CDE Detailed Report

Disease: Huntington's Disease
Sub-Domain: Epidemiology/Environmental History
CRF: Infection History

Displaying 1 - 10 of 10
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
C08116 Meningitis or encephalitis episode age value MengtisEncphtisEpAgVal Participant's/subject's age at the time of the meningitis or encephalitis episode Participant's/subject's age at the time of the meningitis or encephalitis episode Age at the time of meningitis/encephalitis? Numeric Values

Please provide your approximate age at th time of the episode and whether you were hospitalized.

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Infection History Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08117 Meningitis or encephalitis episode hospitalization indicator MengtisEncphtisEpHospInd Indicator of whether the participant/subject was hospitalized for the meningitis or encephalitis episode Indicator of whether the participant/subject was hospitalized for the meningitis or encephalitis episode Hospitalized Yes;No Yes;No Alphanumeric

Please provide your approximate age at th time of the episode and whether you were hospitalized.

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Infection History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08096 Influenza vaccine history indicator InfluenzaVaccineHistInd Indicator of whether the participant/subject has ever received an influenza vaccination Indicator of whether the participant/subject has ever received an influenza vaccination Have you ever received an influenza vaccination? Yes;No;Unknown Yes;No;Unknown Alphanumeric

If No is answered, skip to question #3 - Have you ever had pneumonia that was diagnosed by a physician?

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Infection History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08097 Influenza vaccine first receive age value InfluenzaVaccine1stRecvdAgeVal Age participant/subject received his/her first influenza vaccination Age participant/subject received his/her first influenza vaccination At what age did you receive the first influenza vaccination? Numeric Values

Only answer if 'Yes' is answered for 'Have you ever received an influenza vaccination?' Age can be collected in years but should be converted to months for data sharing purposes.

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Infection History Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08098 Influenza vaccine received frequency InfluenzaVaccineRecvdFreq Since the participant's/subject's first vaccination, how often does he/she receive the influenza vaccination? Since the participant's/subject's first vaccination, how often does he/she receive the influenza vaccination? Since your first vaccination, how often do you receive the influenza vaccine? Every year or almost every year;Every 2 to 3 years;Every 4 to 5 years;Less frequently than every 5 years Every year or almost every year;Every 2 to 3 years;Every 4 to 5 years;Less frequently than every 5 years Alphanumeric

No additional instructions

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Infection History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08099 Pneumonia history indicator PneumoniaHistInd Indicator of whether the participant/subject has ever had pneumonia diagnosed by a physician Indicator of whether the participant/subject has ever had pneumonia diagnosed by a physician Have you ever had pneumonia that was diagnosed by a physician? Yes;No;Unknown Yes;No;Unknown Alphanumeric

If No is answered, skip to question #4

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Infection History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08100 Pneumonia episode age value PneumoniaEpisdAgeVal Participant's/subject's age at the time of the pneumonia episode Participant's/subject's age at the time of the pneumonia episode For each episode of pneumonia, please provide the approximate age at the time of the episode and whether you were hospitalized Numeric Values

To be recorded for each episode of pneumonia experienced by the participant/subject. Age can be collected in years but should be converted to months for data sharing purposes.

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Infection History Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08101 Pneumonia episode hospitalization indicator PneumoniaEpisdHospitalInd Indicator of whether the participant/subject was hospitalized for the pneumonia episode Indicator of whether the participant/subject was hospitalized for the pneumonia episode Hospitalized Yes;No Yes;No Alphanumeric

Answer for all episodes of pneumonia experienced by the participant/subject.

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Infection History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08114 Meningitis or encephalitis history indicator MengtisEncphtisHistInd Indicator of whether the participant/subject has ever had meningitis or encephalitis (brain infection) diagnosed by a physician Indicator of whether the participant/subject has ever had meningitis or encephalitis (brain infection) diagnosed by a physician Have you ever had meningitis or encephalitis? Yes;No;Unknown Yes;No;Unknown Alphanumeric

If No is answered, End Questionnaire

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Infection History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08115 Meningitis or encephalitis diagnosed type MengtisEncphtisDiagnsdTyp Type of meningitis/encephalitis that participant/subject was diagnosed with Type of meningitis/encephalitis that participant/subject was diagnosed with Please note which condition was diagnosed Meningitis (including spinal meningitis);Encephalitis;Both (including meningoencephalitis);Not sure if diagnosis was meningitis or encephalitis Meningitis (including spinal meningitis);Encephalitis;Both (including meningoencephalitis);Not sure if diagnosis was meningitis or encephalitis Alphanumeric

Answer only if previous question was answered Yes

No references available Adult Supplemental 3.00 2013-07-22 09:34:41.527 Infection History Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

CSV