CDE Detailed Report
Disease: system
Subdomain Name: Demographics
CRF: system
Displaying 101 - 123 of 123
Subdomain Name: Demographics
CRF: system
Displaying 101 - 123 of 123
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C21976 | Sport high school other participation text | SportHighSchoolOtherPartTxt | Which sports participant/subject played in high school | Which sports participant/subject played in high school | Which other sports did the subject play in high school? | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 18:12:02.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| 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 | Who is the primary person living with the subject? | Alone;Child;Group living situation, boarding house;Homeless;Military barracks;Other;Other patients (in hospital/nursing home);Other residents;Other, specify;Parent or legal guardian;Personal care attendant;Roommates/friends;Self;Sibling;Spouse or partner;Unable to obtain information | Alone;Child;Group living situation, boarding house;Homeless;Military barracks;Other;Other patients (in hospital/nursing home);Other residents;Other, specify;Parent or legal guardian;Personal care attendant;Roommates/friends;Self;Sibling;Spouse or partner;Unable to obtain information | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-24 11:38:01.2 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Multiple Pre-Defined Values Selected |
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| C21804 | Job classification current other text | JobClassNowOTH | The free-text field related to Job classification-now specifying other text | The free-text field related to Job classification-now specifying other tex | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-03 11:17:16.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| C21987 | Sport recreational other participation text | SportRecreationlOtherPlaydTxt | Which other sport(s) the participant/subject played recreationally | Which other sport(s) the participant played/subject recreationally | Which other recreational sports did the subject play? | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 18:33:20.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| C22687 | Marital or partner status other text | MartlPartnerStatusOTH | The free-text field related to Marital or partner status specifying other text. Status of participant/subjects current domestic relationships | The free-text field related to Marital or partner status specifying other text. Status of participant/subjects current domestic relationship | Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2016-08-01 13:44:07.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| C18614 | Education primary caregiver year count | EduPrimCaregiverYrCt | Number of years of education of the primary caregiver (age 5 and beyond) | Number of years of education of the primary caregiver (age 5 and beyond | How many years of education does the parent, guardian, or caregiver have? | Numeric Values |
In order to apply to international setting, this data element was made to supplement C00013 |
Adult;Pediatric | Supplemental | 3.00 | 2013-10-07 00:00:00.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Free-Form Entry |
0 | 30 | year | ||||||||
| C21816 | Sport elementary school other participation text | ElementarySchoolSportOthrPlayd | The free-text field to specify which other sports the participant/subject played in elementary school | The free-text field to specify which other sports the participant/subject played in elementary school | Which other sports did the subject play in elementary school? | Alphanumeric |
The free-text field to specify which other sports the participant played in elementary school |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-03 11:59:33.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 4000 |
Free-Form Entry |
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| C00025 | Language primary text | LangPrimryTxt | Text for the language the participant/subject speaks most often | Text for the language the participant/subject speaks most often | What is the subject's primary language (use ISO code)? | eng;spa;sgn;chi;fre;ger;Other, specify | English;Spanish;Sign Languages;Chinese languages;French;German;Other, specify | Alphanumeric |
Choose one. It may be easier to record the full name of the language using Language primary text and code the data later using the ISO 639-2 alpha-3 codes. Data Sharing Instructions: The language data should be coded using the ISO 639-2 codes prior to aggregation or sharing. |
ISO 639-2 language codes (http: //www.loc.gov/standards/iso639-2/php/code_list.php) | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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| 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 | What is the subject's marital status? | Never married;Married;Domestic partnership;Divorced;Separated;Widowed | Never married;Married;Domestic partnership;Divorced;Separated;Widowed | Alphanumeric |
STROKE: Johnson NJ, Backlund E, Sorlie PD, Loveless CA. Marital status and mortality: the national longitudinal mortality study. Ann Epidemiol. 2000;10:224-238. NCI CDE Browser Public ID = 2188083 |
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 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
2188083 | |||||||
| C22698 | Parent occupation primary status | ParentOccupationPrimaryStatus | The status indicating the participant's/subject's parent, guardian, or caregiver's current primary occupational status | The status indicating the participant's/subject's parent, guardian, or caregiver's current primary occupational statu | What is the parent's, guardian's, or caregiver's current primary occupational status? | Homemaker;Other, specify;Paid work;Retired;Retired;Student;Unemployed;Unknown;Unpaid work | Homemaker;Other, specify;Paid work (employed/self-employed, including military);Retired (disability pension);Retired (non-disability);Student (including on the job training);Unemployed (none of the above);Unknown;Unpaid work (volunteer) | Alphanumeric | Adult | Supplemental | 1.00 | 2014-06-06 08:50:45.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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| C19287 | Income basic needs status | IncomeBasicNeedsStatus | The status of how the household currently manages to meet basic needs as defined by food, shelter and clothing | The status of how the household currently manages to meet basic needs as defined by food, shelter and clothin | Does the subject's income meet the subject's household's basic needs? | Very well;Very poorly;Unknown;Refused to answer;Rather well;Rather poorly;Adequately (neither well nor poorly) | Very well;Very poorly;Unknown;Refused to answer;Rather well;Rather poorly;Adequately (neither well nor poorly) | Alphanumeric | Adult | Supplemental | 1.00 | 2014-06-06 11:03:24.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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| C21977 | Sport high school other participation total year count | SportHighSchoolOtherYrsCt | Total combined number of years participant/subject played other sport(s) in high school | Total combined number of years participant/subject played other sport(s) in high school | How many total combined years did the subject play other sports in high school? | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 18:12:55.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Free-Form Entry |
0 | |||||||||||
| C21988 | Sport recreational other participation year count | SportRecreationlOtherYrsCt | Total number of years participant/subject played other sport(s) recreationally | Total number of years participant/subject played other sport(s) recreationally | How many total combined years did the subject play other recreational sports? | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2016-06-06 18:34:23.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Free-Form Entry |
0 | |||||||||||
| C14123 | Country of residence name | CntryResdnceName | Country where the participant/subject currently lives | Country where the participant/subject currently live | What is the subject's current country of residence name? | Alphanumeric |
This CDE should be used in combination with Country of residence ISO code CDE when there is no ISO code available for the country name. It may be easier to record the full name of the country and code the data later using the ISO 3166-1 alpha-2 codes. |
Adult;Pediatric | Supplemental | 3.00 | 2013-06-21 00:00:00.0 | FITBIR Demographics Form | Demographics | Participant Characteristics | 255 |
Free-Form Entry |
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| C21805 | Caregiver primary extended type | CaregvPrimryExtendType | Type of relationship between the person who acts as the primary caregiver for the participant/subject and the participant/subject | Type of relationship between the person who acts as the primary caregiver for the participant/subject and the participant/subject | What is the relationship between the person who acts as the primary caregiver for the subject and the subject? | Adoptive father;Adoptive mother;Adoptive parents;Biological father;Biological father - not a primary caregiver;Biological mother;Biological mother - not a primary caregiver;Biological parents;Child;Grandfather;Grandmother;Home aide;Legal guardian;Long-term care/nursing facility staff;Parent;Relative;Self;Sibling;Spouse or partner;Stepfather;Stepmother;Stepparent;Unknown;Other, specify | Adoptive father;Adoptive mother;Adoptive parents;Biological father;Biological father - not a primary caregiver;Biological mother;Biological mother - not a primary caregiver;Biological parents;Child;Grandfather;Grandmother;Home aide;Legal guardian;Long-term care/nursing facility staff;Parent;Relative;Self;Sibling;Spouse or partner;Stepfather;Stepmother;Stepparent;Unknown;Other, specify | Alphanumeric |
Type of relationship between the person who acts as the primary caregiver for the participant/subject and the participant/subject |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-03 11:18:55.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Multiple Pre-Defined Values Selected |
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| C22688 | Parent Race USA Category | ParentRaceUSACat | The participant's/subject's parent self declared racial origination, independent of ethnic origination, using OMB approved categories | The participant's/subject's parent self declared racial origination, independent of ethnic origination, using OMB approved categorie | What is the parent, guardian, or caregiver's race, based on the OBM race standards? | American Indian or Alaska Native;Asian;Black or African-American;Native Hawaiian or Other Pacific Islander;White;Unknown;Not Reported | A person having origins in any of the original peoples of North and South America (including Central America) , and who maintains tribal affiliation or community attachment.;A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.;A person having origins in any of the black racial groups of Africa. Terms such as "Haitian" can be used in addition to "Black or African American.";A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.;A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.;Could not be determined or unsure;Not provided or unavailable | Alphanumeric |
The participant's/subject's parent self declared racial origination, independent of ethnic origination, using OMB approved categories. Choose all that apply. Response is obtained by report of the participant/subject or caretaker. Collecting information on race may not be allowed in some countries for concerns related to discrimination. In other countries, however, these concerns are considered a reason for recording race in order to guarantee equal access to care. Investigators receiving funding from the US National Institutes of Health (NIH) are required to report the number of subjects enrolled on an annual basis using the racial categories listed. |
Adult;Pediatric | Core | 3.00 | 2013-07-25 08:54:08.2 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Multiple Pre-Defined Values Selected |
2192199 | ||||||||
| C18658 | Employment expanded status | EmplmtExpndStatus | Status of participant/subject's current employment (expanded list) | Status of participant/subject's current employment (expanded list) | What is the status of the subject's current employment? | Working full time;Working 20-34 hrs/week, at least minimum wage;Working less than 20 hrs/week, at least minimum wage;Temporary/odd jobs/less than minimum wage jobs;Special employment;Sick leave or maternity leave;Unemployed;Other, specify;Not in paid workforce;Unable to obtain information;Unknown | Working full time (35 hrs or more/week, at least minimum wage);Working 20-34 hrs/week, at least minimum wage;Working less than 20 hrs/week, at least minimum wage;Temporary/odd jobs/less than minimum wage jobs;Special employment (sheltered workshop, supportive employment, job coach);Sick leave or maternity leave;Unemployed;Other, specify;Not in paid workforce (including child, retired, student, homemaker, disabled pre-injury);Unable to obtain information;Unknown | Alphanumeric |
Prior TBI studies utilized the Employment Status data element for data capture Choose one. |
National Health and Nutrition Examination Survey (http: //www.cdc.gov/nchs/nhanes.htm) | Adult;Pediatric | Supplemental | 1.00 | 2013-07-16 14:01:43.01 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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| C21817 | Sport elementary school other participation total year count | ElemntrySchoolSportOtherYrsCt | Total combined number of years the participant/subject played other sport(s) in elementary school | Total combined number of years the participant/subject played other sport(s) in elementary school | What are the total combined years the subject played the other sports in elementary school? | Numeric Values |
Total combined number of years the participant played other sport(s) in elementary school |
Adult;Pediatric | Supplemental | 1.00 | 2016-06-03 12:00:40.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Free-Form Entry |
0 | 100 | |||||||||
| C00026 | Language spoken Fluent text | LangSpokeFluentTxt | Text for each language that the participant/subject speaks fluently | Text for each language that the participant/subject speaks fluently | Please list each language the subject can speak fluently: | Alphanumeric |
Text for all languages participant/subject speaks fluently. It may be easier to record the full name of the language and code the data later using the ISO 639-2 codes. The language data should be coded using the ISO 639-2 codes prior to aggregation or sharing. |
ISO 639-2 language codes (http://www.loc.gov/standards/iso639-2/php/code_list.php) | Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | FITBIR Demographics Form | Demographics | Participant Characteristics | 255 |
Free-Form Entry |
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| C00208 | Military USA service branch type | MilUSAServBrnchTyp | Branch of service in the U.S. military, not including the Commissioned Corps | Branch of service in the U.S. military, not including the Commissioned Corps | Which branch of service in the U.S. Military is the subject involved? | Air force;Army;Marine Corps;Navy;Coast Guard;Other, specify;Air Force Reserve;Army Reserve;Coast Guard Reserves;Navy Reserves;Marine Corps Reserves;Air National Guard;Army National Guard | Air force;Army;Marine Corps;Navy;Coast Guard;Other, specify;Air Force Reserve;Army Reserve;Coast Guard Reserves;Navy Reserves;Marine Corps Reserves;Air National Guard;Army National Guard | Alphanumeric |
Choose one. Response is obtained by report of the participant/subject or relatives. |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-20 10:21:25.65 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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| C22699 | Parent employment expanded status | ParentEmplmtExpndStatus | Status of the participant's/subject's parent, guardian, or caregiver's current employment | Status of the participant's/subject's parent, guardian, or caregiver's current employment | What is the status of the parent's, guardian's, or caregiver's current employment? | Working full time;Working 20-34 hrs/week, at least minimum wage;Working less than 20 hrs/week, at least minimum wage;Temporary/odd jobs/less than minimum wage jobs;Special employment;Sick leave or maternity leave;Unemployed;Other, specify;Not in paid workforce;Unable to obtain information;Unknown | Working full time (35 hrs or more/week, at least minimum wage);Working 20-34 hrs/week, at least minimum wage;Working less than 20 hrs/week, at least minimum wage;Temporary/odd jobs/less than minimum wage jobs;Special employment (sheltered workshop, supportive employment, job coach);Sick leave or maternity leave;Unemployed;Other, specify;Not in paid workforce (including child, retired, student, homemaker, disabled pre-injury);Unable to obtain information;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2013-07-16 14:01:43.01 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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| C21114 | Visit post baseline day count | VisitPostBaselineDayCt | The number of days since baseline visit | The number of days since baseline visi | The number of days since baseline | Numeric Values |
Enter the number of days passed since the baseline visit |
Adult;Pediatric | Supplemental | 1.00 | 2015-06-12 14:49:48.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Free-Form Entry |
day | ||||||||||
| C21978 | Sport college participation indicator | SportCollegePartInd | Indicator whether the participant/subject played sports in college | Indicator whether the participant/subject played sports in colleg | Did the subject participate in sports in college? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult | Supplemental | 1.00 | 2016-06-06 18:13:59.0 | FITBIR Demographics Form | Demographics | Participant Characteristics |
Single Pre-Defined Value Selected |
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