of0
 
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: Epilepsy
Sub-Domain: Quality of Life
CRF: Healthy Days Core Module (CDC HRQOL-4)
Item count: 4 (4 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
C13201
Healthy Days Core Module (CDC HRQOL) - general health scale
CDCHRQOLGenHlthScale
The scale related to general health as part of the Healthy Days Core Module (CDC HRQOL).
Would you say that in general your health is
1;2;3;4;5;7;9;
Excellent;Very good;Good;Fair;Poor;Don't Know/Not Sure;Refused;
Numeric Values
Instruction to test adminstrator - Please read these possible responses to participant: "Excellent, Very Good, Good, Fair, or Poor" Do not read these responses to participant: "Don't know/not sure or Refused"
Ronen GM, Ronen, DL, Streiner, PR, & the Canadian Pediatric Epilepsy Network. Health-related Quality of Life in Children with Epilepsy: Development and Validation of Self-report and Parent Proxy Measures. Epilepsia. 2003; 44: 598-612.
Adult
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Healthy Days Core Module (CDC HRQOL-4)
Quality of Life
Outcomes and End Points
CDC HRQOL - 4 Q1
 
Single Pre-Defined Value Selected
       
C13202
Healthy Days Core Module (CDC HRQOL) - poor physical health days last 30 days count
CDCHRQOLPoorPhysHlthDLst30DCt
The Healthy Days Core Module (CDC HRQOL) assessment addressing the number of days of poor physical health during the past 30 days.
For how many days during the past 30 days was your general health not good?
  
Numeric Values
Record the number of days using two digits
Ronen GM, Ronen, DL, Streiner, PR, & the Canadian Pediatric Epilepsy Network. Health-related Quality of Life in Children with Epilepsy: Development and Validation of Self-report and Parent Proxy Measures. Epilepsia. 2003; 44: 598-612.
Adult
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Healthy Days Core Module (CDC HRQOL-4)
Quality of Life
Outcomes and End Points
CDC HRQOL - 4 Q2
 
Free-Form Entry
0
30
day
    
C13203
Healthy Days Core Module (CDC HRQOL) - poor mental health days last 30 days count
CDCHRQOLPoorMntlHlthDLst30DCt
The Healthy Days Core Module (CDC HRQOL) assessment addressing the number of days of poor mental health, including stress, depression, and problems with emotions, during the past 30 days.
Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30;88;77;99;
0;1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30;88;77;99;
Numeric Values
Record the number of days using two digits. If Q2 and Q3 = "None" (88), then skip Q4 and end questionnaire
Ronen GM, Ronen, DL, Streiner, PR, & the Canadian Pediatric Epilepsy Network. Health-related Quality of Life in Children with Epilepsy: Development and Validation of Self-report and Parent Proxy Measures. Epilepsia. 2003; 44: 598-612.
Adult
Supplemental
3.0
7/16/2013
Aliases for variable name not defined
Healthy Days Core Module (CDC HRQOL-4)
Quality of Life
Outcomes and End Points
CDC HRQOL - 4 Q3
 
Single Pre-Defined Value Selected
       
C13204
Healthy Days Core Module (CDC HRQOL) - mental physical health prevents activity days last 30 days count
CDCHRQOLMntlPhyHltPrvActDLtDCt
The Healthy Days Core Module (CDC HRQOL) assessment addressing the number of days of poor mental health that prevented usual activities, such as self-care, work, or recreation, during the past 30 days.
   
Numeric Values
Record the number of days using two digits
Ronen GM, Ronen, DL, Streiner, PR, & the Canadian Pediatric Epilepsy Network. Health-related Quality of Life in Children with Epilepsy: Development and Validation of Self-report and Parent Proxy Measures. Epilepsia. 2003; 44: 598-612.
Adult
Supplemental
3.0
8/28/2013
Aliases for variable name not defined
Healthy Days Core Module (CDC HRQOL-4)
Quality of Life
Outcomes and End Points
CDC HRQOL - 4 Q4
 
Free-Form Entry
0
30
day
    
07-24-2017
Page 1 of 1