CDE Detailed Report

Disease: Huntington's Disease
Sub-Domain: Epidemiology/Environmental History
CRF: PD DOC Mini Environmental Risk Questionnaire for Parkinson's Disease Patients Baseline (PD DOC MERQ-PD-B)

Displaying 51 - 54 of 54
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
C10264 Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) - ovary removal preparkinson's disease indicator PDDOCMERQOvryRemovlPrePDInd Indicator for whether the participant/subject has ever had one or both ovaries surgically removed before he or she was diagnosed with Parkinson's Disease, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Indicator for whether the participant/subject has ever had one or both ovaries surgically removed before he or she was diagnosed with Parkinson's Disease, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Before you were diagnosed with PD, did you ever have one or both ovaries surgically removed? (0=No, 1=Yes, 9=Uncertain) 0;1;9;N No;Yes;Uncertain;Male Alphanumeric

No instructions available

Copyright © 2005 PD-DOC and the NIEHS/Parkinson Institute Working Group on Environmental Risk Questionnaires. This questionnaire was supported by PD-DOC grant (U01NS050095). Adult Supplemental 3.00 2013-07-22 09:34:41.527 PD DOC Mini Environmental Risk Questionnaire for Parkinson's Disease Patients Baseline (PD DOC MERQ-PD-B) Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C10232 Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) - age twenty one forty zip code PDDOCMERQAge2140ZipCode Zip code for the location that the participant/subject spent the majority of his or her time from 21-40 years, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Zip code for the location that the participant/subject spent the majority of his or her time from 21-40 years, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Zip code/Postal Code Alphanumeric

What was your place of residence for the majority of the time in each of the following time periods? (if unknown, enter N)

Copyright © 2005 PD-DOC and the NIEHS/Parkinson Institute Working Group on Environmental Risk Questionnaires. This questionnaire was supported by PD-DOC grant (U01NS050095). Adult Supplemental 3.00 2013-07-22 09:34:41.527 PD DOC Mini Environmental Risk Questionnaire for Parkinson's Disease Patients Baseline (PD DOC MERQ-PD-B) Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C10243 Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) - parkinson diagnosis year date PDDOCMERQPrknsnDiagYrDate Date of the year when the participant/subject was diagnosed with Parkinson's Disease, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Date of the year when the participant/subject was diagnosed with Parkinson's Disease, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) If you have been diagnosed with Parkinson's disease, in what year were you diagnosed? Date or Date & Time

Year should be recorded as YYYY.

Copyright © 2005 PD-DOC and the NIEHS/Parkinson Institute Working Group on Environmental Risk Questionnaires. This questionnaire was supported by PD-DOC grant (U01NS050095). Adult Supplemental 3.00 2013-07-22 09:34:41.527 PD DOC Mini Environmental Risk Questionnaire for Parkinson's Disease Patients Baseline (PD DOC MERQ-PD-B) Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C18055 Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) - specify other chemical fume text PDDOCMERQSpecifyOthrChemFumTxt Text specifying the other chemicals or fumes that the participant/subject has worked with for more than 6 months Text specifying the other chemicals or fumes that the participant/subject has worked with for more than 6 months Specify Alphanumeric Copyright © 2005 PD-DOC and the NIEHS/Parkinson Institute Working Group on Environmental Risk Questionnaires. This questionnaire was supported by PD-DOC grant (U01NS050095). Adult Supplemental 3.00 2013-07-20 10:46:24.96 PD DOC Mini Environmental Risk Questionnaire for Parkinson's Disease Patients Baseline (PD DOC MERQ-PD-B) Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

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