CDE Detailed Report
Sub-Domain: Epidemiology/Environmental History
CRF: Risk Factor Questionnaire (RFQ) - Female Health History
Displaying 1 - 18 of 18
CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guideline) | Sub Domain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
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C16641 | Risk Factor Questionnaire (RFQ) - female health history-hormone replacement therapy start age year unknown indicator | RFQFemHlthHxHRTStrtAgeYrUnkInd | The indicator if the participant/subject does not know when she started taking hormone replacement therapy, indicate as "Don't Know" as part of the risk factor questionnaire female health history. | If the participant/subject does not know when she started taking hormone replacement therapy, indicate as Don't Know as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | If Yes, at what age did you start taking hormone replacement therapy? | Don't know | Don't know | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C16631 | Risk Factor Questionnaire (RFQ) - female health history-live birth number | RFQFemHlthHxLiveBirthNum | If yes, how many live births as part of the risk factor questionnaire female health history. | If yes, how many live births as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | If Yes, how many live births have you had? | Numeric Values |
live births |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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C16642 | Risk Factor Questionnaire (RFQ) - female health history-hormone replacement therapy stop age or year value | RFQFemHlthHxHRTStopAgeYrVal | Age (or year) participant/subject stopped taking hormone replacement therapy as part of the risk factor questionnaire female health history. | Age (or year) participant/subject stopped taking hormone replacement therapy as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | If Yes, at what age did you stop taking hormone replacement therapy? | Numeric Values |
Age oe YeaR |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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C16632 | Risk Factor Questionnaire (RFQ) - female health history-first menstrual period age status | RFQFemHlthHxFrstMensPdStatus | The status related to participant's/subject's first menstrual period as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | Age value of a participant's/subject's first menstrual period as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | At what age did you have your first menstrual period? | Never had a menstrual period;Don't know | Never had a menstrual period;Don't know | Alphanumeric |
If value is "Never had a menstrual period", then end questionnaire |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C16643 | Risk Factor Questionnaire (RFQ) - female health history-hormone replacement therapy stop age year indicator | RFQFemHlthHxHRTStopAgeYrInd | If the participant/subject currently takes or does not know when she stopped taking hormone replacement therapy, indicate as Currently Take or Don't Know as part of the risk factor questionnaire female health history. | If the participant/subject currently takes or does not know when she stopped taking hormone replacement therapy, indicate as Currently Take or Don't Know as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | If Yes, at what age did you stop taking hormone replacement therapy? | Currently Take;Don't know | Currently Take;Don't know | Alphanumeric |
If currently on hormone replacement therapy, leave blank and check "currently take". |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C16633 | Risk Factor Questionnaire (RFQ) - female health history-current menstrual status indicator | RFQFemHlthHxCrntMenstrlStatInd | Participant's/subject's current menstrual status as part of the risk factor questionnaire female health history. | Participant's/subject's current menstrual status as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | What is your current menstrual status? | Pregnant or breastfeeding;Still having periods and not going through menopause;Still having periods and on hormone replacement therapy;Going through menopause;Periods stopped themselves or natural menopause;Periods stopped by surgery or surgical menopause | Pregnant or breastfeeding;Still having periods and not going through menopause;Still having periods and on hormone replacement therapy;Going through menopause;Periods stopped themselves or natural menopause;Periods stopped by surgery or surgical menopause | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C16644 | Risk Factor Questionnaire (RFQ) - female health history-hormone replacement therapy total year value | RFQFemHlthHxHRTTtlYrVal | The total number of years participant/subject took hormone replacement therapy as part of the risk factor questionnaire female health history. | The total number of years participant/subject took hormone replacement therapy as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | If Yes, during the above period, how many years in total did you take hormone replacement therapy? | Numeric Values |
The period of time in question is during or after menopause for a period of at least 6 months. Do not include any months/years during the above period when participant/subject may have temporarily stopped taking hormone replacement therapy. |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
C16634 | Risk Factor Questionnaire (RFQ) - female health history-age year menstrual period stopped natural value | RFQFemHlthHxAgYrMnstPdStpNtVal | The age (or year) the participant's/subject's periods stopped naturally or by menopause as part of the Risk factor questionnaire Female Health History. | The age (or year) the participant's/subject's periods stopped naturally or by menopause as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | Age or Year | Numeric Values |
Answer only if "Periods stopped themselves or natural menopause" is answered. Answer for age OR year, NOT both. |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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C17695 | Risk Factor Questionnaire (RFQ) - Female Health History-first menstrual period age value | RFQFHHFrstMenstrlPeriodAgeVal | Age of participant's/subject's first menstrual period as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | Age of participant's/subject's first menstrual period as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | At what age did you have your first menstrual period? | Numeric Values | Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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C16635 | Risk Factor Questionnaire (RFQ) - female health history-age year menstrual period stop surgery surgical menopause value | RFQFemHlthHxPdStpSxSugMenpsVal | The age (or year) the participant's/subject's periods stopped by surgery or surgical menopause | The age (or year) the participant's/subject's periods stopped by surgery or surgical menopause | Age or Year | Numeric Values |
Answer only if "Periods stopped by surgery or surgical menopause" is answered. Answer for age OR year, NOT both. |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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C19054 | Risk Factor Questionnaire (RFQ) - female health history-surgery stop menopause other text | RFQFemHlthHxSxStpMenopsOTH | The free-text field related to 'Risk Factor Questionnaire (RFQ) - female health history-surgery stop menopause type' specifying other text. If periods stopped by surgery or surgical menopause, indicate type of surgery the participant/subject underwent as part of the risk factor questionnaire female health history. | The free-text field related to 'Risk Factor Questionnaire (RFQ) - female health history-surgery stop menopause type' specifying other text. If periods stopped by surgery or surgical menopause, indicate type of surgery the participant/subject underwent | Other, specify | Alphanumeric |
Answered only if current menstrual status is "Periods stopped by surgery or surgical menopause" |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History | 4000 |
Free-Form Entry |
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C16636 | Risk Factor Questionnaire (RFQ) - female health history-surgery stop menopause type | RFQFemHlthHxSxStpMenopsTyp | If periods stopped by surgery or surgical menopause, indicate type of surgery the participant/subject underwent as part of the risk factor questionnaire female health history. | If periods stopped by surgery or surgical menopause, indicate type of surgery the participant/subject underwent as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | What type of surgery did you have? | Removal of uterus and both ovaries;Removal of one ovary;Removal of both ovaries;Removal of uterus but not both ovaries;Other, specify;Don't know | Removal of uterus and both ovaries;Removal of one ovary;Removal of both ovaries;Removal of uterus but not both ovaries;Other, specify;Don't know | Alphanumeric |
Answered only if current menstrual status is "Periods stopped by surgery or surgical menopause" |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C16637 | Risk Factor Questionnaire (RFQ) - female health history-age year surgery stop menstrual value | RFQFemHlthHxAgYrSxStpMenopsVal | The age (or year) of the participant/subject in relation to current menstrual status as part of the risk factor questionnaire female health history. | The age (or year) of the participant/subject in relation to current menstrual status as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | Age or Year | Numeric Values |
Answer for year OR age, not both. Answer only if current menstrual status is "Other specify". |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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C16638 | Risk Factor Questionnaire (RFQ) - female health history-no menopause indicator | RFQFemHlthHxNoMenopsInd | If the participant/subject has not experienced menopause, check the box on the CRF as part of the risk factor questionnaire female health history. | If the participant/subject has not experienced menopause, check the box on the CRF as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | If you have not experienced menopause, check this box | Alphanumeric |
End questionnaire |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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C16639 | Risk Factor Questionnaire (RFQ) - female health history-hormone replacement therapy use six month indicator | RFQFemHlthHxHRTUse6MnthInd | Participant/subject used hormone replacement therapy during or after menopause for a period of at least 6 months as part of the risk factor questionnaire female health history. | Participant/subject used hormone replacement therapy during or after menopause for a period of at least 6 months as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | Have you ever used hormone replacement therapy during or after menopause for a period of at least 6 months? | Yes;No;Don't know | Yes;No;Don't know | Alphanumeric |
Hormone replacement therapy includes pills, injections, vaginal creams, skin patches, and suppositories. |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C16629 | Risk Factor Questionnaire (RFQ) - female health history-ever pregnant indicator | RFQFemHlthHxEverPregInd | Has the participant/subject ever been pregnant as part of the risk factor questionnaire female health history. | Has the participant/subject ever been pregnant as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | Have you ever been pregnant? | Yes;No;Don't know | Yes;No;Don't know | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Exploratory | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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C16640 | Risk Factor Questionnaire (RFQ) - female health history-hormone replacement therapy start age year value | RFQFemHlthHxHRTStartAgeYrVal | Age or year participant/subject started taking hormone replacement therapy as part of the risk factor questionnaire female health history. | Age (or year) participant/subject started taking hormone replacement therapy as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | If Yes, at what age did you start taking hormone replacement therapy? | Numeric Values |
Age oe YeaR |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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C16630 | Risk Factor Questionnaire (RFQ) - female health history-pregnancy number | RFQFemHlthHxPregNum | If yes, how many pregnancies as part of the risk factor questionnaire female health history. | If yes, how many pregnancies as part of the Risk Factor Questionnaire (RFQ) - Female Health History. | If Yes, how many pregnancies have you had? | Numeric Values |
pregancies |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-14 19:48:50.273 | Risk Factor Questionnaire (RFQ) - Female Health History | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |