CDE Detailed Report
Disease: Huntington's Disease
Sub-Domain: Epidemiology/Environmental History
CRF: Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco
Displaying 1 - 15 of 15
Sub-Domain: Epidemiology/Environmental History
CRF: Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco
Displaying 1 - 15 of 15
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C09257 | Risk Factor Questionnaire (RFQ) - lifetime regularly smoked status | RFQLifetimeRegSmokedStatus | Lifetime smoking status of the participant/subject to determine if they have smoked regularly as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Lifetime smoking status of the participant/subject to determine if they have smoked regularly as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | In your lifetime, have you ever regularly smoked cigarettes, that is, at least one cigarette per day for 6 months or longer? | No;Yes | No;Yes | Alphanumeric |
Skip to Question 5 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C10473 | Risk Factor Questionnaire (RFQ) - currently smoking status | RFQCurntlySmokingStatus | Smoking status of the participant/subject to determine if they are currently smoking as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Smoking status of the participant/subject to determine if they are currently smoking as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Currently smoke | Currently smoke | Currently smoke | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C09258 | Risk Factor Questionnaire (RFQ) - age year start regularly smoking value | RFQAgeYrStrtRegSmokingVal | Age or year the participant/subject started regularly smoking cigarettes as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Age or year the participant/subject started regularly smoking cigarettes as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | If Yes, at what age (or in what year) did you start regularly smoking cigarettes? | Numeric Values |
Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C10474 | Risk Factor Questionnaire (RFQ) - average cigarettes smoked per day number | RFQAvgCigsSmokedPerDayNum | Average number of cigarettes smoked per day by the participant/subject when regularly smoking as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Average number of cigarettes smoked per day by the participant/subject when regularly smoking as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | During the time that you regularly smoked, on average, how much did you smoke PER DAY? | Numeric Values |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C09259 | Risk Factor Questionnaire (RFQ) - age year stop regularly smoking value | RFQAgeYrStopRegSmokingVal | Age or year the participant/subject stopped regularly smoking cigarettes as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Age or year the participant/subject stopped regularly smoking cigarettes as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | If Yes, at what age (or in what year) did you stop regularly smoking cigarettes? | Numeric Values |
Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C10475 | Risk Factor Questionnaire (RFQ) - currently use smokeless tobacco status | RFQCurntlyUseSmklessTobcoStat | Smokeless tobacco use status of the participant/subject to determine if they are currently using smokeless tobacco or snuff as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Smokeless tobacco use status of the participant/subject to determine if they are currently using smokeless tobacco or snuff as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Currently use | Currently Use | Currently Use | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C09260 | Risk Factor Questionnaire (RFQ) - period no regular smoking status | RFQPrdNoRegSmokingStatus | Smoking status of the participant/subject to determine if there were periods of a year or more where they did not regularly smoke as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Smoking status of the participant/subject to determine if there were periods of a year or more where they did not regularly smoke as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Were there periods of a year or more when you did NOT regularly smoke cigarettes? | No;Yes | No;Yes | Alphanumeric |
Skip to Question 4 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C09261 | Risk Factor Questionnaire (RFQ) - start age no regular smoking value | RFQStrtAgeNoRegSmokingVal | Age where the participant/subject started to stop smoking as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Age where the participant/subject started to stop smoking as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Start age | Numeric Values |
Years |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C09262 | Risk Factor Questionnaire (RFQ) - stop age no regular smoking value | RFQStopAgeNoRegSmokingVal | Age where the participant/subject started smoking again as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Age where the participant/subject started smoking again as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Stop age | Numeric Values |
Years |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C09263 | Risk Factor Questionnaire (RFQ-U) - smoking no tobacco use age range | RFQSmkngTobcoUsAgeRange | Period 3: If Yes, what ages were you when you did NOT regularly smoke? | Period 3: If Yes, what ages were you when you did NOT regularly smoke? | Alphanumeric |
Enter the 'Start Age' and 'Stop Age' for each period Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History | 10 |
Free-Form Entry |
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| C09264 | Risk Factor Questionnaire (RFQ) - average packs smoked per day number | RFQAvgPacksSmokedPerDayNum | Average number of cigarette packs the participant/subject smoked per day when regularly smoking as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Average number of cigarette packs the participant/subject smoked per day when regularly smoking as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | During the time that you regularly smoked, on average, how much did you smoke PER DAY? | Numeric Values |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C09265 | Risk Factor Questionnaire (RFQ) - used smokeless snuff tobacco status | RFQUsedSmklessSnuffTobcoStatus | Determine if the subject/participant used smokeless tobacco or snuff regularly as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Determine if the subject/participant used smokeless tobacco or snuff regularly as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Have you ever used smokeless tobacco such as chewing tobacco or snuff regularly, that is, at least once per day for 6 months or longer? | No;Yes | No;Yes | Alphanumeric |
End of Questionnaire |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C09266 | Risk Factor Questionnaire (RFQ) - age or year start regularly using smokeless tobacco value | RFQAgeYrStrtRegSmklessTobcoVal | Age or year when the subject/participant started using smokeless tobacco or snuff regularly as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Age or year when the subject/participant started using smokeless tobacco or snuff regularly as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | If Yes, at what age (or in what year) did you start regularly using smokeless tobacco? | Numeric Values |
Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format. |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C09256 | Risk Factor Questionnaire (RFQ) - lifetime smoked status | RFQLifetimeSmokedStatus | Lifetime smoking status of the participant/subject to determine if they have smoked 100 or more cigarettes as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Lifetime smoking status of the participant/subject to determine if they have smoked 100 or more cigarettes as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | In your lifetime, have you smoked 100 or more cigarettes (5 packs)? | No;Yes | No;Yes | Alphanumeric |
Skip to Question 5 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C09267 | Risk Factor Questionnaire (RFQ) - age year stop regularly using smokeless tobacco value | RFQAgeYrStpRgUsSmklessTobcoVal | Age or year when the subject/participant stopped using smokeless tobacco or snuff regularly as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | Age or year when the subject/participant stopped using smokeless tobacco or snuff regularly as part of the Risk Assessment Questionnaire (RFQ) Smoking and Tobacco. | If Yes, at what age (or in what year) did you stop regularly using smokeless tobacco? | Numeric Values |
Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format. |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ-U) - Smoking and Tobacco | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
