|
subjectkey |
GUID |
|
Required |
The NDAR Global Unique Identifier (GUID) for research subject |
NDAR*
|
|
|
|
src_subject_id |
String |
20
|
Required |
Subject ID how it's defined in lab/project |
|
|
id, subjectid |
|
interview_date |
Date |
|
Required |
Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY |
|
|
visit_date |
|
interview_age |
Integer |
|
Required |
Age in months at the time of the interview/test/sampling/imaging. |
0 :: 1260
|
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.
|
|
|
sex |
String |
20
|
Required |
Sex of subject at birth |
M;F; O; NR
|
M = Male; F = Female; O=Other; NR = Not reported
|
gender |
Query
|
week_psych |
Integer |
|
Recommended |
Week |
|
|
week |
Query
|
adssq9u |
Integer |
|
Recommended |
Severity of Symptom: Decreased appetite (Non-imputed Version) |
0::3
|
0= Not present; 1= Mild; 2= Moderate; 3= Severe
|
appt_dec |
Query
|
days_baseline |
Integer |
|
Recommended |
Days since baseline |
|
|
date |
Query
|
vis_type |
Integer |
|
Recommended |
Visit type |
0::2
|
1=Phone/remote; 0=doctor's office/In person; 2=No, not phone interview
|
phone |
Query
|
seg_q09 |
Integer |
|
Recommended |
Sleep disturbance |
0::4
|
0=Absent 1=Mild 2=Moderate 3=Severe; 4=not done
|
safte01, sleep |
Query
|
casr69 |
Integer |
|
Recommended |
I have nightmares |
0::4
|
0=Not at all/never; 1=Just a little/occasionally; 2=Pretty much/often; 3=Very much/frequently; 4=not done
|
nitemare, safte02 |
Query
|
se_b8 |
Integer |
|
Recommended |
8. Drowsy, sleepy |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe'; 4= not done; -9=unknown
|
drowsiness, drowsy, safte03 |
Query
|
se_b18 |
Integer |
|
Recommended |
18. Anxiety, fear, nervousness |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe'; 4= not done; -9=unknown
|
nervous, safte04 |
Query
|
aer007a |
Integer |
|
Recommended |
Decreased Energy/Fatigue |
0::4;-9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4=not done
|
fatigue, safte05 |
Query
|
se_b1 |
Integer |
|
Recommended |
Irritable, easily annoyed, touchy, (emotionally over-reactive) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe'; 4= not done; -9=unknown
|
irritabl, safte06 |
Query
|
safte07 |
Integer |
|
Recommended |
Poor memory |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
memory |
Query
|
sefcnss36 |
Integer |
|
Recommended |
Central Nervous System - Difficulty concentrating (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4=not done
|
concntrt, safte08 |
Query
|
safte09 |
Integer |
|
Recommended |
Feeling strange or unreal |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
strange |
Query
|
se11 |
Integer |
|
Recommended |
Hallucinations |
0::4
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; 4=not done
|
hearsee, safte10 |
Query
|
safte11 |
Integer |
|
Recommended |
Abnormal sensations |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
abnsens |
Query
|
aer014a |
Integer |
|
Recommended |
Tingling or numbness (paresthesia) |
0::3; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown
|
numbness, safte12 |
Query
|
se_b15 |
Integer |
|
Recommended |
15. Dizzy, balance unstable |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe'; 4= not done; -9=unknown
|
dizziness, dizzy, safte13 |
Query
|
sefcnss20 |
Integer |
|
Recommended |
Central Nervous System - Headaches (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4=not done
|
headache, safte14 |
Query
|
aer016a |
Integer |
|
Recommended |
Blurred vision |
0::4;-9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4=not done
|
blurvisn, safte15, vision |
Query
|
safte16 |
Integer |
|
Recommended |
Ringing in ears or trouble hearing |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
hearing |
Query
|
seforals45 |
Integer |
|
Recommended |
Mouth and Nose - Nasal congestion (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4= not done
|
congestion, safte17, stufnose |
Query
|
seforals44 |
Integer |
|
Recommended |
Mouth and Nose - Dry mouth (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4= not done
|
drymouth, safte18 |
Query
|
sefcnss18 |
Integer |
|
Recommended |
Central Nervous System - Drooling (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4=not done
|
drool, safte19 |
Query
|
sefmuss56 |
Integer |
|
Recommended |
Musculo-Skeletal - Muscular cramps (Severity) |
0::3
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe
|
cramps, safte120, safte20 |
Query
|
se_b25 |
Integer |
|
Recommended |
25. Muscle twitches or sudden sounds |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe'; 4= not done; -9=unknown
|
safte21, twitch |
Query
|
safte22 |
Integer |
|
Recommended |
Trouble sitting still |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
sitstill |
Query
|
sefcnss30 |
Integer |
|
Recommended |
Central Nervous System - Tremor (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4=not done
|
safte23, tremor |
Query
|
safte24 |
Integer |
|
Recommended |
Poor coordination or unsteadiness |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
unsteady |
Query
|
sefcnss28 |
Integer |
|
Recommended |
Central Nervous System - Slurred speech (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4=not done; -9 =missing
|
safte25, slurspch |
Query
|
safte26 |
Integer |
|
Recommended |
Heartbeat rapid or pounding |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
heartpnd |
Query
|
safte27 |
Integer |
|
Recommended |
Trouble catching breath |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
hyprvent |
Query
|
safte28 |
Integer |
|
Recommended |
Chest pain |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
chestpn |
Query
|
aesa20 |
Integer |
|
Recommended |
Nausea: Have you had any problems with nausea? (Severe=unable to eat without vomiting) |
0::4
|
0=Absent; 1=Mild; 2=Moderate; 3=Severe; 4=not done
|
nausea, safte29 |
Query
|
sefgass6 |
Integer |
|
Recommended |
Gastrointestinal - Abdominal pain (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4= not done
|
safte30, stomach |
Query
|
sefgass11 |
Integer |
|
Recommended |
Gastrointestinal - Constipation (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4= not done
|
const, constipation, safte31 |
Query
|
se_b12 |
Integer |
|
Recommended |
12. Diarrhea, loose bowel movements |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe'; 4= not done; -9=unknown
|
diarrhea, safte32 |
Query
|
safte33 |
Integer |
|
Recommended |
Difficulty starting urination |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
urin_dif |
Query
|
sefgens48 |
Integer |
|
Recommended |
Genito Urinary - Frequent urination (Severity) |
0::4
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; 4= not done
|
safte34, urin_frq |
Query
|
safte35 |
Integer |
|
Recommended |
Menstrual irregularities |
0::4; -9; -888
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done; -9=missing; -888 =NA
|
mensirr |
Query
|
safte36 |
Integer |
|
Recommended |
Loss of sexual interest |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
sexloss |
Query
|
safte37 |
Integer |
|
Recommended |
Problems with sexual arousal |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
sexprob |
Query
|
safte38 |
Integer |
|
Recommended |
Delayed or absent orgasm |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
absorgsm |
Query
|
sefcnss29 |
Integer |
|
Recommended |
Central Nervous System - Sweating (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4=not done
|
safte39, sweat |
Query
|
safte40 |
Integer |
|
Recommended |
Fluid retention or swelling |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
swell |
Query
|
sefgass9 |
Integer |
|
Recommended |
Gastrointestinal - Appetite increase (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4= not done
|
appt_inc, safte42 |
Query
|
sefgass10 |
Integer |
|
Recommended |
Gastrointestinal - Weight gain (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4= not done
|
safte43, wght_inc |
Query
|
sefgass8 |
Integer |
|
Recommended |
Gastrointestinal - Weight loss (Severity) |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4= not done
|
safte44, wght_dec |
Query
|
safte46 |
Integer |
|
Recommended |
Diminished mental acuity/sharpness |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
mental |
Query
|
safte47 |
Integer |
|
Recommended |
Difficulties finding words |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
diffword |
Query
|
safte48 |
Integer |
|
Recommended |
Apathy/Emotional Indifference |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
apathy |
Query
|
safte49 |
Integer |
|
Recommended |
Dizziness when you stand up |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
standizz |
Query
|
safte50 |
Integer |
|
Recommended |
Bruising |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
bruise |
Query
|
safte51 |
Integer |
|
Recommended |
Hair thinning/loss |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
hairloss |
Query
|
aer020a |
Integer |
|
Recommended |
Hot Flashes |
0::4;-9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4=not done
|
hotflash, safte52 |
Query
|
sefders53 |
Integer |
|
Recommended |
Dermatology - Rash (Severity) |
0::4
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; 4=not done
|
allergy, safte45 |
Query
|
safte53 |
Integer |
|
Recommended |
Clenching of teeth at night |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
clench |
Query
|
safte54 |
Integer |
|
Recommended |
Strange taste in mouth |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
taste |
Query
|
safte55 |
Integer |
|
Recommended |
Unable to sit still |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
unabsit |
Query
|
saftse |
Integer |
|
Recommended |
Overall side-effects interference |
1::4; 999
|
1=Overall side-effects interference: No side effects; 2=Overall side-effects interference: Mildly; 3=Overall side-effects interference: Moderately; 4=Overall side-effects interference: Markedly; 999=Overall side-effects interference: Not Done
|
bother |
|
date_updated |
Date |
|
Recommended |
Date record updated |
|
|
edit_date |
Query
|
safte41 |
Integer |
|
Recommended |
Appetite decreased |
0::4
|
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Not Done
|
|
|
session_id |
String |
20
|
Recommended |
session ID/screening ID |
|
|
screeningid |
|
version_form |
String |
121
|
Recommended |
Form used/assessment name |
|
|
form_name |
|
site |
String |
101
|
Recommended |
Site |
|
Study Site
|
site_uid |
Query
|
visit |
String |
60
|
Recommended |
Visit name |
|
|
visit_name |
|
status |
String |
50
|
Recommended |
Status |
|
|
tstst |
Query
|
slow_heartbeat |
Integer |
|
Recommended |
slow heartbeat |
0::4; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown; 4=not done
|
|
Query
|
aesa11 |
Integer |
|
Recommended |
Insomnia: Have you had any problems with falling asleep, staying asleep, or waking up too early? (Severe = sleep time disrupted more than 3 hours most nights). |
0;1;2;3
|
Absent=0; Mild=1; Moderate=2; Severe=3
|
insomnia |
Query
|
aer030a |
Integer |
|
Recommended |
Confusion |
0::3; -9
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe; -9=unknown
|
confusion |
|
other_condname1 |
String |
255
|
Recommended |
Name Other Condition - 1 |
|
|
|
|
other_condname2 |
String |
255
|
Recommended |
Name Other Condition - 2 |
|
|
|
|
other_condname3 |
String |
255
|
Recommended |
Name Other Condition - 3 |
|
|
|
|
other_condname4 |
String |
255
|
Recommended |
Name Other Condition - 4 |
|
|
|
|
ad3o |
String |
100
|
Recommended |
Specify other |
|
|
otherspecify |
|
ad6o |
String |
200
|
Recommended |
Specify other |
|
|
|
|
d8o |
String |
255
|
Recommended |
Specify other |
|
|
|
|
et2ao |
String |
500
|
Recommended |
Specify other |
|
|
|
|
et2bo |
String |
100
|
Recommended |
Specify other |
|
|
|
|
fc2_2o |
String |
500
|
Recommended |
Specify other |
|
|
|
Query
|
aesa21a1 |
Integer |
|
Recommended |
Clinician Rating of Severity for Adverse Event in question a |
0;1;2;3;8;9
|
0=Absent; 1=Mild; 2=Moderate; 3=Severe; 8=Unknown; 9=Not Assessed
|
|
Query
|
aesa21b1 |
Integer |
|
Recommended |
Clinician Rating of Severity for Adverse Event in question b |
0;1;2;3;8;9
|
0=Absent; 1=Mild; 2=Moderate; 3=Severe; 8=Unknown; 9=Not Assessed
|
|
Query
|
aesa21c1 |
Integer |
|
Recommended |
Clinician Rating of Severity for Adverse Event in question c |
0;1;2;3;8;9
|
0=Absent; 1=Mild; 2=Moderate; 3=Severe; 8=Unknown; 9=Not Assessed
|
|
Query
|
aesa21d1 |
Integer |
|
Recommended |
Clinician Rating of Severity for Adverse Event in question d |
0;1;2;3;8;9
|
0=Absent; 1=Mild; 2=Moderate; 3=Severe; 8=Unknown; 9=Not Assessed
|
|
Query
|
aes3svrt |
Integer |
|
Recommended |
Severity of AE 3 |
0::3
|
1 = Mild; 2 = Moderate; 3 = Severe; 0=Absent
|
|
Query
|
sefoths62 |
Integer |
|
Recommended |
Other - Other (Severity) |
0::3
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe
|
other |
Query
|
tesi_c_111 |
Integer |
|
Recommended |
Interviewer: In your clinical judgment how severe was this event for the child? Event 1 |
0::3
|
|
|
Query
|
tesi_c_112 |
Integer |
|
Recommended |
Interviewer: In your clinical judgment how severe was this event for the child? Event 2 |
0::3
|
|
|
Query
|
tesi_c_113 |
Integer |
|
Recommended |
Interviewer: In your clinical judgment how severe was this event for the child? Event 3 |
0::3
|
|
|
|
key_questions_q8 |
String |
100
|
Recommended |
How severe are the symptoms? |
|
|
|
Query
|
sefoths59 |
Integer |
|
Recommended |
Other - Excessive thirst (Severity) |
0::3
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe
|
|
Query
|
sefders54 |
Integer |
|
Recommended |
Dermatology - Other (Severity) |
0::3
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe
|
dermatitis |
Query
|
sefders51 |
Integer |
|
Recommended |
Dermatology - Photosensitivity (Severity) |
0::3
|
0=Absent, 1=Mild, 2=Moderate, 3=Severe
|
|
Query
|
psc34_u |
Integer |
|
Recommended |
Condition 34: Tremor, trembling or shakiness |
0::3
|
0 = Not at all; 1 = Just a little; 2 = Pretty much; 3 = Very much
|
tremor |
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
|
|
|
excitement |
Integer |
|
Recommended |
Excitement |
0::3
|
0=absent, 1=mild, 2=moderate, 3= severe
|
|
|
rigidity |
Integer |
|
Recommended |
rigidity |
0::3
|
0=Absent; 1=Mild; 2=Moderate; 3=Severe
|
|
|
dystonia |
Integer |
|
Recommended |
Dystonia |
0::5
|
0=None; 1=Focal dystonia (more than one joint); 2=Segmental dystonia (two extremities); 3=Generalized dystonia (>2 extremities); 4=None; 5=Focal dystonia (one joint)
|
|
|
akathisia |
Integer |
|
Recommended |
Akathisia |
0::3
|
0=absent, 1=mild, 2=moderate, 3= severe
|
|
|
syncope |
Integer |
|
Recommended |
syncope |
0::3
|
0=Absent; 1=Mild; 2=Moderate; 3=Severe
|
|
|
tachycardia |
Integer |
|
Recommended |
Tachycardia |
0::3
|
0=absent, 1=mild, 2=moderate, 3= severe
|
|
|
bradycardia |
Integer |
|
Recommended |
bradycardia |
0::3
|
0=Absent; 1=Mild; 2=Moderate; 3=Severe
|
|
|
salivation |
Integer |
|
Recommended |
Salivation |
0::3
|
0=absent, 1=mild, 2=moderate, 3= severe
|
|
|
vomiting |
Integer |
|
Recommended |
Vomiting |
0::3
|
0=absent, 1=mild, 2=moderate, 3= severe
|
|
|
anorexia |
Integer |
|
Recommended |
does participant have anorexia? 0 = no; 1 = yes |
0;1
|
0 = No; 1 = Yes
|
|
|
faintness |
Integer |
|
Recommended |
Faintness |
0::3
|
0=absent, 1=mild, 2=moderate, 3= severe
|
|
|
weakness |
Integer |
|
Recommended |
Difficult accepting weakness |
1::7
|
1= Strongly Disagree;2 = Somewhat Disagree;3 = Disagree;4 = Neutral or Undecided;5 = Agree;6 = Somewhat Agree;7 = Strongly Agree; I set my personal goals and standards as high as possible
|
|
|
q43 |
String |
100
|
Recommended |
43. Any other trouble with your chest (specify):. Past week. |
|
|
|
|
q__4 |
Integer |
|
Recommended |
4. Seizures. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q4 |
|
q__5 |
String |
100
|
Recommended |
5. Any other problems with your head (specify):. Past week. |
|
|
q5 |
|
q__6 |
String |
100
|
Recommended |
6. Any other problems with your head (specify):. Past week. |
|
|
q6 |
|
q__7 |
Integer |
|
Recommended |
7. Eye irritation. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q7 |
|
q__8 |
Integer |
|
Recommended |
8. Eye swelling. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q8 |
|
q__9 |
Integer |
|
Recommended |
9. Blurred vision. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q9 |
|
q__10 |
Integer |
|
Recommended |
10. Double vision. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q10 |
|
q__11 |
Integer |
|
Recommended |
11. Poor vision. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q11 |
|
q__12 |
Integer |
|
Recommended |
12. Light bothering your eyes. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q12 |
|
q__13 |
String |
100
|
Recommended |
13. Any other problems with your eyes (specify):. Past week. |
|
|
q13 |
|
q44 |
Integer |
|
Recommended |
44. Rapid heart rate. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q__14 |
String |
100
|
Recommended |
14. Any other problems with your eyes (specify):. Past week. |
|
|
q14 |
|
q__15 |
Integer |
|
Recommended |
15. Earache. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q15 |
|
q__16 |
Integer |
|
Recommended |
16. Ear discharge. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q16 |
|
q__17 |
Integer |
|
Recommended |
17. Trouble hearing. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q17 |
|
q__18 |
Integer |
|
Recommended |
18. Ringing or whistling or other noises in ear. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q18 |
|
q__19 |
String |
100
|
Recommended |
19. Any other problems with your ears (specify):. Past week. |
|
|
q19 |
|
q__20 |
String |
100
|
Recommended |
20. Any other problems with your ears (specify):. Past week. |
|
|
q20 |
|
q__21 |
Integer |
|
Recommended |
21. Sores in your mouth. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q21 |
|
q__22 |
Integer |
|
Recommended |
22. Dry mouth. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q22 |
|
q__23 |
Integer |
|
Recommended |
23. Too much saliva. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q23 |
|
q45 |
Integer |
|
Recommended |
45. Irregular heart beat. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q__24 |
Integer |
|
Recommended |
24. Swollen or sore tongue. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q24 |
|
q__25 |
Integer |
|
Recommended |
25. Bleeding gums. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q25 |
|
q__26 |
Integer |
|
Recommended |
26. Dental problems. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q26 |
|
q__27 |
String |
100
|
Recommended |
27. Any other problems with your mouth or teeth (specify):. Past week. |
|
|
q27 |
|
q__28 |
String |
100
|
Recommended |
28. Any other problems with your mouth or teeth (specify):. Past week. |
|
|
q28 |
|
q__29 |
Integer |
|
Recommended |
29. Nasal congestion. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q29 |
|
q__30 |
Integer |
|
Recommended |
30. Nose bleeds. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q30 |
|
q__31 |
Integer |
|
Recommended |
31. Sore throat. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q31 |
|
q__32 |
Integer |
|
Recommended |
32. Laryngitis. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q32 |
|
q__33 |
Integer |
|
Recommended |
33. Difficulty Swallowing. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q33 |
|
q46 |
String |
100
|
Recommended |
46. Any other trouble with your heart (specify):. Past week. |
|
|
|
|
q__34 |
String |
100
|
Recommended |
34. Any other problems with your nose or throat (specify):. Past week. |
|
|
q34 |
|
q__35 |
String |
100
|
Recommended |
35. Any other problems with your nose or throat (specify):. Past week. |
|
|
q35 |
|
q47 |
String |
100
|
Recommended |
47. Any other trouble with your heart (specify):. Past week. |
|
|
|
|
q48 |
Integer |
|
Recommended |
48. Stomach/abdominal discomfort. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q49 |
Integer |
|
Recommended |
49. Nausea. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q50 |
Integer |
|
Recommended |
50. Vomiting. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q51 |
Integer |
|
Recommended |
51. Heartburn. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q52 |
String |
100
|
Recommended |
52. Any other trouble with your stomach or abdomen (specify): . Past week. |
|
|
|
|
q53 |
String |
100
|
Recommended |
53. Any other trouble with your stomach or abdomen (specify): . Past week. |
|
|
|
|
q54 |
Integer |
|
Recommended |
54. Diarrhea. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q55 |
Integer |
|
Recommended |
55. Constipation. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q56 |
Integer |
|
Recommended |
56. Gas. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q57 |
Integer |
|
Recommended |
57. Change in color of stools. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q58 |
Integer |
|
Recommended |
58. Hemorrhoids. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q59 |
Integer |
|
Recommended |
59. Painful bowel movements. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q60 |
String |
100
|
Recommended |
60. Any other changes in your bowel movements (specify): . Past week. |
|
|
|
|
q61 |
String |
100
|
Recommended |
61. Any other changes in your bowel movements (specify): . Past week. |
|
|
|
|
q62 |
Integer |
|
Recommended |
62. Appetite increase. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q36 |
Integer |
|
Recommended |
36. Chest pain. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q63 |
Integer |
|
Recommended |
63. Appetite decrease. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q64 |
Integer |
|
Recommended |
64. Weight gain. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q65 |
Integer |
|
Recommended |
65. Weight loss. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q66 |
Integer |
|
Recommended |
66. Bad taste or change in taste. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q67 |
Integer |
|
Recommended |
67. Increased thirst. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q68 |
String |
100
|
Recommended |
68. Any other change in appetite (specify): . Past week. |
|
|
|
|
q69 |
String |
100
|
Recommended |
69. Any other change in appetite (specify): . Past week. |
|
|
|
|
q70 |
Integer |
|
Recommended |
70. Painful urination. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q71 |
Integer |
|
Recommended |
71. Burning sensation with urination. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q72 |
Integer |
|
Recommended |
72. Difficulty in starting to urinate. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q37 |
Integer |
|
Recommended |
37. Shortness of breath. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q73 |
Integer |
|
Recommended |
73. Decrease in force of urinary stream. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q74 |
Integer |
|
Recommended |
74. More frequent urination. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q75 |
Integer |
|
Recommended |
75. Change in color of urine. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q76 |
String |
100
|
Recommended |
76. Any other problems with urination (specify): . Past week. |
|
|
|
|
q77 |
String |
100
|
Recommended |
77. Any other problems with urination (specify): . Past week. |
|
|
|
|
q78 |
Integer |
|
Recommended |
78. Menstrual irregularity. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q79 |
Integer |
|
Recommended |
79. Cramps. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q80 |
Integer |
|
Recommended |
80. Heavy bleeding. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q81 |
Integer |
|
Recommended |
81. Spotting. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q82 |
Integer |
|
Recommended |
82. Tension. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q38 |
Integer |
|
Recommended |
38. Wheezing. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q83 |
Integer |
|
Recommended |
83. Hot flashes. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q84 |
Integer |
|
Recommended |
84. Lengthening of menstrual period. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q85 |
Integer |
|
Recommended |
85. Shortening of menstrual period. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q86 |
String |
100
|
Recommended |
86. Any other problems with your menstrual period (specify):. Past week. |
|
|
|
|
q87 |
String |
100
|
Recommended |
87. Any other problems with your menstrual period (specify):. Past week. |
|
|
|
|
q88 |
Integer |
|
Recommended |
88. Discomfort in genitals. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q89 |
Integer |
|
Recommended |
89. Swelling or discharge from genitals. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q90 |
Integer |
|
Recommended |
90. Decrease in interest in sex. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q91 |
Integer |
|
Recommended |
91. Increase in interest in sex. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q92 |
Integer |
|
Recommended |
92. Delayed orgasm or inability to reach orgasm. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q39 |
Integer |
|
Recommended |
39. Coughing. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q93 |
Integer |
|
Recommended |
For MALES: difficulty achieving or maintaining an erection . Past week. |
|
|
|
|
q94 |
String |
100
|
Recommended |
94. Any other problems with genitals or sexual functioning (specify): . Past week. |
|
|
|
|
q95 |
String |
100
|
Recommended |
95. Any other problems with genitals or sexual functioning (specify): . Past week. |
|
|
|
|
q96 |
Integer |
|
Recommended |
96. Aches, pains in muscles, bones, or joints. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q97 |
Integer |
|
Recommended |
97. Swelling in legs or arms. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q98 |
Integer |
|
Recommended |
98. Tingling or numbness in hands or feet. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q99 |
String |
100
|
Recommended |
99. Any other trouble with your muscles, bones, or joints (specify):. Past week. |
|
|
|
|
q100 |
String |
100
|
Recommended |
100. Any other trouble with your muscles, bones, or joints (specify):. Past week. |
|
|
|
|
q101 |
Integer |
|
Recommended |
101. Feeling unsteady on your feet. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q102 |
Integer |
|
Recommended |
102. Trouble with starting to move. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q40 |
Integer |
|
Recommended |
40. Breast or nipple pain or discharge. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q103 |
Integer |
|
Recommended |
103. Controlling unwanted bodily movements. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q104 |
Integer |
|
Recommended |
104. Feeling restless or like you cannot stay still. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q105 |
Integer |
|
Recommended |
105. Shaking. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q106 |
Integer |
|
Recommended |
106. Feeling still or rigid. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q107 |
String |
100
|
Recommended |
107. Any other difficulty with walking or moving (specify): . Past week. |
|
|
|
|
q108 |
String |
100
|
Recommended |
108. Any other difficulty with walking or moving (specify): . Past week. |
|
|
|
|
q109 |
Integer |
|
Recommended |
109. Rashes, itching, or irritation. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q110 |
Integer |
|
Recommended |
110. Bruising. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q111 |
Integer |
|
Recommended |
111. Increased irritation in sunlight. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q112 |
Integer |
|
Recommended |
112. Sweating a lot. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q41 |
Integer |
|
Recommended |
41. Breast tenderness. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q113 |
String |
100
|
Recommended |
113. Any other trouble with your scalp or skin (specify):. Past week. |
|
|
|
|
q114 |
String |
100
|
Recommended |
114. Any other trouble with your scalp or skin (specify):. Past week. |
|
|
|
|
q115 |
Integer |
|
Recommended |
115. Fever or chills. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q116 |
Integer |
|
Recommended |
116. Feeling tired or fatigued. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q117 |
Integer |
|
Recommended |
117. Too much energy. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q118 |
Integer |
|
Recommended |
118. Jumpiness or feeling jittery. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q119 |
Integer |
|
Recommended |
119. Feeling excited, overactive, or elated. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q120 |
Integer |
|
Recommended |
120. Problems falling asleep. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q121 |
Integer |
|
Recommended |
121. Problems staying asleep. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q122 |
Integer |
|
Recommended |
122. Waking up too early. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q42 |
String |
100
|
Recommended |
42. Any other trouble with your chest (specify):. Past week. |
|
|
|
|
q123 |
Integer |
|
Recommended |
123. Sleeping too much. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q124 |
Integer |
|
Recommended |
124. Feeling drowsy during the day. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q125 |
Integer |
|
Recommended |
125. Trouble thinking, concentrating, or remembering. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q126 |
Integer |
|
Recommended |
126. Feeling down, depressed, or blue. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q127 |
Integer |
|
Recommended |
127. Feeling anxious. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q128 |
Integer |
|
Recommended |
128. Irritability. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
|
|
q129 |
String |
100
|
Recommended |
129. Any other problems with your thinking, mood, or energy, or with other aspects of your health not mentioned above (specify): . Past week. |
|
|
|
|
q__1 |
Integer |
|
Recommended |
1. Headaches. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q1 |
|
q__2 |
Integer |
|
Recommended |
2. Dizziness or faintness. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q2 |
|
q__3 |
Integer |
|
Recommended |
3. Loss of consciousness. Past week. |
1::5
|
1=Not at all; 2=A little bit; 3=Moderately; 4=Quite a bit; 5=Extremely
|
q3 |