CDE Detailed Report

Disease: Headache
Sub-Domain: General Health History
CRF: Behavioral History

Displaying 1 - 32 of 32
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
C19502 Tobacco cigarettes smoke daily average value TobccoCigrtSmkeDailyAvgVal Tobacco cigarettes smoked daily average number If participant is a former or current smoker, documents the average number of cigarettes he/she smokes or did smoke on a daily basis During the time that you regularly smoked, on average, how much did you smoke per day? Number of cigarettes: Numeric Values

History can be obtained from participant/subject, family member, friend, or chart/medical record.

PhenX Toolkit https://www.phenxtoolkit.org/index.php - Protocol 1 : Tobacco - 30-Day Quantity and Frequency (Adolescent Protocol) #030801 Adult;Pediatric Supplemental 3.00 2013-07-17 09:26:36.973 Behavioral History General Health History Participant History and Family History

Free-Form Entry

C56008 Perceived Stress Scale (PSS) - Unable control important thing life scale PSSUnablCntrlImprtntThngLfScl Scale of how often in the last month that the participant/subject has felt that he or she was unable to control the important things in his/her life Scale of how often in the last month that the participant/subject has felt that he or she was unable to control the important things in his/her life In the last month, how often have you felt that you were unable to control the important things in your life? Never;Almost Never;Sometimes;Fairly Often;Very Often Never;Almost Never;Sometimes;Fairly Often;Very Often Alphanumeric

The four questions listed were taken from the PSS-4 item questionnaire. The questions in this scale ask about the participant's feelings and thoughts during the last month.

No references available Adult;Pediatric Supplemental 1.00 2017-06-05 11:52:29.0 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00703 Tobacco use started age value TobcoUseStrtAgeVal Age in years when participant/subject started using tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) Age in years when participant/subject started using tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) Age started tobacco use (years): Numeric Values

History can be obtained from participant/ subject, family member, friend, or chart/ medical record. The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected.

No references available Adult;Pediatric Supplemental 3.00 2013-07-18 14:26:06.9 Behavioral History General Health History Participant History and Family History

Free-Form Entry

0 120 year 2178045
C06108 Tobacco smoke pack-year value TobccoSmkePckYrVal If participant is a former or current cigarette smoker, documents the number of pack-years of smoking [(average number smoked daily)/20] x (number of years smoked) = pack-years] If participant is a former or current cigarette smoker, documents the number of pack-years of smoking [(average number smoked daily)/20] x (number of years smoked) = pack-years] For former or current cigarette smokers only, indicate the number of pack-years of smoking: [(average number of cigarettes smoked daily)/20] x (number of years smoked: _____pack-years Numeric Values

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type

No references available Adult;Pediatric Supplemental 3.00 2013-07-17 09:26:36.973 Behavioral History General Health History Participant History and Family History

Free-Form Entry

pack-years
C56009 Perceived Stress Scale (PSS) - Confident handle personal problem scale PSSCnfdntHndlPrsnlPrblmScl Scale of how often in the last month that the participant/subject has felt confident in his or her ability to handle his or her personal problems Scale of how often in the last month that the participant/subject has felt confident in his or her ability to handle his or her personal problems In the last month, how often have you felt confident about your ability to handle your personal problems? Never;Almost Never;Sometimes;Fairly Often;Very Often Never;Almost Never;Sometimes;Fairly Often;Very Often Alphanumeric

The four questions listed were taken from the PSS-4 item questionnaire. The questions in this scale ask about the participant's feelings and thoughts during the last month.

No references available Adult;Pediatric Supplemental 1.00 2017-06-05 11:52:29.0 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00704 Alcohol drinking day average drinks consumed range AlcDrinkingDayAvgDrinksCnsmRng The counted number of drinks containing alcohol consumed by the participant/subject on a typical day when he/she is drinking. It is noted that the meaning of "drinks consumed" differs from one nation and culture to another, so the most common alcoholic beverages likely to be consumed will be defined as well as quantity of each that constitutes a drink (approximately 10 grams of pure ethanol). For example, one bottle of beer (330 ml at 5% ethanol), a glass of wine (140 ml at 12% ethanol), and a shot of spirits (40 ml at 40% ethanol) represent a standard drink of about 13 g of ethanol. The counted number of drinks containing alcohol consumed by the participant/subject on a typical day when he/she is drinking. It is noted that the meaning of "drinks consumed" differs from one nation and culture to another. How many alcoholic drinks do you have on a typical day when you are drinking? 1 or 2;3 or 4;5 or 6;7, 8, or 9;10 or more;Unknown 1 or 2;3 or 4;5 or 6;7, 8, or 9;10 or more;Unknown Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Question is from the Alcohol Use Disorders Identification Test (AUDIT) - http://www.who.int/substance_abuse/activities/sbi/en/ Adult;Pediatric Supplemental 3.00 2013-07-18 16:35:19.49 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3171647
C18670 Subscribed drug or substance illicitly used other text SbscrbdDrgSubIllctUseOTH The free-text field related to 'Drug or substance illicitly used category' specifying other text. Category of illegal drugs, prescription, or over-the-counter drugs the participant/subject used for purposes other than those for which they are meant to be used, or in large amounts Drug or substance illicitly used category' specifying other text. Category of illegal drugs, prescription, or over-the-counter drugs the participant/subject used for purposes other than those for which they are meant to be used, or in large amounts Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol) Alphanumeric Adult Supplemental 1.00 2014-05-27 13:34:46.0 Behavioral History General Health History Participant History and Family History 4000

Free-Form Entry

3171797
C56010 Perceived Stress Scale (PSS) - Thing going your way scale PSSThingGoingYourWayScl Scale of how often in the last month that the participant/subject has felt that things were going his or her way Scale of how often in the last month that the participant/subject has felt that things were going his or her way In the last month, how often have you felt that things were going your way? Never;Almost Never;Sometimes;Fairly Often;Very Often Never;Almost Never;Sometimes;Fairly Often;Very Often Alphanumeric

The four questions listed were taken from the PSS-4 item questionnaire. The questions in this scale ask about the participant's feelings and thoughts during the last month.

No references available Adult;Pediatric Supplemental 1.00 2017-06-05 11:52:29.0 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00705 Alcohol current use indicator AlcCurntUseInd Indicator of whether the participant/subject consumed at least one alcoholic drink within the past 12 months Indicator of whether the participant/subject consumed at least one alcoholic drink within the past 12 months Current drinker? (Consumed at least one drink within the past year) Yes;No;Unknown Yes;No;Unknown Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record. In the U.S., a single drink serving contains about 14 grams of ethanol or "pure" alcohol. Although the drinks below are different sizes, each one contains the same amount of pure alcohol and counts as a single drink: 12 oz. of beer (about %% alcohol) = 8-9 oz. of malt liquor (about 7% alcohol) = 5 oz. of wine (about 12% alcohol) = 1.5 oz. of hard liquor (about 40% alcohol)

No references available Adult;Pediatric Supplemental 3.00 2013-07-18 14:26:06.9 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3171540
C20377 Pittsburgh Sleep Quality Index (PSQI) - Past month bed time PSQIPastMonthBedTime The bed time (recorded as 24-hour clock or military time) for the majority of the nights in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI). The bed time (recorded as 24-hour clock or military time) for the majority of the nights in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI). In the last month, when have you gone to bed at night? Date or Date & Time

The first four questions were taken from the PSQI. The questions in this scale ask about the participant's sleep quality.

No references available Adult;Pediatric Supplemental 1.00 2015-03-11 11:17:32.0 Behavioral History General Health History Participant History and Family History

Free-Form Entry

C56011 Perceived Stress Scale (PSS) - Difficulty piling up unable overcome scale PSSDffcltyPlngUpUnablOvrcmScl Scale of how often in the last month that the participant/subject has felt that difficulties were piling up so high that he or she could not overcome them Scale of how often in the last month that the participant/subject has felt that difficulties were piling up so high that he or she could not overcome them In the last month, how often have you felt difficulties were piling up so high that you could not overcome them? Never;Almost Never;Sometimes;Fairly Often;Very Often Never;Almost Never;Sometimes;Fairly Often;Very Often Alphanumeric

The four questions listed were taken from the PSS-4 item questionnaire. The questions in this scale ask about the participant's feelings and thoughts during the last month.

No references available Adult;Pediatric Supplemental 1.00 2017-06-05 11:52:29.0 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00706 Alcohol prior use indicator AlcPriorUseInd Indicator of the participant's/subject's alcohol consumption prior to the past 12 months Indicator of the participant's/subject's alcohol consumption prior to the past 12 months Past drinker? (Consumed at least one drink prior to the past year) Yes;No;Unknown Yes;No;Unknown Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3171578
C55907 Nonsubscribed drug or substance illicitly used category NonsbscrbdDrgSubIllctUseCat Category of illegal drugs, prescription, or over-the-counter drugs unsubscribed by the participant/subject, and used for purposes other than those for which they are meant to be used, or in large amounts Category of illegal drugs, prescription, or over-the-counter drugs unsubscribed by the participant/subject, and used for purposes other than those for which they are meant to be used, or in large amounts If YES, specify type(s) used (select all that apply): Sedatives (e.g., sleeping pills, barbiturates, Seconal, Quaaludes, or Chloral Hydrate);Tranquilizers or anti-anxiety drugs (e.g., Valium, Librium, muscle relaxants, or Xanax);Painkillers (e.g., Codeine, Darvon, Percodan, Dilaudid, or Demerol);Stimulants (e.g., Preludin, Benzedrine, Methadrine, uppers, or speed);Marijuana, hash, THC, or grass;Cocaine or crack;Hallucinogens (e.g., Ecstasy, LSD, mescaline, psilocybin, PCP, angel dust, or peyote);Inhalants or Solvents (e.g., amyl nitrate, nitrous oxide, glue, toluene, or gasoline;Heroin;Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol) Sedatives (e.g., sleeping pills, barbiturates, Seconal, Quaaludes, or Chloral Hydrate);Tranquilizers or anti-anxiety drugs (e.g., Valium, Librium, muscle relaxants, or Xanax);Painkillers (e.g., Codeine, Darvon, Percodan, Dilaudid, or Demerol);Stimulants (e.g., Preludin, Benzedrine, Methadrine, uppers, or speed);Marijuana, hash, THC, or grass;Cocaine or crack;Hallucinogens (e.g., Ecstasy, LSD, mescaline, psilocybin, PCP, angel dust, or peyote);Inhalants or Solvents (e.g., amyl nitrate, nitrous oxide, glue, toluene, or gasoline;Heroin;Other, specify (e.g., Methadone, Elavil, steroids, Thorazine, or Haldol) Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

PhenX Toolkit - Substances - Lifetime Use Protocol #031100: https://www.phenxtoolkit.org/index.php Adult;Pediatric Supplemental 3.00 2013-07-22 09:34:41.527 Behavioral History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

3171797
C56029 Pittsburgh Sleep Quality Index (PSQI) - Fall asleep past month length value PSQIFallAsleepPastMnthLngthVal The value of time (in minutes) it takes the subject to fall asleep the majority of the nights in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI). The value of time (in minutes) it takes the subject to fall asleep the majority of the nights in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI). In the last month, how long (in minutes) has it taken you to fall asleep each night? Numeric Values

The first four questions were taken from the PSQI. The questions in this scale ask about the participant's sleep quality.

No references available Adult;Pediatric Supplemental 1.00 2015-03-11 11:17:32.0 Behavioral History General Health History Participant History and Family History

Free-Form Entry

minutes
C00707 Alcohol consume six or more drinks frequency AlcConsume6MoreDrinkFreq The rate of occurrence for when the participant/subject consumes six or more drinks containing alcohol on one occasion. It is noted that the meaning of "drinks consumed" differs from one nation and culture to another, so the most common alcoholic beverages likely to be consumed will be defined as well as quantity of each that constitutes a drink (approximately 10 grams of pure ethanol). For example, one bottle of beer (330 ml at 5% ethanol), a glass of wine (140 ml at 12% ethanol), and a shot of spirits (40 ml at 40% ethanol) represent a standard drink of about 13 g of ethanol. The rate of occurrence for when the participant/subject consumes six or more drinks containing alcohol on one occasion. It is noted that the meaning of "drinks consumed" differs from one nation and culture to another. How often do you have six or more drinks on one occasion? Never;Less than monthly;Monthly;Weekly;Daily or almost daily Never;Less than monthly;Monthly;Weekly;Daily or almost daily Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Question is from the Alcohol Use Disorders Identification Test (AUDIT) - http://www.who.int/substance_abuse/activities/sbi/en/ Adult;Pediatric Supplemental 3.00 2013-07-18 16:35:19.49 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3171659
C55953 Tobacco use stopped age not applicable status TobcoUseStopAgeNoAplcblStat Status indicating that age stopped tobacco use does not apply to the subject/participant as they are still using tobacco. Status indicating that age stopped tobacco use does not apply to the subject/participant as they are still using tobacco. N/A - still using tobacco Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type

No references available Adult;Pediatric Supplemental 3.00 2013-07-18 14:26:06.9 Behavioral History General Health History Participant History and Family History 255

Free-Form Entry

2524471
C56031 Pittsburgh Sleep Quality Index (PSQI) - Get up morning past month time PSQIGetupMorningPastMonthTime The time at which the subject got up in the morning during the past month, as part of the Pittsburgh Sleep Quality Index (PSQI). The time at which the subject got up in the morning during the past month, as part of the Pittsburgh Sleep Quality Index (PSQI). During the past month, when have you usually gotten up in the morning? Date or Date & Time

The first four questions were taken from the PSQI. The questions in this scale ask about the participant's sleep quality.

No references available Adult;Pediatric Supplemental 1.00 2015-03-11 11:17:32.0 Behavioral History General Health History Participant History and Family History

Free-Form Entry

C00708 Alcohol use related to hospitalization indicator AlcUseRelatedHospInd Indicator of whether the participant/subject has been hospitalized for an alcohol-related problem (i.e., esophageal varices, delirium tremens (DTs), cirrhosis and others) Indicator of whether the participant/subject has been hospitalized for an alcohol-related problem (i.e., esophageal varices, delirium tremens (DTs), cirrhosis and others) Have you ever been hospitalized for an alcohol-related problem? (e.g., esophageal varices, delirium tremens (DTs), cirrhosis, etc.) Yes;No;Unknown Yes;No;Unknown Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

No references available Adult;Pediatric Supplemental 3.00 2013-07-18 14:26:06.9 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3171677
C55959 Tobacco packs smoked daily average value TobcoPackSmokedDlyAvgVal Average number of packs of cigarettes the participant/subject smokes daily (On the days you smoked cigarettes during the past 30 days, how many cigarettes did you smoke per day, on average?) Average number of packs of cigarettes the participant/subject smokes daily (On the days you smoked cigarettes during the past 30 days, how many cigarettes did you smoke per day, on average?) During the time that you regularly smoked, on average, how much did you smoke per day? Number of Packs: Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type

No references available Adult;Pediatric Supplemental 3.00 2013-07-18 14:26:06.9 Behavioral History General Health History Participant History and Family History 255

Free-Form Entry

3170853
C56034 Pittsburgh Sleep Quality Index (PSQI) - Asleep past month hour duration PSQIAsleepPastMonthHourDur The duration of time (in hours) the subject was asleep the majority of the nights in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI). The duration of time (in hours) the subject was asleep the majority of the nights in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI). In the last month, how many hours of actual sleep did you get at night? (This may e different than the number of hours you spent in bed) Numeric Values

The first four questions were taken from the PSQI. The questions in this scale ask about the participant's sleep quality.

No references available Adult;Pediatric Supplemental 1.00 2015-03-11 11:17:32.0 Behavioral History General Health History Participant History and Family History

Free-Form Entry

0 5000 hours
C00710 Tobacco current use indicator TobcoUseCurntInd Indicator for whether the participant/subject regularly uses tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) at the present time. Indicator for whether the participant/subject regularly uses tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) at the present time. Current tobacco use? Yes;No;Unknown Yes;No;Unknown Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.
Supplemental - Highly Recommended based on study type, disease stage and disease type.

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3170060
C55966 Alcohol use stopped age not applicable status AlcUseStopAgeNoAplcblStat Status indicating that age quit drinking does not apply to the subject/participant, as they are still ingesting alcoholic beverages, including social drinking Status indicating that age quit drinking does not apply to the subject/participant, as they are still ingesting alcoholic beverages, including social drinking N/A -- still drinking alcohol Alphanumeric

Skip is Q7 and Q8 are both no

No references available Adult;Pediatric Supplemental 3.00 2013-07-18 14:26:06.9 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

2008448
C00711 Tobacco prior use indicator TobcoPriorUseInd Indicator of the participant's/subject's past regular tobacco (e.g., cigarettes, cigars, chewing tobacco or pipe) use prior to the past 12 months Indicator of the participant's/subject's past regular tobacco (e.g., cigarettes, cigars, chewing tobacco or pipe) use prior to the past 12 months Past tobacco use? (Regular use of cigarettes, cigars, chewing tabacco or pipes prior ro the past year) Yes;No;Unknown Yes;No;Unknown Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3170080
C55977 Overall diet health scale OverallDietHealthScl A general scale of how healthy the participant/subject's diet is A general scale of how healthy the participant/subject's diet is In general, how healthy is your overall diet? Excellent;Good;Fair;Poor;Very good Excellent;Good;Fair;Poor;Very good Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type

No references available Adult;Pediatric Supplemental 1.00 2017-06-05 09:36:12.0 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00700 Alcohol use stopped age value AlcUseStopAgeVal Age in years when participant/subject stopped ingesting alcoholic beverages, including social drinking Age in years when participant/subject stopped ingesting alcoholic beverages, including social drinking Age quit drinking (years): Numeric Values

History can be obtained from participant/ subject, family member, friend, or chart/ medical record. The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected.

No references available Adult;Pediatric Supplemental 3.00 2013-07-18 14:26:06.9 Behavioral History General Health History Participant History and Family History

Free-Form Entry

0 120 year 2008448
C00713 Drug or substance current illicit use indicator DrgSubstCurrntIllicitUseInd Indicator of participant's/subject's use of illegal drugs, prescription or over-the-counter drugs in the past year for purposes other than those for which they are meant to be used, or in large amounts Indicator of participant's/subject's use of illegal drugs, prescription or over-the-counter drugs in the past year for purposes other than those for which they are meant to be used, or in large amounts Current drug user? Yes;No;Unknown Yes;No;Unknown Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3171724
C55989 Regular aerobic exercise indicator RegularAerobicExerciseInd Indicator related to whether or not the participant/subject participates in regular aerobic exercise Indicator related to whether or not the participant/subject participates in regular aerobic exercise Regular aerobic exercise No;Yes;Unknown No;Yes;Unknown Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type

No references available Adult;Pediatric Supplemental 1.00 2017-06-05 10:05:06.0 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00701 Tobacco use stopped age value TobcoUseStopAgeVal Age in years when participant/subject stopped using tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) Age in years when participant/subject stopped using tobacco products (e.g., cigarettes, cigars, chewing tobacco or pipe) Age stopped tobacco use (years): Numeric Values

History can be obtained from participant/ subject, family member, friend, or chart/ medical record. The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected.

No references available Adult;Pediatric Supplemental 3.00 2013-07-18 14:26:06.9 Behavioral History General Health History Participant History and Family History

Free-Form Entry

0 120 year 2524471
C00714 Behavioral history assessment date and time BehavrlHistAssmtDateTime Date (and time, if applicable and known) the participant/subject behavioral history was taken. Date (and time, if applicable and known) the participant/subject behavioral history was taken. Date behavioral history taken: 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.).
Supplemental - Highly Recommended based on study type, disease stage and disease type.

No references available Adult;Pediatric Supplemental 3.00 2013-07-18 14:26:06.9 Behavioral History General Health History Participant History and Family History

Free-Form Entry

3170040
C55993 Regular aerobic exercise days week number RglrArbcExrcsDysWkNum Number of days per typical week that the participant/subject engages in aerobic exercises Number of days per typical week that the participant/subject engages in aerobic exercises If yes, during a typical week how many days do you get regular aerobic exercise 0;1-2;3-5;6-7 0;1-2;3-5;6-7 Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type

No references available Adult;Pediatric Supplemental 1.00 2017-06-05 10:17:15.0 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00702 Alcohol use started age value AlcUseStrtAgeVal Age in years when participant/subject started ingesting alcoholic beverages, including social drinking Age in years when participant/subject started ingesting alcoholic beverages, including social drinking Age started drinking (years): Numeric Values

History can be obtained from participant/ subject, family member, friend, or chart/ medical record. The age in years should be collected or N/A (Not applicable if subject never smoked) should be selected.

No references available Adult;Pediatric Supplemental 3.00 2013-07-18 14:26:06.9 Behavioral History General Health History Participant History and Family History

Free-Form Entry

0 120 year 2008447
C00730 Alcohol use frequency AlcUseFreq The frequency of consumption of alcohol by the participant. The frequency of consumption of alcohol by the participant. How often do you have a drink containing alcohol? Monthly or less;2 to 4 times a month;2 to 3 times a week;4 or more times a week;Never Monthly or less;2 to 4 times a month;2 to 3 times a week;4 or more times a week;Never Alphanumeric

History can be obtained from participant/ subject, family member, friend, or chart/ medical record.

Supplemental - Highly Recommended based on study type, disease stage and disease type

Question is from the Alcohol Use Disorders Identification Test (AUDIT) - http://www.who.int/substance_abuse/activities/sbi/en/ Adult;Pediatric Supplemental 3.00 2013-07-18 16:35:19.49 Behavioral History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3171627
CSV