CDE Detailed Report

Disease: Huntington's Disease
Sub-Domain: Epidemiology/Environmental History
CRF: History of Early Exposure to Huntington's disease

Displaying 1 - 23 of 23
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
C08079 Full biological brothers number FullBioBrothersNum Number of full biological brothers the participant/subject has Number of full biological brothers the participant/subject has How many full brothers do you have? Numeric Values

Answer only if previous question was answered Yes and brothers is applicable

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08105 Day care start date DayCareStrtDate Date participant/subject first started day care outside of home Date (and time if applicable and known) participant/subject first started day care outside of home If "Yes," in what year did the child begin and end the first (next) attendance? Date or Date & Time

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08080 Twin sibling indicator TwinSiblingInd Indicator of whether the participant/subject has a twin brother or sister Indicator of whether the participant/subject has a twin brother or sister Do you have a twin brother or sister? Yes;No;Unknown Yes;No;Unknown Alphanumeric

If No is answered, skip to question #3 - Including yourself, please identify who is the oldest of your siblings?

No references available Adult;Pediatric Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08106 Day care end date DayCareEndDate Date participant/subject ended day care outside of home Date (and time if applicable and known) participant/subject ended day care outside of home If "Yes," in what year did the child begin and end the first (next) attendance? Date or Date & Time

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08081 Twin sibling type TwinSiblingTyp Type of twin the participant/subject has Type of twin the participant/subject has Are you and your twin identical or not identical? Identical;Not identical (fraternal);Unknown Identical;Not identical (fraternal);Unknown Alphanumeric

No additional instructions

No references available Adult;Pediatric Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08107 Day care hours per week value DayCareHoursPerWkVal Approximate hours per week the participant/subject attended day care as a child Approximate hours per week the participant/subject attended day care as a child About how many hours per week does child attend? Numeric Values

Answer in hours

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

hour
C08082 Sibling rank type SiblingRankTyp Sibling rank order to identify who is the eldest sibling and the second eldest sibling Sibling rank order to identify who is the eldest sibling and the second eldest sibling Including yourself, please identify who is the oldest of your siblings? Eldest;Second Eldest Eldest;Second Eldest Alphanumeric

Choose one response

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08108 Preschool attendance indicator PreschoolAttendanceInd Indicator of whether the participant/subject attended preschool as a child Indicator of whether the participant/subject attended preschool as a child As a child, did you attend preschool? Yes;No Yes;No Alphanumeric

If No is answered, End Questionnaire

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08083 Sibling name SiblingName Name of the sibling Name of the sibling Eldest Name; 2nd Eldest Name Alphanumeric

Answer for both eldest and second eldest sibling

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08109 Preschool start date PreschlStrtDate Date participant/subject first started preschool Date (and time if applicable and known) participant/subject first started preschool If "Yes," in what year did the child begin and end the first (next) attendance? Date or Date & Time

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08084 Sibling gender type SiblingGenderTyp Reported gender of the sibling. Gender is the socially constructed identity of sex Reported gender of the sibling. Gender is the socially constructed identity of sex Sex Female;Male;Unknown;Unspecified Female;Male;Unknown;Undifferentiated/Indeterminant/Intersex Alphanumeric

Answer for both eldest and second eldest sibling

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

2200604
C08110 Preschool end date PreschlEndDate Date participant/subject ended preschool Date (and time if applicable and known) participant/subject ended preschool If "Yes," in what year did the child begin and end the first (next) attendance? Date or Date & Time

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08085 Sibling alive indicator SiblingAliveInd Indicator of whether the participant's/subject's sibling is still living Indicator of whether the participant's/subject's sibling is still living Is this brother/sister still living? Yes;No;Unknown;Respondent Yes;No;Unknown;Respondent Alphanumeric

Answer for both eldest and second eldest sibling

No references available Adult;Pediatric Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08111 Preschool hours per week value PreschoolHoursPerWkVal Approximate hours per week the participant/subject attended preschool as a child Approximate hours per week the participant/subject attended preschool as a child About how many hours per week does child attend? Numeric Values

Answer in hours

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

hour
C08086 Sibling current age value SiblingCurntAgeVal Current age of the living sibling Current age of the living sibling If "Yes," please identify how old this brother/sister is now? Numeric Values

If Yes is answered for previous question, answer for both eldest and second eldest sibling.

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08112 Birth weight category BirthWgtCat Categorization of the participant's/subject's birth weight Categorization of the participant's/subject's birth weight What best describes your weight at birth? Underweight;Average weight;Overweight;Unknown Underweight;Average weight;Overweight;Unknown Alphanumeric

No additional instructions

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08076 Breastfed indicator BreastfedInd Indicator of whether the participant/subject was breastfed by his/her mother Indicator of whether the participant/subject was breastfed by his/her mother Did your mother breastfeed you? Yes;No;Unknown Yes;No;Unknown Alphanumeric

If No is answered, skip to Sibship/Birth Order section

No references available Adult;Pediatric Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08087 Sibling death age value SiblingDeathAgeVal Age of sibling when he/she died Age of sibling when he/she died If "No," please identify how old this brother/sister was when s/he died? Numeric Values

If No is answered for previous question, answer for both eldest and second eldest sibling.

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08113 Born prematurely indicator BornPrematurInd Indicator of whether the participant/subject was informed by a physician or parent/guardian that he/she was born prematurely Indicator of whether the participant/subject was informed by a physician or parent/guardian that he/she was born prematurely Were you told by a doctor or one of your parents that you were born premature? Yes;No;Unknown Yes;No;Unknown Alphanumeric

No additional instructions

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08077 Full biological sibling indicator FullBioSiblingInd Indicator of whether the participant/subject has any full biological brothers and/or sisters. Full brothers and/or sisters are defined as those with whom a birth mother and father is shared. Indicator of whether the participant/subject has any full biological brothers and/or sisters. Full brothers and/or sisters are defined as those with whom a birth mother and father is shared. Do you have any full brothers and/or sisters, that is, those with whom you share both birth mother and father? Yes;No;Unknown Yes;No (Skip to Preschool Attendance);Unknown Alphanumeric

Please include brothers and sisters who are living or deceased, but do not include adopted, foster, half, or step brothers or sisters

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08088 Age value unit of measure AgeValUoM Unit of measure used to initially record the age value Unit of measure used to initially record the age value If "No," please identify how old this brother/sister was when s/he died? Days;Weeks;Months;years Days;Weeks;Months;years Alphanumeric

Answer only if oldest brother/sister is dead and age at death was recorded. Choose one unit.

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08078 Full biological sisters number FullBioSistersNum Number of full biological sisters the participant/subject has Number of full biological sisters the participant/subject has How many full sisters do you have? Numeric Values

Answer only if previous question was answered Yes and sisters is applicable

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

2192217
C08104 Day care attendance indicator DayCareAttendanceInd Indicator of whether the participant/subject attended day care outside of the home as a child. Indicator of whether the participant/subject attended day care outside of the home as a child. As a child, did you attend day care outside of your home? Yes;No Yes;No (Skip to Question 2) Alphanumeric

If No is answered, skip to question #2 - As a child, did you attend preschool?

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 History of Early Exposure to Huntington's disease Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

CSV