CDE Detailed Report
Disease: Parkinson's Disease
Sub-Domain: Other Non-Motor
CRF: Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ)
Displaying 1 - 29 of 29
Sub-Domain: Other Non-Motor
CRF: Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ)
Displaying 1 - 29 of 29
| 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 / 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C09626 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling previous year frequency | CHRLSQFeelingPreviousYearFreq | The frequency as related to how often in the previous year the participant/subject experienced these uncomfortable feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The frequency as related to how often in the previous year the participant/subject experienced these uncomfortable feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | And a year ago, how often did you experience these feelings? | Everyday;4-5 days per week;2-3 days per week;1 day per week;2 days per month;1 day per month or less;Never | Everyday;4-5 days per week;2-3 days per week;1 day per week;2 days per month;1 day per month or less;Never | Alphanumeric |
Please circle only one answer |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09616 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling cause leg move frequency | CHRLSQFeelingCauseLegMoveFreq | The frequency as related to whether or not the participant's/subject's legs move/jump on their own because of their uncomfortable feelings while they're awake, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The frequency as related to whether or not the participant/subject's legs move/jump on their own because of their uncomfortable feelings while they're awake, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | When you are awake and having these feelings, how often do you find that your legs move or jump on their own without you making them move? | Never;Sometimes;Often;Almost always;Always | Never;Sometimes;Often;Almost always;Always | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09627 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling 5 year frequency | CHRLSQFeeling5YearFreq | The frequency as related to how often five years ago the participant/subject experienced these uncomfortable feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The frequency as related to how often five years ago the participant/subject experienced these uncomfortable feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | And 5 years ago, how often did you experience these feelings in your legs? | Everyday;4-5 days per week;2-3 days per week;1 day per week;2 days per month;1 day per month or less;Never | Everyday;4-5 days per week;2-3 days per week;1 day per week;2 days per month;1 day per month or less;Never | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09617 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling most occur time | CHRLSQFeelingMostOccurTime | Time of day the participant's/subject's uncomfortable feelings are most likely to occur, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Time of day the participant's/subject's uncomfortable feelings are most likely to occur, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Which times of day are these feelings in your legs most likely to occur? | Morning;Mid-day;Afternoon;Evening;Night;About equal at all times | Morning;Mid-day;Afternoon;Evening;Night;About equal at all times | Alphanumeric |
Choose all that apply |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Multiple Pre-Defined Values Selected |
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| C09628 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling 1st age value | CHRLSQFeeling1stAgeVal | The value of the age the participant/subject was when they first experienced these uncomfortable feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The value of the age the participant/subject was when they first experienced these uncomfortable feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Approximately how old were you when you first noticed these feelings in your legs? | Numeric Values |
Write age in years. |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Free-Form Entry |
year | |||||||||
| C09618 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling least occur time | CHRLSQFeelingLeastOccurTime | Time of day the participant's/subject's uncomfortable feelings are least likely to occur, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Time of day the participant's/subject's uncomfortable feelings are least likely to occur, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Which times of day are these feelings in your legs least likely to occur? | Morning;Mid-day;Afternoon;Evening;Night;About equal at all times | Morning;Mid-day;Afternoon;Evening;Night;About equal at all times | Alphanumeric |
Choose all that apply |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Multiple Pre-Defined Values Selected |
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| C09629 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - subject children similar value | CHRLSQSubjectChldrnSimilarVal | The value of how many of the participant's/subject's own children the participant/subject thinks has these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The value of how many of the participant's/subject's own children the participant/subject thinks has these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Thinking about your own children, how many of these children do you think have similar feelings in their legs? | Numeric Values |
Please write in the number that do and do not have these feelings, and the number for whom you don't know whether they have these feelings. If you do not have children or siblings, please indicate so. |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Free-Form Entry |
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| C09608 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - recurrent uncomfortable leg sitting indicator | CHRLSQRcrntUncmftLegSttngInd | The indicator of whether or not the participant/subject has recurrent uncomfortable feelings or sensations in their legs while sitting or lying down, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The indicator of whether or not the participant/subject has recurrent uncomfortable feelings or sensations in their legs while sitting or lying down, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Do you have, or have you had, recurrent uncomfortable feelings or sensations in your legs while sitting or lying down? | No;Yes | No;Yes | Alphanumeric |
If you answered YES to either Question 1 or 2 continue Question 3. If you answered NO to BOTH stop here . |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09619 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling relief move once frequency | CHRLSQFeelingReliefMoveOnceFrq | The frequency as related to whether or not the participant's/subject's moving a leg once will relieve their uncomfortable feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The frequency as related to whether or not the participant's/subject's moving a leg once will relieve their uncomfortable feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Will simply changing leg positions by itself once without continuing to move usually relieve these feelings? | Usually relieves;Does not usually relieve;Don't know | Usually relieves;Does not usually relieve;Don't know | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09630 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - subject children dissimilar value | CHRLSQSubjectChldrnDsmilarVal | The value of how many of the participant's/subject's own children the participant/subject thinks doesn't have these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The value of how many of the participant's/subject's own children the participant/subject thinks doesn't have these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Thinking about your own children, how many of these children do you think don't have similar feelings in their legs? | Numeric Values |
Please write in the number that do and do not have these feelings, and the number for whom you don't know whether they have these feelings. If you do not have children or siblings, please indicate so. |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Free-Form Entry |
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| C09609 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - recurrent need move leg indicator | CHRLSQRcrntNeedMoveLegSttngInd | The indicator of whether or not the participant/subject has or has had a recurrent need or urge to move their legs while sitting or lying down, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The indicator of whether or not the participant/subject has or has had a recurrent need or urge to move their legs while sitting or lying down, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Do you have, or have you had, a recurrent need or urge to move your legs while sitting or lying down? | No;Yes | No;Yes | Alphanumeric |
If you answered YES to either Question 1 or 2 continue Question 3. If you answered NO to BOTH stop here . |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09620 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling ever cramp cause indicator | CHRLSQFeelingEverCrmpCauseInd | The indicator of whether or not the participant's/subject's uncomfortable feelings are ever due to muscle cramps, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The indicator of whether or not the participant's/subject's uncomfortable feelings are ever due to muscle cramps, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Are these feelings ever due to muscle cramps? | Yes;No;Never exposed | Yes;No;Never exposed | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09631 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - subject children unsure value | CHRLSQSubjectChldrnUnsureVal | The value of how many of the participant's/subject's own children the participant/subject is unsure of whether they have these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The value of how many of the participant's/subject's own children the participant/subject is unsure of whether they have these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Thinking about your own children, how many of these children do you not know if they have similar feelings in their legs? | Numeric Values |
Please write in the number that do and do not have these feelings, and the number for whom you don't know whether they have these feelings. If you do not have children or siblings, please indicate so. |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Free-Form Entry |
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| C09610 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling urge description status | CHRLSQFeelingUrgeDescrStatus | The status related to the description of the participant's/subject's usual feelings/urges, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The status related to the description of the participant's/subject's usual feelings/urges, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Would you describe these feelings and the feeling of an urge to move your leg as usually: | More painful than uncomfortable;Uncomfortable, but not really painful;Both painful and uncomfortable | More painful than uncomfortable;Uncomfortable, but not really painful;Both painful and uncomfortable | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09621 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling always cramp cause indicator | CHRLSQFeelingAlwysCrmpCauseInd | The indicator of whether or not the participant's/subject's uncomfortable feelings are always due to muscle cramps, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The indicator of whether or not the participant's/subject's uncomfortable feelings are always due to muscle cramps, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | If so, are they always due to muscle cramps? | Yes;No;Never exposed | Yes;No;Never exposed | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09632 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - subject sibling similar value | CHRLSQSubjectSiblingSimilarVal | The value of how many of the participant's/subject's siblings the participant/subject thinks has these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The value of how many of the participant's/subject's siblings the participant/subject thinks has these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Thinking about your brothers and sisters, how many of these do you think have similar feelings in their legs? | Numeric Values |
Please write in the number that do and do not have these feelings, and the number for whom you don't know whether they have these feelings. If you do not have children or siblings, please indicate so. |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Free-Form Entry |
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| C09611 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - common physical state status | CHRLSQCommonPhysStateStatus | The status related to the participant's/subject's most common physical state when experiencing uncomfortable feeling in the legs, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The status related to the participant's/subject's most common physical state when experiencing uncomfortable feeling in the legs, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Are you more likely to have these feelings when resting (either sitting or lying down) or when you are physically active? | Resting;Active | Resting;Active | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09622 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling only sitting status | CHRLSQFeelingOnlySttngStatus | The status related to whether or not the participant's/subject's uncomfortable feelings occur only when sitting, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The status related to whether or not the participant's/subject's uncomfortable feelings occur only when sitting, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Do these feelings occur only when sitting or only when lying down? | Neither;Only when sitting;Only when lying down;Both when sitting and when lying down | Neither;Only when sitting;Only when lying down;Both when sitting and when lying down | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09633 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - subject sibling dissimilar value | CHRLSQSubjectSiblingDsmilarVal | The value of how many of the participant's/subject's siblings the participant/subject thinks doesn't have these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The value of how many of the participant's/subject's siblings the participant/subject thinks doesn't have these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Thinking about your own brothers and sisters, how many of these do you think don't have similar feelings in their legs? | Numeric Values |
Please write in the number that do and do not have these feelings, and the number for whom you don't know whether they have these feelings. If you do not have children or siblings, please indicate so. |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Free-Form Entry |
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| C09612 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling start resting indicator | CHRLSQFeelingStrtRestngInd | The indicator of whether or not the participant's/subject's uncomfortable feelings in the legs usually start when resting, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The indicator of whether or not the participant's/subject's uncomfortable feelings in the legs usually start when resting, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Do these feelings usually start when you are resting (either sitting or lying down)? | No;Yes | No;Yes | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09623 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling distress status | CHRLSQFeelingDistressingStatus | The status related to how distressing the participant's/subject's uncomfortable feelings in the legs are, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The status related to how distressing the participant's/subject's uncomfortable feelings in the legs are, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | When you actually experience these feelings in your legs, how distressing are they? | Not at all distressing;A little bit;Moderately;Extremely distressing | Not at all distressing;A little bit;Moderately;Extremely distressing | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09634 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - subject sibling unsure value | CHRLSQSubjectSiblingUnsureVal | The value of how many of the participant's/subject's siblings the participant/subject is unsure of whether they have these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The value of how many of the participant's/subject's siblings the participant/subject is unsure of whether they have these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Thinking about your own brothers and sisters, how many of these do you not know if they have similar feelings in their legs? | Numeric Values |
Please write in the number that do and do not have these feelings, and the number for whom you don't know whether they have these feelings. If you do not have children or siblings, please indicate so. |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Free-Form Entry |
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| C09613 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling better moving indicator | CHRLSQFeelingBetterMovingInd | The indicator of whether or not the participant's/subject's uncomfortable feelings in the legs usually get better when moving, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The indicator of whether or not the participant's/subject's uncomfortable feelings in the legs usually get better when moving, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | If you get up or move around when you have these feelings, do these feelings get any better while you actually keep moving? | Yes;No;Don't know | Yes;No;Don't know | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09624 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling worse night other status | CHRLSQFeelingWrseNightOthrStat | The status related to whether the participant's/subject's uncomfortable feelings are worse at night or evening than other parts of the day, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The status related to whether the participant's/subject's uncomfortable feelings are worse at night or evening than other parts of the day, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Are these feelings worse at night or in the evening then at other times of the day? | Worse in evening/night;Worse at other times;No difference | Worse in evening/night;Worse at other times;No difference | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09635 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - subject biological mother similar indicator | CHRLSQSubjectBioMthrSimilarInd | The indicator of whether or not the participant's/subject's biological mother has/had these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The indicator of whether or not the participant's/subject's biological mother has/had these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Did or does your biological mother have these feelings in her legs? | Yes;No;Never exposed | Yes;No;Never exposed | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09614 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling reason moving indicator | CHRLSQFeelingRsnMovingInd | The indicator of whether or not the participant's/subject's gets up or moves around because of their uncomfortable feelings in the legs, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The indicator of whether or not the participant's/subject's gets up or moves around because of their uncomfortable feelings in the legs, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Do you sometimes get up or move around for no other reason then because you have these feelings in your legs? | Yes;No;Not sure | Yes;No;Not sure | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09625 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling past 12 month frequency | CHRLSQFeelingPast12MnthFreq | The frequency as related to how often in the past 12 months the participant/subject experienced these uncomfortable feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The frequency as related to how often in the past 12 months the participant/subject experienced these uncomfortable feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | In the past 12 months, how often did you experience these feelings in your legs? | Everyday;4-5 days per week;2-3 days per week;1 day per week;2 days per month;1 day per month or less;Never | Everyday;4-5 days per week;2-3 days per week;1 day per week;2 days per month;1 day per month or less;Never | Alphanumeric |
Please circle only one answer |
Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09636 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - subject biological father similar indicator | CHRLSQSubjectBioFthrSimilarInd | The indicator of whether or not the participant's/subject's biological father has/had these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The indicator of whether or not the participant's/subject's biological father has/had these feelings, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Did or does your biological father have these feelings in his legs? | Yes;No;Never exposed | Yes;No;Never exposed | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C09615 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) - feeling overwhelming moving indicator | CHRLSQFeelingOvrwhlmMovingInd | The indicator of whether or not the participant's/subject's uncomfortable feelings in the legs get overwhelming to the point where they can't resist moving, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | The indicator of whether or not the participant's/subject's uncomfortable feelings in the legs get overwhelming to the point where they can't resist moving, as part of the Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) form. | Do these feelings ever become overwhelming to the point that you cannot resist moving? | No;Yes | No;Yes | Alphanumeric | Allen et al. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Medicine 2009;10(10):1097-1100. | Adult | Supplemental | 3.00 | 2013-07-22 09:34:41.527 | Cambridge-Hopkins Restless Legs Syndrome Diagnostic Questionnaire (CH-RLSQ) | Other Non-Motor | Outcomes and End Points |
Single Pre-Defined Value Selected |
