ID

14813

Description

The Age-Related Hearing Impairment instrument is a self-administered questionnaire which asks about an individual’s hearing impairment history, history of ear diseases and operations, family history, and history of exposure to loud noises. ODM derived from: https://cde.nlm.nih.gov Primary source: https://www.phenxtoolkit.org/ Recent publication: Hendershot, T., Pan, H., Haines, J., Harlan, W.R., Marazita, M.L., McCarty, C.A., Ramos, E.M., and Hamilton, C.M. (2015) Using the PhenX toolkit to add standard measures to a study. Curr. Protoc. Hum. Genet. 86:1.21.1-1.21.17. doi: 10.1002/0471142905.hg0121s86 Permission to publish granted by Carol M. Hamilton.

Lien

https://cde.nlm.nih.gov

Mots-clés

  1. 29/04/2016 29/04/2016 -
  2. 20/09/2021 20/09/2021 -
Téléchargé le

29 avril 2016

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0

Modèle Commentaires :

Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.

Groupe Item commentaires pour :

Item commentaires pour :

Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.

Personal and Family History of Hearing Loss Protocol PhenX Toolkit

Personal and Family History of Hearing Loss Protocol PhenX Toolkit

PhenX - personal and family history of hearing loss protocol
Description

PhenX - personal and family history of hearing loss protocol

Alias
UMLS CUI-1
C3171804
Do you have any difficulty with your hearing?
Description

any difficulty with hearing

Type de données

boolean

Alias
UMLS CUI [1]
C1313969
In which ear(s) do you have a hearing difficulty?
Description

ear hearing difficulty

Type de données

text

Alias
UMLS CUI [1,1]
C1313969
UMLS CUI [1,2]
C0013443
At what age did you first notice a hearing difficulty?
Description

age onset hearing difficulty

Type de données

integer

Alias
UMLS CUI [1,1]
C0206132
UMLS CUI [1,2]
C1313969
How quickly did your hearing difficulty develop?
Description

hearing difficulty development

Type de données

text

Alias
UMLS CUI [1,1]
C1313969
UMLS CUI [1,2]
C0242656
Do you know the reason for your hearing difficulty?
Description

reason for hearing difficulty

Type de données

text

Alias
UMLS CUI [1,1]
C1313969
UMLS CUI [1,2]
C0392360
Do you know the reason for your hearing difficulty? (if there is a separate cause for each of your ears, please note them accordingly) Describe:
Description

reason for hearing difficulty description

Type de données

text

Alias
UMLS CUI [1,1]
C1313969
UMLS CUI [1,2]
C0392360
Does your hearing vary from day to day?
Description

hearing vary from day to day

Type de données

text

Alias
UMLS CUI [1]
C3260786
Do you find it very difficult to follow a conversation if there is background noise (e.g. TV, radio, children playing)?
Description

background noise

Type de données

boolean

Alias
UMLS CUI [1]
C1303045
Are you particularly sensitive to loud sounds?
Description

sensitive to loud sounds

Type de données

boolean

Alias
UMLS CUI [1]
C0034880
Do you sometimes feel a fullness or blockage in your ears?
Description

feeling of blockage in ears

Type de données

text

Alias
UMLS CUI [1]
C2199600
Nowadays, do you ever get noises in your head or ears (tinnitus) which usually last longer than five minutes?
Description

tinnitus

Type de données

boolean

Alias
UMLS CUI [1]
C0040264
Have you ever had an ear disease that has caused your hearing to get worse?
Description

ear disease

Type de données

boolean

Alias
UMLS CUI [1]
C0013447
Have you ever had discharge of blood or pus, or smelly discharge (not wax) from either ear?
Description

discharge from ear

Type de données

text

Alias
UMLS CUI [1]
C0155540
Have you ever had an ear operation?
Description

ear operation

Type de données

text

Alias
UMLS CUI [1]
C0198010
Have you ever suffered from attacks of dizziness in which things seem to spin around you?
Description

dizziness

Type de données

text

Alias
UMLS CUI [1]
C0012833
Do you feel unsteady when walking in the dark?
Description

feel unsteady walking in the dark

Type de données

boolean

Alias
UMLS CUI [1]
C3260804
Do you have any brothers or sisters with normal hearing?
Description

any brothers or sisters with normal hearing

Type de données

boolean

Alias
UMLS CUI [1,1]
C0234725
UMLS CUI [1,2]
C0037047
Do you have any brothers or sisters with normal hearing? (how many of your brothers/sisters have normal hearing?)
Description

brothers or sisters with normal hearing number

Type de données

integer

Alias
UMLS CUI [1,1]
C0234725
UMLS CUI [1,2]
C0037047
Do you have any brothers or sisters with hearing difficulties?
Description

Do you have any brothers or sisters with hearing difficulties?

Type de données

boolean

Alias
UMLS CUI [1,1]
C1313969
UMLS CUI [1,2]
C0037047
Do you have any brothers or sisters with hearing difficulties? (how many of your brothers/sisters have hearing difficulties?)
Description

brothers or sisters with hearing difficulties number

Type de données

integer

Alias
UMLS CUI [1,1]
C1313969
UMLS CUI [1,2]
C0037047
Do you have any children with normal hearing?
Description

children with normal hearing

Type de données

boolean

Alias
UMLS CUI [1,1]
C0234725
UMLS CUI [1,2]
C0008059
How many children with normal hearing?
Description

children with normal hearing number

Type de données

integer

Alias
UMLS CUI [1,1]
C0234725
UMLS CUI [1,2]
C0008059
Do you have any children with hearing difficulties? (how many of your children have hearing difficulties?)
Description

children with hearing difficulties

Type de données

boolean

Alias
UMLS CUI [1,1]
C1313969
UMLS CUI [1,2]
C0008059
How many children with hearing difficulties? (how many of your children have hearing difficulties?)
Description

children with hearing difficulties number

Type de données

integer

Alias
UMLS CUI [1,1]
C1313969
UMLS CUI [1,2]
C0008059
Relative [PhenX]
Description

relative

Type de données

text

Alias
UMLS CUI [1]
C3172260
Do you have uncles, aunts, cousins, nephews, or nieces with hearing difficulties?
Description

family members with hearing difficulties

Type de données

boolean

Alias
UMLS CUI [1,1]
C1313969
UMLS CUI [1,2]
C0086282
Do you know if any of your relatives have already participated in this investigation?
Description

relatives have already participated in this investigation

Type de données

text

Alias
UMLS CUI [1,1]
C2348568
UMLS CUI [1,2]
C0086282
Relative [PhenX]
Description

relative

Type de données

text

Alias
UMLS CUI [1]
C3172260
Do you know if any of your relatives have already participated in this investigation? Name of your relative that have already participated in this investigation
Description

other relative name

Type de données

text

Alias
UMLS CUI [1]
C3260822
If yes, what is his/her relationship to you?
Description

relationship

Type de données

text

Alias
UMLS CUI [1]
C0015608
Do you suffer from migraine?
Description

migraine

Type de données

boolean

Alias
UMLS CUI [1]
C0149931
How often do you generally have attacks?
Description

migraine attack frequency

Type de données

text

Alias
UMLS CUI [1,1]
C0149931
UMLS CUI [1,2]
C0439603
Have you ever suffered a hearing loss from meningitis or encephalitis?
Description

hearing loss from meningitis or encephalitis

Type de données

text

Alias
UMLS CUI [1,1]
C3887873
UMLS CUI [1,2]
C0025289
UMLS CUI [2,1]
C3887873
UMLS CUI [2,2]
C0014038
Have you ever had a whiplash injury?
Description

whiplash injury

Type de données

text

Alias
UMLS CUI [1]
C0043145
Have you ever been knocked unconscious (e.g., in a traffic accident, contact sport, a fight or after a fall)?
Description

knocked unconscious

Type de données

text

Alias
UMLS CUI [1]
C0560617
Has a doctor ever told you that you had a myocardial infarction or heart attack?
Description

myocardial infarction or heart attack

Type de données

text

Alias
UMLS CUI [1]
C0027051
Have you ever had heart surgery?
Description

heart surgery

Type de données

boolean

Alias
UMLS CUI [1]
C0018821
What operation(s)? (Please describe)
Description

heart surgery description

Type de données

text

Alias
UMLS CUI [1]
C0018821
Have you ever had coronary artery catheterization?
Description

coronary artery catheterization

Type de données

boolean

Alias
UMLS CUI [1]
C0179744
What type of intervention(s) (e.g., stent, balloon dilatation)?
Description

type arterial catheterization

Type de données

boolean

Alias
UMLS CUI [1]
C0179744
Have you ever been told by a physician that you had a stroke?
Description

stroke

Type de données

boolean

Alias
UMLS CUI [1]
C0038454
Date of health-related event
Description

date of health-related event

Type de données

date

Alias
UMLS CUI [1]
C3261226
Have you ever had an operation on your carotid artery?
Description

carotid artery surgery

Type de données

text

Alias
UMLS CUI [1]
C0397645
Do you suffer from intermittent claudication?
Description

intermittent claudication

Type de données

text

Alias
UMLS CUI [1]
C0021775
Do you have other problems with your heart or circulation?
Description

heart problems

Type de données

boolean

Alias
UMLS CUI [1]
C0795691
Do you have other problems with your heart or circulation?
Description

other heart problem

Type de données

text

Alias
UMLS CUI [1,1]
C0795691
UMLS CUI [1,2]
C0205394
Do you suffer from diabetes?
Description

diabetes

Type de données

text

Alias
UMLS CUI [1]
C0011849
Do you need insulin?
Description

insulin

Type de données

boolean

Alias
UMLS CUI [1]
C0021641
Disease history [PhenX]
Description

disease history

Type de données

text

Alias
UMLS CUI [1]
C0683519
Please describe your disease(s):
Description

disease description

Type de données

text

Alias
UMLS CUI [1]
C3259023
Autoimmune diseases [PhenX]
Description

autoimmune diseases

Type de données

text

Alias
UMLS CUI [1]
C0004364
Have you ever had other operations (not covered by the previous questions)?
Description

other operations

Type de données

text

Alias
UMLS CUI [1,1]
C0543467
UMLS CUI [1,2]
C0205394
Do you have other serious health problems that are not covered by the previous questions?
Description

other serious health problems

Type de données

boolean

Alias
UMLS CUI [1,1]
C3258154
UMLS CUI [1,2]
C0205394
Please describe these problems:
Description

serious health problem description

Type de données

text

Alias
UMLS CUI [1,1]
C3258154
UMLS CUI [1,2]
C0205394
Have you ever been treated for a serious infection with an antibiotic (other than penicillin) which was administered by injection/drip for a week or more?
Description

infection with an antibiotic

Type de données

boolean

Alias
UMLS CUI [1,1]
C0009450
UMLS CUI [1,2]
C0338237
If 'YES', for what sort of infections did you receive these antibiotics?
Description

sort of infections antibiotics

Type de données

text

Alias
UMLS CUI [1,1]
C0009450
UMLS CUI [1,2]
C0338237
Have you had cancer or leukemia?
Description

cancer or leukemia

Type de données

boolean

Alias
UMLS CUI [1]
C0006826
UMLS CUI [2]
C0023418
Cancer Site/Type?
Description

cancer type

Type de données

text

Alias
UMLS CUI [1]
C3173298
Have you been treated with chemotherapy or other medication for this condition?
Description

chemotherapy or other medication

Type de données

boolean

Alias
UMLS CUI [1]
C0392920
Chemotherapy treatment Cancer
Description

chemotherapy treatment

Type de données

text

Alias
UMLS CUI [1]
C0392920
Have you ever received radiotherapy to your head or neck for a tumor?
Description

radiotherapy to your head or neck

Type de données

boolean

Alias
UMLS CUI [1,1]
C1522449
UMLS CUI [1,2]
C0460004
What kind of tumor(s)?
Description

tumor type

Type de données

text

Alias
UMLS CUI [1,1]
C0460004
UMLS CUI [1,2]
C0006826
Surgery Date?
Description

surgery date

Type de données

date

Alias
UMLS CUI [1]
C1628561
On average how often do you take painkillers?
Description

painkillers

Type de données

integer

Alias
UMLS CUI [1,1]
C0002771
UMLS CUI [1,2]
C0439603
Do you take aspirin on a daily basis for your heart or to dilute your blood?
Description

aspirin on a daily basis

Type de données

boolean

Alias
UMLS CUI [1,1]
C0004057
UMLS CUI [1,2]
C0332173
If 'YES', how long have you been taking aspirin so far?
Description

aspirin how long

Type de données

text

Alias
UMLS CUI [1]
C0004057
Have you ever fired a gun?
Description

ever fired a gun

Type de données

boolean

Alias
UMLS CUI [1]
C3259043
Weapon type [PhenX]
Description

weapon type

Type de données

text

Alias
UMLS CUI [1]
C0336663
Estimate the total number of shots fired.
Description

total number of shots fired

Type de données

text

Alias
UMLS CUI [1]
C3258157
Did you use ear protection?
Description

use ear protection

Type de données

text

Alias
UMLS CUI [1]
C0567457
If any, which type of ear protection did you use?
Description

type of ear protection

Type de données

text

Alias
UMLS CUI [1]
C3258282
During your leisure time, are you/have you been regularly (more than once a week) exposed to loud sound or noise (so that you have to shout to make yourself heard by someone who was more than 1 m away from you)?
Description

leisure time loud sound

Type de données

boolean

Alias
UMLS CUI [1,1]
C0086542
UMLS CUI [1,2]
C0028263
What kind of loud sound?
Description

kind of loud sound

Type de données

text

Alias
UMLS CUI [1]
C3258353
For how many years have you been exposed to this loud sound?
Description

years exposed to loud sound

Type de données

integer

Unités de mesure
  • years
Alias
UMLS CUI [1]
C3259370
years
How many hours per week have you been exposed to this loud sound?
Description

hours per week exposed loud sound

Type de données

text

Alias
UMLS CUI [1]
C3259372
Did you use ear protection?
Description

use ear protection loud music

Type de données

text

Alias
UMLS CUI [1]
C0567457
What kind of work {were you/was SP} doing?
Description

occupation

Type de données

text

Alias
UMLS CUI [1]
C0028811
Have you been exposed to solvents (e.g., thrichloroethylene, toluene, evaporations from paints or lacquers) for more than one year in one of your jobs?
Description

exposed to solvents

Type de données

boolean

Alias
UMLS CUI [1]
C3261233
Which solvents?
Description

which solvents

Type de données

text

Alias
UMLS CUI [1]
C0037638
In which year did the solvent exposure start?
Description

year solvent exposure start

Type de données

integer

Alias
UMLS CUI [1,1]
C0037638
UMLS CUI [1,2]
C2826743
How many hours per day were you exposed to noise?
Description

hours per day were you exposed to noise

Type de données

text

Alias
UMLS CUI [1]
C1260971
Do you suffer from white finger syndrome/Raynaud's syndrome caused by excessive vibration (e.g., pneumatic hammers or drills)?
Description

white finger syndrome

Type de données

text

Alias
UMLS CUI [1]
C0034735
Have you ever worked for more than 1 year in a place where you had to raise your voice to make yourself heard by someone standing 1 m away from you?
Description

loud working environment

Type de données

boolean

Alias
UMLS CUI [1]
C3261238
Please describe the most important noise source(s)
Description

noise source

Type de données

text

Alias
UMLS CUI [1]
C3261240
What was the noise level (if you are aware of it) in dB?
Description

noise level

Type de données

float

Alias
UMLS CUI [1]
C3257923
What was the noise dose (equivalent noise level if you are aware of it) in dBs?
Description

noise dose

Type de données

float

Alias
UMLS CUI [1]
C3257922
How many hours per day were you exposed to noise?
Description

hours per day were you exposed to noise

Type de données

text

Alias
UMLS CUI [1]
C1260971
Was this a constant loud noise or an impulse noise (i.e., noise with (ir)regular high peaks of sound, like hammering)?
Description

constant loud noise or an impulse noise

Type de données

text

Alias
UMLS CUI [1]
C3261245
Body height --standing
Description

body height

Type de données

float

Unités de mesure
  • cm
Alias
UMLS CUI [1]
C0005890
cm
Body weight
Description

body weight

Type de données

float

Unités de mesure
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Dominant hand
Description

dominant hand

Type de données

integer

Alias
UMLS CUI [1]
C0449722
Are you susceptible to sunburn?
Description

susceptible to sunburn

Type de données

text

Alias
UMLS CUI [1]
C3260560
What is the color of your eyes?
Description

color of eyes

Type de données

text

Alias
UMLS CUI [1]
C0015396
Have you ever smoked regularly?
Description

ever smoked regularly

Type de données

boolean

Alias
UMLS CUI [1]
C0037369
At which age did you start smoking?
Description

age start smoking

Type de données

integer

Alias
UMLS CUI [1]
C3260574
For how many years did you (have you) smoke(d) up to now?
Description

years smoking

Type de données

integer

Unités de mesure
  • years
Alias
UMLS CUI [1,1]
C0037369
UMLS CUI [1,2]
C0439234
years
Approximately how many cigarettes do (did) you smoke on average?
Description

how many cigarettes

Type de données

text

Alias
UMLS CUI [1]
C3169451
Do you drink alcohol regularly (every week)?
Description

drink alcohol

Type de données

boolean

Alias
UMLS CUI [1]
C0001948
How many drinks do you have on average? (A small bottle of beer - 25cl, red or white wine - 12cl, or a small glass of spirits - 4cl counts as 1 drink)
Description

amount of drinks

Type de données

text

Alias
UMLS CUI [1]
C0001967
List of operations
Description

List of operations

Which ear?
Description

ear side

Type de données

text

Alias
UMLS CUI [1,1]
C0013443
UMLS CUI [1,2]
C0441987
Date of trauma or procedure
Description

date of trauma or procedure

Type de données

date

Alias
UMLS CUI [1]
C2584899
Grandparents Origin
Description

Grandparents Origin

Where did your mother's father (your maternal grandfather) originate from? Specify Country
Description

country of origin family member

Type de données

text

Alias
UMLS CUI [1]
C3260806
Where did your mother's father (your maternal grandfather) originate from? Specify Region
Description

region of origin

Type de données

text

Alias
UMLS CUI [1]
C3258107
Mother/Father History
Description

Mother/Father History

Natural parent [PhenX]
Description

natural parent

Type de données

text

Alias
UMLS CUI [1]
C0337465
As far as you know, does/did your mother have hearing problems?
Description

mother have hearing problems

Type de données

boolean

Alias
UMLS CUI [1,1]
C0260662
UMLS CUI [1,2]
C0026591
What was his/her occupation?
Description

occupation

Type de données

text

Alias
UMLS CUI [1]
C0028811
Age of onset
Description

age of onset

Type de données

integer

Alias
UMLS CUI [1]
C0206132
What is/was the cause of her hearing problem (if known)?
Description

cause of her hearing problem

Type de données

text

Alias
UMLS CUI [1,1]
C1313969
UMLS CUI [1,2]
C0392360
Age at death
Description

age at death

Type de données

integer

Alias
UMLS CUI [1]
C0742983
Hearing difficulty: Siblings
Description

Hearing difficulty: Siblings

Relative [PhenX]
Description

relative

Type de données

text

Alias
UMLS CUI [1]
C3172260
Sex
Description

sex

Type de données

integer

Alias
UMLS CUI [1]
C0079399
Birth Date Family member
Description

birth Date family member

Type de données

date

Alias
UMLS CUI [1]
C2599455
Age of onset of health-related event family member
Description

age of onset of health-related event

Type de données

integer

Alias
UMLS CUI [1,1]
C0441471
UMLS CUI [1,2]
C0206132
UMLS CUI [1,3]
C0086282
List of other operations
Description

List of other operations

History of surgical procedures
Description

history of surgical procedures

Type de données

text

Alias
UMLS CUI [1]
C0489540
Other operation year
Description

other operation year

Type de données

integer

Alias
UMLS CUI [1,1]
C0543467
UMLS CUI [1,2]
C0205394
Medication list
Description

Medication list

Current medication, Name
Description

medication name

Type de données

text

Alias
UMLS CUI [1]
C2360065
Please write down the medical reason why you had or have to take this medication. If necessary you can add an additional copy of this page
Description

medical reason for medication

Type de données

text

Alias
UMLS CUI [1,1]
C0013227
UMLS CUI [1,2]
C0392360
Duration of treatment
Description

duration of treatment

Type de données

durationDatetime

Alias
UMLS CUI [1]
C0444921

Similar models

Personal and Family History of Hearing Loss Protocol PhenX Toolkit

Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
PhenX - personal and family history of hearing loss protocol
C3171804 (UMLS CUI-1)
any difficulty with hearing
Item
Do you have any difficulty with your hearing?
boolean
C1313969 (UMLS CUI [1])
Item
In which ear(s) do you have a hearing difficulty?
text
C1313969 (UMLS CUI [1,1])
C0013443 (UMLS CUI [1,2])
Code List
In which ear(s) do you have a hearing difficulty?
CL Item
Left (Left)
C0205091 (UMLS CUI-1)
CL Item
Right (Right)
C0205090 (UMLS CUI-1)
CL Item
Both (Both)
C1706086 (UMLS CUI-1)
age onset hearing difficulty
Item
At what age did you first notice a hearing difficulty?
integer
C0206132 (UMLS CUI [1,1])
C1313969 (UMLS CUI [1,2])
Item
How quickly did your hearing difficulty develop?
text
C1313969 (UMLS CUI [1,1])
C0242656 (UMLS CUI [1,2])
Code List
How quickly did your hearing difficulty develop?
CL Item
Suddenly (over a few days)  (Suddenly (over a few days) )
C3842292 (UMLS CUI-1)
CL Item
Over a few months (Over a few months)
C3842291 (UMLS CUI-1)
CL Item
Over several years (Over several years)
C3842290 (UMLS CUI-1)
Item
Do you know the reason for your hearing difficulty?
text
C1313969 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
Code List
Do you know the reason for your hearing difficulty?
CL Item
I have no idea about the cause of my hearing problem  (I have no idea about the cause of my hearing problem )
C3842289 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
reason for hearing difficulty description
Item
Do you know the reason for your hearing difficulty? (if there is a separate cause for each of your ears, please note them accordingly) Describe:
text
C1313969 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
Item
Does your hearing vary from day to day?
text
C3260786 (UMLS CUI [1])
Code List
Does your hearing vary from day to day?
CL Item
No (No)
CL Item
Yes, in my left ear (Yes, in my left ear)
CL Item
Yes, in my right ear (Yes, in my right ear)
CL Item
Yes, in both ears (Yes, in both ears)
background noise
Item
Do you find it very difficult to follow a conversation if there is background noise (e.g. TV, radio, children playing)?
boolean
C1303045 (UMLS CUI [1])
sensitive to loud sounds
Item
Are you particularly sensitive to loud sounds?
boolean
C0034880 (UMLS CUI [1])
Item
Do you sometimes feel a fullness or blockage in your ears?
text
C2199600 (UMLS CUI [1])
Code List
Do you sometimes feel a fullness or blockage in your ears?
CL Item
No (No)
CL Item
Yes, in my left ear (Yes, in my left ear)
CL Item
Yes, in my right ear (Yes, in my right ear)
CL Item
Yes, in both ears (Yes, in both ears)
tinnitus
Item
Nowadays, do you ever get noises in your head or ears (tinnitus) which usually last longer than five minutes?
boolean
C0040264 (UMLS CUI [1])
ear disease
Item
Have you ever had an ear disease that has caused your hearing to get worse?
boolean
C0013447 (UMLS CUI [1])
Item
Have you ever had discharge of blood or pus, or smelly discharge (not wax) from either ear?
text
C0155540 (UMLS CUI [1])
Code List
Have you ever had discharge of blood or pus, or smelly discharge (not wax) from either ear?
CL Item
No (No)
C1298908 (UMLS CUI-1)
CL Item
Don't know (Don't know)
C3843613 (UMLS CUI-1)
CL Item
From my left ear (From my left ear)
C3842285 (UMLS CUI-1)
CL Item
From my right ear (From my right ear)
C3842284 (UMLS CUI-1)
Item
Have you ever had an ear operation?
text
C0198010 (UMLS CUI [1])
Code List
Have you ever had an ear operation?
CL Item
No  (No )
C1298908 (UMLS CUI-1)
CL Item
Don't know (Don't know)
C3843613 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
Item
Have you ever suffered from attacks of dizziness in which things seem to spin around you?
text
C0012833 (UMLS CUI [1])
Code List
Have you ever suffered from attacks of dizziness in which things seem to spin around you?
CL Item
No  (No )
CL Item
Yes, within the last year  (Yes, within the last year )
CL Item
Yes, more than a year ago (Yes, more than a year ago)
feel unsteady walking in the dark
Item
Do you feel unsteady when walking in the dark?
boolean
C3260804 (UMLS CUI [1])
any brothers or sisters with normal hearing
Item
Do you have any brothers or sisters with normal hearing?
boolean
C0234725 (UMLS CUI [1,1])
C0037047 (UMLS CUI [1,2])
brothers or sisters with normal hearing number
Item
Do you have any brothers or sisters with normal hearing? (how many of your brothers/sisters have normal hearing?)
integer
C0234725 (UMLS CUI [1,1])
C0037047 (UMLS CUI [1,2])
Do you have any brothers or sisters with hearing difficulties?
Item
Do you have any brothers or sisters with hearing difficulties?
boolean
C1313969 (UMLS CUI [1,1])
C0037047 (UMLS CUI [1,2])
brothers or sisters with hearing difficulties number
Item
Do you have any brothers or sisters with hearing difficulties? (how many of your brothers/sisters have hearing difficulties?)
integer
C1313969 (UMLS CUI [1,1])
C0037047 (UMLS CUI [1,2])
children with normal hearing
Item
Do you have any children with normal hearing?
boolean
C0234725 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
children with normal hearing number
Item
How many children with normal hearing?
integer
C0234725 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
children with hearing difficulties
Item
Do you have any children with hearing difficulties? (how many of your children have hearing difficulties?)
boolean
C1313969 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
children with hearing difficulties number
Item
How many children with hearing difficulties? (how many of your children have hearing difficulties?)
integer
C1313969 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
Item
Relative [PhenX]
text
C3172260 (UMLS CUI [1])
Code List
Relative [PhenX]
CL Item
Mother (Mother)
C0026591 (UMLS CUI-1)
CL Item
Father (Father)
C0015671 (UMLS CUI-1)
CL Item
Sister (Sister)
C0337514 (UMLS CUI-1)
CL Item
Brother (Brother)
C0337527 (UMLS CUI-1)
CL Item
Daughter (Daughter)
C0011011 (UMLS CUI-1)
CL Item
Son  (Son )
C0037683 (UMLS CUI-1)
CL Item
Maternal Grandmother (Maternal Grandmother)
C1273525 (UMLS CUI-1)
CL Item
Maternal Grandfather (Maternal Grandfather)
C1273523 (UMLS CUI-1)
CL Item
Paternal Grandmother (Paternal Grandmother)
C1273524 (UMLS CUI-1)
CL Item
Paternal Grandfather (Paternal Grandfather)
C1292533 (UMLS CUI-1)
CL Item
Maternal Aunt (Maternal Aunt)
C3714275 (UMLS CUI-1)
CL Item
Maternal Uncle (Maternal Uncle)
C3714277 (UMLS CUI-1)
CL Item
Paternal Aunt (Paternal Aunt)
C3714274 (UMLS CUI-1)
CL Item
Paternal Uncle (Paternal Uncle)
C3714276 (UMLS CUI-1)
CL Item
Child 1 (Child 1)
C3844033 (UMLS CUI-1)
CL Item
Sibling 1 (Sibling 1)
C3844026 (UMLS CUI-1)
CL Item
Adopted son or daughter (Adopted son or daughter)
C3844043 (UMLS CUI-1)
CL Item
Half sibling (Half sibling)
C0337505 (UMLS CUI-1)
CL Item
Half-sister (Half-sister)
C0337518 (UMLS CUI-1)
CL Item
Stepson or stepdaughter (Stepson or stepdaughter)
C3844041 (UMLS CUI-1)
CL Item
Self (Self)
C0036588 (UMLS CUI-1)
family members with hearing difficulties
Item
Do you have uncles, aunts, cousins, nephews, or nieces with hearing difficulties?
boolean
C1313969 (UMLS CUI [1,1])
C0086282 (UMLS CUI [1,2])
Item
Do you know if any of your relatives have already participated in this investigation?
text
C2348568 (UMLS CUI [1,1])
C0086282 (UMLS CUI [1,2])
Code List
Do you know if any of your relatives have already participated in this investigation?
CL Item
As far as I know, none of my relatives has already participated in this investigation  (As far as I know, none of my relatives has already participated in this investigation )
CL Item
One of my relatives has already participated in this investigation (One of my relatives has already participated in this investigation)
Item
Relative [PhenX]
text
C3172260 (UMLS CUI [1])
Code List
Relative [PhenX]
CL Item
Mother (Mother)
C0026591 (UMLS CUI-1)
CL Item
Father (Father)
C0015671 (UMLS CUI-1)
CL Item
Sister (Sister)
C0337514 (UMLS CUI-1)
CL Item
Brother (Brother)
C0337527 (UMLS CUI-1)
CL Item
Daughter (Daughter)
C0011011 (UMLS CUI-1)
CL Item
Son  (Son )
C0037683 (UMLS CUI-1)
CL Item
Maternal Grandmother (Maternal Grandmother)
C1273525 (UMLS CUI-1)
CL Item
Maternal Grandfather (Maternal Grandfather)
C1273523 (UMLS CUI-1)
CL Item
Paternal Grandmother (Paternal Grandmother)
C1273524 (UMLS CUI-1)
CL Item
Paternal Grandfather (Paternal Grandfather)
C1292533 (UMLS CUI-1)
CL Item
Maternal Aunt (Maternal Aunt)
C3714275 (UMLS CUI-1)
CL Item
Maternal Uncle (Maternal Uncle)
C3714277 (UMLS CUI-1)
CL Item
Paternal Aunt (Paternal Aunt)
C3714274 (UMLS CUI-1)
CL Item
Paternal Uncle (Paternal Uncle)
C3714276 (UMLS CUI-1)
CL Item
Child 1 (Child 1)
C3844033 (UMLS CUI-1)
CL Item
Sibling 1 (Sibling 1)
C3844026 (UMLS CUI-1)
CL Item
Adopted son or daughter (Adopted son or daughter)
C3844043 (UMLS CUI-1)
CL Item
Half sibling (Half sibling)
C0337505 (UMLS CUI-1)
CL Item
Half-sister (Half-sister)
C0337518 (UMLS CUI-1)
CL Item
Stepson or stepdaughter (Stepson or stepdaughter)
C3844041 (UMLS CUI-1)
CL Item
Self (Self)
C0036588 (UMLS CUI-1)
other relative name
Item
Do you know if any of your relatives have already participated in this investigation? Name of your relative that have already participated in this investigation
text
C3260822 (UMLS CUI [1])
Item
If yes, what is his/her relationship to you?
text
C0015608 (UMLS CUI [1])
Code List
If yes, what is his/her relationship to you?
CL Item
Spouse (current or previous) (Spouse (current or previous))
C3842295 (UMLS CUI-1)
CL Item
Parent  (Parent )
C0030551 (UMLS CUI-1)
CL Item
Father-in-law/mother-in-law  (Father-in-law/mother-in-law )
C3842294 (UMLS CUI-1)
CL Item
Child  (Child )
C0008059 (UMLS CUI-1)
CL Item
Sibling  (Sibling )
C0037047 (UMLS CUI-1)
CL Item
Daughter-in-law (Daughter-in-law)
C1553705 (UMLS CUI-1)
CL Item
Son-in-law (Son-in-law)
C2350007 (UMLS CUI-1)
CL Item
Other relative  (Other relative )
C3174795 (UMLS CUI-1)
CL Item
Old neighbor (Old neighbor)
C3842311 (UMLS CUI-1)
CL Item
Current neighbor  (Current neighbor )
C3842310 (UMLS CUI-1)
CL Item
School/class mate  (School/class mate )
C3842309 (UMLS CUI-1)
CL Item
Compatriot (Compatriot)
C3842308 (UMLS CUI-1)
CL Item
Teacher  (Teacher )
C0221457 (UMLS CUI-1)
CL Item
Student  (Student )
C0038492 (UMLS CUI-1)
CL Item
Current co-worker  (Current co-worker )
C3842307 (UMLS CUI-1)
CL Item
Current boss/superior (Current boss/superior)
C3842306 (UMLS CUI-1)
CL Item
Current subordinate  (Current subordinate )
C3842305 (UMLS CUI-1)
CL Item
Co-worker, boss/superior, or subordinate from a previous firm  (Co-worker, boss/superior, or subordinate from a previous firm )
C3840848 (UMLS CUI-1)
CL Item
Client  (Client )
C0008942 (UMLS CUI-1)
CL Item
Person working for another firm, but known through work relations (Person working for another firm, but known through work relations)
C3842304 (UMLS CUI-1)
CL Item
Someone from the same religious group (Someone from the same religious group)
C3842303 (UMLS CUI-1)
CL Item
Someone from the same association, club or group (Someone from the same association, club or group)
C3842302 (UMLS CUI-1)
CL Item
Close friend (Close friend)
C0682339 (UMLS CUI-1)
CL Item
Ordinary friend  (Ordinary friend )
C3842301 (UMLS CUI-1)
CL Item
Someone known because he/she provides a service to me or my family  (Someone known because he/she provides a service to me or my family )
C3842300 (UMLS CUI-1)
CL Item
Someone know from the Internet  (Someone know from the Internet )
C3842299 (UMLS CUI-1)
CL Item
An acquaintance  (An acquaintance )
C3842298 (UMLS CUI-1)
CL Item
Indirect relationship (known via someone else)  (Indirect relationship (known via someone else) )
C3842297 (UMLS CUI-1)
CL Item
Else (Else)
C3842296 (UMLS CUI-1)
migraine
Item
Do you suffer from migraine?
boolean
C0149931 (UMLS CUI [1])
Item
How often do you generally have attacks?
text
C0149931 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
Code List
How often do you generally have attacks?
CL Item
Often (more than one attack a month)  (Often (more than one attack a month) )
CL Item
Regularly (an attack once a month on average)  (Regularly (an attack once a month on average) )
CL Item
Sporadically (between 4 and 10 times a year)  (Sporadically (between 4 and 10 times a year) )
CL Item
Rarely (less than one attack every 3 months) (Rarely (less than one attack every 3 months))
Item
Have you ever suffered a hearing loss from meningitis or encephalitis?
text
C3887873 (UMLS CUI [1,1])
C0025289 (UMLS CUI [1,2])
C3887873 (UMLS CUI [2,1])
C0014038 (UMLS CUI [2,2])
Code List
Have you ever suffered a hearing loss from meningitis or encephalitis?
CL Item
No  (No )
C1298908 (UMLS CUI-1)
CL Item
Don't know (Don't know)
C3843613 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
Item
Have you ever had a whiplash injury?
text
C0043145 (UMLS CUI [1])
Code List
Have you ever had a whiplash injury?
CL Item
No  (No )
C1298908 (UMLS CUI-1)
CL Item
Don't know (Don't know)
C3843613 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
Item
Have you ever been knocked unconscious (e.g., in a traffic accident, contact sport, a fight or after a fall)?
text
C0560617 (UMLS CUI [1])
Code List
Have you ever been knocked unconscious (e.g., in a traffic accident, contact sport, a fight or after a fall)?
CL Item
No  (No )
C1298908 (UMLS CUI-1)
CL Item
Don't know (Don't know)
C3843613 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
Item
Has a doctor ever told you that you had a myocardial infarction or heart attack?
text
C0027051 (UMLS CUI [1])
Code List
Has a doctor ever told you that you had a myocardial infarction or heart attack?
CL Item
No  (No )
C1298908 (UMLS CUI-1)
CL Item
Don't know (Don't know)
C3843613 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
heart surgery
Item
Have you ever had heart surgery?
boolean
C0018821 (UMLS CUI [1])
heart surgery description
Item
What operation(s)? (Please describe)
text
C0018821 (UMLS CUI [1])
coronary artery catheterization
Item
Have you ever had coronary artery catheterization?
boolean
C0179744 (UMLS CUI [1])
type arterial catheterization
Item
What type of intervention(s) (e.g., stent, balloon dilatation)?
boolean
C0179744 (UMLS CUI [1])
stroke
Item
Have you ever been told by a physician that you had a stroke?
boolean
C0038454 (UMLS CUI [1])
date of health-related event
Item
Date of health-related event
date
C3261226 (UMLS CUI [1])
Item
Have you ever had an operation on your carotid artery?
text
C0397645 (UMLS CUI [1])
Code List
Have you ever had an operation on your carotid artery?
CL Item
No  (No )
C1298908 (UMLS CUI-1)
CL Item
Don't know (Don't know)
C3843613 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
Item
Do you suffer from intermittent claudication?
text
C0021775 (UMLS CUI [1])
Code List
Do you suffer from intermittent claudication?
CL Item
No  (No )
C1298908 (UMLS CUI-1)
CL Item
Don't know (Don't know)
C3843613 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
heart problems
Item
Do you have other problems with your heart or circulation?
boolean
C0795691 (UMLS CUI [1])
other heart problem
Item
Do you have other problems with your heart or circulation?
text
C0795691 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Item
Do you suffer from diabetes?
text
C0011849 (UMLS CUI [1])
Code List
Do you suffer from diabetes?
CL Item
No  (No )
C1298908 (UMLS CUI-1)
CL Item
Don't know (Don't know)
C3843613 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
insulin
Item
Do you need insulin?
boolean
C0021641 (UMLS CUI [1])
Item
Disease history [PhenX]
text
C0683519 (UMLS CUI [1])
Code List
Disease history [PhenX]
CL Item
Osteoporosis  (Osteoporosis )
C0029456 (UMLS CUI-1)
CL Item
Osteoarthritis  (Osteoarthritis )
C0029408 (UMLS CUI-1)
CL Item
Multiple sclerosis - MS  (Multiple sclerosis - MS )
C0026769 (UMLS CUI-1)
CL Item
Epilepsy  (Epilepsy )
C0014544 (UMLS CUI-1)
CL Item
Lung problems  (Lung problems )
C0740941 (UMLS CUI-1)
CL Item
Allergy  (Allergy )
C0020517 (UMLS CUI-1)
CL Item
Diseases of the stomach or intestine  (Diseases of the stomach or intestine )
C3842273 (UMLS CUI-1)
CL Item
Kidney diseases  (Kidney diseases )
C0022658 (UMLS CUI-1)
CL Item
Liver diseases (Liver diseases)
C0023895 (UMLS CUI-1)
CL Item
Skin diseases  (Skin diseases )
C0037274 (UMLS CUI-1)
CL Item
Psychiatric problems  (Psychiatric problems )
C1306597 (UMLS CUI-1)
CL Item
Blood diseases (Blood diseases)
C0018939 (UMLS CUI-1)
CL Item
Diseases of the thyroid gland (Diseases of the thyroid gland)
C0040128 (UMLS CUI-1)
disease description
Item
Please describe your disease(s):
text
C3259023 (UMLS CUI [1])
Item
Autoimmune diseases [PhenX]
text
C0004364 (UMLS CUI [1])
Code List
Autoimmune diseases [PhenX]
CL Item
Rheumatoid arthritis - rheumatism  (Rheumatoid arthritis - rheumatism )
CL Item
Inflammatory bowel disease crohn’s disease or colitis ulcerosa  (Inflammatory bowel disease crohn’s disease or colitis ulcerosa )
CL Item
Lupus erythematosus  (Lupus erythematosus )
CL Item
Psoriasis  (Psoriasis )
CL Item
Wegener’s granulomatosis (Wegener’s granulomatosis)
CL Item
Vasculitis  (Vasculitis )
CL Item
Nephritis  (Nephritis )
CL Item
Hashimoto thyroiditis  (Hashimoto thyroiditis )
CL Item
Cogan’s syndrome  (Cogan’s syndrome )
CL Item
Behcet’s syndrome  (Behcet’s syndrome )
CL Item
Other (Other)
other operations
Item
Have you ever had other operations (not covered by the previous questions)?
text
C0543467 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
other serious health problems
Item
Do you have other serious health problems that are not covered by the previous questions?
boolean
C3258154 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
serious health problem description
Item
Please describe these problems:
text
C3258154 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
infection with an antibiotic
Item
Have you ever been treated for a serious infection with an antibiotic (other than penicillin) which was administered by injection/drip for a week or more?
boolean
C0009450 (UMLS CUI [1,1])
C0338237 (UMLS CUI [1,2])
sort of infections antibiotics
Item
If 'YES', for what sort of infections did you receive these antibiotics?
text
C0009450 (UMLS CUI [1,1])
C0338237 (UMLS CUI [1,2])
cancer or leukemia
Item
Have you had cancer or leukemia?
boolean
C0006826 (UMLS CUI [1])
C0023418 (UMLS CUI [2])
cancer type
Item
Cancer Site/Type?
text
C3173298 (UMLS CUI [1])
chemotherapy or other medication
Item
Have you been treated with chemotherapy or other medication for this condition?
boolean
C0392920 (UMLS CUI [1])
Item
Chemotherapy treatment Cancer
text
C0392920 (UMLS CUI [1])
Code List
Chemotherapy treatment Cancer
CL Item
None  (None )
CL Item
Chemotherapy, NOS  (Chemotherapy, NOS )
CL Item
Chemo - Single Agent  (Chemo - Single Agent )
CL Item
Chemo - Multiple Agent  (Chemo - Multiple Agent )
CL Item
Not Recommended  (Not Recommended )
CL Item
Patient Died Before Therapy  (Patient Died Before Therapy )
CL Item
Not Administered, Unknown Reason (Not Administered, Unknown Reason)
CL Item
Refused  (Refused )
CL Item
Chem recommended (Chem recommended)
CL Item
Unknown, Death Cert Only (Unknown, Death Cert Only)
radiotherapy to your head or neck
Item
Have you ever received radiotherapy to your head or neck for a tumor?
boolean
C1522449 (UMLS CUI [1,1])
C0460004 (UMLS CUI [1,2])
tumor type
Item
What kind of tumor(s)?
text
C0460004 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
surgery date
Item
Surgery Date?
date
C1628561 (UMLS CUI [1])
painkillers
Item
On average how often do you take painkillers?
integer
C0002771 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
aspirin on a daily basis
Item
Do you take aspirin on a daily basis for your heart or to dilute your blood?
boolean
C0004057 (UMLS CUI [1,1])
C0332173 (UMLS CUI [1,2])
Item
If 'YES', how long have you been taking aspirin so far?
text
C0004057 (UMLS CUI [1])
Code List
If 'YES', how long have you been taking aspirin so far?
CL Item
3 months – 1 year  (3 months – 1 year )
CL Item
1-5 years  (1-5 years )
CL Item
More than 5 years (More than 5 years)
ever fired a gun
Item
Have you ever fired a gun?
boolean
C3259043 (UMLS CUI [1])
Item
Weapon type [PhenX]
text
C0336663 (UMLS CUI [1])
Code List
Weapon type [PhenX]
CL Item
Light weapons (rifles or shotguns)  (Light weapons (rifles or shotguns) )
CL Item
Heavy weapons(artillery or bazookas) (Heavy weapons(artillery or bazookas))
Item
Estimate the total number of shots fired.
text
C3258157 (UMLS CUI [1])
Code List
Estimate the total number of shots fired.
CL Item
Less than 10 shots  (Less than 10 shots )
CL Item
10–100 shots  (10–100 shots )
CL Item
101–1,000 shots  (101–1,000 shots )
CL Item
1,001–10,000 shots  (1,001–10,000 shots )
CL Item
More than 10,000 shots (More than 10,000 shots)
Item
Did you use ear protection?
text
C0567457 (UMLS CUI [1])
Code List
Did you use ear protection?
CL Item
Always  (Always )
CL Item
Most of the time  (Most of the time )
CL Item
More than 50% of the time  (More than 50% of the time )
CL Item
Less than 50% of the time  (Less than 50% of the time )
CL Item
Never (Never)
Item
If any, which type of ear protection did you use?
text
C3258282 (UMLS CUI [1])
Code List
If any, which type of ear protection did you use?
CL Item
Plugs  (Plugs )
CL Item
Earmuff  (Earmuff )
CL Item
'Active' protection ('Active' protection)
leisure time loud sound
Item
During your leisure time, are you/have you been regularly (more than once a week) exposed to loud sound or noise (so that you have to shout to make yourself heard by someone who was more than 1 m away from you)?
boolean
C0086542 (UMLS CUI [1,1])
C0028263 (UMLS CUI [1,2])
kind of loud sound
Item
What kind of loud sound?
text
C3258353 (UMLS CUI [1])
years exposed to loud sound
Item
For how many years have you been exposed to this loud sound?
integer
C3259370 (UMLS CUI [1])
Item
How many hours per week have you been exposed to this loud sound?
text
C3259372 (UMLS CUI [1])
Code List
How many hours per week have you been exposed to this loud sound?
CL Item
1-3 hours each week  (1-3 hours each week )
CL Item
3-10 hours each week (3-10 hours each week)
CL Item
1-3 hours each day  (1-3 hours each day )
CL Item
More than 3 hours each day (More than 3 hours each day)
Item
Did you use ear protection?
text
C0567457 (UMLS CUI [1])
Code List
Did you use ear protection?
CL Item
Always  (Always )
CL Item
Most of the time  (Most of the time )
CL Item
More than 50% of the time  (More than 50% of the time )
CL Item
Less than 50% of the time  (Less than 50% of the time )
CL Item
Never (Never)
occupation
Item
What kind of work {were you/was SP} doing?
text
C0028811 (UMLS CUI [1])
exposed to solvents
Item
Have you been exposed to solvents (e.g., thrichloroethylene, toluene, evaporations from paints or lacquers) for more than one year in one of your jobs?
boolean
C3261233 (UMLS CUI [1])
which solvents
Item
Which solvents?
text
C0037638 (UMLS CUI [1])
year solvent exposure start
Item
In which year did the solvent exposure start?
integer
C0037638 (UMLS CUI [1,1])
C2826743 (UMLS CUI [1,2])
Item
How many hours per day were you exposed to noise?
text
C1260971 (UMLS CUI [1])
Code List
How many hours per day were you exposed to noise?
CL Item
Less than 1 hour each day  (Less than 1 hour each day )
CL Item
1-5 hours each day  (1-5 hours each day )
CL Item
More than 5 hours each day (More than 5 hours each day)
Item
Do you suffer from white finger syndrome/Raynaud's syndrome caused by excessive vibration (e.g., pneumatic hammers or drills)?
text
C0034735 (UMLS CUI [1])
Code List
Do you suffer from white finger syndrome/Raynaud's syndrome caused by excessive vibration (e.g., pneumatic hammers or drills)?
CL Item
No  (No )
C1298908 (UMLS CUI-1)
CL Item
Don't know (Don't know)
C3843613 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
loud working environment
Item
Have you ever worked for more than 1 year in a place where you had to raise your voice to make yourself heard by someone standing 1 m away from you?
boolean
C3261238 (UMLS CUI [1])
noise source
Item
Please describe the most important noise source(s)
text
C3261240 (UMLS CUI [1])
noise level
Item
What was the noise level (if you are aware of it) in dB?
float
C3257923 (UMLS CUI [1])
noise dose
Item
What was the noise dose (equivalent noise level if you are aware of it) in dBs?
float
C3257922 (UMLS CUI [1])
Item
How many hours per day were you exposed to noise?
text
C1260971 (UMLS CUI [1])
Code List
How many hours per day were you exposed to noise?
CL Item
Less than 1 hour each day  (Less than 1 hour each day )
CL Item
1-5 hours each day  (1-5 hours each day )
CL Item
More than 5 hours each day (More than 5 hours each day)
Item
Was this a constant loud noise or an impulse noise (i.e., noise with (ir)regular high peaks of sound, like hammering)?
text
C3261245 (UMLS CUI [1])
Code List
Was this a constant loud noise or an impulse noise (i.e., noise with (ir)regular high peaks of sound, like hammering)?
CL Item
Constant noise  (Constant noise )
CL Item
Impulse noise  (Impulse noise )
CL Item
Both (Both)
body height
Item
Body height --standing
float
C0005890 (UMLS CUI [1])
body weight
Item
Body weight
float
C0005910 (UMLS CUI [1])
Item
Dominant hand
integer
C0449722 (UMLS CUI [1])
Code List
Dominant hand
CL Item
Right (1)
CL Item
Left (2)
Item
Are you susceptible to sunburn?
text
C3260560 (UMLS CUI [1])
Code List
Are you susceptible to sunburn?
CL Item
Very much  (Very much )
C2984081 (UMLS CUI-1)
CL Item
Much  (Much )
C2984081 (UMLS CUI-1)
CL Item
Not very much (Not very much)
C3841905 (UMLS CUI-1)
CL Item
Not at all (Not at all)
C2003901 (UMLS CUI-1)
Item
What is the color of your eyes?
text
C0015396 (UMLS CUI [1])
Code List
What is the color of your eyes?
CL Item
Very light blue or very light grey  (Very light blue or very light grey )
C3841904 (UMLS CUI-1)
CL Item
Blue (Blue)
C3810842 (UMLS CUI-1)
CL Item
Grey (Grey)
C1269776 (UMLS CUI-1)
CL Item
Green (Green)
C3812802 (UMLS CUI-1)
CL Item
Light brown (Light brown)
C3841903 (UMLS CUI-1)
CL Item
Dark brown (Dark brown)
C3841902 (UMLS CUI-1)
ever smoked regularly
Item
Have you ever smoked regularly?
boolean
C0037369 (UMLS CUI [1])
age start smoking
Item
At which age did you start smoking?
integer
C3260574 (UMLS CUI [1])
years smoking
Item
For how many years did you (have you) smoke(d) up to now?
integer
C0037369 (UMLS CUI [1,1])
C0439234 (UMLS CUI [1,2])
Item
Approximately how many cigarettes do (did) you smoke on average?
text
C3169451 (UMLS CUI [1])
Code List
Approximately how many cigarettes do (did) you smoke on average?
CL Item
Less than 5 each day  (Less than 5 each day )
CL Item
5-10 each day  (5-10 each day )
CL Item
10-20 each day (10-20 each day)
CL Item
More than 20 each day (More than 20 each day)
drink alcohol
Item
Do you drink alcohol regularly (every week)?
boolean
C0001948 (UMLS CUI [1])
Item
How many drinks do you have on average? (A small bottle of beer - 25cl, red or white wine - 12cl, or a small glass of spirits - 4cl counts as 1 drink)
text
C0001967 (UMLS CUI [1])
Code List
How many drinks do you have on average? (A small bottle of beer - 25cl, red or white wine - 12cl, or a small glass of spirits - 4cl counts as 1 drink)
CL Item
Less than 1 drink a week  (Less than 1 drink a week )
CL Item
1–5 drinks each week (1–5 drinks each week)
CL Item
1–3 drinks each day (1–3 drinks each day)
CL Item
More than 3 drinks each day (More than 3 drinks each day)
Item Group
List of operations
Item
Which ear?
text
C0013443 (UMLS CUI [1,1])
C0441987 (UMLS CUI [1,2])
Code List
Which ear?
CL Item
Left (Left)
C0205091 (UMLS CUI-1)
CL Item
Right (Right)
C0205090 (UMLS CUI-1)
CL Item
Both (Both)
C1706086 (UMLS CUI-1)
date of trauma or procedure
Item
Date of trauma or procedure
date
C2584899 (UMLS CUI [1])
Item Group
Grandparents Origin
country of origin family member
Item
Where did your mother's father (your maternal grandfather) originate from? Specify Country
text
C3260806 (UMLS CUI [1])
region of origin
Item
Where did your mother's father (your maternal grandfather) originate from? Specify Region
text
C3258107 (UMLS CUI [1])
Item Group
Mother/Father History
Item
Natural parent [PhenX]
text
C0337465 (UMLS CUI [1])
Code List
Natural parent [PhenX]
CL Item
Father (Father)
C0015671 (UMLS CUI-1)
CL Item
Mother (Mother)
C0026591 (UMLS CUI-1)
mother have hearing problems
Item
As far as you know, does/did your mother have hearing problems?
boolean
C0260662 (UMLS CUI [1,1])
C0026591 (UMLS CUI [1,2])
occupation
Item
What was his/her occupation?
text
C0028811 (UMLS CUI [1])
age of onset
Item
Age of onset
integer
C0206132 (UMLS CUI [1])
cause of her hearing problem
Item
What is/was the cause of her hearing problem (if known)?
text
C1313969 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
age at death
Item
Age at death
integer
C0742983 (UMLS CUI [1])
Item Group
Hearing difficulty: Siblings
Item
Relative [PhenX]
text
C3172260 (UMLS CUI [1])
Code List
Relative [PhenX]
CL Item
Mother (Mother)
C0026591 (UMLS CUI-1)
CL Item
Father (Father)
C0015671 (UMLS CUI-1)
CL Item
Sister (Sister)
C0337514 (UMLS CUI-1)
CL Item
Brother (Brother)
C0337527 (UMLS CUI-1)
CL Item
Daughter (Daughter)
C0011011 (UMLS CUI-1)
CL Item
Son  (Son )
C0037683 (UMLS CUI-1)
CL Item
Maternal Grandmother (Maternal Grandmother)
C1273525 (UMLS CUI-1)
CL Item
Maternal Grandfather (Maternal Grandfather)
C1273523 (UMLS CUI-1)
CL Item
Paternal Grandmother (Paternal Grandmother)
C1273524 (UMLS CUI-1)
CL Item
Paternal Grandfather (Paternal Grandfather)
C1292533 (UMLS CUI-1)
CL Item
Maternal Aunt (Maternal Aunt)
C3714275 (UMLS CUI-1)
CL Item
Maternal Uncle (Maternal Uncle)
C3714277 (UMLS CUI-1)
CL Item
Paternal Aunt (Paternal Aunt)
C3714274 (UMLS CUI-1)
CL Item
Paternal Uncle (Paternal Uncle)
C3714276 (UMLS CUI-1)
CL Item
Child 1 (Child 1)
C3844033 (UMLS CUI-1)
CL Item
Sibling 1 (Sibling 1)
C3844026 (UMLS CUI-1)
CL Item
Adopted son or daughter (Adopted son or daughter)
C3844043 (UMLS CUI-1)
CL Item
Half sibling (Half sibling)
C0337505 (UMLS CUI-1)
CL Item
Half-sister (Half-sister)
C0337518 (UMLS CUI-1)
CL Item
Stepson or stepdaughter (Stepson or stepdaughter)
C3844041 (UMLS CUI-1)
CL Item
Self (Self)
C0036588 (UMLS CUI-1)
Item
Sex
integer
C0079399 (UMLS CUI [1])
Code List
Sex
CL Item
Male (1)
C1706180 (UMLS CUI-1)
CL Item
Female (2)
C0015780 (UMLS CUI-1)
birth Date family member
Item
Birth Date Family member
date
C2599455 (UMLS CUI [1])
age of onset of health-related event
Item
Age of onset of health-related event family member
integer
C0441471 (UMLS CUI [1,1])
C0206132 (UMLS CUI [1,2])
C0086282 (UMLS CUI [1,3])
Item Group
List of other operations
history of surgical procedures
Item
History of surgical procedures
text
C0489540 (UMLS CUI [1])
other operation year
Item
Other operation year
integer
C0543467 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Item Group
Medication list
medication name
Item
Current medication, Name
text
C2360065 (UMLS CUI [1])
medical reason for medication
Item
Please write down the medical reason why you had or have to take this medication. If necessary you can add an additional copy of this page
text
C0013227 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
duration of treatment
Item
Duration of treatment
durationDatetime
C0444921 (UMLS CUI [1])

Utilisez ce formulaire pour les retours, les questions et les améliorations suggérées.

Les champs marqués d’un * sont obligatoires.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial