CDE Detailed Report

Disease: content
Sub-Domain: Epidemiology/Environmental History
CRF: welcome

Displaying 1 - 7 of 7
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
C00716 Drug or substance illicit use duration DrgSubsIllctUseDur Duration, in years, the participant/subject has used unprescribed, controlled psychoactive drugs or substances. Duration, in years, the participant/subject has used unprescribed, controlled psychoactive drugs or substances. Total Years Used Numeric Values No references available Adult;Pediatric Supplemental 3.00 2013-07-22 09:34:41.527 Non-prescribed Drug Use Questionnaire Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

0 99 Year 2004152
C08232 Drug or substance illicit use ever indicator DrgSubIllicitEverUseInd Indicator of participant's/subject's use of illegal drugs, prescription or over-the-counter drugs at any point in his/her lifetime for purposes other than those for which they are meant to be used, or in large amounts Indicator of participant's/subject's use of an unprescribed, controlled psychoactive drugs or substances used by the participant/subject. at any point in his/her lifetime Ever Used? Yes;No;Unknown Yes;No;Unknown Alphanumeric No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Non-prescribed Drug Use Questionnaire Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08233 Drug or substance first illicit use date and time DrgSubFirstIllicitUseDateTime Date (and time if applicable and known) the participant/subject first used the category of illegal drugs, prescription or over-the-counter drugs Date of the participant's/subject's first use of an unprescribed, controlled psychoactive drugs or substances used by the participant/subject. Year First Used Date or Date & Time No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Non-prescribed Drug Use Questionnaire Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08234 Drug or substance last illicit use date and time DrgSubLastIllicitUseDateTime Date (and time if applicable and known) of the participant's/subject's last use of an unprescribed, controlled psychoactive drugs or substances used by the participant/subject. Date (and time if applicable and known) of the participant's/subject's last use of an unprescribed, controlled psychoactive drugs or substances used by the participant/subject. Year Last Used Date or Date & Time No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Non-prescribed Drug Use Questionnaire Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08235 Drug or substance illicit use frequency DrgSubIllicitUseFreq The subject's/participant's average or typical use frequency during the year of greatest use of an unprescribed, controlled psychoactive drugs or substances used by the participant/subject. The subject's/participant's average or typical use frequency during the year of greatest use of an unprescribed, controlled psychoactive drugs or substances used by the participant/subject. Frequency of Use Alphanumeric No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Non-prescribed Drug Use Questionnaire Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C18670 Subscribed drug or substance illicitly used other text SbscrbdDrgSubIllctUseOTH The free-text field related to 'Drug or substance illicitly used category' specifying other text. Category of illegal drugs, prescription, or over-the-counter drugs the participant/subject used for purposes other than those for which they are meant to be used, or in large amounts Drug or substance illicitly used category' specifying other text. Category of illegal drugs, prescription, or over-the-counter drugs the participant/subject used for purposes other than those for which they are meant to be used, or in large amounts Other, specify Alphanumeric No references available Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Non-prescribed Drug Use Questionnaire Epidemiology/Environmental History Participant History and Family History 4000

Free-Form Entry

3171797
C00712 Subscribed drug or substance illicitly used category SbscrbdDrgSubIllctUseCat Category of illegal drugs, prescription, or over-the-counter drugs subscribed by the participant/subject, and used for purposes other than those for which they are meant to be used, or in large amounts Category of illegal drugs, prescription, or over-the-counter drugs subscribed by the participant/subject, and used for purposes other than those for which they are meant to be used, or in large amounts If YES, specify illicit drug type(s) used Sedatives (e.g., sleeping pills, barbiturates, Seconal, Quaaludes, or Chloral Hydrate);Tranquilizers or anti-anxiety drugs (e.g., Valium, Librium, muscle relaxants, or Zanax);Painkillers (e.g., Codeine, Darvon, Percodan, Dilaudid, or Demerol);Stimulants (e.g., Preludin, Benzedrine, Methadrine, uppers, or speed);Marijuana, hash, THC, or grass;Cocaine or crack;Hallucinogens (e.g., Ecstasy, LSD, mescaline, psilocybin, PCP, angel dust, or peyote);Inhalants or Solvents (e.g., amyl nitrate, nitrous oxide, glue, toluene, or gasoline;Heroin;Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol) Sedatives (e.g., sleeping pills, barbiturates, Seconal, Quaaludes, or Chloral Hydrate);Tranquilizers or anti-anxiety drugs (e.g., Valium, Librium, muscle relaxants, or Zanax);Painkillers (e.g., Codeine, Darvon, Percodan, Dilaudid, or Demerol);Stimulants (e.g., Preludin, Benzedrine, Methadrine, uppers, or speed);Marijuana, hash, THC, or grass;Cocaine or crack;Hallucinogens (e.g., Ecstasy, LSD, mescaline, psilocybin, PCP, angel dust, or peyote);Inhalants or Solvents (e.g., amyl nitrate, nitrous oxide, glue, toluene, or gasoline;Heroin;Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol) Alphanumeric No references available Adult;Pediatric Supplemental 3.00 2013-07-22 09:34:41.527 Non-prescribed Drug Use Questionnaire Epidemiology/Environmental History Participant History and Family History

Multiple Pre-Defined Values Selected

3171797
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