CDE Detailed Report

Disease: Friedreich's Ataxia
Sub-Domain: Social Status
CRF: Social Status

Displaying 1 - 11 of 11
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
C10680 Unpaid assistance per day hours number UnpdAsstPerDayHrsCt How many hours in a typical 24-hour day do you have someone with you [unpaid assistance] to provide physical assistance for personal care activities such as eating, bathing, dressing, toileting and mobility? The number of hours per day the subject/participant utilizes an unpaid assistant How many hours in a typical 24-hour day do you have someone with you (unpaid assistance) to provide physical assistance for personal care activities such as eating, bathing, dressing, toileting and mobility? Numeric Values

Record the number of hours of unpaid assistance (family, others) the participant/subject receives in a 24-hour day.

No references available Adult;Pediatric Supplemental 3.00 2013-07-11 15:03:49.2 Social Status Social Status Participant Characteristics

Free-Form Entry

C10681 In-home assistance for remembering, decision making, or judgment duration InhmAsstRememDecisMakDura Amount of time per day the subject/participant requires the help of an assistant for decision making/remembering Amount of time per day the subject/participant requires the help of an assistant for decision making/remembering How much time is someone with you in your home to assist you with activities that require remembering, decision making, or judgment? Someone else is always with me to observe or supervise;Someone else is always around, but they only check on me now and then;Sometimes I am left alone for an hour or two;Sometimes I am left alone for most of the day;I have been left alone all day and all night, but someone checks in on me;I am left alone without anyone checking on me. Someone else is always with me to observe or supervise;Someone else is always around, but they only check on me now and then;Sometimes I am left alone for an hour or two;Sometimes I am left alone for most of the day;I have been left alone all day and all night, but someone checks in on me;I am left alone without anyone checking on me. Alphanumeric

Choose only one.

No references available Adult;Pediatric Supplemental 3.00 2013-07-11 15:03:49.2 Social Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C18677 Employment other text EmplmtOTH The free-text field related to 'Employment status' specifying other text. Status of participant/subject's current employment The free-text field related to 'Employment status' specifying other text. Status of participant/subject's current employment Other, specify Alphanumeric

Choose one.

National Health and Nutrition Examination Survey (http://www.cdc.gov/nchs/nhanes.htm) Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Social Status Social Status Participant Characteristics 4000

Free-Form Entry

C00012 Education level USA type EduLvlUSATyp Highest grade or level of school participant/subject has completed or the highest degree received Highest grade or level of school participant/subject has completed or the highest degree received Education level Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational/technical/vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational/technical/vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Alphanumeric

Choose highest level attained.

National Health and Nutrition Examination Survey (NHANES); National Health Interview Survey (NHIS); PhenX Toolkit Current Educational Attainment #011001 (https://www.phenxtoolkit.org) Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Social Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

3134878
C00204 Employment current status EmplmtStatu Status of participant/subject's current employment Status of participant/subject's current employment Employment status Working Now;Only temporarily laid off, sick leave, or maternity leave;Looking for work, unemployed;Retired;Other, specify;Disabled, permanently or temporarily;Keeping house;Student;Unknown Working Now;Only temporarily laid off, sick leave, or maternity leave;Looking for work, unemployed;Retired;Other, specify;Disabled, permanently or temporarily;Keeping house;Student;Unknown Alphanumeric

Choose one.

National Health and Nutrition Examination Survey (http://www.cdc.gov/nchs/nhanes.htm) Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Social Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C00206 Family income supported persons count FamilyIncmeSupprtPersCt Count of all people, including the participant/subject, who are supported by the household gross annual income reported Count of all people, including the participant/subject, who are supported by the household gross annual income reported Family size Numeric Values

including yourself, number of people supported by family income

American Community Survey questionnaire. U.S. Department of Commerce, U.S. Census Bureau. http://www.census.gov/acs/www/Downloads/questionnaires/2012/Quest12.pdf Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Social Status Social Status Participant Characteristics

Free-Form Entry

1 99
C00207 Marital or partner status MartlPartnerStatus Status of participant/subject's current domestic relationship, whether marital or partnered Status of participant/subject's current domestic relationship, whether marital or partnered Marital/partner status Never married;Married;Domestic partnership;Divorced;Separated;Widowed Never married;Married;Domestic partnership;Divorced;Separated;Widowed Alphanumeric

Choose one. Response is obtained by report of the participant/subject or a reliable proxy.

Johnson NJ, Backlund E, Sorlie PD, Loveless CA. Marital status and mortality: the national longitudinal mortality study. Ann Epidemiol. 2000;10:224-238. Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Social Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

2188083
C00214 Living with persons count PrsnCohabitCt Count of other people with whom the participant/subject currently lives, cohabits, or stays Count of other people with whom the participant/subject currently lives, cohabits, or stays Number of people the participant/subject lives or stays with Numeric Values

Answer should be recorded as a 2 digit number (i.e., one should be recorded as 01, ten should be recorded as 10). Participant/subject should NOT be included. Include everyone who is living or staying at location for more than 2 months. Include anyone else staying there who does not have another place to stay even if they are here for 2 months or less. Do not include anyone who is living somewhere else for more than 2 months, such as college student living away or someone in the Armed Forces on deployment.

American Community Survey questionnaire. U.S. Department of Commerce, U.S. Census Bureau. http://www.census.gov/acs/www/Downloads/questionnaires/2012/Quest12.pdf Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Social Status Social Status Participant Characteristics

Free-Form Entry

0 99
C00215 Living with person relationship type LivPrsnRltnshpTyp Type(s) of relationship(s) between the participant/subject and all people with whom she or he currently lives, cohabits, or stays Type(s) of relationship(s) that obtain between the participant/subject and all people with whom she or he currently lives, cohabits, or stays Persons living with Husband or wife;Biological son or daughter;Adopted son or daughter;Stepson or stepdaughter;Brother or sister;Father or mother;Stepfather or stepmother;Grandchild;Grandparent;Parent-in-law;Son-in-law or daughter-in-law;Other relative;Roomer or boarder;Housemate or roommate;Unmarried partner;Foster child;Other nonrelative;Military unit member;N/A - Homeless;N/A - Alone;Personal care attendant;Other patient/ resident in care facility;Unknown Husband or wife;Biological son or daughter;Adopted son or daughter;Stepson or stepdaughter;Brother or sister;Father or mother;Stepfather or stepmother;Grandchild;Grandparent;Parent-in-law;Son-in-law or daughter-in-law;Other relative;Roomer or boarder;Housemate or roommate;Unmarried partner;Foster child;Other nonrelative;Military unit member;N/A - Homeless;N/A - Alone;Personal care attendant;Other patient/ resident in care facility;Unknown Alphanumeric

Skip this data element if the participant/ subject lives alone. If he/she lives with one or more people, choose all that apply.

American Community Survey questionnaire. U.S. Department of Commerce, U.S. Census Bureau, http://www.census.gov/acs/www/Downloads/questionnaires/2012/Quest12.pdf Four additional permissible values were added on for FA. Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Social Status Social Status Participant Characteristics

Multiple Pre-Defined Values Selected

C10678 Employment full-time status EmplymtFullTimeStatus Status of participant/subject's current full-time employment Status of participant/subject's current full-time employment Full-time employment Yes;No;Hours vary;Unknown;Not reported Yes;No;Hours vary;Unknown;Not reported Alphanumeric

Choose one.

No references available Adult;Pediatric Supplemental 3.00 2013-08-28 16:08:00.453 Social Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C10679 Paid assistance per day hours number PdAsstPerDayHrsCt How many hours in a typical 24-hour day do you have someone with you [paid assistance] to provide physical assistance for personal care activities such as eating, bathing, dressing, toileting and mobility? The number of hours per day the subject/participant utilizes a paid assistant How many hours in a typical 24-hour day do you have someone with you (paid assistance) to provide physical assistance for personal care activities such as eating, bathing, dressing, toileting and mobility? Numeric Values

Record the number of hours of paid assistance the participant/subject receives in a 24-hour day.

No references available Adult;Pediatric Supplemental 3.00 2013-07-11 15:03:49.2 Social Status Social Status Participant Characteristics

Free-Form Entry

CSV