CDE Detailed Report

Disease: Spinal Muscular Atrophy
Subdomain Name: Social Status
CRF: Social Status

Displaying 1 - 19 of 19
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 / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
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

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
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

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

Include everyone who is living or staying here for more than 2 months. Include participant/subject if they are living here for more than 2 months. Include anyone else staying here 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
C18684 Health insurance other text HlthInsOTH The free-text field related to 'Health insurance type' specifying other text. Type of insurance that the participant/subject currently has providing coverage for medical, surgical or hospital care The free-text field related to 'Health insurance type' specifying other text. Type of insurance that the participant/subject currently has providing coverage for medical, surgical or hospital care Other, specify Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Social Status Social Status Participant Characteristics 4000

Free-Form Entry

2953262
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

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 Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Social Status Social Status Participant Characteristics

Multiple Pre-Defined Values Selected

C18861 Health insurance private group other text HlthInsPrivatGrpOTH The free-text field related to 'Health insurance private group type' specifying other text. Type of private or group health insurance, if any, in which the participant/subject is currently enrolled The free-text field related to 'Health insurance private group type' specifying other text. Type of private or group health insurance, if any, in which the participant/subject is currently enrolled Other, specify Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Social Status Social Status Participant Characteristics 4000

Free-Form Entry

C00226 Health insurance type HlthInsTyp Type of insurance that the participant/subject currently has providing coverage for medical, surgical or hospital care Type of insurance that the participant/subject currently has providing coverage for medical, surgical or hospital care Type of health insurance Medicaid;Medicare;Employer-sponsored disability insurance;Private or group health insurance;National Health Insurance;Veterans Affairs/Military;No Insurance/Self-pay;Unknown;Other, specify Medicaid;Medicare;Employer-sponsored disability insurance;Private or group health insurance;National Health Insurance;Veterans Affairs/Military;No Insurance/Self-pay;Unknown;Other, specify Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Social Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

2953262
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 status Yes;No;Hours vary;Unknown Yes;No;Hours vary;Unknown Alphanumeric

Works 35 hours or more per week

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

C12602 Discharge post acute location DischrgPostAcuteLoc Location, post-acute discharge, at which participant/subject is currently staying Location, post-acute discharge, at which participant/subject is currently staying Location post-acute discharge Own home with self care;Another family member's/friend's home;Short term/general hospital for inpatient care;Skilled nursing facility with Medicare certification in anticipation of skilled care;Home under care of organized home health;Hospice- home service organization;Court/law enforcement facility;Hospital-based Medicare approved swing bed;Federal health care facility;Medicare certified long term care hospital;Hospice- medical facility providing hospice level of care;Critical Access Hospital;Nursing facility certified under Medicaid but not certified under Medicare;Psychiatric hospital or psychiatric distinct part unit of a hospital;Another type of health care institution not defined above Own home with self care;Another family member's/friend's home;Short term/general hospital for inpatient care;Skilled nursing facility (SNF) with Medicare certification in anticipation of skilled care;Home under care of organized home health;Hospice- home service organization;Court/law enforcement facility;Hospital-based Medicare approved swing bed;Federal health care facility;Medicare certified long term care hospital (LTCH);Hospice- medical facility providing hospice level of care;Critical Access Hospital (CAH);Nursing facility certified under Medicaid but not certified under Medicare;Psychiatric hospital or psychiatric distinct part unit of a hospital;Another type of health care institution not defined above Alphanumeric

Choose one for the participant's/subject's current location post-acute discharge

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Social Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

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

Select the 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 Core 3.00 2013-07-25 08:54:08.2 Social Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

3134878
C12605 Caregiver primary type CaregvrPrimryType Type of relationship that the person who serves as the participant/subject's primary caregiver has with the participant/subject Type of relationship that the person who serves as the participant/subject's primary caregiver has with ther participant/subject Primary caregiver for the participant/subject Self;Sibling;Spouse or partner;Home aide;Parent or legal guardian;Long-term care/nursing facility staff;Child;Other Self;Sibling;Spouse or partner;Home aide;Parent or legal guardian;Long-term care/nursing facility staff;Child;Other Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Social Status Social Status Participant Characteristics

Multiple Pre-Defined Values Selected

C00202 Education school participation status EduSchoolParticipStatus Status of participant/subject's current attendance at school Status of participant/subject's current attendance at school School status Going to school;On vacation from school (between grades);Neither;Unknown Going to school;On vacation from school (between grades);Neither;Unknown Alphanumeric

Choose one

National Health and Nutrition Examination Survey (http://www.cdc.gov/nchs/nhanes.htm) Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Social Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C12606 Health insurance private group type HlthInsPrivatGrpTyp Type of private or group health insurance, if any, in which the participant/subject is currently enrolled Type of private or group health insurance, if any, in which the participant/subject is currently enrolled Health insurance private or group type Traditional indemnity plan, often called fee-for-service plan;Health Maintenance Organization;Individual Practice Association;Preferred Provider Organization;Point-of-Service;Other, specify Traditional indemnity plan, often called fee-for-service plan;Health Maintenance Organization (HMO);Individual Practice Association (IPA);Preferred Provider Organization (PPO);Point-of-Service (POS);Other, specify Alphanumeric

Choose all that apply

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Social Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

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

C12607 Education level maternal USA type EduLvlMaternalUSATyp Indicator of the highest level of education completed by the participant/subject's mother Indicator of the highest level of education completed by the participant/subject's mother Maternal 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, or vocational program;Associate degree: academic program;Bachelor's degree;Master's degree;Professional school degree;Doctoral degree;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, or 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

Select the highest level attained

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

Single Pre-Defined Value Selected

C00205 Family income range FmlyIncRng Range, in U.S. dollars, of the annual pre-tax, pre-deduction total income, of the household of which the participant/subject is a member Range, in U.S. dollars, of the annual pre-tax, pre-deduction total income, of the household of which the participant/subject is a member Total annual gross income of a household including the participant/subject $15,000 to $24,999;$25,000 to $34,999;$35,000 to $49,999;$50,000 to $74,999;$75,000 to $99,999;$100,000 and over;Refused;Unknown;Under $15,000 $15,000 to $24,999;$25,000 to $34,999;$35,000 to $49,999;$50,000 to $74,999;$75,000 to $99,999;$100,000 and over;Refused;Unknown;Under $15,000 Alphanumeric

Choose one. This includes pre-tax cash income earned by persons, money wages and salaries, self-employment income, property income (dividends, interest and rents), money transfer payments from a variety of government and private welfare and social insurance schemes (such as social security, unemployment and workers' compensation, and public assistance), private and government retirement income, interpersonal transfers (such as alimony and child support) and other periodic income. This excludes certain lump sum payments and capital gains.

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

Single Pre-Defined Value Selected

C12609 Education level paternal USA type EduLvlPaternalUSATyp Indicator of the highest level of education completed by the participant/subject's father Indicator of the highest level of education completed by the participant/subject's father Paternal 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, or vocational program;Associate degree: academic program;Bachelor's degree;Master's degree;Professional school degree;Doctoral degree;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, or 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

Select the highest level attained

No references available Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 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 Number of people supported by this income, including you Numeric Values

No additional instructions

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
C12819 Disability benefit indicator DisabltyBenefitInd Indicator of whether participant/subject receives disability benefit payments Indicator of whether participant/subject receives disability benefit payments Disability benefits Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one

No references available Adult Supplemental 3.00 2013-07-24 11:38:01.2 Social Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

CSV