CDE Detailed Report

Disease: system
Subdomain Name: General Health History
CRF: files

Displaying 51 - 63 of 63
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
C58252 Industrial plant live within 300 meter indicator IndustPlntLivWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of an industrial plant Indicator of whether the subject/participant currently lives within 300 meters of an industrial plant Industrial plant(s): 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 10:17:46.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58308 Pesticide pet type PesticidePetTyp The type of pesticide used on the subject/participant's pets (as sprays, collars, powders, etc.) The type of pesticide used on the subject/participant's pets (as sprays, collars, powders, etc.) Please specify type: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:41:02.0 Exposure History General Health History Participant History and Family History 128

Free-Form Entry

C58266 Cell tower ever live within 300 meter year range CellTwrEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of a cell tower Range of years during which the subject/participant lived within 300 meters of a cell tower Cellphone towers: Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 10:32:10.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58280 Residence current age value RsdncCrrntAgeVal Value for the age of the subject/participant's current residence Value for the age of the subject/participant's current residence How old is it? Numeric Values Adult;Pediatric Exploratory 1.00 2018-02-07 10:51:04.0 Exposure History General Health History Participant History and Family History

Free-Form Entry

Years
C58221 Heavy traffic live within 300 meter type HvyTrfcLvWin300MTyp Type of heavy traffic that the subject/participant within 300 meters of which the subject/participant lives now or has lived Type of heavy traffic that the subject/participant within 300 meters of which the subject/participant lives now or has lived Heavy traffic (please specify) Busy street;Highway Busy street;Highway Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-06 16:13:02.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58295 Residential vacuum equipment type ResidentialVacuumEquipTyp Type of vacuum equipment (if any) used in the subject/participant's residence Type of vacuum equipment (if any) used in the subject/participant's residence Do you use: Central vacuum;HEPA filter vacuum;Other, specify Central vacuum;HEPA filter vacuum;Other, specify Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:24:17.0 Exposure History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58253 Industrial plant ever live within 300 meter year range IndustPlntEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of an industrial plant Range of years during which the subject/participant lived within 300 meters of an industrial plant Industrial plant(s) Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 10:18:56.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58309 Pesticide pet use frequency text PestcidUsPetFrqTxt Text field for specifying the frequency with which pesticides are used on the subject/participant's pets (as sprays, collars, powders, etc.) Text field for specifying the frequency with which pesticides are used on the subject/participant's pets (as sprays, collars, powders, etc.) Please specify how often: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:42:06.0 Exposure History General Health History Participant History and Family History 32

Free-Form Entry

C58267 Windmill live within 300 meter indicator WndmllLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of a windmill Indicator of whether the subject/participant currently lives within 300 meters of a windmill Windmills 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 10:33:05.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58281 Apartment residence location ApartmentResidenceLoc Location of apartment residence in the building Location of apartment residence in the building If apartment: Above store;Basement Above store;Basement Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:58:10.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58242 Vehicle idle area live within 300 meter indicator VehIdlAreaLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of a vehicle idling area Indicator of whether the subject/participant currently lives within 300 meters of a vehicle idling area Vehicle idling area: 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 09:51:36.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58296 Residential vacuum equipment other text RsdntlVcuumEquipOthTxt The free-text field related to 'Residential vacuum equipment type' specifying other text The free-text field related to 'Residential vacuum equipment type' specifying other text Other, specify: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:27:12.0 Exposure History General Health History Participant History and Family History 64

Free-Form Entry

C58254 Industrial plant live within 300 meter type IndustPlntLivWin300MTyp Type of industrial plant that the subject/participant within 300 meters of which the subject/participant lives now or has lived Type of industrial plant that the subject/participant within 300 meters of which the subject/participant lives now or has lived Industrial plant(s) (please specify type): Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:19:49.0 Exposure History General Health History Participant History and Family History 32

Free-Form Entry

CSV