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CDE Detailed Report
This report contains detailed information about the selected CDEs.
Note: If at least one CDE was selected from a copyright- or trademark-protected instrument/scale then all of the CDEs from that instrument/scale are included in this report.
Disease: Cerebral Palsy
Sub-Domain: Epidemiology/Environmental History
CRF: Risk Factor Questionnaire (RFQ) - Residential History
Item count: 10 (10 distinct CDEs)
CDE ID
CDE Name
Variable Name
Definition / Description
Question Text
Permissible Value
Description
Data Type
Instructions
References
Population
Classification (e.g., Core)
Version #
Version Date
Aliases for Variable Name
CRF Module / Guideline
© or TM
Sub-Domain
Domain
Previous Title
Size
Input Restrictions
Min Value
Max Value
Measurement Type
LOINC ID
SNOMED
caDSR ID
CDISC ID
C22790
Risk Factor Questionnaire (RFQ) – residential history age 0-17 residence duration
RFQResHxAge017ResDur
Duration at residence lived from birth through age 17.
Duration of Residence
  
Alphanumeric
No instructions available
No references available
Pediatric
Supplemental
1.0
10/28/2016
Aliases for variable name not defined
Risk Factor Questionnaire (RFQ) - Residential History
Epidemiology/Environmental History
Participant History and Family History
 
255
Free-Form Entry
       
C08662
Risk Factor Questionnaire (RFQ) - residential history age 0 17 first residence city text
RFQResHxAg0171stResdnceCityTxt
Text specifying the participant's/subject's first city or town of residence
City/Town
  
Alphanumeric
No instructions available
No references available
Pediatric
Supplemental
3.0
7/18/2013
RsA1City
Risk Factor Questionnaire (RFQ) - Residential History
Epidemiology/Environmental History
Participant History and Family History
RFQ Residential History (Birth - Age 17) City/Town
255
Free-Form Entry
       
C08663
Risk Factor Questionnaire (RFQ) - residential history age 0 17 first residence state text
RFQResHxAge0171stRsdncStateTxt
Text specifying the participant's/subject's first state of residence
State
  
Alphanumeric
No instructions available
No references available
Pediatric
Supplemental
3.0
7/18/2013
RsA1State
Risk Factor Questionnaire (RFQ) - Residential History
Epidemiology/Environmental History
Participant History and Family History
RFQ Residential History (Birth - Age 17) State
255
Free-Form Entry
       
C08664
Risk Factor Questionnaire (RFQ) - residential history age 0 17 first residence zip code number
RFQResHxAge0171stRsdncZpCdNum
Number specifying the participant's/subject's first zip code of residence
Zip Code
  
Numeric Values
No instructions available
No references available
Pediatric
Supplemental
3.0
7/18/2013
RsA1Zip
Risk Factor Questionnaire (RFQ) - Residential History
Epidemiology/Environmental History
Participant History and Family History
RFQ Residential History (Birth - Age 17) Zip code
 
Free-Form Entry
       
C08665
Risk Factor Questionnaire (RFQ) - birth age 17 residential history first residence country text
RFQBrthAg17ResHxFstResCntryTxt
Text specifying the participant's/subject's first country of residence
Country
  
Alphanumeric
No instructions available
No references available
Pediatric
Supplemental
3.0
7/18/2013
RsA1Country
Risk Factor Questionnaire (RFQ) - Residential History
Epidemiology/Environmental History
Participant History and Family History
RFQ Residential History (Birth - Age 17) Country
255
Free-Form Entry
       
C08666
Risk Factor Questionnaire (RFQ) - birth age 17 residential history first residence location type
RFQBrthAg17ResHxFstResLocTyp
Type describing the participant's/subject's first location of residence
At the time you lived there, was the residence located in a
Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Large town (25,000-99,999 people);Rural, farm;
Large City (>250,000 people);Midsized city (100,000-250,000 people);Small town (2,500-24,999 people);Rural, non-farm;Suburb of a large city;Large town (25,000-99,999 people);Rural, farm;
Alphanumeric
Choose one.
No references available
Pediatric
Supplemental
3.0
7/18/2013
RsA2
Risk Factor Questionnaire (RFQ) - Residential History
Epidemiology/Environmental History
Participant History and Family History
RFQ Residential History (Birth - Age 17) Q1
 
Single Pre-Defined Value Selected
       
C08667
Risk Factor Questionnaire (RFQ) - birth age 17 residential history first residence well water indicator
RFQBrthAg17ResHxFstResWlWtrInd
Indicator as to whether the participant's/subject's source of drinking water was a private well at the first residence
Was your main source of drinking water at this residence a private well?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Pediatric
Supplemental
3.0
7/18/2013
RsA3
Risk Factor Questionnaire (RFQ) - Residential History
Epidemiology/Environmental History
Participant History and Family History
RFQ Residential History (Birth - Age 17) Q2
 
Single Pre-Defined Value Selected
       
C08668
Risk Factor Questionnaire (RFQ) - birth age 17 residential history first residence near farm fields indicator
RFQBrthAg17ResHxFstRsNrFmFdInd
Indicator as to whether the participant's/subject's first residence was located near farm fields (within 1/4mile)
Was this residence located near farm fields (within 1/4 mile)?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Pediatric
Supplemental
3.0
7/18/2013
RsA4
Risk Factor Questionnaire (RFQ) - Residential History
Epidemiology/Environmental History
Participant History and Family History
RFQ Residential History (Birth - Age 17) Q3
 
Single Pre-Defined Value Selected
       
C08669
Risk Factor Questionnaire (RFQ) - birth age 17 residential history first residence pesticide use indicator
RFQBrthAg17ResHxFstRsPstUseInd
Indicator as to whether the participant's/subject's first residence was located near pesticide spraying activities during the span of residence
Was there pesticide spraying at or around this residence when you lived there?
Yes;No;
Yes;No;
Alphanumeric
No instructions available
No references available
Pediatric
Supplemental
3.0
7/18/2013
RsA5
Risk Factor Questionnaire (RFQ) - Residential History
Epidemiology/Environmental History
Participant History and Family History
RFQ Residential History (Birth - Age 17) Q4
 
Single Pre-Defined Value Selected
       
C08670
Risk Factor Questionnaire (RFQ) - birth age 17 residential history first residence pesticide use frequency
RFQBrthAg17ResHxFstRsPstUsFreq
Frequency of pesticide spraying near the participant's/subject's first residence during the span of residence
How often did the spraying happen?
<1 time per year;1-3 times per year;4-10 times per year;>10 times per year;Don't know;
<1 time per year;1-3 times per year;4-10 times per year;>10 times per year;Don't know;
Alphanumeric
Choose one.
No references available
Pediatric
Supplemental
3.0
7/18/2013
RsA5a
Risk Factor Questionnaire (RFQ) - Residential History
Epidemiology/Environmental History
Participant History and Family History
RFQ Residential History (Birth - Age 17) Q5
 
Single Pre-Defined Value Selected
       
07-21-2019
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