CDE Detailed Report

Disease: content
Sub-Domain: Activities of Daily Living/Performance
CRF: welcome

Displaying 1 - 8 of 8
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
C17025 Migraine Disability Assessment (MIDAS) - Household work productivity half reduction past three months day count MIDASHshldWrkProHReP3MCt Number of days in the last three months the participant/subject has experienced productivity reduction by half or more while doing household work because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form. Number of days in the last three months the participant/subject has experienced productivity reduction by half or more while doing household work because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form. How many days in the last 3 months was your productivity in household work reduced by half or more because of your headaches? Numeric Values

Please answer the following questions about ALL of the headaches you have had over the last 3 months. Select zero if you did not have the activity in the last 3 months. Do not include days you counted in Q3 where you did not do household work.

This survey was developed by Richard B. Lipton, MD, Professor of Neurology, Albert Einstein College of Medicine, New York, NY, and Walter F. Stewart, MPH, PhD, Associate Professor of Epidemiology, Johns Hopkins University, Baltimore, MD. Stewart WF, Lipton RB, Kolodner KB, Sawyer J, Lee C, Liberman JN (2000). Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers. Pain 88(1):41-52. PMID 11098098. Adult Supplemental-Highly Recommended 3.00 2013-07-16 14:01:43.01 Migraine Disability Assessment Test (MIDAS) Activities of Daily Living/Performance Outcomes and End Points

Free-Form Entry

day
C17026 Migraine Disability Assessment (MIDAS) - Activity missed past three months day count MIDASActMissP3MDayCt Number of days in the last three months the participant/subject has missed family, social, or leisure activities because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form. Number of days in the last three months the participant/subject has missed family, social, or leisure activities because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form. On how many days in the last 3 months did you miss family, social or leisure activities because of your headaches? Numeric Values

Please answer the following questions about ALL of the headaches you have had over the last 3 months. Select zero if you did not have the activity in the last 3 months.

This survey was developed by Richard B. Lipton, MD, Professor of Neurology, Albert Einstein College of Medicine, New York, NY, and Walter F. Stewart, MPH, PhD, Associate Professor of Epidemiology, Johns Hopkins University, Baltimore, MD. Stewart WF, Lipton RB, Kolodner KB, Sawyer J, Lee C, Liberman JN (2000). Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers. Pain 88(1):41-52. PMID 11098098. Adult Supplemental-Highly Recommended 3.00 2013-07-16 14:01:43.01 Migraine Disability Assessment Test (MIDAS) Activities of Daily Living/Performance Outcomes and End Points

Free-Form Entry

day
C17027 Migraine Disability Assessment (MIDAS) - total days 3 months number MIDASTotDay3MNum The total number of days in the past three months the participant/subject had those activity change due to headache, as part of the Migraine Disability Assessment (MIDAS) Test form. The total number of days in the past three months the participant/subject had those activity change due to headache, as part of the Migraine Disability Assessment (MIDAS) Test form. Total Q1 - Q5 Numeric Values

After you have filled out this questionnaire, add the total number of days from questions 1-5

This survey was developed by Richard B. Lipton, MD, Professor of Neurology, Albert Einstein College of Medicine, New York, NY, and Walter F. Stewart, MPH, PhD, Associate Professor of Epidemiology, Johns Hopkins University, Baltimore, MD. Stewart WF, Lipton RB, Kolodner KB, Sawyer J, Lee C, Liberman JN (2000). Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers. Pain 88(1):41-52. PMID 11098098. Adult Supplemental-Highly Recommended 3.00 2013-07-16 14:01:43.01 Migraine Disability Assessment Test (MIDAS) Activities of Daily Living/Performance Outcomes and End Points

Free-Form Entry

C17028 Migraine Disability Assessment (MIDAS) - Headache past three months day count MIDASHdacheP3MDayCt Count the total number of days in the past three months the participant/subject had headache, as part of the Migraine Disability Assessment (MIDAS) Test form. Count the total number of days in the past three months the participant/subject had headache, as part of the Migraine Disability Assessment (MIDAS) Test form. On how many days in the last 3 months did you have a headache? Numeric Values

Information your physician will need to know about your headache. If a headache lasted more than 1 day, count each day.

This survey was developed by Richard B. Lipton, MD, Professor of Neurology, Albert Einstein College of Medicine, New York, NY, and Walter F. Stewart, MPH, PhD, Associate Professor of Epidemiology, Johns Hopkins University, Baltimore, MD. Stewart WF, Lipton RB, Kolodner KB, Sawyer J, Lee C, Liberman JN (2000). Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers. Pain 88(1):41-52. PMID 11098098. Adult Supplemental-Highly Recommended 3.00 2013-07-16 14:01:43.01 Migraine Disability Assessment Test (MIDAS) Activities of Daily Living/Performance Outcomes and End Points

Free-Form Entry

day
C17029 Migraine Disability Assessment (MIDAS) - Headache average pain intensity scale MIDASHdcheAvePainIntenScl Average pain scale of the headache experienced by the participant/subject, as part of the Migraine Disability Assessment (MIDAS) Test form. Average pain scale of the headache experienced by the participant/subject, as part of the Migraine Disability Assessment (MIDAS) Test form. On a scale of 0-10, on average how painful were these headaches? Numeric Values

Information your physician will need to know about your headache. Where 0 = no pain at all, and 10 = pain as bad as it can be

This survey was developed by Richard B. Lipton, MD, Professor of Neurology, Albert Einstein College of Medicine, New York, NY, and Walter F. Stewart, MPH, PhD, Associate Professor of Epidemiology, Johns Hopkins University, Baltimore, MD. Stewart WF, Lipton RB, Kolodner KB, Sawyer J, Lee C, Liberman JN (2000). Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers. Pain 88(1):41-52. PMID 11098098. Adult Supplemental-Highly Recommended 3.00 2013-07-16 14:01:43.01 Migraine Disability Assessment Test (MIDAS) Activities of Daily Living/Performance Outcomes and End Points

Free-Form Entry

0 10
C17022 Migraine Disability Assessment (MIDAS) - School work absent past three month day count MIDASSchoWorkAbsPast3MDayCt Number of days in the last three months the participant/subject has missed work or school because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form. Number of days in the last three months the participant/subject has missed work or school because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form. On how many days in the last 3 months did you miss work or school because of your headaches? Numeric Values

Please answer the following questions about ALL of the headaches you have had over the last 3 months. Select zero if you did not have the activity in the last 3 months.

Innovative Medical Research, 1997 2007, AstraZeneca Pharmaceuticals, LP. All Rights reserved. Adult Supplemental-Highly Recommended 3.00 2013-07-16 14:01:43.01 Migraine Disability Assessment Test (MIDAS) Activities of Daily Living/Performance Outcomes and End Points

Free-Form Entry

day
C17023 Migraine Disability Assessment (MIDAS) - School work productivity reduction past three months day count MIDASSchlWrkProRedP3MDayCt Number of days in the last three months the participant/subject has experienced productivity reduction by half or more while at work or school because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form. Number of days in the last three months the participant/subject has experienced productivity reduction by half or more while at work or school because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form. How many days in the last 3 months was your productivity at work or school reduced by half or more because of your headaches? Numeric Values

Please answer the following questions about ALL of the headaches you have had over the last 3 months. Select zero if you did not have the activity in the last 3 months. Do not include days you counted in Question 1 where you missed work or school.

This survey was developed by Richard B. Lipton, MD, Professor of Neurology, Albert Einstein College of Medicine, New York, NY, and Walter F. Stewart, MPH, PhD, Associate Professor of Epidemiology, Johns Hopkins University, Baltimore, MD. Stewart WF, Lipton RB, Kolodner KB, Sawyer J, Lee C, Liberman JN (2000). Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers. Pain 88(1):41-52. PMID 11098098. Adult Supplemental?Highly Recommended 3.00 2013-07-16 14:01:43.01 Migraine Disability Assessment Test (MIDAS) Activities of Daily Living/Performance Outcomes and End Points

Free-Form Entry

day
C17024 Migraine Disability Assessment (MIDAS) - Household work not done past three months day count MIDASHshldNotDoneP3MDayCt Number of days in the last three months the participant/subject has not done household work because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form. Number of days in the last three months the participant/subject has not done household work because of their headaches, as part of the Migraine Disability Assessment (MIDAS) Test form. On how many days in the last 3 months did you not do household work (such as housework, home repairs and maintenance, shopping, caring for children and relatives) because of your headaches? Numeric Values

Please answer the following questions about ALL of the headaches you have had over the last 3 months. Select zero if you did not have the activity in the last 3 months.

This survey was developed by Richard B. Lipton, MD, Professor of Neurology, Albert Einstein College of Medicine, New York, NY, and Walter F. Stewart, MPH, PhD, Associate Professor of Epidemiology, Johns Hopkins University, Baltimore, MD. Stewart WF, Lipton RB, Kolodner KB, Sawyer J, Lee C, Liberman JN (2000). Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers. Pain 88(1):41-52. PMID 11098098. Adult Supplemental-Highly Recommended 3.00 2013-07-16 14:01:43.01 Migraine Disability Assessment Test (MIDAS) Activities of Daily Living/Performance Outcomes and End Points

Free-Form Entry

day
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