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NIMH Data Archive
NDA ABCD CCF OAI NIAAADA AMP SCZ HEAL

PROMIS: Patient Reported Outcome Measurement Information System

377 Shared Subjects

N/A
Clinical Assessments
Questionnaire
11/25/2015
promis01
03/04/2022
View Change History
01
Definition
Submission Template
Query Element Name Data Type Size Required Description Value Range Notes Aliases
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 bid, catieid, newid, participant_id, prom_id, record_id, subject, subject_id
interview_date Date Required Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY date_of_interview, date_of_rating, pnsdate, prom_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. age, dema1
sex String 20 Required Sex of subject at birth M;F; O; NR M = Male; F = Female; O=Other; NR = Not reported dema2, gender, prom_gen
Query visit String 60 Recommended Visit name promis_date
Query promis_1 Integer Recommended Are you able to do chores such as vacuuming or yard work?
1::5; -999
1=Unable to do; 2=With much difficulty; 3=With some difficulty; 4=With a little difficulty; 5=Without any difficulty; -999 = Missing pfa11
Query promis_2 Integer Recommended Are you able to go up and down stairs at a normal pace?
1::5; -999
1=Unable to do; 2=With much difficulty; 3=With some difficulty; 4=With a little difficulty; 5=Without any difficulty; -999 = Missing pfa21
Query promis_3 Integer Recommended Are you able to go for a walk of at least 15 minutes?
1::5; -999
1=Unable to do; 2=With much difficulty; 3=With some difficulty; 4=With a little difficulty; 5=Without any difficulty; -999 = Missing pfa23
Query promis_4 Integer Recommended Are you able to run errands and shop?
1::5; -999
1=Unable to do; 2=With much difficulty; 3=With some difficulty; 4=With a little difficulty; 5=Without any difficulty; -999 = Missing pfa53
Query promis_5 Integer Recommended I felt fearful
1::5; -999
1=Never; 2=Rarely; 3= Sometimes; 4=Often; 5=Always; -999 = Missing edanx01
Query promis_6 Integer Recommended I found it hard to focus on anything other than my anxiety
1::5; -999
1=Never; 2=Rarely; 3= Sometimes; 4=Often; 5=Always; -999 = Missing edanx40
Query promis_7 Integer Recommended My worries overwhelmed me
1::5; -999
1=Never; 2=Rarely; 3= Sometimes; 4=Often; 5=Always; -999 = Missing edanx41
Query promis_8 Integer Recommended I felt uneasy
1::5; -999
1=Never; 2=Rarely; 3= Sometimes; 4=Often; 5=Always; -999 = Missing edanx53
Query promis_9 Integer Recommended I felt worthless
1::5; -999
1=Never; 2=Rarely; 3= Sometimes; 4=Often; 5=Always; -999 = Missing eddep04
Query promis_10 Integer Recommended I felt helpless
1::5; -999
1=Never; 2=Rarely; 3= Sometimes; 4=Often; 5=Always; -999 = Missing eddep06
Query promis_11 Integer Recommended I felt depressed
1::5; -999
1=Never; 2=Rarely; 3= Sometimes; 4=Often; 5=Always; -999 = Missing eddep29
Query promis_12 Integer Recommended I felt hopeless
1::5; -999
1=Never; 2=Rarely; 3= Sometimes; 4=Often; 5=Always; -999 = Missing eddep41
Query promis_13 Integer Recommended I feel fatigued
1::5; -999
1= Not at all; 2=A little bit; 3=Somewhat; 4=Quite a bit; 5= Very much; -999 = Missing hi7
Query promis_14 Integer Recommended I have trouble starting things because I am tired
1::5; -999
1= Not at all; 2=A little bit; 3=Somewhat; 4=Quite a bit; 5= Very much; -999 = Missing an3
Query promis_15 Integer Recommended How run-down did you feel on average?
1::5; -999
1= Not at all; 2=A little bit; 3=Somewhat; 4=Quite a bit; 5= Very much; -999 = Missing fatexp41
Query promis_16 Integer Recommended How fatigued were you on average?
1::5; -999
1= Not at all; 2=A little bit; 3=Somewhat; 4=Quite a bit; 5= Very much; -999 = Missing fatexp40
Query promis_17 Integer Recommended My sleep quality was
1::5; -999
1=Very good; 2=Good; 3=Fair; 4=Poor; 5=Very poor; -999 = Missing sleep109
Query promis_18 Integer Recommended My sleep was refreshing
1::5; -999
1=Very much; 2=Quite a bit; 3=Somewhat; 4=A little bit; 5=Not at all; -999 = Missing sleep116
Query promis_19 Integer Recommended I had a problem with my sleep
1::5; -999
1= Not at all; 2=A little bit; 3=Somewhat; 4=Quite a bit; 5= Very much; -999 = Missing sleep20
Query promis_20 Integer Recommended I had difficulty falling asleep
1::5; -999
1= Not at all; 2=A little bit; 3=Somewhat; 4=Quite a bit; 5= Very much; -999 = Missing sleep44
Query srpsat07 Integer Recommended I am satisfied with how much work I can do (include work at home) 1::5 5=Not at all; 4=A little bit; 3=Somewhat; 2=Quite a bit; 1=Very much promis_21
Query srpsat24 Integer Recommended I am satisfied with my ability to work (include work at home) 1::5 5=Not at all; 4=A little bit; 3=Somewhat; 2=Quite a bit; 1=Very much promis_22
Query promis_23 Integer Recommended I am satisfied with my ability to do regular personal and household responsibilities 1::5; -999 1= Not at all; 2=A little bit; 3=Somewhat; 4=Quite a bit; 5= Very much; -999 = Missing
Query srpsat49 Integer Recommended I am satisfied with my ability to perform my daily routines 1::5 5=Not at all; 4=A little bit; 3=Somewhat; 2=Quite a bit; 1=Very much promis_24
Query promis_25 Integer Recommended How much did pain interfere with your day to day activities?
1::5; -999
1= Not at all; 2=A little bit; 3=Somewhat; 4=Quite a bit; 5= Very much; -999 = Missing painin9
Query promis_26 Integer Recommended How much did pain interfere with work around the home?
1::5; -999
1= Not at all; 2=A little bit; 3=Somewhat; 4=Quite a bit; 5= Very much; -999 = Missing painin22
Query promis_27 Integer Recommended How much did pain interfere with your ability to participate in social activities?
1::5; -999
1= Not at all; 2=A little bit; 3=Somewhat; 4=Quite a bit; 5= Very much; -999 = Missing painin31
Query promis_28 Integer Recommended How much did pain interfere with your household chores?
1::5; -999
1= Not at all; 2=A little bit; 3=Somewhat; 4=Quite a bit; 5= Very much; -999 = Missing painin34
Query promis_pain_intensity Integer Recommended How would you rate your pain on average?
0::10; -999
0=No pain; 10=Worst imaginable pain; -999 = Missing global07
study String 100 Recommended Study; The code for each individual study
Query srpper11_caps Integer Recommended I have trouble doing all of my regular leisure activities with others
1::5; -999
5 = Never; 4= Rarely; 3=Sometimes; 2=Often; 1=Always; -999=missing
Query srpper18_caps Integer Recommended I have trouble doing all of the family activities that I want to
1::5; -999
5 = Never; 4= Rarely; 3=Sometimes; 2=Often; 1=Always; -999=missing
Query srpper23_caps Integer Recommended I have trouble doing all of my usual work (include work at home)
1::5; -999
5 = Never; 4= Rarely; 3=Sometimes; 2=Often; 1=Always; -999=missing
Query srpper46_caps Integer Recommended I have trouble doing all of the activities with friends that I want to
1::5; -999
5 = Never; 4= Rarely; 3=Sometimes; 2=Often; 1=Always; -999=missing
labsample25 Integer Recommended Past week: Have you taken any vitamins or other supplements 0;1 0=No; 1=Yes prom_supplement
prom_homemade Integer Recommended In an average week, how often do you cook and consume home cooked meals? (Exclude ready-to-eat meals like boxed macaroni and cheese, ramen noodles, lean cuisine) 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_ready_made_meals Integer Recommended In an average week, how often do you consume ready-to-eat meals (i.e macaroni and cheese, ramen noodles, lean cuisine)? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_restaurant Integer Recommended In an average week, how often do you eat food prepared at a restaurant, including carry-out/take-out? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_wheaties Integer Recommended In an average week, how often do you eat at least 2 servings of whole grains in a day? 1::5 1= Never; 2= Rarely (less than once per week); 3= Occasionally (1 to 2 times per week); 4= Regularly (3 to 5 times per week); 5= Daily
prom_daily_fruits Integer Recommended In an average week, how often to you consume at least 2-3 servings of fruit in a day? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_veg_daily Integer Recommended In an average week, how often do you consume at least 2-3 servings of vegetables, including potatoes in a day? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_diff_plants Integer Recommended In an average week, how many different plant species do you eat? 1::5 1= less than 5; 2= 6-10; 3= 11-20; 4= 21-30; 5= greater then 30; e.g. If you consume a can of soup that contains carrots, potatoes and onion, you can count this as 3 different plants; If you consume multi-grain bread, each different grain counts as a plant.
prom_fermented Integer Recommended How often do you consume one or more servings of fermented vegetables in or plant products a day in an average week? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_dairy Integer Recommended In an average week, how often do you consume at least 2 servings of milk or cheese a day? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_dairy_subs Integer Recommended In an average week, how often do you consume milk substitutes? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_supplement_2 String 100 Recommended If taking nutritional/herbal supplement.... please specify which ones.
prom_frozen_desserts Integer Recommended How often do you eat frozen desserts? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_red_meat Integer Recommended In an average week, how often do you eat red meat? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_high_fat_meat Integer Recommended In an average week, how often do you consume higher fat red meats like prime rib, T-bone steak, hamburger, ribs, bacon, etc.? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_poultry Integer Recommended How many days in an average week do you consume poultry at least once a day? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_seafood Integer Recommended How many days in an average week do you consume seafood? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_salted_snacks Integer Recommended How many days in an average week do you consume salted snacks? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_sugary_sweets Integer Recommended How many days in an average week do you consume sugary sweets? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_olive_oil Integer Recommended How many days in an average week do you cook with olive oil? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_whole_eggs Integer Recommended Consume whole eggs. 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_sweet_beverage Integer Recommended Drink 16 ounces or more of a sugar sweetened beverage such as non diet soda or fruit drink or punch in a day? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_paleo Integer Recommended Do you eat a paleo, modified paleo, primal, FODMAP, Weston-Price, or other low-grain, low processed food diet? 0;1 0= No; 1= Yes
prom_art_sweeteners Integer Recommended Consume diet beverages with artificial sweeteners? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_water Integer Recommended Consume at least 1L of water in a day? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_food_antibiotics Integer Recommended Do you eat meat/dairy products from animals treated with antibiotics? 0::2 1= Yes; 0= No; 2= Unsure
prom_diet_restrict Integer Recommended Do you follow any other special diet restrictions other than those indicated above? 0;1 0= No; 1= Yes
prom_diet_other String 100 Recommended If you follow a diet other than those indicated above, please specify:
prom_drinking_source Integer Recommended What is your drinking water source at home? 1::5 1= City; 2= Well; 3= Bottled; 4= Filtered; 5= Not sure
prom_current_residence Integer Recommended When did you move to your current state of residence? 1::5 1= Within the past month; 2= Within the past 3 months; 3= Within the past 6 months; 4= Within the past year; 5= I have lived in my current state of residence for more than a year
prom_travel Integer Recommended I have traveled outside of the United States in the past _________. 1::5 1= Month; 2= 3 months; 3= 6 months; 4= 1 year; 5= I have not been outside of the United States in the past year.
prom_travel_explain String 100 Recommended If you have traveled outside of the United States in the past 1-6 months, please explain
prom_roommates Integer Recommended How many non-family roommates do you have? 1::5 1= None; 2= One; 3= Two; 4= Three; 5= More than three
prom_roommate_participate Integer Recommended Are any of your roommates participating in this study? 1::3 1= Yes; 2= No; 3= Not sure
prom_room_participate_2 String 100 Recommended If your roommates are participating in this study, please explain
prom_related_participants Integer Recommended Are you related to or live with any of the other participants in this study? 1::3 1= Yes; 2= No; 3= Not sure
prom_dog Integer Recommended Do you have a dog(s)? 0;1 0= No; 1= Yes
prom_dog_explain String 100 Recommended If you have a dog, please explain
prom_cats Integer Recommended Do you have a cat(s)? 0;1 0= No; 1= Yes
prom_cats_explain String 100 Recommended If you have a cat, please explain
prom_other_pets Integer Recommended Do you have any other pet(s)? 0;1 0= No; 1= Yes
prom_other_pets_explain String 100 Recommended If you have any other pets, please explain
equest30 String 15 Recommended What is your height? (Please give your best estimate.) prom_ht
prom_dom_hand Integer Recommended Which is your dominant hand? 1::3 1= I am right handed; 2= I am left handed; 3= I am ambidextrous
prom_exercise Integer Recommended How often do you exercise? 1::5 1= Daily; 2= Regularly (3-5 times/week); 3= Occasionally (1-2 times/week); 4= Rarely (few times/month); 5= Never
prom_indoor_outdoor Integer Recommended Do you generally exercise indoors or outdoors? 1::5 1= Indoors; 2= Outdoors; 3= Both; 4= Depends on the season; 5= None of the above
prom_fingernails Integer Recommended Do you bite your fingernails? 0;1 0= No; 1= Yes
prom_pool Integer Recommended How often do you use a swimming pool/hot tub? 1::5 1= Daily; 2= Regularly (3-5 times/week); 3= Occasionally (1-2 times/week); 4= Rarely (few times/month); 5= Never
prom_cigarettes Integer Recommended How often do you smoke cigarettes? 1::5 1= Daily; 2= Regularly (3-5 times/week); 3= Occasionally (1-2 times/week); 4= Rarely (few times/month); 5= Never
prom_alcohol Integer Recommended How often do you drink alcohol? 1::5 1= Daily; 2= Regularly (3-5 times/week); 3= Occasionally (1-2 times/week); 4= Rarely (few times/month); 5= Never
prom_drinks_consumed Integer Recommended How many drinks do you consume if you do drink alcohol? 1::4 1= None; 2= 1-2 servings; 3= 3-6; 4= More than 6
prom_type_alcohol Integer Recommended What type(s) of alcohol do you typically consume (select all that apply)? Beer/ Cider 0; 1 0= No; 1= Yes prom_type_alcohol___1
prom_type_alcohol_spirits String 100 Recommended Define different spirit-types:
prom_diet Integer Recommended How would you classify your diet? 1::5 1= Omnivore; 2= Omnivore but do not eat red meat; 3= Vegetarian; 4= Vegetarian but eat seafood; 5= Vegan
prom_teeth_brush Integer Recommended How often do you brush your teeth? 1::4 1= 2 + times/day; 2= 1-2 times/day; 3= Once a day; 4= Never
prom_floss Integer Recommended How often do you floss your teeth? 1::5 1= Daily; 2= Regularly (3-5 times/week); 3= Occasionally (1-2 times/week); 4= Rarely (few times/month); 5= Never
prom_cosmetics Integer Recommended How often do you wear facial cosmetics? 1::4 1= Daily; 2= Regularly (3-5 times/week); 3= Occasionally (1-2 times/week); 4= Rarely (few times/month)
prom_deodorant Integer Recommended Do you use deodorant or antiperspirant (antiperspirants generally contain aluminum)? 1::4 1= I use deodorant; 2= I use an antiperspirant; 3= Not sure= but I use some form of deodorant/antiperspirant; 4= I do not use deodorant or an antiperspirant
prom_sleep Integer Recommended Approximately how many hours of sleep to you get in an average night? 1::5 1= Less than 5 hours; 2= 5-6 hours; 3= 6-7 hours; 4= 7-8 hours; 5= 8 or more hours
prom_fab_softener Integer Recommended Do you use fabric softener when drying your clothes? 0;1 0= No; 1= Yes
prom_bowel_day Integer Recommended How many times do you have a bowel movement in an average day? 1::6 1= Less than one; 2= One; 3= Two; 4= Three; 5= Four; 6= Five or more
prom_bowel_move Integer Recommended Describe the quality of your bowel movements: 1::3 1= I tend to be constipated (have difficulty passing stool) - Type 1 and 2;; 2= I tend to have diarrhea (watery stool) - Type 5= 6 and 7; 3= I tend to have normal formed stool - Type 3 and 4.
prom_antibiotics Integer Recommended I have taken antibiotics in the last ____________. (If you answered a or b, please indicate which antibiotic you took and what you were treating in the supplemental answer section 1::5 1= Week; 2= Month; 3= 6 months; 4= Year; 5= I have not taken antibiotics in the past year.
prom_antibiotics_note String 100 Recommended If you have taken antibiotics in the last week or month, please specify what antibiotics and what they were used to treat:
prom_multivitamin Integer Recommended Are you taking a daily multivitamin? 0;1 0= No; 1= Yes
prom_flu Integer Recommended I have received a flu vaccine in the last ____________. 1::5 1= Week; 2= Month; 3= 6 months; 4= Year; 5= I have not gotten the flu vaccine in the past year.
prom_bc Integer Recommended Are you currently using some form of hormonal birth control? 1::6 1= Yes, I am taking the pill; 2= Yes, I use an injected contraceptive (DMPA); 3= Yes, I use a contraceptive patch (Ortho-Evra); 4= Yes, I use the NuvaRing; 5= Yes, I use a hormonal IUD (Mirena); 6= No
prom_preg Integer Recommended Are you currently pregnant? 1::3 1= Yes; 2= No; 3= Not sure
prom_preg_y_due_date String 100 Recommended If yes, please indicate your due date:
prom_weight Integer Recommended My weight has _________ within the last 6 months. 1::3 1= Increased more than 10 pounds; 2= Decreased more than 10 pounds; 3= Remained stable
prom_tonsil Integer Recommended Have you had your tonsils removed? 1::3 1= Yes; 2= No; 3= Not sure
prom_appendix Integer Recommended Have you had you appendix removed? 1::3 1= Yes; 2= No; 3= Not sure
prom_chickenpox Integer Recommended Have you had chickenpox? 1::3 1= Yes; 2= No; 3= Not sure
prom_rxacne Integer Recommended Do you currently take prescription medication for facial acne? 0;1 0= No; 1= Yes
prom_counter_acne Integer Recommended Do you use over the counter products to control facial acne? 0;1 0= No; 1= Yes
prom_freq_probiotic Integer Recommended How frequently do you take a probiotic? 1::5 1= Never; 2= Rarely (a few times/month); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_rx_overcounter Integer Recommended Do you currently take over the counter or prescription medication for other conditions? 0;1 0= No; 1= Yes
prom_rx_overcounter_other String 100 Recommended if you take over the counter prescription medications...
prom_c_section Integer Recommended Were you born via caesarean section (C-section)? 1::3 1= Yes; 2= No; 3= Not sure
prom_infant Integer Recommended How were you fed as an infant? 1::4 1= Primarily breast milk; 2= Primarily infant formula; 3= A mixture of breast milk and formula; 4= Not sure
prom_add Integer Recommended Have you been diagnosed with ADD/ADHD? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_alzheimers Integer Recommended Have you been diagnosed with Alzheimer's Disease/Dementia 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_asthma Integer Recommended Have you been diagnosed with Asthma, Cystic fibrosis, or COPD (chronic obstructive pulmonary disease)? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_asd Integer Recommended Have you been diagnosed with Autism or Autism Spectrum Disorder? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_autoimmune Integer Recommended Have you been diagnosed with autoimmune disease such as Lupus (systemic lupus erythematosus), R.A. (rheumatoid arthritis), MS (multiple sclerosis), Hashimoto's thyroiditis 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_candida Integer Recommended Have you ever been diagnosed with Candida or fungal overgrowth in the gut? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_freq_vitb Integer Recommended How frequently do you take Vitamin B complex, folate or folic acid? 1::5 1= Never; 2= Rarely (a few times/month); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_clostridium Integer Recommended Have you ever been diagnosed with Clostridium difficile (C. diff) infection? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_coronary Integer Recommended Have you ever been diagnosed with coronary artery disease, heart disease, or suffered a heart attack and/or stroke? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_mental_health Integer Recommended Have you ever been diagnosed mental health illness? 0;1 0= No; 1= Yes
prom_mental_health_2 Integer Recommended If you responded yes to question please select which disorder/s from the following list: Depression 0; 1 0= No; 1= Yes prom_mental_health_2___1
prom_diabetes Integer Recommended Have you ever been diagnosed with diabetes? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_diabetes_type Integer Recommended If you responded yes to question 40), which type of diabetes? 1::4 1= Prediabetes; 2= Type I diabetes; 3= Type II diabetes; 4= Gestational diabetes
prom_epilepsy Integer Recommended Have you ever been diagnosed with epilepsy or seizure disorder? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_ibs Integer Recommended Have you ever been diagnosed with irritable bowel syndrome (IBS)? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_ibd Integer Recommended Have you ever been diagnosed with inflammatory bowel disease (IBD)? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_migranes Integer Recommended Have you ever been diagnosed with migraines? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_vitd Integer Recommended How frequently do you take a Vitamin D supplement? 1::5 1= Never; 2= Rarely (a few times/month); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_kidney_disease Integer Recommended Have you ever been diagnosed with kidney disease? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_liver Integer Recommended Have you ever been diagnosed with liver disease? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_phenylketonuria Integer Recommended Have you ever been diagnosed with phenylketonuria? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_sibo Integer Recommended Have you ever been diagnosed with small intestinal bacterial overgrowth (SIBO)? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_skin Integer Recommended Have you ever been diagnosed with a skin condition? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_throid Integer Recommended Have you ever been diagnosed with thyroid disease? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_cancer Integer Recommended Have you ever been diagnosed with cancer? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_cancer_treat Integer Recommended If you have been diagnosed with cancer, how was it treated? 1::4 1= No treatment; 2= Surgery only; 3= Chemotherapy; 4= Radiation therapy
prom_gerd Integer Recommended Have you ever been diagnosed with acid reflux or GERD (gastro-esophageal reflux disease? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_thyroid Integer Recommended Have you ever been diagnosed with thyroid disease? 1::4 1= I do not have this condition; 2= Diagnosed by a medical professional (doctor= physician assistant); 3= Diagnosed by an alternative medicine practitioner; 4= Self-diagnosed
prom_vitd_iu String 100 Recommended If takes a vitamin D supplement.... How many IUs(i.e. 1000, 2000, etc)?
prom_critical_condition String 100 Recommended Have you ever been diagnosed with any other relevant clinical condition?
prom_allergies Integer Recommended Do you have seasonal allergies? 0;1 0= No; 1= Yes
prom_non_allergies Integer Recommended Do you have any of the following non-food allergies? (check all that apply) Drug (Penicillin) 0; 1 0= No; 1= Yes prom_non_allergies___1
prom_lactose Integer Recommended Are you lactose intolerant? 0;1 0= No; 1= Yes
prom_gluten Integer Recommended Are you gluten intolerant? 1::4 1= I was diagnosed with celiac disease; 2= I was diagnosed with gluten allergy (anti-gluten IgG)= but not celiac disease; 3= I do not eat gluten because it makes me feel bad; 4= No
prom_allergies_food Integer Recommended I am allergic to (mark all that apply) Peanuts 0; 1 0= No; 1= Yes prom_allergies_food___1
prom_allergies_food_other String 100 Recommended If other, please specify:
prom_dreams Integer Recommended Do you have vivid and/or frightening dreams? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_ensure Integer Recommended Are you an adult who receives most (more than 75% of daily calories) of their nutrition from adult nutritional shakes (i.e. Ensure)? 0;1 0= No; 1= Yes
prom_meat_eggs Integer Recommended In an average week, how often do you consume meat/eggs? 1::5 1= Never; 2= Rarely (less than once/week); 3= Occasionally (1-2 times/week); 4= Regularly (3-5 times/week); 5= Daily
prom_mental_health_2___5 Integer Recommended If you responded yes to question please select which disorder/s from the following list: Anorexia nervosa 0; 1 0= No; 1= Yes
prom_mental_health_2___6 Integer Recommended If you responded yes to question please select which disorder/s from the following list: Bulimia nervosa 0; 1 0= No; 1= Yes
prom_mental_health_2___7 Integer Recommended If you responded yes to question please select which disorder/s from the following list: Substance abuse 0; 1 0= No; 1= Yes
prom_non_allergies___2 Integer Recommended Do you have any of the following non-food allergies? (check all that apply) Pet dander 0; 1 0= No; 1= Yes
prom_non_allergies___3 Integer Recommended Do you have any of the following non-food allergies? (check all that apply) Bee stings 0; 1 0= No; 1= Yes
prom_non_allergies___4 Integer Recommended Do you have any of the following non-food allergies? (check all that apply) Poison ivy or oak 0; 1 0= No; 1= Yes
prom_non_allergies___5 Integer Recommended Do you have any of the following non-food allergies? (check all that apply) Sun 0; 1 0= No; 1= Yes
prom_allergies_food___2 Integer Recommended I am allergic to (mark all that apply) Tree nuts 0; 1 0= No; 1= Yes
prom_allergies_food___3 Integer Recommended I am allergic to (mark all that apply) Shellfish 0; 1 0= No; 1= Yes
prom_allergies_food___4 Integer Recommended I am allergic to (mark all that apply) Other 0; 1 0= No; 1= Yes
prom_allergies_food___5 Integer Recommended I am allergic to (mark all that apply) I have no food allergies that I know of 0; 1 0= No; 1= Yes
prom_type_alcohol___2 Integer Recommended What type(s) of alcohol do you typically consume (select all that apply)? Sour beers 0; 1 0= No; 1= Yes
prom_type_alcohol___3 Integer Recommended What type(s) of alcohol do you typically consume (select all that apply)? White Wine 0; 1 0= No; 1= Yes
prom_type_alcohol___4 Integer Recommended What type(s) of alcohol do you typically consume (select all that apply)? Red Wine 0; 1 0= No; 1= Yes
prom_type_alcohol___5 Integer Recommended What type(s) of alcohol do you typically consume (select all that apply)? Spirits/ hard alcohol 0; 1 0= No; 1= Yes
prom_mental_health_2___2 Integer Recommended If you responded yes to question please select which disorder/s from the following list: Bipolar disorder 0; 1 0= No; 1= Yes
prom_mental_health_2___3 Integer Recommended If you responded yes to question please select which disorder/s from the following list: PTSD (post-traumatic stress disorder) 0; 1 0= No; 1= Yes
prom_mental_health_2___4 Integer Recommended If you responded yes to question please select which disorder/s from the following list: Schizophrenia 0; 1 0= No; 1= Yes
site String 101 Recommended Site Study Site
Data Structure

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

  • Element Name: This is the standard element name
  • Data Type: Which type of data this element is, e.g. String, Float, File location.
  • Size: If applicable, the character limit of this element
  • Required: This column displays whether the element is Required for valid submissions, Recommended for valid submissions, Conditional on other elements, or Optional
  • Description: A basic description
  • Value Range: Which values can appear validly in this element (case sensitive for strings)
  • Notes: Expanded description or notes on coding of values
  • Aliases: A list of currently supported Aliases (alternate element names)
  • For valid elements with shared data, on the far left is a Filter button you can use to view a summary of shared data for that element and apply a query filter to your Cart based on selected value ranges

At the top of this page you can also:

  • Use the search bar to filter the elements displayed. This will not filter on the Size of Required columns
  • Download a copy of this definition in CSV format
  • Download a blank CSV submission template prepopulated with the correct structure header rows ready to fill with subject records and upload

Please email the The NDA Help Desk with any questions.

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