommended |
Respiratory/Pulmonary System |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
q02a, respiratory_diagnosis_past |
Query
|
medhisx_q02c |
Integer |
|
Recommended |
Respiratory/Pulmonary Clin. Relevant |
1::3; -9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown
|
q02c |
Query
|
medhisx_q04c |
Integer |
|
Recommended |
Endocrinological System Clin. Relevant |
1::3; -9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown
|
q04c |
Query
|
medhisx_q08a |
Integer |
|
Recommended |
Skin/Appendages |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
q08a |
Query
|
medhisx_q14c |
Integer |
|
Recommended |
Hematopoietic System Clinically Relevant |
1::3; -9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown
|
q14c |
Query
|
medhisx_q15a |
Integer |
|
Recommended |
Other 1 |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
q15a |
Query
|
medhisx_q15c |
Integer |
|
Recommended |
Other 1 Clinically Relevant |
1::3; -9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown
|
q15c |
Query
|
medhisx_q16a |
Integer |
|
Recommended |
Other 2 |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
q16a |
Query
|
medhisx_q16c |
Integer |
|
Recommended |
Other 2 Clinically Relevant |
1::3; -9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown
|
q16c |
Query
|
medhisx_q17a |
Integer |
|
Recommended |
Other 3 |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
q17a |
Query
|
medhisx_q17c |
Integer |
|
Recommended |
Other 3 Clinically Relevant |
1::3; -9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown
|
q17c |
Query
|
medhisx_q18 |
Integer |
|
Recommended |
Adverse Psycho-social |
1;2;9
|
1=Yes; 2=No; 9=Not applicable
|
q18 |
Query
|
medhisx_q19 |
Integer |
|
Recommended |
Fragile X Syndrome |
1;2;9
|
1=Yes; 2=No; 9=Not applicable
|
q19 |
Query
|
medhisx_q20 |
Integer |
|
Recommended |
Cornelia De Lange Syndrome |
1;2;9
|
1=Yes; 2=No; 9=Not applicable
|
q20 |
Query
|
medhisx_q21 |
Integer |
|
Recommended |
Landau-Kleffner Syndrome |
1;2;9
|
1=Yes; 2=No; 9=Not applicable
|
q21 |
Query
|
medhisx_q22 |
Integer |
|
Recommended |
Sturge Weber Syndrome |
1;2;9
|
1=Yes; 2=No; 9=Not applicable
|
q22 |
Query
|
medhisx_q23 |
Integer |
|
Recommended |
Other Genetic Syndrome |
1;2;9
|
1=Yes; 2=No; 9=Not applicable
|
q23 |
Query
|
medhisx_q24 |
Integer |
|
Recommended |
Neurofibromatosis |
1;2;9
|
1=Yes; 2=No; 9=Not applicable
|
q24 |
Query
|
medhisx_q27 |
Integer |
|
Recommended |
Conigenital Rubella Exposure |
1;2;9
|
1=Yes; 2=No; 9=Not applicable
|
q27 |
Query
|
ci_enrolled |
Integer |
|
Recommended |
Participant enrolled |
0;1
|
0=No; 1=Yes
|
enrolled |
Query
|
sitedatasource_1 |
Integer |
|
Recommended |
Source of Data: Site |
0;1; -888; -999
|
0=False; 1=True; -888=Not Applicable; -999=Missing;
|
infosrcr |
Query
|
sitedatasource_phone |
Integer |
|
Recommended |
Source of Data: Telephone |
0;1; -888; -999
|
0=False; 1=True; -888=Not Applicable; -999=Missing;
|
infosrct |
Query
|
sitedatasource_physician |
Integer |
|
Recommended |
Source of Data: Physician |
0;1; -888; -999
|
0=False; 1=True; -888=Not Applicable; -999=Missing;
|
infosrcp |
Query
|
anymedhist |
Integer |
|
Recommended |
No Medication History |
1;2
|
1= Yes; 2= No
|
nomeds |
Query
|
ad_exc11 |
Integer |
|
Recommended |
Current use of antidepressants or anticonvulsants |
0;1
|
0=No; 1=Yes
|
antimed, psych_meds |
|
medication_name |
String |
255
|
Recommended |
Name of medication |
|
|
medname |
|
cmind |
String |
200
|
Recommended |
Indication |
|
|
purpind |
Query
|
cmroute |
Integer |
|
Recommended |
Route |
|
1 = oral; 2 = intravenous; 3 = subcutaneous; 4 = topical; 5 = inhalation; 6 = transdermal; 7 = rectal; 8 = intramuscular; 9 = sublingual; 10 = PEG; 99 = Other (specify); 999 =unknown; 11=oral/intramuscular; 12 = Nasal; 13 = Vaginal; 14 = Auricular; 15 = Intra-articular; 16 = Intraocular; 17 = Depot
|
route |
|
cmrouto |
String |
200
|
Recommended |
Route other specify |
|
|
|
|
ddose |
String |
50
|
Recommended |
daily dose |
|
-9=unknown
|
dose |
Query
|
cmunit |
Integer |
|
Recommended |
Units |
|
1 = micrograms (mkg); 2 = milligrams (mg); 3 = grams (g); 4 = tablet(s); 5 = capsule(s); 6 = gtt; 7 = meq; 8 = international units (IU); 9 = units (U); 10=Percent (%); 11=Compount/more than one medicine combind; 12=Grains (gr); 13=mg/kg; 99 = Other (specify); 14 = ml; 15 = mg/mL; 16 = mcg/mL; 17 = tbls; 18 = 3tts; 19 = cc; 20 = ss; 21 = puff; 22 = spray/squirt; 23 = suppository; 24 = teaspoon; 25 = uL; 26 = unknown; 27 = oz;28=millicurie; 29=microcurie
|
units |
|
cmunito |
String |
200
|
Recommended |
Unit other specify |
|
|
|
Query
|
cmfreq |
Integer |
|
Recommended |
Frequency |
|
1 = QD; 2 = BID; 3 = TID; 4 = QID; 5 = QHS; 6 = CONT IV; 7 = PRN; 8=Q4H; 9=Q6H; 10=Q8H; 11=Q12H; 12=BIS; 13=QS; 14=QM; 15=U; 99 = Other (specify); 16=QOD; 17=qam; 18=qw; 19=q30m; 20=q1h; 21=q5h; 22=biw; 23=qpm; 24=q15m; 25=q3h; 26 = q6pm; 27=tiw; 28 = ac; 29 = q2h;30=once; 31=Unknown
|
freq |
|
cmfreqo |
String |
200
|
Recommended |
Frequency other specify |
|
|
|
Query
|
startdy |
Integer |
|
Recommended |
Start Day |
|
|
adddate |
Query
|
endday |
Integer |
|
Recommended |
Stop Day |
|
|
stopdate |
Query
|
cmcont |
Integer |
|
Recommended |
Continuing at end of study? |
1;2
|
1=Yes; 2=No
|
continue |
|
comments |
String |
4,000
|
Recommended |
Comments about assessment |
|
|
co_notes, med_compliance_comments, medical_history |
|
labsample29 |
String |
10
|
Recommended |
Date of last menstrual period |
|
NA=if male or pre-puberty
|
lmp_date |
Query
|
reason_irregular_period |
Integer |
|
Recommended |
Reason for irregular period |
0::3
|
0= Surgical Menopause;1= Natural Menopause;2= Non-Menopausal;3= Birth Control
|
|
Query
|
smoker |
Integer |
|
Recommended |
Smoker? |
0 :: 4; 9
|
0=No; 1=Yes; 2= Yes, but not regularly (less than 10 per day); 3= Yes, regularly (10 or more a day); 4= Former smoker; 9=NK/missing
|
co_current_smoke_yn, smoking, smoking_status |
Query
|
quantity_currentuse |
Float |
|
Recommended |
Number of cigarettes smoked per day |
0 :: 500
|
|
cigs_per_day |
Query
|
cr3c |
Float |
|
Recommended |
Tobacco Use: If yes, smoked: Number of pack-years |
|
|
co_pack_years, pack_years |
|
current_medication |
String |
300
|
Recommended |
subject's current medications |
|
|
meds |
Query
|
drug_class |
Integer |
|
Recommended |
Drug Class |
1::6
|
1= Antidepressants;2= Mood Stabilizers;3= Sedatives;4= Antipsychotics;5= Stimulants;6= Other
|
|
Query
|
antidepressants |
Integer |
|
Recommended |
Antidepressants |
|
1= Anafranil (clomipramine hydrchloride);2= Asendin (amoxapine);3= Celexa (citalopram hydrobromide);4= Desyrel (trazodone);5= Effexor (venlafaxine);6= Lexapro (escitalopram oxalate);7= Ludiomil (maprotiline);8= Luvox (fluvoxamine);9= Marplan (isocarboxazid);10= Nardil (phenelzine sulfate);11= Norpramin (desipramine);12= Pamelor/Aventyl (nortriptyline);13= Parnate (tranylcypromine);14= Paxil (paroxetine);15= Prozac (fluoxetine);16= Remeron (mirtazapine);17= Serzone (nefazodone);18= Sinequan (doxepine);19= Surmontil (trimipramine);20= Tofranil (imipramine);21= Vivactil (protriptyline);22= Wellbutrin (bupropion);23= Zoloft (sertraline);24= Cymbalta (duloxetine)
|
|
Query
|
mood_stabilizers1 |
Integer |
|
Recommended |
Mood Stabilizers |
|
1= Lamictal (lamotrigine);2= Lithium;3= Tegretol (carbamazepine);4= Valproic Acid (depakene= depakote)
|
mood_stabilizers |
Query
|
sedatives1 |
Integer |
|
Recommended |
Sedatives / Hypnotics / Minor Tranquilizers |
|
1= Ambien (zolpidem= midzolam);2= Atarax (hydroxyzine);3= Ativan (lorazepam);4= Benadryl (diphenhydramine);5= Buspar (buspirone);6= Dalmane (flurazepam hydrochloride);7= Halcion (triazolam);8= Klonopin (clonazepam);9= Librium (chlordiazepoxide);10= Miltown/Equanil (meprobamate);11= Noctec (chloral hydrate);12= Placidyl (ethchlorvynol);13= Restoril (temazepam);14= Seconal (secobarbital);15= Serax (oxazepam);16= Tranzene (chlorazepate);17= Valium (diazepam);18= Xanax (alprazolam)
|
sedatives |
Query
|
antipsychotics1 |
Integer |
|
Recommended |
Antipsychotics |
|
1= Abilify (ariprapizole);2= Clozaril (clozapine);3= Geodon (ziprasidone);4= Haldol (haloperidol);5= Loxitane (loxapine);6= Mellaril (thioridazine);7= Moban (molindone);8= Navane (thiothixene);9= Prolixin (fluphenazine);10= Risperdal (risperidone);11= Serentil (mesoridazine);12= Seroquel (sertindole);13= Stelazine (trifluoperazine);14= Thorazine (chlorpromazine);15= Trilafon (perphenazine);16= Zyprexa (olanzapine)
|
antipsychotics |
Query
|
stimulants1 |
Integer |
|
Recommended |
Stimulants |
|
1= Adderall (amphetamine/dextroamphetamine);2= Concerta (methylphenidate hydrochloride);3= Cylert (pemoline);4= Dexedrine (amphetamine);5= Metadate (methylphenidate hydrochloride);6= Provigil (modafinil);7= Ritalin (methylphenidate)
|
stimulants |
Query
|
other_drugs1 |
Integer |
|
Recommended |
Other Drugs |
|
1= Neurontin (gabapentin);2= Trileptal (oxycarbazepine [anti-epileptic]);3= Topamax (topiramate [anti-epileptic]);4= Strattera (atomoxetine [norepinephrine reuptake blocker]);5= Symbyax (olanzapine and fluoxetine hydrochloride)
|
other_drugs |
Query
|
macnumep |
Integer |
|
Recommended |
Total number of episodes of manic syndrome, including current |
|
99 = too numerous or indistinct to count; -9=Unknown
|
lifetime_episodes_mania |
Query
|
manic_age |
Integer |
|
Recommended |
Manic and Hypomania Age of Onset |
|
-9=Unknown
|
age_of_onset_mania |
Query
|
depr_onset |
Integer |
|
Recommended |
Depression age of onset |
|
|
age_of_onset_depression |
Query
|
lifetime_episodes_depression |
Integer |
|
Recommended |
Number of lifetime depressed episodes |
|
|
|
Query
|
recent_episode |
Integer |
|
Recommended |
Most recent episode |
1::5
|
1= Depression;2= Hypomania;3= Mania;4= Mixed;5= Unknown
|
|
|
recent_episode_notes |
String |
255
|
Recommended |
Approximate dates/notes about recent episode |
|
|
|
Query
|
age_concern_yr |
Integer |
|
Recommended |
Age of first developmental concern (years) |
0::100
|
|
agedevelopconcernsyr |
Query
|
aut_related |
String |
10
|
Recommended |
Is there an Autism related diagnosis |
Yes; No; Not known
|
|
autismrelateddiagnosis |
Query
|
additional_it_q1 |
String |
20
|
Recommended |
Do you have any concerns about your child's development? |
|
|
developmentalconcerns |
Query
|
diag_ageatdiag |
Integer |
|
Recommended |
Age at diagnosis(in months) |
|
|
diagnosisagemon |
Query
|
diag_ageatdiag_yr |
Integer |
|
Recommended |
Age at diagnosis(in years) |
0::100
|
|
ageatdiagnosisyear, diagnosisageyr |
|
diag_diagnosismadeby_otr |
String |
4,000
|
Recommended |
Diagnosis made by Other specified |
|
|
diagmadebyother, diagnosismadebyother |
Query
|
age_3word_year |
Integer |
|
Recommended |
Age at 3-word sentences (in years) |
|
|
p7902devhistagefirst3wordsente |
Query
|
ad016_year |
Integer |
|
Recommended |
Age of first single words (years) |
|
|
p7902devhistagefirstwordsyear |
Query
|
walk10_age_yr |
Integer |
|
Recommended |
Walking 10 steps - age (years) |
|
|
p7902devhistagewalkingyear |
Query
|
devel_changes |
Integer |
|
Recommended |
Any changes in developmental history since last visit? |
1; 2; 9
|
1 = Yes; 2 = No; 9 = Not applicable
|
p7902devhistchangesindevhist |
|
devel_changes_spec |
String |
50
|
Recommended |
Any changes in developmental history since last visit? - Specified |
|
|
p7902devhistchangesindevhistsp |
Query
|
adja5b |
Integer |
|
Recommended |
Admission to an emergency department |
0;1
|
1=Yes; 0=No Indicate all criteria defining the study endpoint (select all that apply):
|
p7902devhistemergencyvisits |
Query
|
srfa6g |
Integer |
|
Recommended |
Emergency Room (Medical) number of visits |
0::200
|
|
er, p7902devhistnumofemergencyvisi |
Query
|
numhosp |
Integer |
|
Recommended |
If yes, number of times hospitalized |
|
|
hospital, p7902devhistnumofhospitalizati |
Query
|
diag_changes |
Integer |
|
Recommended |
Changes in diagnostic history since last visit? |
0; 1
|
0 = No; 1 = Yes
|
changessincelastvisit |
|
physicianspecialty |
String |
50
|
Recommended |
Physicians's specialty |
|
|
|
Query
|
co_levels_ppm |
Float |
|
Recommended |
Expired CO levels (PPM) |
|
|
|
Query
|
co_levels_cohb |
Float |
|
Recommended |
Expired CO levels ( COHb) |
|
|
|
Query
|
cr3 |
Integer |
|
Recommended |
Tobacco Use: Did person ever smoke? |
0;1; 9
|
0 = no;1 = yes; 9=NK/missing
|
co_ever_smoke_yn |
Query
|
co_age_start |
Integer |
|
Recommended |
If you have ever smoked or currently smoke, what age did you start: |
|
|
|
|
cig_smoke |
String |
200
|
Recommended |
The amount of cigarettes you smoke and ages you have smoked |
|
|
co_how_many_cigs |
Query
|
freq_unit_per |
Integer |
|
Recommended |
Frequency unit |
1::3
|
1=Per day; 2=Per week; 3=Per month
|
co_smoke_freq |
Query
|
prescan_003 |
Integer |
|
Recommended |
How many cigarettes did you smoke during the last 8 hours? |
|
|
co_smoke_today_how_many |
|
labsample27 |
String |
100
|
Recommended |
Time since subject last smoked tobacco |
|
NA=Non-user
|
co_smoke_last, tobacco_tlu |
Query
|
cigarette_number_packs |
Float |
|
Recommended |
indicate the average number of packs of cigarettes smoked daily |
|
|
co_packs_day |
Query
|
cigaretteuse_time_yrs |
Float |
|
Recommended |
indicate the number of years that the participant has smoked cigarettes |
|
|
co_years_smokes |
Query
|
co_age_quit |
Integer |
|
Recommended |
What age did you quit? |
|
|
|
Query
|
co_nic_replace_yn |
Integer |
|
Recommended |
Are you on nicotine replacement? |
1;2;9
|
1=Yes; 2=No; 9=Unknown/Missing
|
|
|
doa_futdt |
String |
20
|
Recommended |
Future date entered (Assessment) |
|
|
co_doa_futdt |
|
dode |
String |
10
|
Recommended |
Date of Data Entry |
|
|
co_dode |
|
dode_futdt |
String |
20
|
Recommended |
Future date entered (Data Entry) |
|
|
co_dode_futdt |
Query
|
form_completed |
Integer |
|
Recommended |
Was the form completed? |
1::4
|
1=Yes; 2=No; 3=Unverified; 4 = N/A-Not in age range
|
co_form_complete |
Query
|
form_explain |
Integer |
|
Recommended |
Why was this form not completed? |
86::99
|
99=Participant unable to complete due to cognitive impairment; 98=Participant unable to complete due to physical impairment; 97=Participant refused to begin/finish; 96=Participant completed but with less than best effort; 95=Participant unable to be contacted; 94=Participant deceased; 93=Participant withdrew consent; 92=Time constraints; 91=Rater forgot to administer; 90=Missed appointment; 89=Participant was terminated from study; 88=Other;87 = Not Done (reason unspecified); 86 = Not Applicable
|
co_explain |
|
other_reason_nc |
String |
100
|
Recommended |
Other reason form was not completed |
|
|
co_other_reason_nc |
Query
|
assessment_complete |
Integer |
|
Recommended |
Complete? |
0::2
|
0=Incomplete; 1=Unverified; 2=Complete
|
nicotine_expired_co_complete |
Query
|
migraine_current |
Integer |
|
Recommended |
Has the subject had a migraine within the last month |
0;1
|
0=No; 1=Yes
|
|
Query
|
pol_therapy |
Integer |
|
Recommended |
Physical, occupational, or language therapy |
0;1
|
0=No; 1=Yes
|
|
Query
|
neurologist |
Integer |
|
Recommended |
Has the subject ever seen a neurologist? |
0;1
|
0=No; 1=Yes
|
|
|
surg_surgtype1 |
String |
255
|
Recommended |
TYPE OF SURGERY 1 |
|
|
|
|
medreason1 |
String |
250
|
Recommended |
Reason for taking medication 1 |
|
|
|
|
pcpkps_76 |
String |
100
|
Recommended |
Referral Speicified |
|
|
|
|
surg_reasonhosp1 |
String |
255
|
Recommended |
WHY HOSPITALIZED 1 |
|
|
|
Query
|
head_circum |
Float |
|
Recommended |
Head Circumference (in cm) |
|
-1 = Not known; -999 = No Data
|
|
Query
|
chrt_que_1a |
Integer |
|
Recommended |
1. Suicide Ideation - Passive (i.e. wanting to be dead) and/or active (i.e. method, intent, plan) suicidal ideation present. |
0;1
|
0=No; 1=Yes
|
|
Query
|
ca639 |
Integer |
|
Recommended |
Past psychosis - Suicidal behavior: Suicidal gestures or attempts |
0;1
|
0=No; 1=Yes
|
neuro_psych_psychosis |
Query
|
ss10 |
Integer |
|
Recommended |
Interview reliability |
1::5
|
1=Very good; 2=Good; 3=Fair; 4=Poor; 5=Very poor
|
|
Query
|
ari_c_2 |
Integer |
|
Recommended |
2. Often Lose temper. |
0::2; -9
|
0=not true, 1=somewhat true, 2=certainly true; -9=incomplete
|
|
|
wk_mri_date |
Date |
|
Recommended |
MRI. Date |
|
|
mri002 |
|
petdd |
Date |
|
Recommended |
PET date |
|
|
pet002 |
|
pet003 |
String |
150
|
Recommended |
CPKPET comments |
|
|
|
Query
|
visnum |
Float |
|
Recommended |
Numeric Visit Number |
|
-1.5 = Pre-Screening; -1 = Screening; 0 = Baseline; ## = Visit ## (from 1 to 10); Whole numbers = standard monthly visits; #.001 - #.009 = Unscheduled; #.1 = End of Phase 1; #.2 = End of Phase 2; #.3 = End of Phase 3; #.4 = End of Open Choice Phase; #.5 = End of Study; #.6 = Genetic Analysis; 1000=all visits
|
visit_number_med_hx |
Query
|
aescode |
Integer |
|
Recommended |
Staff code number of person completing this form |
|
999= Missing Data
|
rater_med_hx |
Query
|
race |
String |
30
|
Recommended |
Race of study subject |
American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported; Other Non-White; Other
|
|
|
Query
|
ethnicity |
String |
30
|
Recommended |
Ethnicity of participant |
Hispanic or Latino; Not Hispanic or Latino; Unknown
|
|
|
Query
|
panss_115 |
String |
500
|
Recommended |
G1.Do you have any medical illness or disease? |
|
|
|
|
rev_immunomedallergymed |
String |
255
|
Recommended |
Medication Allergies: Medications |
|
|
|
Query
|
v1_mh_cap1_ongoing |
Integer |
|
Recommended |
Condition 1 Ongoing (yes/no) |
0;1
|
0= no; 1= yes
|
|
Query
|
mhf_22 |
Integer |
|
Recommended |
Checks if condition is ongoing - other III |
0;1
|
0=No; 1=Yes
|
|
Query
|
saea26a3a |
Integer |
|
Recommended |
med illness 1 ongoing |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
saea26b3a |
Integer |
|
Recommended |
med illness 2 ongoing |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
saea26c3a |
Integer |
|
Recommended |
med illness 3 ongoing |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
saea26d3a |
Integer |
|
Recommended |
med illness 4 ongoing |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
thc14d |
Integer |
|
Recommended |
Event 1: Is it on going |
0;1
|
0=No; 1=Yes
|
|
Query
|
thc19d |
Integer |
|
Recommended |
Event 2: Is it on going |
0;1
|
0=No; 1=Yes
|
|
|
fammedhx_other_specify |
String |
255
|
Recommended |
If any other disorder/illness: specify |
|
|
dukemed_otherspecify |
|
fammedhx_other_specify2 |
String |
255
|
Recommended |
If any other disorder/illness: specify 2 |
|
|
|
|
fammedhx_other_specify3 |
String |
255
|
Recommended |
If any other disorder/illness: specify 3 |
|
|
|
|
surg_surgtype2 |
String |
255
|
Recommended |
TYPE OF SURGERY 2 |
|
|
|
|
surg_surgtype3 |
String |
255
|
Recommended |
TYPE OF SURGERY 3 |
|
|
|
|
wk_surgery_other |
String |
50
|
Recommended |
Surgery. If other, please specify |
|
|
|
|
wk_surgery_com |
String |
250
|
Recommended |
Surgery. Comments (Medications taken?) |
|
|
gen_med_surgery_info, histroy_of_surgeries |
Query
|
dx_ongoing |
Integer |
|
Recommended |
Is diagnosis ongoing? |
0;1
|
0 = no; 1 = yes
|
|
Query
|
mhx2_b |
Integer |
|
Recommended |
If diabetes history, what is the non-insulin control? |
1;2
|
1=Diet controlled; 2=Oral hypoglycemics
|
|
Query
|
pcos |
Integer |
|
Recommended |
diagnosed pcos |
0;1;-7; -9; -8
|
0=No; 1=Yes; -7=Refused; -9=unknown; -8=NA
|
|
|
otherrace |
String |
100
|
Recommended |
specify other race |
|
The following questions are about you or the child's family.
|
|
Query
|
fls1 |
Integer |
|
Recommended |
Have you fallen since your last appointment? |
0;1;-7;-9
|
0 =no; 1 = yes; -9 = don't know; -7 = refused
|
|
Query
|
mse1 |
Integer |
|
Recommended |
Feeling dizzy or faint |
0;1;-7;-9
|
0 =no; 1 = yes; -9 = don't know; -7 = refused
|
|
Query
|
fls1d |
Integer |
|
Recommended |
Did you sustain any injuries? Any bruises? |
0;1;-7;-9
|
0 =no; 1 = yes; -9 = don't know; -7 = refused
|
|
Query
|
fls1e |
Integer |
|
Recommended |
Did you see a physician or seek medical attention? |
0;1;-7;-9
|
0 =no; 1 = yes; -9 = don't know; -7 = refused
|
|
Query
|
me2 |
Integer |
|
Recommended |
Status |
0;1
|
0 = Past [Inactive]; 1 = Active
|
|
|
surgerydatedd1_1 |
Date |
|
Recommended |
Date surgery 1 |
|
|
|
|
surgerydatedd2_1 |
Date |
|
Recommended |
Surgery Date 2 |
|
|
|
|
surgerydatedd3_1 |
Date |
|
Recommended |
Surgery Date 3 |
|
|
|
|
typeofsurgerycode4_1 |
String |
100
|
Recommended |
Type of surgery Code 4 |
|
|
|
|
typeofsurgerycode5_1 |
String |
100
|
Recommended |
Type of surgery Code 5 |
|
|
|
Query
|
sigp1 |
Integer |
|
Recommended |
Physician signature present |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sigd1 |
Integer |
|
Recommended |
Physician/PI signature date (days since randomization) |
|
|
|
Query
|
temperature |
Float |
|
Recommended |
Temperature (degrees Fahrenheit) |
0::300
|
|
|
Query
|
pulse |
Float |
|
Recommended |
Pulse |
|
|
med_121 |
Query
|
hips |
Float |
|
Recommended |
6. Hips |
|
inches; 999=Legitimately skipped
|
|
Query
|
waist |
Float |
|
Recommended |
5. Waist |
|
inches
|
|
Query
|
hd_01 |
Float |
|
Recommended |
Head circumference measurement number 1 |
0 :: 1260
|
(cm)
|
|
Query
|
hd_02 |
Float |
|
Recommended |
Head circumference measurement number 2 |
0 :: 1260
|
(cm)
|
|
Query
|
hd_03 |
Float |
|
Recommended |
Head circumference measurement number 3 |
0 :: 1260
|
(cm)
|
|
Query
|
mominch |
Float |
|
Recommended |
How tall is the child's BIOLOGIC mother (inches)? |
|
|
|
Query
|
mother_weight |
Float |
|
Recommended |
Mother - Weight |
|
|
|
Query
|
dadinch |
Float |
|
Recommended |
How tall is the child's BIOLOGIC father (inches)? |
|
|
|
Query
|
shoeson |
Integer |
|
Recommended |
Shoes on during height measurement? |
1
|
1 = Yes
|
|
Query
|
sysbp |
Float |
|
Recommended |
Sitting systolic blood pressure (mmHg) |
|
|
med_119 |
Query
|
diabp |
Float |
|
Recommended |
Sitting diastolic blood pressure (mmHg) |
|
|
med_120 |
Query
|
hd_avg |
Float |
|
Recommended |
Head circumference measurement: Average |
0::1260
|
|
|
Query
|
dadwgt |
Float |
|
Recommended |
Biological Father's weight in pounds |
|
|
|
Query
|
relac |
Integer |
|
Recommended |
Other relative 1's relationship to subject |
1::10
|
1 = Stepmother; 2 = Adoptive Mother; 3 = Grandmother; 4 = Other Female Relative; 5 = Other Female Nonrelative; 6 = Stepfather; 7 = Adoptive Father; 8 = Grandfather; 9 = Other Male Relative; 10 = Other Male Nonrelative
|
|
Query
|
relachgt |
Float |
|
Recommended |
Other relative 1's height in inches |
|
|
|
Query
|
relacwgt |
Float |
|
Recommended |
Other relative 1's weight in pounds |
|
|
|
Query
|
relad |
Integer |
|
Recommended |
Other relative 2's relationship to subject |
1::10
|
1 = Stepmother; 2 = Adoptive Mother; 3 = Grandmother; 4 = Other Female Relative; 5 = Other Female Nonrelative; 6 = Stepfather; 7 = Adoptive Father; 8 = Grandfather; 9 = Other Male Relative; 10 = Other Male Nonrelative
|
|
Query
|
reladhgt |
Float |
|
Recommended |
Other relative 2's height in inches |
|
|
|
Query
|
reladwgt |
Float |
|
Recommended |
Other relative 2's weight in pounds |
|
|
|
Query
|
relae |
Integer |
|
Recommended |
Other relative 3's relationship to subject |
1::10
|
1 = Stepmother; 2 = Adoptive Mother; 3 = Grandmother; 4 = Other Female Relative; 5 = Other Female Nonrelative; 6 = Stepfather; 7 = Adoptive Father; 8 = Grandfather; 9 = Other Male Relative; 10 = Other Male Nonrelative
|
|
Query
|
relaehgt |
Float |
|
Recommended |
Other relative 3's height in inches |
|
|
|
Query
|
relaewgt |
Float |
|
Recommended |
Other relative 3's weight in pounds |
|
|
|
Query
|
relaf |
Integer |
|
Recommended |
Other relative 4's relationship to subject |
1::10
|
1 = Stepmother; 2 = Adoptive Mother; 3 = Grandmother; 4 = Other Female Relative; 5 = Other Female Nonrelative; 6 = Stepfather; 7 = Adoptive Father; 8 = Grandfather; 9 = Other Male Relative; 10 = Other Male Nonrelative
|
|
Query
|
relafhgt |
Float |
|
Recommended |
Other relative 4's height in inches |
|
|
|
Query
|
relafwgt |
Float |
|
Recommended |
Other relative 4's weight in pounds |
|
|
|
|
smoking_other_desc |
String |
100
|
Recommended |
What is nicotine product is used |
|
|
|
Query
|
alcohol_3 |
Integer |
|
Recommended |
Maximum number of drinks in a given day in the past month |
|
|
|
Query
|
ears_past_or_current |
Integer |
|
Recommended |
Ears Diagnosis: Past or Current |
1::3
|
1= Past; 2= Current; 3= N/A
|
|
|
nose |
String |
50
|
Recommended |
Nose(nasal congestion, nose bleeds, postnasal drip): describe and include year of diagnosis |
|
|
|
Query
|
nose_diagnosis_past_or_cur |
Integer |
|
Recommended |
Nose Diagnosis:Past or Current |
1::3
|
1= Past; 2= Current; 3= N/A
|
|
|
throat_mouth |
String |
50
|
Recommended |
Throat/Mouth(tonsilitis, dry mouth, mouth sores, scratch/sore throat): describe and include year of diagnosis |
|
|
|
Query
|
throat_mouth_diagnosis_pas |
Integer |
|
Recommended |
Throat/Mouth Diagnosis:Past or Current |
1::3
|
1= Past; 2= Current; 3= N/A
|
|
Query
|
drug_alcohol_use_start_pas |
Integer |
|
Recommended |
Drug/Alcohol use start: Past or Current |
1::3
|
1= Past; 2= Current; 3= N/A
|
|
|
drug_alcohol_use |
String |
200
|
Recommended |
Drug/Alcohol use: describe and include year of diagnosis |
|
|
|
Query
|
dem_55_asthma |
Integer |
|
Recommended |
Do you have asthma? |
0;1
|
1=Yes; 0=No
|
asthma, asthma_yn |
Query
|
asthma_dx |
Integer |
|
Recommended |
Asthma was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
asthmaage |
Integer |
|
Recommended |
Asthma (Age) |
|
months
|
asthma_age |
Query
|
asthma_ly |
Integer |
|
Recommended |
Asthma was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
cfmh_othr_tuberscl |
Integer |
|
Recommended |
Tuberous Sclerosis |
1;0
|
0 = No; 1 = Yes
|
tuberculosis_yn |
Query
|
tuberculosis_dx |
Integer |
|
Recommended |
Tuberculosis was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
medhx_tuber_age |
Integer |
|
Recommended |
Tuberous Sclerosis: Age diagnosed/onset (in months) |
|
|
tuberculosis_age |
Query
|
tuberculosis_ly |
Integer |
|
Recommended |
Tuberculosis a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
breathing_yn |
Integer |
|
Recommended |
Any other trouble breathing, such as Emphysema, chronic bronchitis, or brown lung |
0; 1
|
0= No; 1= Yes
|
|
Query
|
breathing_dx |
Integer |
|
Recommended |
Any other trouble breathing, such as Emphysema, chronic bronchitis, or brown lung was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
medhx_sleep_breathe_age |
Integer |
|
Recommended |
Difficulty breathing: Age started (in months) |
|
|
breathing_age |
Query
|
breathing_ly |
Integer |
|
Recommended |
Any other trouble breathing, such as Emphysema, chronic bronchitis, or brown lung was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
arg_yn |
Integer |
|
Recommended |
Arthritis, rheumatism, or gout diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
arg_dx |
Integer |
|
Recommended |
Arthritis, rheumatism, or gout was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
arg_age |
Integer |
|
Recommended |
Arthritis, rheumatism, or gout age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
arg_ly |
Integer |
|
Recommended |
Arthritis, rheumatism, or gout was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
diabetes_yn |
Integer |
|
Recommended |
High sugar or diabetes diagnosis |
0; 1
|
0= No; 1= Yes
|
med_023 |
Query
|
diabetes_dx |
Integer |
|
Recommended |
High sugar or diabetes was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
rev_endodiabetesage |
Integer |
|
Recommended |
Diabetes: Age(in months) |
0 :: 1200
|
|
diabetes_age |
Query
|
diabetes_ly |
Integer |
|
Recommended |
High sugar or diabetes was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
insulin_yn |
Integer |
|
Recommended |
Insulin dependence diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
insulin_dx |
Integer |
|
Recommended |
Insulin dependence was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
insulin_age |
Integer |
|
Recommended |
Insulin dependence age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
insulin_ly |
Integer |
|
Recommended |
Insulin dependence was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
thyroid |
Integer |
|
Recommended |
Thyroid disease |
1;0;-7
|
0=No; 1=Yes;-7=Refused
|
hypthy_yn |
Query
|
hypthy_dx |
Integer |
|
Recommended |
Hypo- or Hyper-thyroidism was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
hypthy_age |
Integer |
|
Recommended |
Hypo- or Hyper-thyroidism age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
hypthy_ly |
Integer |
|
Recommended |
Hypo- or Hyper-thyroidism was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
feversym |
Integer |
|
Recommended |
Rheumatic or Scarlet fever |
0;1
|
1=Yes, 0=No
|
rheu_yn |
Query
|
rheu_dx |
Integer |
|
Recommended |
Rheumatic fever or rheumatic heart disease was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
feverage |
Integer |
|
Recommended |
Rheumatic or Scarlet fever (Age) |
|
months
|
rheu_age |
Query
|
rheu_ly |
Integer |
|
Recommended |
Rheumatic fever or rheumatic heart disease was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
arterio_yn |
Integer |
|
Recommended |
Hardening of the arteries or arteriosclerosis diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
arterio_dx |
Integer |
|
Recommended |
Hardening of the arteries or arteriosclerosis was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
arterio_age |
Integer |
|
Recommended |
Hardening of the arteries or arteriosclerosis age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
arterio_ly |
Integer |
|
Recommended |
Hardening of the arteries or arteriosclerosis was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
hbp_yn |
Integer |
|
Recommended |
High blood pressure diagnosis |
0; 1
|
0= No; 1= Yes
|
hbp_dx01 |
Query
|
hbp_dx |
Integer |
|
Recommended |
High blood pressure was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
hbp_age |
Integer |
|
Recommended |
High blood pressure age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
hbp_ly |
Integer |
|
Recommended |
High blood pressure was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
stroke_dx |
Integer |
|
Recommended |
A stroke or Cerebrovascular accident was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
stroke_age |
Integer |
|
Recommended |
A stroke or Cerebrovascular accident age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
stroke_ly |
Integer |
|
Recommended |
A stroke or Cerebrovascular accident was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
heartatk_dx |
Integer |
|
Recommended |
Heart attack was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
heartatk_age |
Integer |
|
Recommended |
Heart attack age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
heartatk_ly |
Integer |
|
Recommended |
Heart attack was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
highchol_yn |
Integer |
|
Recommended |
High cholestrol diagnosis |
0; 1
|
0= No; 1= Yes
|
high_col_dx |
Query
|
highchol_dx |
Integer |
|
Recommended |
High cholestrol was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
highchol_age |
Integer |
|
Recommended |
High cholestrol age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
highchol_ly |
Integer |
|
Recommended |
High cholestrol was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
cfmh_othr_cancer |
Integer |
|
Recommended |
Cancer |
1;0
|
0 = No; 1 = Yes
|
cancer_yn |
|
othmem_cancer_cmt |
String |
255
|
Recommended |
Cancer. Specify Type |
|
|
cancer_type |
Query
|
cancer_dx |
Integer |
|
Recommended |
Cancer was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
cancer_age |
Integer |
|
Recommended |
Cancer age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
cancer_ly |
Integer |
|
Recommended |
Cancer was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
cyst_yn |
Integer |
|
Recommended |
Non-cancerous Tumor, growth of Cyst diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
cyst_dx |
Integer |
|
Recommended |
Non-cancerous Tumor, growth of Cyst was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
cyst_age |
Integer |
|
Recommended |
Non-cancerous Tumor, growth of Cyst age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
cyst_ly |
Integer |
|
Recommended |
Non-cancerous Tumor, growth of Cyst was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
scq_07 |
Integer |
|
Recommended |
Liver Disease |
0;1
|
0=No; 1=Yes
|
liver_yn |
Query
|
liver_dx |
Integer |
|
Recommended |
Liver problems was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
liver_age |
Integer |
|
Recommended |
Liver problems age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
liver_ly |
Integer |
|
Recommended |
Liver problems was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
ulcer_dx |
Integer |
|
Recommended |
Stomach ulcers were diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
ulcer_age |
Integer |
|
Recommended |
Stomach ulcers age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
ulcer_ly |
Integer |
|
Recommended |
Stomach ulcers were a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
digest_yn |
Integer |
|
Recommended |
Digestive problems diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
digest_dx |
Integer |
|
Recommended |
Digestive problems was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
digest_age |
Integer |
|
Recommended |
Digestive problems age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
digest_ly |
Integer |
|
Recommended |
Digestive problems was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
medhx_ulc |
Integer |
|
Recommended |
Ulcerative Colitis |
0::2
|
0 = No, 1 = Yes, 2 = Not sure
|
colitis_yn |
Query
|
colitis_dx |
Integer |
|
Recommended |
Colitis was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
medhx_ulc_age |
Integer |
|
Recommended |
Ulcerative Colitis: Age diagnosed/onset (in months) |
|
|
colitis_age |
Query
|
colitis_ly |
Integer |
|
Recommended |
Colitis was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
cfmh_othr_sicklecell |
Integer |
|
Recommended |
Sickle cell anemia |
1;0
|
0 = No; 1 = Yes
|
anemia_yn |
Query
|
anemia_dx |
Integer |
|
Recommended |
Anemia was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
anemia_age |
Integer |
|
Recommended |
Anemia age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
anemia_ly |
Integer |
|
Recommended |
Anemia was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
skin_dx |
Integer |
|
Recommended |
Skin condition was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
skin_age |
Integer |
|
Recommended |
Skin condition age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
skin_ly |
Integer |
|
Recommended |
Skin condition was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
cfmh_othr_hearingimp |
Integer |
|
Recommended |
Hearing impairment |
1;0
|
0 = No; 1 = Yes
|
hear_yn |
Query
|
hear_dx |
Integer |
|
Recommended |
Serious hearing trouble was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
hear_age |
Integer |
|
Recommended |
Serious hearing trouble age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
hear_ly |
Integer |
|
Recommended |
Serious hearing trouble was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
medhx_colorblind |
Integer |
|
Recommended |
Color blind? |
0;1
|
0 = No, 1 = Yes
|
colorblind_yn |
Query
|
colorblind_dx |
Integer |
|
Recommended |
Color blind was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
colorblind_age |
Integer |
|
Recommended |
Color blind age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
colorblind_ly |
Integer |
|
Recommended |
Color blind was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
glasses_yn |
Integer |
|
Recommended |
Needing glasses diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
glasses_dx |
Integer |
|
Recommended |
Needing glasses was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
glasses_age |
Integer |
|
Recommended |
Needing glasses age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
glasses_ly |
Integer |
|
Recommended |
Needing glasses was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
|
glasses_vis |
String |
25
|
Recommended |
Quality of vision |
|
If so, how bad is your vision?
|
|
Query
|
contact_yn |
Integer |
|
Recommended |
Contact lenses diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
contact_dx |
Integer |
|
Recommended |
Contact lenses was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
contact_age |
Integer |
|
Recommended |
Contact lenses age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
contact_ly |
Integer |
|
Recommended |
Contact lenses was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
blind_yn |
Integer |
|
Recommended |
Blindness diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
blind_dx |
Integer |
|
Recommended |
Blindness was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
blind_age |
Integer |
|
Recommended |
Blindness age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
blind_ly |
Integer |
|
Recommended |
Blindness was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
speech_yn |
Integer |
|
Recommended |
Speech impairment diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
speech_dx |
Integer |
|
Recommended |
Speech impairment was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
speech_age |
Integer |
|
Recommended |
Speech impairment age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
speech_ly |
Integer |
|
Recommended |
Speech impairment was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
kidney_dx |
Integer |
|
Recommended |
Kidney, bladder or urinary tract problem was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
medhx_kidur_age |
Integer |
|
Recommended |
Kidney/Urinary: Age diagnosed/onset (in months) |
|
|
kidney_age |
Query
|
kidney_ly |
Integer |
|
Recommended |
Kidney, bladder or urinary tract problem was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
othsympt |
Integer |
|
Recommended |
other menstrual symptoms |
0;1;-7
|
0=No; 1=Yes; -7=Refused
|
menstrual_yn |
Query
|
menstrual_dx |
Integer |
|
Recommended |
Menstrual trouble was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
menstrual_age |
Integer |
|
Recommended |
Menstrual trouble age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
menstrual_ly |
Integer |
|
Recommended |
Menstrual trouble was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
uterus_yn |
Integer |
|
Recommended |
Disease of uterus or ovaries diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
uterus_dx |
Integer |
|
Recommended |
Disease of uterus or ovaries was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
uterus_age |
Integer |
|
Recommended |
Disease of uterus or ovaries age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
uterus_ly |
Integer |
|
Recommended |
Disease of uterus or ovaries was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
maslump_yn |
Integer |
|
Recommended |
Mastectomy or Lumpectomy diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
maslump_dx |
Integer |
|
Recommended |
Mastectomy or Lumpectomy was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
maslump_age |
Integer |
|
Recommended |
Mastectomy or Lumpectomy age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
maslump_ly |
Integer |
|
Recommended |
Mastectomy or Lumpectomy was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
hysterec_dx |
Integer |
|
Recommended |
Hysterectomy was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
hysterec_age |
Integer |
|
Recommended |
Hysterectomy age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
hysterec_ly |
Integer |
|
Recommended |
Hysterectomy was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
seize_yn |
Integer |
|
Recommended |
Seizures, convulsions, blackouts or fainting spells diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
seize_dx |
Integer |
|
Recommended |
Seizures, convulsions, blackouts or fainting spells was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
seizuresage |
Integer |
|
Recommended |
Seizures/Epilepsy (Age) |
|
months
|
seize_age |
Query
|
seize_ly |
Integer |
|
Recommended |
Seizures, convulsions, blackouts or fainting spells was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
std_yn |
Integer |
|
Recommended |
STD diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
std_dx |
Integer |
|
Recommended |
STD was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
std_age |
Integer |
|
Recommended |
STD age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
std_ly |
Integer |
|
Recommended |
STD was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
paralysis_yn |
Integer |
|
Recommended |
Paralysis diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
paralysis_dx |
Integer |
|
Recommended |
Paralysis was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
paralysis_age |
Integer |
|
Recommended |
Paralysis age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
paralysis_ly |
Integer |
|
Recommended |
Paralysis was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
headtrauma_yn |
Integer |
|
Recommended |
Head trauma diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
headtrauma_dx |
Integer |
|
Recommended |
Head trauma was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
headtrauma_age |
Integer |
|
Recommended |
Head trauma age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
headtrauma_ly |
Integer |
|
Recommended |
Head trauma was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
coma_yn |
Integer |
|
Recommended |
Coma diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
coma_dx |
Integer |
|
Recommended |
Coma was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
coma_age |
Integer |
|
Recommended |
Coma age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
coma_ly |
Integer |
|
Recommended |
Coma was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
migraine_dx |
Integer |
|
Recommended |
Migraine was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
migraine_age |
Integer |
|
Recommended |
Migraine age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
migraine_ly |
Integer |
|
Recommended |
Migraine was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
back_yn |
Integer |
|
Recommended |
Trouble with neck, back or spine diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
back_dx |
Integer |
|
Recommended |
Trouble with neck, back or spine was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
back_age |
Integer |
|
Recommended |
Trouble with neck, back or spine age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
back_ly |
Integer |
|
Recommended |
Trouble with neck, back or spine was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
cfmh_othr_learndis |
Integer |
|
Recommended |
Learning Disability |
1;0
|
0 = No; 1 = Yes
|
learn_yn |
Query
|
learn_dx |
Integer |
|
Recommended |
Learning disability was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
medhx_learndisability_age |
Integer |
|
Recommended |
Learning Disabilities: Age diagnosed (in months) |
|
|
learn_age |
Query
|
learn_ly |
Integer |
|
Recommended |
Learning disability was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
medhx_2b |
Integer |
|
Recommended |
Has she/he ever been to a doctor for any of these things… Allergies Alergias |
1 ; 0
|
1 = Yes; 0 = No
|
allergies_yn |
Query
|
allergies_dx |
Integer |
|
Recommended |
Allergies were diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
allergies_age |
Integer |
|
Recommended |
Allergies age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
allergies_ly |
Integer |
|
Recommended |
Allergies were a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
dental_yn |
Integer |
|
Recommended |
Dental problems diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
dental_dx |
Integer |
|
Recommended |
Dental problems was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
dental_age |
Integer |
|
Recommended |
Dental problems age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
dental_ly |
Integer |
|
Recommended |
Dental problems was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
Query
|
pms_yn |
Integer |
|
Recommended |
Symptoms of pre-menstrual syndrome such as bloating, irritability, feeling down diagnosis |
0; 1
|
0= No; 1= Yes
|
|
Query
|
pms_dx |
Integer |
|
Recommended |
Symptoms of pre-menstrual syndrome such as bloating, irritability, feeling down was diagnosed by |
1; 2
|
1= Self; 2= Doctor
|
|
Query
|
pms_age |
Integer |
|
Recommended |
Symptoms of pre-menstrual syndrome such as bloating, irritability, feeling down age of onset |
|
About how old were you when you first had this condition?
|
|
Query
|
pms_ly |
Integer |
|
Recommended |
Symptoms of pre-menstrual syndrome such as bloating, irritability, feeling down was a problem last year |
0; 1
|
0= No; 1= Yes
|
|
|
med_cur |
String |
500
|
Recommended |
Medications taking currently |
|
Current medications
|
|
|
med_prev |
String |
500
|
Recommended |
Medications taken previously |
|
Previous medications
|
|
Query
|
depress_familyhx |
Integer |
|
Recommended |
Depression: Anyone in family had symptoms |
0;1;-7;-8;-9
|
0 = No; 1 = Yes; -7 = Don't know; -8 = Refused to answer; -9 = Does not apply
|
fam_dep_yn |
|
fam_dep_rel |
String |
25
|
Recommended |
Depression diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_dep_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
fam_mania_yn |
Integer |
|
Recommended |
Mania diagnosed in family member |
0; 1
|
0= No; 1= Yes
|
|
|
fam_mania_rel |
String |
25
|
Recommended |
Mania diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_mania_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
schizo_familyhx |
Integer |
|
Recommended |
Schizophrenia: Anyone in family had symptoms |
0;1;-7;-8;-9
|
0 = No; 1 = Yes; -7 = Don't know; -8 = Refused to answer; -9 = Does not apply
|
fam_schiz_yn |
|
fam_schiz_rel |
String |
25
|
Recommended |
Schizophrenia/Psychosis diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_schiz_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
panic_familyhx |
Integer |
|
Recommended |
Panic or Anxiety Disorder: Anyone in family had symptoms |
0;1;-7;-8;-9
|
0 = No; 1 = Yes; -7 = Don't know; -8 = Refused to answer; -9 = Does not apply
|
fam_anx_yn |
|
fam_anx_rel |
String |
25
|
Recommended |
Panic/Anxiety diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_anx_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
ocd_familyhx |
Integer |
|
Recommended |
Obsessive Compulsive Disorder: Anyone in family had symptoms |
0;1;-7;-8;-9
|
0 = No; 1 = Yes; -7 = Don't know; -8 = Refused to answer; -9 = Does not apply
|
fam_ocd_yn |
|
fam_ocd_rel |
String |
25
|
Recommended |
Obsessive/Compulsive Disorder diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_ocd_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
alcohol_familyhx |
Integer |
|
Recommended |
Alcohol Abuse/Dependence: Anyone in family had symptoms |
0;1;-7;-8;-9
|
0 = No; 1 = Yes; -7 = Don't know; -8 = Refused to answer; -9 = Does not apply
|
fam_subabuse_yn |
|
fam_subabuse_rel |
String |
25
|
Recommended |
Alcohol/Drug Abuse diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_subabuse_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
fam_eat_yn |
Integer |
|
Recommended |
Eating Disorder diagnosed in family member |
0; 1
|
0= No; 1= Yes
|
|
|
fam_eat_rel |
String |
25
|
Recommended |
Eating Disorder diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_eat_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
fam_other_psy1_yn |
Integer |
|
Recommended |
Other condition diagnosed in family member |
0; 1
|
0= No; 1= Yes
|
|
|
fam_other_psy1_spec |
String |
25
|
Recommended |
Please specify what this diagnosis is |
|
|
|
|
fam_other_psy1_rel |
String |
25
|
Recommended |
Other condition diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_other_psy1_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
fam_diabetes_yn |
Integer |
|
Recommended |
Diabetes diagnosed in family member |
0; 1
|
0= No; 1= Yes
|
|
|
fam_diabetes_rel |
String |
25
|
Recommended |
Diabetes diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_diabetes_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
fam_hypertens_yn |
Integer |
|
Recommended |
Hypertensive Disease diagnosed in family member |
0; 1
|
0= No; 1= Yes
|
|
|
fam_hypertens_rel |
String |
25
|
Recommended |
Hypertensive Disease diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_hypertens_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
fam_heart_yn |
Integer |
|
Recommended |
Heart Disease diagnosed in family member |
0; 1
|
0= No; 1= Yes
|
|
|
fam_heart_rel |
String |
25
|
Recommended |
Heart Disease diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_heart_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
fam_cancer_yn |
Integer |
|
Recommended |
Cancer diagnosed in family member |
0; 1
|
0= No; 1= Yes
|
|
|
fam_cancer_rel |
String |
25
|
Recommended |
Cancer diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_cancer_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
fam_other_med1_yn |
Integer |
|
Recommended |
Other condition diagnosed in family member |
0; 1
|
0= No; 1= Yes
|
|
|
fam_other_med1_spec |
String |
25
|
Recommended |
Please specify what this diagnosis is |
|
|
|
|
fam_other_med1_rel |
String |
25
|
Recommended |
Other condition diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_other_med1_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
seizure_familyhx |
Integer |
|
Recommended |
Seizures: Anyone in family had symptoms |
0;1;-7;-8;-9
|
0 = No; 1 = Yes; -7 = Don't know; -8 = Refused to answer; -9 = Does not apply
|
fam_seize_yn |
|
fam_seize_rel |
String |
25
|
Recommended |
Seizures diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_seize_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
fam_stroke_yn |
Integer |
|
Recommended |
Stroke diagnosed in family member |
0; 1
|
0= No; 1= Yes
|
|
|
fam_stroke_rel |
String |
25
|
Recommended |
Stroke diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_stroke_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
fhx02a |
Integer |
|
Recommended |
Dementia:No immediate family members |
0;1
|
1=Yes; 0=No
|
fam_dementia_yn |
|
fam_dementia_rel |
String |
25
|
Recommended |
Dementia diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_dementia_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
|
|
Query
|
fam_other_med2_yn |
Integer |
|
Recommended |
Other condition diagnosed in family member |
0; 1
|
0= No; 1= Yes
|
|
|
fam_other_med2_spec |
String |
25
|
Recommended |
Please specify what this diagnosis is |
|
|
|
|
fam_other_med2_rel |
String |
25
|
Recommended |
Other condition diagnosed in which family member |
|
Mother; Father; Sister; Brother; DZ twin sister; DZ twin brother; MZ twin sister; MZ twin brother; Maternal aunt; Maternal uncle; Paternal aunt; Paternal uncle; Maternal cousin; Paternal cousin; Maternal grandmother; Maternal grandfather; Paternal grandmother; Paternal grandfather
|
|
|
fam_other_med2_info |
String |
25
|
Recommended |
Additional info about the family member's diagnosis |
|
For psychiatric history, please note if the person was hospitalized (or medication only) under "Additional Information".
|
|
Query
|
eyes_diagnosis_past_or_cur |
Integer |
|
Recommended |
Diagnoses with eyes |
1::3
|
1= Past; 2= Current; 3= N/A
|
|
Query
|
history_of_surgeries |
Integer |
|
Recommended |
History of Sugeries |
1::3
|
1= Past; 2= Current; 3= N/A
|
|
|
medication1_name |
String |
500
|
Recommended |
Name first medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
med1_name |
|
med1_type |
String |
50
|
Recommended |
Type of medication 1 |
|
|
|
|
medication1_dosage |
String |
150
|
Recommended |
First medication dosage |
|
0 = No medication; 999 = Missing
|
med1_dose |
|
med1_length |
String |
50
|
Recommended |
How long have you been taking medication 1 |
|
|
|
|
med1_last_taken |
String |
50
|
Recommended |
When did you last take medication 1 |
|
|
|
|
medication2_name |
String |
500
|
Recommended |
Name second medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
med2_name |
|
med2_type |
String |
50
|
Recommended |
Type of medication 2 |
|
|
|
|
medication2_dosage |
String |
100
|
Recommended |
Second medication dosage |
|
0 = No medication; 999 = Missing
|
med2_dose |
|
med2_length |
String |
50
|
Recommended |
How long have you been taking medication 2 |
|
|
|
|
med2_last_taken |
String |
50
|
Recommended |
When did you last take medication 2 |
|
|
|
|
medication3_name |
String |
500
|
Recommended |
Name third medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
med3_name |
|
med3_type |
String |
50
|
Recommended |
Type of medication 3 |
|
|
|
|
medication3_dosage |
String |
100
|
Recommended |
Third medication dosage |
|
0 = No medication; 999 = Missing
|
med3_dose |
|
med3_length |
String |
50
|
Recommended |
How long have you been taking medication 3 |
|
|
|
|
med3_last_taken |
String |
50
|
Recommended |
When did you last take medication 3 |
|
|
|
|
medication4_name |
String |
500
|
Recommended |
Name fourth medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
med4_name |
|
med4_type |
String |
50
|
Recommended |
Type of medication 4 |
|
|
|
|
medication4_dosage |
String |
100
|
Recommended |
Fourth medication dosage |
|
0 = No medication; 999 = Missing
|
med4_dose |
|
med4_length |
String |
50
|
Recommended |
How long have you been taking medication 4 |
|
|
|
|
med4_last_taken |
String |
50
|
Recommended |
When did you last take medication 4 |
|
|
|
|
medication5_name |
String |
500
|
Recommended |
Name fifth medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
med5_name |
|
med5_type |
String |
50
|
Recommended |
Type of medication 5 |
|
|
|
|
medication5_dosage |
String |
100
|
Recommended |
Fifth medication dosage |
|
0 = No medication; 999 = Missing
|
med5_dose |
|
med5_length |
String |
50
|
Recommended |
How long have you been taking medication 5 |
|
|
|
|
med5_last_taken |
String |
50
|
Recommended |
When did you last take medication 5 |
|
|
|
|
medication6_name |
String |
500
|
Recommended |
Name sixth medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
med6_name |
|
med6_type |
String |
50
|
Recommended |
Type of medication 6 |
|
|
|
|
medication6_dosage |
String |
100
|
Recommended |
Sixth medication dosage |
|
0 = No medication; 999 = Missing
|
med6_dose |
|
med6_length |
String |
50
|
Recommended |
How long have you been taking medication 6 |
|
|
|
|
med6_last_taken |
String |
50
|
Recommended |
When did you last take medication 6 |
|
|
|
|
medication7_name |
String |
500
|
Recommended |
Name seventh medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
med7_name |
|
med7_type |
String |
50
|
Recommended |
Type of medication 7 |
|
|
|
|
medication7_dosage |
String |
100
|
Recommended |
Seventh medication dosage |
|
0 = No medication; 999 = Missing
|
med7_dose |
|
med7_length |
String |
50
|
Recommended |
How long have you been taking medication 7 |
|
|
|
|
med7_last_taken |
String |
50
|
Recommended |
When did you last take medication 7 |
|
|
|
|
medication8_name |
String |
500
|
Recommended |
Name eighth medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
med8_name |
|
med8_type |
String |
50
|
Recommended |
Type of medication 8 |
|
|
|
|
medication8_dosage |
String |
100
|
Recommended |
Eighth medication dosage |
|
0 = No medication; 999 = Missing
|
med8_dose |
|
med8_length |
String |
50
|
Recommended |
How long have you been taking medication 8 |
|
|
|
|
med8_last_taken |
String |
50
|
Recommended |
When did you last take medication 8 |
|
|
|
Query
|
cardiac_surgery |
Integer |
|
Recommended |
History of cardiac surgery |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
head_injury |
Integer |
|
Recommended |
History of head injury with loss of consciousness |
0;1
|
0 = No; 1 = Yes
|
|
|
preeeg_6_1a |
String |
100
|
Recommended |
If you have had any coffee or caffeine today, when was the last time? |
|
0 = No caffeine
|
caffeine_tlu |
|
alcohol_tlu |
String |
50
|
Recommended |
Time of last use of alcohol |
|
|
|
|
rec_drugs_tlu |
String |
50
|
Recommended |
Time of last use of recreational drugs |
|
|
|
Query
|
color_vision_screening |
Integer |
|
Recommended |
Passed color vision screening? |
|
0 = No; 1 = Yes
|
|
Query
|
drug_screen |
Integer |
|
Recommended |
Drug screen result |
|
0 = Negative; 1= Positive
|
|
Query
|
pregnan |
Integer |
|
Recommended |
pregnancy test |
0::6;-7;9
|
0=Negative; 1=Positive; 2=Test not conducted; -7=Refused; 9=NA;3=Not pregnant (per pregnancy test); 4=Not pregnant (has not reached menarche); 5=Pregnancy suspected, but not confirmed; 6 = Equivocal
|
pregnancy_test |
|
eeg_result |
String |
255
|
Recommended |
Details of EEG result(s) |
|
|
eeg_conducted_comments |
|
med_135 |
Integer |
|
Recommended |
Ears: no ear lesions, ear canals and tympanic membranes without lesions |
0;1
|
1 = Yes;0 = No
|
|
|
med_136 |
Integer |
|
Recommended |
Nose: septum in midline and mucous membrane without lesions |
0;1
|
1 = Yes;0 = No
|
|
|
med_137 |
Integer |
|
Recommended |
Mouth/Tongue: mucous of tongue, gums and throat without lesions, normal tongue mobility |
0;1
|
1 = Yes;0 = No
|
|
|
med_138 |
Integer |
|
Recommended |
Teeth: teeth without cavities or missing pieces |
0;1
|
1 = Yes;0 = No
|
|
|
med_139 |
Integer |
|
Recommended |
Neck: supple, no goiter, no lymphadenopathy |
0;1
|
1 = Yes;0 = No
|
|
|
med_147 |
Integer |
|
Recommended |
Limbs: no deformities and no limitations in mobility, no muscle atrophy |
0;1
|
1 = Yes;0 = No
|
|
|
med_150 |
Integer |
|
Recommended |
Motor: full range of motion and 5/5 motor strength in all extremities/muscle groups |
0;1
|
1 = Yes;0 = No
|
|
|
med_153 |
Integer |
|
Recommended |
Cerebellar: Romberg test negative, no ataxia |
0;1
|
1 = Yes;0 = No
|
|
|
sens_exam |
String |
10
|
Recommended |
Is sensory exam normal? |
|
NK = Not known
|
med_151 |
|
chest_lung |
String |
10
|
Recommended |
Chest/lung exam |
|
|
med_141 |
|
cran_nerv |
String |
10
|
Recommended |
Are the cranial nerves normal (do face, tongue and palate move normally)? |
|
NK = Not known
|
med_149 |
|
abdomen |
String |
10
|
Recommended |
Abdomen exam |
|
|
med_143 |
|
nerflxs |
Integer |
|
Recommended |
Neuro Exam Reflexes Results |
|
1=Normal; 2=Abnormal
|
med_152 |
|
temp_celc |
Integer |
|
Recommended |
temperature Celsius |
|
|
|
|
hr_screening_status |
Integer |
|
Recommended |
Heart Rate Results |
|
1= Normal; 2= Abnormal
|
med_142 |
|
cardio_respratecount |
String |
50
|
Recommended |
Respiratory Rate - Count |
|
|
med_122 |
|
q19_b6 |
Integer |
|
Recommended |
Abnormal movement (includes tics, dyskinesias) |
0::2
|
0 = No, 1 = Yes, 2 = Not sure
|
med_131 |
|
dysm_eyes |
Integer |
|
Recommended |
Eyes - Normal |
0; 1
|
0 = No; 1 = Yes
|
med_134 |
|
dysm_head |
Integer |
|
Recommended |
Head - Normal |
0; 1
|
0 = No; 1 = Yes
|
med_133 |
|
height_met |
Float |
|
Recommended |
Height - Metric Unit |
|
999 = Missing; -999 = No Data
|
med_109 |
|
med_129 |
Integer |
|
Recommended |
Nourishment/Hydration normal? |
0;1
|
1 = Well nourished, normal skin turgor and hydration;0 = No
|
|
|
med_130 |
Integer |
|
Recommended |
Gait/ambulation normal? |
0;1
|
1 = no ataxia, normal gait and station; 0 = abnormal
|
|
|
timepoint_label |
String |
50
|
Recommended |
Timepoint/visit label |
|
|
timepoint |
|
baseline_k_007 |
Integer |
|
Recommended |
Chronic pain, like headaches, joint pain, neck pain, or back pain that you experience frequently |
|
0=No; 1=Yes; -888=Not Applicable; -999=Missing;
|
dukemed_pain |
|
medhx_autodisorder |
Integer |
|
Recommended |
Autoimmune Disorders |
0::2
|
0 = No, 1 = Yes, 2 = Not sure
|
dukemed_autoim |
|
dukemed_cpd_notes |
String |
500
|
Recommended |
Neurological disorders - Notes |
|
|
|
|
dukemed_headtrauma_notes |
String |
500
|
Recommended |
Head trauma - Notes |
|
|
|
|
dukemed_pain_notes |
String |
500
|
Recommended |
Chronic pain disorders - Notes |
|
|
|
|
dukemed_endo_notes |
String |
500
|
Recommended |
Endocrine disorders such as Thyroid disease - Notes |
|
|
|
|
dukemed_metabolic_notes |
String |
500
|
Recommended |
Metabolic disorders such as Diabetes - Notes |
|
|
|
|
dukemed_kidney_notes |
String |
500
|
Recommended |
Kidney disease - Notes |
|
|
|
|
dukemed_autoim_notes |
String |
500
|
Recommended |
Autoimmune disorders such as Lupus - Notes |
|
|
|
|
dukemed_cancer_notes |
String |
500
|
Recommended |
Cancer - Notes |
|
|
|
|
dukemed_hivaid_notes |
String |
500
|
Recommended |
HIV/AIDS - Notes |
|
|
|
|
dukemed_headaches_notes |
String |
500
|
Recommended |
Headaches - Notes |
|
|
|
|
duke_related |
String |
500
|
Recommended |
Would you say these conditions affect or are related to your sleep problems? |
|
|
|
|
duke_cond_length |
String |
500
|
Recommended |
How long have you experienced these conditions? What about the sleep problem? |
|
|
|
|
duke_cond_manage |
String |
500
|
Recommended |
How well is the condition managed? Do you take medications? |
|
|
|
|
dukemed_heart_notes |
String |
500
|
Recommended |
Heart attack - Notes |
|
|
|
|
dukemed_pulm_notes |
String |
500
|
Recommended |
Pulmonary disease - Notes |
|
|
|