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Information:
Fel:
ID
14813
Beskrivning
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.
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Versioner (2)
- 2016-04-29 2016-04-29 -
- 2021-09-20 2021-09-20 -
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29 april 2016
DOI
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Creative Commons BY-NC 3.0
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Personal and Family History of Hearing Loss Protocol PhenX Toolkit
Personal and Family History of Hearing Loss Protocol PhenX Toolkit
Similar models
Personal and Family History of Hearing Loss Protocol PhenX Toolkit
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
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])
C0013443 (UMLS CUI [1,2])
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])
C1313969 (UMLS CUI [1,2])
Item
How quickly did your hearing difficulty develop?
text
C1313969 (UMLS CUI [1,1])
C0242656 (UMLS CUI [1,2])
C0242656 (UMLS CUI [1,2])
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])
C0392360 (UMLS CUI [1,2])
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])
C0392360 (UMLS CUI [1,2])
Item
Does your hearing vary from day to day?
text
C3260786 (UMLS CUI [1])
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])
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)
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])
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])
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])
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])
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])
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])
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])
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])
C0008059 (UMLS CUI [1,2])
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])
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])
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)
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])
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])
C0439603 (UMLS CUI [1,2])
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])
C0025289 (UMLS CUI [1,2])
C3887873 (UMLS CUI [2,1])
C0014038 (UMLS CUI [2,2])
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)
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])
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])
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])
C0205394 (UMLS CUI [1,2])
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])
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])
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])
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])
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])
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])
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])
C0338237 (UMLS CUI [1,2])
cancer or leukemia
Item
Have you had cancer or leukemia?
boolean
C0006826 (UMLS CUI [1])
C0023418 (UMLS CUI [2])
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])
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])
C0460004 (UMLS CUI [1,2])
tumor type
Item
What kind of tumor(s)?
text
C0460004 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
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])
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])
C0332173 (UMLS CUI [1,2])
Item
If 'YES', how long have you been taking aspirin so far?
text
C0004057 (UMLS CUI [1])
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])
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])
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)
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])
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])
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)
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])
C2826743 (UMLS CUI [1,2])
Item
How many hours per day were you exposed to noise?
text
C1260971 (UMLS CUI [1])
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])
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])
CL Item
Right (1)
CL Item
Left (2)
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)
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])
C0439234 (UMLS CUI [1,2])
Item
Approximately how many cigarettes do (did) you smoke on average?
text
C3169451 (UMLS CUI [1])
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)
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])
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])
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])
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])
C0392360 (UMLS CUI [1,2])
age at death
Item
Age at death
integer
C0742983 (UMLS CUI [1])
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)
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])
C0206132 (UMLS CUI [1,2])
C0086282 (UMLS CUI [1,3])
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])
C0205394 (UMLS CUI [1,2])
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])
C0392360 (UMLS CUI [1,2])
duration of treatment
Item
Duration of treatment
durationDatetime
C0444921 (UMLS CUI [1])