CDE Detailed Report

Disease: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Sub-Domain: General Health History
CRF: Exposure History

Displaying 51 - 63 of 63
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (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
C58274 Insect borne pathogen endemic area ever live within 300 meter year range InsBrnPthEndArEvLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) Range of years during which the subject/participant lived within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) Area where Lyme Disease, Zika virus or other insect borne pathogens are endemic Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 10:39:32.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58248 Pesticide spray area live within 300 meter indicator PstcdSpryAreaLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of a pesticide spray area (e.g., farm, orchard, golf course) Indicator of whether the subject/participant currently lives within 300 meters of a pesticide spray area (e.g., farm, orchard, golf course) Areas sprayed with pesticides, e.g., farms, orchards, golf course: No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-07 10:12:31.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58291 Residence test radon indicator ResidenceTestRadonInd Indicator of whether the subject/participant's residence has been tested for radon Indicator of whether the subject/participant's residence has been tested for radon Has your home or apartment building been tested for radon? No;Yes No;Yes Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:13:19.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58305 Pesticide residence type PesticideResidenceTyp Type(s) of pesticide(s) used in the subject/participant's residence Type(s) of pesticide(s) used in the subject/participant's residence Please specify type: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:36:46.0 Exposure History General Health History Participant History and Family History 128

Free-Form Entry

C58261 Electrical tower live within 300 meter indicator ElectrcTwrLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of an electrical tower Indicator of whether the subject/participant currently lives within 300 meters of an electrical tower Electricity towers: No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-07 10:25:24.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C04814 Residence type ResdncTyp Type of residence where the participant/subject is currently living Type of residence where the participant/subject is currently living Is your residence: Apartment;House, detached;House, semi-detached;Mobile home Apartment;House, detached;House, semi-detached;Mobile home Alphanumeric Adult;Pediatric Exploratory 3.00 2013-07-20 10:21:25.65 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58276 Sun exposure excess protect self frequency category SunExpExcssPrtctSlfFrqCat Category for the frequency with which the subject/participant protects him/herself from excess sun exposure Category for the frequency with which the subject/participant protects him/herself from excess sun exposure Do you protect yourself from excess sun exposure? Rarely;Occasionally;Often;Always Rarely;Occasionally;Often;Always Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:42:07.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58249 Pesticide spray area ever live within 300 meter year range PstcdSpryAreaEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of a pesticide spray area (e.g., farm, orchard, golf course) Range of years during which the subject/participant lived within 300 meters of a pesticide spray area (e.g., farm, orchard, golf course) Areas sprayed with pesticides, e.g., farms, orchards, golf course: Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 10:14:55.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58292 Residence renovation indicator ResidenceRenovationInd Indicator of whether any renovation has been done to the subject/participant's residence Indicator of whether any renovation has been done to the subject/participant's residence Have any renovations been done? No;Yes No;Yes Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:14:20.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58306 Pesticide residence use frequency text PestcidRsdncUsFrqTxt Text specifying the frequency with which pesticide is used in the subject/participant's residence Text specifying the frequency with which pesticide is used in the subject/participant's residence Please specify how often: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:37:54.0 Exposure History General Health History Participant History and Family History 32

Free-Form Entry

C58263 Electrical tower ever live within 300 meter year range ElectrcTwrEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of an electrical tower Range of years during which the subject/participant lived within 300 meters of an electrical tower Electricity towers: Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 10:26:45.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58219 Heavy traffic live within 300 meter indicator HvyTrfcLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of heavy traffic Indicator of whether the subject/participant currently lives within 300 meters of heavy traffic Heavy traffic: No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-06 16:07:48.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58277 Tanning bed use indicator TanningBedUseInd Indicator of whether the subject/participant uses tanning beds Indicator of whether the subject/participant uses tanning beds Do you use a tanning bed? No;Yes No;Yes Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:45:16.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

CSV