of0
Export
 
CDE Detailed Report
This report contains detailed information about the selected CDEs.
Disease: Epilepsy
CRF: Migraine Headaches Questionnaire 21-Item
Item count: 31 (31 distinct CDEs)
CDE ID
CDE Name
Definition / Description
Code List / Permissible Values
Definitions for Codes / Permissible Values
Data Type
Instructions
Additional Notes
References
Classification (e.g., Core)
Version #
Version Date
Variable Name
Aliases for Variable Name
CRF Module / Guideline
Sub-Domain
Domain
C13485
Household member total count
The total number of members in the participant's household.
  
Numeric Values
Write in number
 
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HouseMembTotCt
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13486
Headache Screening Survey (HSS) - household members suffering severe headache count
The total number of members of participant's household who suffer from severe headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
Write in number
 
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembSufSevHdacheCt
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13487
Headache Screening Survey (HSS) - household member suffering severe headache identifier number
The numeric identifier for each members of a participant's household who suffer from severe headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
Please have each member of your household who suffers from severe headaches complete the rest of this card and the following card.
Household Member
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembSufSevHdacheIdNum
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13488
Headache Screening Survey (HSS) - household members age value
The age of each members of a participant's household who suffer from severe headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
Write in age in years. Completed by each member of your household who suffers from severe headaches.
Age
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembAgeVal
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13489
Headache Screening Survey (HSS) - household member sex type
The sex of each members of a participant's household who suffer from severe headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Completed by each member of your household who suffers from severe headaches.
 
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembSexTyp
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13490
Headache Screening Survey (HSS) - household member headache symptom type
The types of headache symptoms experience by each members of a participant's household who suffer from severe headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Choose all that apply. Completed by and answered for each member of your household who suffers from severe headaches.
When you have a severe headache, do you experience any of the following?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembHdacheSympTyp
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13491
Headache Screening Survey (HSS) - household member headache occurrence week frequency
The number headaches experienced by each members of a participant's household who suffer from severe headaches in a week from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
Answer for headache days per week OR per month OR in a year. Completed by and answered for each member of your household who suffers from severe headaches.
About how often do your severe headaches occur? number in a week
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembHdacheOccWkFreq
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13492
Headache Screening Survey (HSS) - household member headache occurrence month frequency
The number headaches experienced by each members of a participant's household who suffer from severe headaches in a month.
  
Numeric Values
Answer for headache days per week OR per month OR in a year. Completed by and answered for each member of your household who suffers from severe headaches.
About how often do your severe headaches occur? number in a month
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembHdacheOccMnthFreq
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13494
Headache Screening Survey (HSS) - household member headache pain scale
The scale to rate the pain caused by a headache experienced by each members of a participant's household who suffer from severe headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Choose only one. Completed by each member of your household who suffers from severe headaches.
Which statement best describes the pain of your severe headaches?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembHdachePainScale
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13495
Headache Screening Survey (HSS) - household members headache affect scale
The scale to rate the affect caused by a headache experienced by each members of a participant's household who suffer from severe headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Choose only one. Completed by each member of your household who suffers from severe headaches.
Which best describes how your are usually affected by severe headaches?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembHdacheAffScale
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13496
Headache Screening Survey (HSS) - household member headache unable to work scale
The scale to rate the ability to function as a result of a headache experienced by each members of a participant's household who suffer from severe headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Choose only one. Completed by each member of your household who suffers from severe headaches.
Each time you have a severe headache, how long are you unable to work or undertake normal activities?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembHdacheUnabWrkScale
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13497
Headache Screening Survey (HSS) - household member headache last 3 month days count
The number of days a headache was experienced by each members of a participant's household who suffer from severe headaches in the last three months from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
If headache lasted more than 1 day, count each day. Completed by each member of your household who suffers from severe headaches.
On how many days in the last 3 months did you have a headache?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembHdacheL3MnthDCt
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13498
Headache Screening Survey (HSS) - household member headache last three month miss work school day count
The number of missed work or schools days as a result of a headache experienced by each members of a participant's household who suffer from severe headaches in the last three months from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
Write in number of days. Completed by each member of your household who suffers from severe headaches.
Because of your headaches on how many days in the last 3 months did you miss work or school?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouMemHdacL3MthMisWrkSchDCt
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13499
Headache Screening Survey (HSS) - household member headache last three month productivity reduced day count
The number of reduced productivity days as a result of a headache experienced by each members of a participant's household who suffer from severe headaches in the last three months from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
Write in number of days. Do not include days missed in question 10a. Completed by each member of your household who suffers from severe headaches.
Because of your headaches on how many days in the last 3 months was your productivity at work/school reduced by half or more?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHoMemHdaL3MthPrdRdDCt
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13503
Headache Screening Survey (HSS) - severe headache began age value
The age value of when person began to have severe headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
Write in age. Completed by each member of your household who suffers from severe headaches.
At what age did you BEGIN having severe headaches?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSSevereHeadacheBeginAgeVal
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13504
Headache Screening Survey (HSS) - severe headache emergency care indicator
Indicator for having gone to hospital emergency room or to an urgent care clinic because of severe headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Completed by each member of your household who suffers from severe headaches.
Have you ever gone to the hospital emergency room or to an urgent care clinic because of your severe headaches?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSSevereHdacheEmergCarInd
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13505
Headache Screening Survey (HSS) - severe headaches treatment type
The types of ways that usually treat severe headache from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Choose only one. Completed by each member of your household who suffers from severe headaches.
Which best describes the way you usually treat severe headaches?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSSevereHdacheTreatTyp
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13506
Headache Screening Survey (HSS) - severe headache previous medication indicator
The indicator for having taken prescription medication for headache on a daily basis from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Completed by each member of your household who suffers from severe headaches.
Have you ever taken prescription medication for headache on a DAILY basis, whether or not you have a headache, to help prevent a severe headache from happening in the first place?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSSevereHdachePrevMedInd
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13507
Headache Screening Survey (HSS) - other current daily medication type
The indicator for currently taking prescription medication for headache on a daily basis from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Choose all that apply. Completed by each member of your household who suffers from severe headaches.
Are you currently taking any other medication on a DAILY basis?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSOtherCurrentDlyMedTyp
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13508
Headache Screening Survey (HSS) - other current daily medication occurrence
The occurrence of the last time that person took prescription medication for headache on a daily basis from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Choose only one. Completed by each member of your household who suffers from severe headaches.
When did you last take prescription medication for headache on a DAILY basis to help prevent a severe headache from happening in the first place?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSOtherCurrentDlyMedOccur
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13509
Headache Screening Survey (HSS) - severe headache considered migraine indicator
The indicator that person considers severe headache to be migraine from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Completed by each member of your household who suffers from severe headaches.
Do you consider your severe headaches to be migraines?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSSevereHdacheConsMigraineInd
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13510
Headache Screening Survey (HSS) - headache diagnosis type
The type as related to headache diagnosis from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Alphanumeric
Choose all that apply. Completed by each member of your household who suffers from severe headaches.
Have you ever been diagnosed by a physician or other health professional as suffering from headaches?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHeadacheDiagTyp
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13511
Headache Screening Survey (HSS) - migraine diagnosis age value
The age value of being diagnosed with migraines from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
Write in age. Completed by each member of your household who suffers from severe headaches.
If diagnosed with migraines, at what age were you FIRST DIAGNOSED with migraines?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSMigraineDiagAgeVal
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13512
Headache Screening Survey (HSS) - migraine household total count
How many household members (including yourself) suffer from MIGRAINE headaches?
  
Numeric Values
Write in number.
How many household members (including yourself) suffer from MIGRAINE headaches? number who suffer migrain headaches:
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
1.0
10/5/2012
HSSMigraineHousehldTtlCt
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13493
Headache Screening Survey (HSS) - household member headache occurrence year frequency
The number headaches experienced by each members of a participant's household who suffer from severe headaches in a year from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
Answer for headache days per week OR per month OR in a year. Completed by and answered for each member of your household who suffers from severe headaches.
About how often do your severe headaches occur? number in a year
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSHouseMembHdacheOccYrFreq
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13500
Headache Screening Survey (HSS) - no household work day count
The number of days in the last 3 months that person could not do household work because of headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
Write in number of days. Completed by each member of your household who suffers from severe headaches.
Because of your headaches on how many days in the last 3 months did you not do household work?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSNotHouseholdWorkDayCt
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
C13501
Headache Screening Survey (HSS) - reduced household work day count
The number of days in the last 3 months that productivity in household work was reduced by half or more because of headaches from Headache Screening Survey (HSS) which is a questionnaire that screens for alcohol dependency without it appearing to be the main focus of the instrument.
  
Numeric Values
Write in number of days. Do not include days counted in question 10c. Completed by each member of your household who suffers from severe headaches.
Because of your headaches on how many days in the last 3 months was your productivity in household work reduced by half or more?
Lipton RL, et al. Prevalence and burden of Migraine in the United States: Data from the American Migraine Study II. Headache. 2001; 41: 646-657.
Supplemental
3.0
8/28/2013
HSSReducedHouseholdWorkDayCt
Aliases for variable name not defined
Migraine Headaches Questionnaire 21-Item
Assessing Comorbidities
Outcomes and End Points
06-20-2019
Page 1 of 2