CDE Detailed Report

Disease: Parkinson'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
C10258 Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) - current smoke status PDDOCMERQCrrntSmkStatus Status for whether the participant/subject smokes regularly now, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Status for whether the participant/subject smokes regularly now, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Do you smoke cigarettes regularly now?(0=No, 1=Yes, 9=Uncertain) 0;1;9 No;Yes;Uncertain Numeric Values

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

C10226 Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) - age eleven twenty city location PDDOCMERQAge1120CtyLoc Location of the city that the participant/subject spent the majority of his or her time from 11-20 years, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Location of the city that the participant/subject spent the majority of his or her time from 11-20 years, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) City 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

C10269 Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) - average dose number PDDOCMERQAvgDoseNum Number of doses measured in number of tablets per week, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Number of doses measured in number of tablets per week, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Average dose measured in number of tablets per week Numeric Values

Answer for each medication category (Q9a, Q9.1a, Q9.2a, Q9.3a, Q9.4a, Q9.5a)

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

C10237 Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) - age forty one sixty country location PDDOCMERQAge4160CntryLoc Location of the country that the participant/subject spent the majority of his or her time from 41-60 years, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Location of the country that the participant/subject spent the majority of his or her time from 41-60 years, as a part of Parkinson's Disease - Mini Environmental Risk Questionnaire (PD-DOC-MERQ) Country 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

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