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Peds - Full Telephone Screening Interview - Version 2

peds_full_phone_screen_v2

02

Full Telephone Screening Interview - Version 2 as defined by the NIH Pediatric MRI Project

Download Definition as
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Element NameData TypeSizeRequiredDescriptionValue RangeNotesAliases
subjectkeyGUIDRequiredThe NDAR Global Unique Identifier (GUID) for research subjectNDAR*
src_subject_idString20RequiredSubject ID how it's defined in lab/projectSubject_ID
timepoint_labelString5RecommendedTimepoint/visit label
admin_statusString20RecommendedInstrument administration statusComplete;Partial;Not Administered;Not ApplicableFullScreen_V2_Administration_Status
fs_v2_respondentString10RecommendedFull Screener (Visit 2): Respondent completing interviewMOM;DAD;FB1;FS1;HB1;HS1;CID1;CIS1;MA1;MU1;PA1;PU1;MGM;MGF;PGM;PGF;OtherFB1 = Full brother 1; FS1 = Full sister 1; HB1 = Half brother 1; HS1 = Half sister 1; CID1 = Child of interest's daughter 1; CIS1 = Child of interest's son 1; MA1 = Maternal aunt 1; MU1 = Maternal uncle 1; PA1 = Paternal aunt 1; PU1 = Paternal uncle 1; MGM = Maternal grandmother; MGF = Maternal grandfather; PGM = Paternal grandmother; PGF = Paternal grandfatherFullScreen_V2_Respondent
fs_v2_resp_no_adopted_childrenIntegerRecommendedFull Screener (Visit 2): How many adopted children do you have?FullScreen_V2_Respondent_No_of_Adopted_Children
fs_v2_resp_no_biol_childrenIntegerRecommendedFull Screener (Visit 2): How many biological children do you have?FullScreen_V2_Respondent_No_of_Biological_Children
fs_v2_resp_no_of_step_childrenIntegerRecommendedFull Screener (Visit 2): How many step children do you have?FullScreen_V2_Respondent_No_of_Step_Children
fs_v2_mother_education_levelString30RecommendedFull Screener (Visit 2): Verification of the biological mother's current education level (Response options - Less Than 6th Grade, Less Than High School, High School, Some College, College, Some Graduate Level, Graduate Level, NA)Less Than 6th Grade;Less Than High School;High School;Some College;College;Some Graduate Level;Graduate Level;NANA = Not availableFullScreen_V2_Mother_Education_Level
fs_v2_mother_ethnicityString30RecommendedFull Screener (Visit 2): Verification of the biological mother's ethnicity (Response options - Hispanic or Latino, Not Hispanic or Latino, NA)Hispanic or Latino;Not Hispanic or Latino;NANA = Not availableFullScreen_V2_Mother_Ethnicity
fs_v2_mother_father_curr_relString20RecommendedFull Screener (Visit 2): To update our records, how is the subject's biological mother currently related to the subject's biological father? (Response options ? Married, Separated, Divorced, Other, NA)Married;Separated;Divorced;Other;NANA = Not availableFullScreen_V2_Mother_to_Father_Current_Relationship
fs_v2_mother_raceString80RecommendedFull Screener (Visit 2): Verification of the biological mother's raceFullScreen_V2_Mother_Race
fs_v2_questions_father_hxString2RecommendedFull Screener (Visit 2): Can the respondent answer questions about the biological father? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Questions_about_Father_History
fs_v2_father_contact_with_famString2RecommendedFull Screener (Visit 2): Is there contact with the subject's biological father (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Father_in_Contact_with_Family
fs_v2_father_education_levelString30RecommendedFull Screener (Visit 2): Verification of the biological father's current education level (Response options - Less Than 6th Grade, Less Than High School, High School, Some College, College, Some Graduate Level, Graduate Level, NA)Less Than 6th Grade;Less Than High School;High School;Some College;College;Some Graduate Level;Graduate Level;NANA = Not availableFullScreen_V2_Father_Education_Level
fs_v2_father_ethnicityString30RecommendedFull Screener (Visit 2): Verification of the biological father's ethnicity (Response options ? Hispanic or Latino, Not Hispanic or Latino, NA)Hispanic or Latino;Not Hispanic or Latino;NANA = Not availableFullScreen_V2_Father_Ethnicity
fs_v2_father_living_at_homeString2RecommendedFull Screener (Visit 2): Verification if the biological father lives at home (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Father_Living_at_Home
fs_v2_father_raceString80RecommendedFull Screener (Visit 2): Verification of the biological father's raceFullScreen_V2_Father_Race
fs_v2_num_household_dependantsIntegerRecommendedFull Screener (Visit 2): What is the total number of dependants (as per tax return) in your family?FullScreen_V2_Number_of_Household_Dependants
fs_v2_family_incomeString20RecommendedFull Screener (Visit 2): Household income for all adults in home (1=$0-$5,000; 2=$5,001-$10,000; 3=$10,001-$15,000; 4=$15,001-$25,000; 5=$25,001-$35,000; 6=$35,001-$50,000; 7=$50,001-$75,000; 8=$75,001-$100,000; 9=$100,001-$150,000; 10=over $150,000)Zero to 5000;5001 to 10000;10001 to 15000;15001 to 25000;25001 to 35000;35001 to 50000;50001 to 75000;75001 to 100000;100001 to 150000;over 150000;No AnswerIn dollarsFullScreen_V2_Family_Income
fs_v2_body_piercingsString2RecommendedFull Screener (Visit 2): Q29 Does the subject have any non-removable body piercings? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Body_Piercings
fs_v2_brain_infectionString2RecommendedFull Screener (Visit 2): Q10 Has the subject had a brain infection, such as meningitis? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Brain_Infection
fs_v2_cancerString2RecommendedFull Screener (Visit 2): Q11 Since the last visit has the subject been treated for any cancer? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Cancer
fs_v2_chemotherapyString2RecommendedFull Screener (Visit 2): Q12 Has the subject been treated with chemotherapy or radiation therapy? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Chemotherapy
fs_v2_chronic_illnessString2RecommendedFull Screener (Visit 2): Since the last visit, has the subject had any chronic illness? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Chronic_Illness
fs_v2_current_weightFloatRecommendedFull Screener (Visit 2): How much does the subject weigh (lb) now?FullScreen_V2_Current_Weight
fs_v2_dental_bracesString2RecommendedFull Screener (Visit 2): Does the subject have dental braces or a permanent retainer? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Dental_Braces
fs_v2_diabetesString2RecommendedFull Screener (Visit 2): Since the last visit has the subject developed diabetes? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Diabetes
fs_v2_eye_problemString2RecommendedFull Screener (Visit 2): Significant problem with eyes (crossed eyes or other than conventional glasses)? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Eye_Problem
fs_v2_face_head_abnormalityString2RecommendedFull Screener (Visit 2): Since the last visit has the subject developed any abnormalities of the face or head? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Face_Head_Abnormality
fs_v2_hearing_impairment_diagString2RecommendedFull Screener (Visit 2): Since the last visit has the subject been diagnosed with a hearing impairment? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Hearing_Impairment_Diagnosis
fs_v2_hearing_impairment_treatString2RecommendedFull Screener (Visit 2): Has the subject had any treatment for hearing impairment? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Hearing_Impairment_Treatment
fs_v2_heart_diseaseString2RecommendedFull Screener (Visit 2): Since [date of last visit to site] has [name] been diagnosed with heart disease? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Heart_Disease
fs_v2_heart_surgeryString2RecommendedFull Screener (Visit 2): Since the last visit has the subject required heart surgery? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Heart_Surgery
fs_v2_height_and_weightString2RecommendedFull Screener (Visit 2): Q1 Did the respondent have a chance to check the subject's height and weight before call? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Height_and_Weight
fs_v2_height_feetIntegerRecommendedHow tall is the subject now (feet)?FullScreen_V2_Height_Feet
fs_v2_height_inchesFloatRecommendedHow tall is the subject now (inches)?FullScreen_V2_Height_Inches
fs_v2_lead_level_age_yearsIntegerRecommendedFull Screener (Visit 2): At what age was the subject's level checked?FullScreen_V2_Lead_Level_Age_Years
fs_v2_lead_level_checkedString10RecommendedFull Screener (Visit 2): In his/her entire life, has the subject ever had his/her lead level checked? (Response options ? Yes, No, Unsure, NA)
Y;N;Unsure;NA
Y = Yes; N = No; NA = Not availableFullScreen_V2_Lead_Level_Checked
fs_v2_lead_poisoning_treatmentString2RecommendedFull Screener (Visit 2): Since the last visit has the subject been treated for lead poisoning? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Lead_Poisoning_Treatment
fs_v2_learning_dis_age_yearsIntegerRecommendedFull Screener (Visit 2): At what age (years) did the subject start to experience learning difficulties?FullScreen_V2_Learning_Disorder_Age_Years
fs_v2_learning_dis_last_visitString2RecommendedFull Screener (Visit 2): Since the last visit has the subject been as having a learning or language disorder? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Learning_Disorder_Since_Last_Visit
fs_v2_learning_disorder_currString2RecommendedFull Screener (Visit 2): Is the learning disorder still present? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Learning_Disorder_Current
fs_v2_learning_disorder_evalString2RecommendedFull Screener (Visit 2): Did the subject have any tests or evaluations for a learning disorder? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Learning_Disorder_Evaluation
fs_v2_loss_of_consc_over_30minString2RecommendedFull Screener (Visit 2): Was the subject unconscious or knocked out for more than 30 minutes? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Loss_of_Consciousness_Over_30Minutes
fs_v2_loss_of_consciousnessString2RecommendedFull Screener (Visit 2): Loss of consciousness? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Loss_of_Consciousness
fs_v2_metal_platesString2RecommendedFull Screener (Visit 2): Does the subject have any metal plates or pins in his/her body? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Metal_Plates
fs_v2_monthly_periodString2RecommendedFull Screener (Visit 2): Has the subject begun to have her monthly periods? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Monthly_Period
fs_v2_neurologist_visitString2RecommendedFull Screener (Visit 2): Has the subject seen a neurologist? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Neurologist_Visit
fs_v2_pacemakerString2RecommendedFull Screener (Visit 2): Did the subject have a pacemaker placed? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Pacemaker
fs_v2_physical_therapyString2RecommendedFull Screener (Visit 2): Physical, occupational, or language therapy, or early intervention program? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Physical_Therapy
fs_v2_psychiatric_dis_age_yrsIntegerRecommendedFull Screener (Visit 2): At what age (years) was that?FullScreen_V2_Psychiatric_Disorder_Age_Years
fs_v2_psychiatric_dis_diagString2RecommendedFull Screener (Visit 2): Has the subject been diagnosed with a psychiatric disorder? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Psychiatric_Disorder_Diagnosis
fs_v2_psychiatric_dis_treatString2RecommendedFull Screener (Visit 2): Was there any treatment provided? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Psychiatric_Disorder_Treatment
fs_v2_repeated_grade_in_schoolString2RecommendedFull Screener (Visit 2): Since the last visit has the subject repeated a grade in school? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Repeated_Grade_in_School
fs_v2_seizuresString2RecommendedFull Screener (Visit 2): Since the last visit has the subject had any seizures? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Seizures
fs_v2_sickle_cell_family_testString2RecommendedFull Screener (Visit 2): Have the family members been tested for sickle cell trait? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Sickle_Cell_Trait_Family_Tested
fs_v2_sickle_cell_trait_familyString2RecommendedFull Screener (Visit 2): Do either you or the subject mother/father have sickle cell trait or disease? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Sickle_Cell_Trait_Family
fs_v2_sickle_cell_trait_subjString2RecommendedFull Screener (Visit 2): Does the subject have sickle cell trait? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Sickle_Cell_Trait_Subject
fs_v2_skin_joint_problemsString2RecommendedFull Screener (Visit 2): Has the subject developed any problems with skin or joints? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Skin_Joint_Problems
fs_v2_special_ed_age_yearsIntegerRecommendedFull Screener (Visit 2): At what age (years) did this begin?FullScreen_V2_Special_Education_Age_Years
fs_v2_special_ed_evaluationString2RecommendedFull Screener (Visit 2): Did the subject have any tests or evaluations? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Special_Education_Evaluation
fs_v2_special_educationString2RecommendedFull Screener (Visit 2): Special education program? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Special_Education
fs_v2_subject_curr_pregnantString2RecommendedFull Screener (Visit 2): Is the subject currently pregnant? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Subject_Currently_Pregnant
fs_v2_surgeryString2RecommendedFull Screener (Visit 2): Has the subject had surgery? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Surgery
fs_v2_surgery_pins_or_implantsString2RecommendedFull Screener (Visit 2): Were any pins or implants used for the surgery? (Y=Yes; N=No; NA=Not Provided)
Y;N;NA
Y = Yes; N = No; NA = Not providedFullScreen_V2_Surgery_Pins_or_Implants
height_metFloatRecommendedHeight - Metric Unit
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Distribution for DataStructure: peds_full_phone_screen_v202 and Element:
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