CDE Detailed Report

Disease: system
Subdomain Name: Dysphagia
CRF: files

Displaying 51 - 66 of 66
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
C10277 Quality of Life in Swallowing Disorders (SWAL-QOL) - eating importance indicator SWALQOLEatngImprtncInd Scale assessing how true the following statement has been for the participant during the last month: Most days, I don't care if I eat or not, as part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates how much the subject cares about eating, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) Most days, I don't care if I eat or not. 1;2;3;4;5 Very much true;Quite a bit true;Somewhat true;A little true;Not at all true Numeric Values

Circle one number on each line

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C10309 Quality of Life in Swallowing Disorders (SWAL-QOL) - swallowing problem not go out indicator SWALQOLSwllwngProbNtGoOtInd Scale assessing how true the following statement has been for the participant during the last month: I do not go out to eat because of my swallowing problem. As part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates subject doesn't go out to eat because of swallowing problem, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) I do not go out to eat because of my swallowing problem. 1;2;3;4;5 Strongly agree;Agree;Uncertain;Disagree;Strongly disagree Numeric Values

Circle one number on each line

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C10320 Quality of Life in Swallowing Disorders (SWAL-QOL) - consistency texture food indicator SWALQOLConsstncyTxtrFdInd Category of consistency or texture of the food the participant has been eating most often in the last week. As part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates consistency or texture of the food subject has been eating in the last week, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) Please circle the letter of the one description below that best describes the consistency or texture of the food you have been eating most often in the last week. A;B;C;D;E A;B;C;D;E Alphanumeric

Choose only one

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19499 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C10288 Quality of Life in Swallowing Disorders (SWAL-QOL) - chewing problem indicator SWALQOLChewngProbInd Scale assessing how true the following statement has been for the participant during the last month: Problems Chewing. As part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates how often subject experiences problem with chewing, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) Problems Chewing 1;2;3;4;5 Almost always;Often;Sometimes;Hardly ever;Never Numeric Values

Circle one number on each line

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C18099 Quality of Life in Swallowing Disorders (SWAL-QOL) - birth date SWALQOLBrthDate Date of the subject's birthday, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) Date of the subject's birthday, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) Please write in your date of birth here Date or Date & Time No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-18 09:11:50.26 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Free-Form Entry

C10299 Quality of Life in Swallowing Disorders (SWAL-QOL) - difficult speak clear problem indicator SWALQOLDifcltSpkClrProbInd Scale assessing how true the following statement has been for the participant during the last month: It's been difficult for me to speak clearly. As part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates how often subject feels it's difficult to speak clearly, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) It's been difficult for me to speak clearly. 1;2;3;4;5 All of the time;Most of the time;Some of the time;A little of the time;None of the time Numeric Values

Circle one number on each line

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C10310 Quality of Life in Swallowing Disorders (SWAL-QOL) - swallowing problem hard social life indicator SWALQOLSwllwProbHrdSoclLifInd Scale assessing how true the following statement has been for the participant during the last month: My swallowing problem makes it hard to have a social life. As part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates subject's swallowing problem makes it hard to have a social life, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) My swallowing problem makes it hard to have a social life. 1;2;3;4;5 Strongly agree;Agree;Uncertain;Disagree;Strongly disagree Numeric Values

Circle one number on each line

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C10278 Quality of Life in Swallowing Disorders (SWAL-QOL) - eating longer indicator SWALQOLEatngLngrInd Scale assessing how true the following statement has been for the participant during the last month: It takes me longer to eat than other people, as part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates subject takes how much longer to eat than other people, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) It takes me longer to eat than other people. 1;2;3;4;5 Very much true;Quite a bit true;Somewhat true;A little true;Not at all true Numeric Values

Circle one number on each line

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C10321 Quality of Life in Swallowing Disorders (SWAL-QOL) - consistency liquid indicator SWALQOLConsstncyLiqInd Category of consistency or texture of the liquids participant has been drinking most often in the last week. As part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates consistency of the liquid subject has been drinking in the last week, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) Please circle the letter of the one description below that best describes the consistency of liquids you have been drinking most often in the last week. A;B;C;D;E A;B;C;D;E Alphanumeric

Choose only one

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19500 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C10289 Quality of Life in Swallowing Disorders (SWAL-QOL) - excess saliva phlegm problem indicator SWALQOLExcsSalvPhlgmProbInd Scale assessing how true the following statement has been for the participant during the last month: Having excess saliva or phlegm. As part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates how often subject experiences having excess saliva or phlegm, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) Having excess saliva or phlegm 1;2;3;4;5 Almost always;Often;Sometimes;Hardly ever;Never Numeric Values

Circle one number on each line

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C18100 Quality of Life in Swallowing Disorders (SWAL-QOL) - age value SWALQOLAgVal Age of the subject, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) Age of the subject, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) What is your age today? Numeric Values No references available Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-18 09:11:50.26 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Free-Form Entry

C10300 Quality of Life in Swallowing Disorders (SWAL-QOL) - fear choke food problem indicator SWALQOLFrChokFdProbInd Scale assessing how true the following statement has been for the participant during the last month: I fear I may start choking when I eat food. As part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates how often subject feels fear of choking on food again, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) I fear I amy start choking when I eat food. 1;2;3;4;5 Almost always;Often;Sometimes;Hardly ever;Never Numeric Values

Circle one number on each line

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C10311 Quality of Life in Swallowing Disorders (SWAL-QOL) - swallowing problem changed activities indicator SWALQOLSwllwngProbChngdActInd Scale assessing how true the following statement has been for the participant during the last month: My usual work or leisure activities have changed because of my swallowing problem. As part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates subject's work or leisure activities have changed because of swallowing problem, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) My usual work or leisure activities have changed because of my swallowing problem. 1;2;3;4;5 Strongly agree;Agree;Uncertain;Disagree;Strongly disagree Numeric Values

Circle one number on each line

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C10279 Quality of Life in Swallowing Disorders (SWAL-QOL) - rare realization hunger indicator SWALQOLRarRealztnHugrInd Scale assessing how true the following statement has been for the participant during the last month: I'm rarely hungry anymore, as part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates how rarely subject feels hungry, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) I'm rarely hungry anymore. 1;2;3;4;5 Very much true;Quite a bit true;Somewhat true;A little true;Not at all true Numeric Values

Circle one number on each line

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C10322 Quality of Life in Swallowing Disorders (SWAL-QOL) - general health indicator SWALQOLGenrlHlthInd Scale assessing the general health of the participant. As part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates the subject's general health condition, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) In general, would you say your health is 1;2;3;4;5 Poor;Fair;Good;Very Good;Excellent Numeric Values

Circle one

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

C10290 Quality of Life in Swallowing Disorders (SWAL-QOL) - clear throat problem indicator SWALQOLClrThrtProbInd Scale assessing how true the following statement has been for the participant during the last month: Having to clear your throat. As part of Quality of Life in Swallowing Disorders (SWAL-QOL) Indicates how often subject experiences having to clear throat, as part of the Quality of Life in Swallowing Disorders (SWAL-QOL) Having to clear your throat 1;2;3;4;5 Almost always;Often;Sometimes;Hardly ever;Never Numeric Values

Circle one number on each line

Colleen A. McHorney, PhD, US Outcomes Research, Merck & Co., Inc., 351 North Sumneytown Pike, UG2MW-05, North Wales, PA 19454 Adult NeuroRehab Supplemental-Highly Recommended 3.00 2013-07-22 16:57:17.79 Quality of Life in Swallowing Disorders (SWAL-QOL) Dysphagia Outcomes and End Points

Single Pre-Defined Value Selected

CSV