CDE Detailed Report

Disease: Cerebral Palsy
Subdomain Name: Epidemiology%2FEnvironmental History
CRF: Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep

Displaying 1 - 11 of 11
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 / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C22781 Risk Factor Questionnaire (RFQ) - ages 2-5 vigorous physical activity indicator RFQAge25VigrsPhysActInd Hours spent doing vigorous physical activities by the subject in an average week between the ages of 2 and 5, as part of the Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Hours spent doing vigorous physical activities by the subject in an average week between the ages of 2 and 5, as part of the Risk Factor Questionnaire (RFQ) - Physical Activity and Slee In a typical week, how many hours of vigorous physical activity did you engage in? Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Alphanumeric

Choose one.

Pediatric Supplemental 1.00 2016-10-27 15:22:07.0 Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Epidemiology%2FEnvironmental History Participant History and Family History

Single Pre-Defined Value Selected

C22782 Risk Factor Questionnaire (RFQ) - age 2-5 moderate physical activity indicator RFQAge25ModrtPhysActInd Hours spent doing moderate physical activities by the subject in an average week between the ages of 2 and 5, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Sleep Hours spent doing moderate physical activities by the subject in an average week between the ages of 2 and 5, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Slee In a typical week, how many hours of moderate physical activity did you engage in? Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Alphanumeric

Choose one.

Pediatric Supplemental 1.00 2016-10-27 15:34:22.0 Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Epidemiology%2FEnvironmental History Participant History and Family History

Single Pre-Defined Value Selected

C22783 Risk Factor Questionnaire (RFQ) - age 2-5 sleep duration indicator RFQAge25SlpDurInd Hours of sleep the subject got in a week between the ages of 2 and 5, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Sleep Hours of sleep the subject got in a week between the ages of 2 and 5, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Slee In a typical week, how many hours of sleep did you get on an average night? Less than 5 hours;5-6 hours;6-7 hours;7-8 hours;More than 8 hours per week;Not applicable Less than 5 hours;5-6 hours;6-7 hours;7-8 hours;More than 8 hours per week;Not applicable Alphanumeric

Choose one.

Pediatric Supplemental 1.00 2016-10-27 15:40:12.0 Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Epidemiology%2FEnvironmental History Participant History and Family History

Single Pre-Defined Value Selected

C22784 Risk Factor Questionnaire (RFQ) - age 6-11 vigorous physical activity indicator RFQAge611VigrsPhysActInd Hours spent doing vigorous physical activities by the subject in an average week between the ages of 6 and 11, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Sleep Hours spent doing vigorous physical activities by the subject in an average week between the ages of 6 and 11, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Slee In a typical week, how many hours of vigorous physical activity did you engage in? Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Alphanumeric

Choose one.

Pediatric Supplemental 1.00 2016-10-27 15:48:27.0 Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Epidemiology%2FEnvironmental History Participant History and Family History

Single Pre-Defined Value Selected

C22785 Risk Factor Questionnaire (RFQ) - age 6-11 moderate physical activity indicator RFQAge611ModrtPhysActInd Hours spent doing moderate physical activities by the subject in an average week between the ages of 6 and 11, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Sleep Hours spent doing moderate physical activities by the subject in an average week between the ages of 6 and 11, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Slee In a typical week, how many hours of moderate physical activity did you engage in? Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Alphanumeric

Choose one.

Pediatric Supplemental 1.00 2016-10-28 10:39:49.0 Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Epidemiology%2FEnvironmental History Participant History and Family History

Single Pre-Defined Value Selected

C22786 Risk Factor Questionnaire (RFQ) - age 6-11 sleep duration indicator RFQAge611SlpDurInd Hours of sleep the subject got in a week between the ages of 6 and 11, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Sleep Hours of sleep the subject got in a week between the ages of 6 and 11, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Slee In a typical week, how many hours of sleep did you get on an average night? Less than 5 hours;5-6 hours;6-7 hours;7-8 hours;More than 8 hours per week;Not applicable Less than 5 hours;5-6 hours;6-7 hours;7-8 hours;More than 8 hours per week;Not applicable Alphanumeric

Choose one.

Pediatric Supplemental 1.00 2016-10-28 10:46:35.0 Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Epidemiology%2FEnvironmental History Participant History and Family History

Single Pre-Defined Value Selected

C22787 Risk Factor Questionnaire (RFQ) - age 12-17 vigorous physical activity indicator RFQAge1217VigrsPhysActInd Hours spent doing vigorous physical activities by the subject in an average week between the ages of 12 and 17, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Sleep Hours spent doing vigorous physical activities by the subject in an average week between the ages of 12 and 17, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Slee In a typical week, how many hours of vigorous physical activity did you engage in? Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Alphanumeric

Choose one.

Pediatric Supplemental 1.00 2016-10-28 10:51:25.0 Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Epidemiology%2FEnvironmental History Participant History and Family History

Single Pre-Defined Value Selected

C22788 Risk Factor Questionnaire (RFQ) - age 12-17 moderate physical activity indicator RFQAge1217ModrtPhysActInd Hours spent doing moderate physical activities by the subject in an average week between the ages of 12 and 17, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Sleep Hours spent doing moderate physical activities by the subject in an average week between the ages of 12 and 17, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Slee In a typical week, how many hours of moderate physical activity did you engage in? Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Less than 1 hour;1-4 hours;5-10 hours;More than 10 hours per week;Not applicable Alphanumeric

Choose one.

Pediatric Supplemental 1.00 2016-10-28 10:55:06.0 Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Epidemiology%2FEnvironmental History Participant History and Family History

Single Pre-Defined Value Selected

C22789 Risk Factor Questionnaire (RFQ) - age 12-17 sleep duration indicator RFQAge1217SlpDurInd Hours of sleep the subject got in a week between the ages of 12 and 17, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Sleep Hours of sleep the subject got in a week between the ages of 12 and 17, as part of the Risk Factor Questionnaire (RFQ)- Physical Activity and Slee In a typical week, how many hours of sleep did you get on an average night? Less than 5 hours;5-6 hours;6-7 hours;7-8 hours;More than 8 hours per week;Not applicable Less than 5 hours;5-6 hours;6-7 hours;7-8 hours;More than 8 hours per week;Not applicable Alphanumeric

Choose one.

Pediatric Supplemental 1.00 2016-10-28 10:59:14.0 Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Epidemiology%2FEnvironmental History Participant History and Family History

Single Pre-Defined Value Selected

C17402 Site name SiteName The name of the site for the study The name of the site for the study Site Name Alphanumeric Adult;Pediatric Core 3.00 2013-06-21 00:00:00.0 Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Epidemiology%2FEnvironmental History Participant History and Family History 255

Free-Form Entry

C19247 Subject ID SubIDNam Subject identification ID Subject identification ID Subject ID Alphanumeric Adult;Pediatric Core 1.00 2014-06-05 13:10:49.0 Risk Factor Questionnaire (RFQ) - Physical Activity and Sleep Epidemiology%2FEnvironmental History Participant History and Family History 255

Free-Form Entry

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