ID

44295

Description

Study ID: 100601 Clinical Study ID: LPL100601 Study Title: LPL100601, A Clinical Outcomes Study of Darapladib versus Placebo in Subjects with Chronic Coronary Heart Disease to Compare the Incidence of Major Adverse Cardiovascular Events (MACE) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00799903 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: darapladib Trade Name: darapladib Study Indication: Atherosclerosis Study part: Lifestyle Questionnaire.

Keywords

Versions (4)
  1. 9/20/17 9/20/17 -
  2. 10/23/17 10/23/17 -
  3. 12/20/17 12/20/17 -
  4. 9/20/21 9/20/21 -
Copyright Holder

GlaxoSmithKline

Uploaded on

September 20, 2021

DOI

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License

Creative Commons BY-NC 3.0
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Lifestyle Questionnaire GSK study Chronic Coronary Heart Disease NCT00799903

English

Lifestyle Questionnaire GSK study Chronic Coronary Heart Disease NCT00799903

1 forms  
How much do you eat the following types of food?
Description

How much do you eat the following types of food?

1. Meat/poultry (e.g. beef, pork, lamb, chicken)
Description

Meat/poultry

Data type

text

Alias
UMLS CUI [1,1]
C0025017
UMLS CUI [1,2]
C0013470
2. Fish (fresh-water and ocean fish, including dried and canned fish)
Description

Fish

Data type

text

Alias
UMLS CUI [1]
C0327606
3. Eggs
Description

Eggs

Data type

text

Alias
UMLS CUI [1]
C0013710
4. Dairy products (Milk, yogurt, cheese, etc.)
Description

Dairy products

Data type

text

Alias
UMLS CUI [1,1]
C0009830
UMLS CUI [1,2]
C0010947
5. Whole grains (whole wheat flour, brown/white rice, corn, oats, etc.)
Description

Whole grains

Data type

text

Alias
UMLS CUI [1]
C4042940
6. Refined/milled grains (white flour, white rice, pasta, noodles, etc.)
Description

Refined/milled grains

Data type

text

Alias
UMLS CUI [1]
C0086369
7. Tofu/soybean curd (textured vegetable protein, soya milk, etc.)
Description

Tofu/soybean curd

Data type

text

Alias
UMLS CUI [1]
C0453233
8. Legumes (beans, lentils, peas, etc.)
Description

Legumes

Data type

text

Alias
UMLS CUI [1]
C4065479
9. Fruits
Description

Fruits

Data type

text

Alias
UMLS CUI [1]
C0016767
10. Vegetables (excluding potatoes)
Description

Vegetables

Data type

text

Alias
UMLS CUI [1]
C0042440
11. Deep fried food (e.g. French fries, potato chips, samosas, egg rolls, etc.)
Description

Deep fried food

Data type

text

Alias
UMLS CUI [1]
C0559579
12. Dessert/sweet snacks (cake, cookie, pie, chocolates, etc.)
Description

Dessert/sweet snacks

Data type

text

Alias
UMLS CUI [1]
C2008798
13. Sweetened drinks (excluding diet drinks)
Description

Sweetened drinks

Data type

text

Alias
UMLS CUI [1]
C3262404
During a typical week, how much of the following alcoholic drinks do you have?
Description

During a typical week, how much of the following alcoholic drinks do you have?

14. Beers
Description

standard drinks per week

Data type

integer

Alias
UMLS CUI [1]
C0559430
15. Red wine
Description

standard drinks per week

Data type

integer

Alias
UMLS CUI [1]
C0349371
16. White wine
Description

standard drinks per week

Data type

integer

Alias
UMLS CUI [1]
C0349372
17. Spirits or liquor (gin, rum, vodka, whisky, etc)
Description

standard drinks per week

Data type

integer

Alias
UMLS CUI [1]
C0301611
18. How often do you have six or more standard drinks on one occasion?
Description

number of standard drinks on one occasion

Data type

text

Alias
UMLS CUI [1]
C3698589
How many hours during a TYPICAL WEEK do you spend on the following activities?
Description

How many hours during a TYPICAL WEEK do you spend on the following activities?

19. Travelling by car, motorcycle, bus, train or other vehicle (including your routine commute)
Description

hours per week

Data type

integer

Alias
UMLS CUI [1,1]
C0040802
UMLS CUI [1,2]
C0449788
20. Relaxing while talking with friends or family
Description

hours per week

Data type

integer

Alias
UMLS CUI [1]
C0035028
21. In an environment where someone is smoking
Description

hours per week

Data type

integer

Alias
UMLS CUI [1]
C1948106
22. Watching TV
Description

hours per week

Data type

integer

Alias
UMLS CUI [1]
C0871498
23. On the computer (including time spent at work and during leisure time)
Description

hours per week

Data type

integer

Alias
UMLS CUI [1]
C3842632
How many hours during a TYPICAL WEEK do you spend doing the following physical activities for 10 minutes or more?
Description

How many hours during a TYPICAL WEEK do you spend doing the following physical activities for 10 minutes or more?

24. Doing MILD physical activity such as easy walking, yoga or Tai Chi
Description

hours per week

Data type

integer

Alias
UMLS CUI [1]
C0026606
Doing MODERATE physical activity such as fast walking, jogging, aerobics, gardening, bicycling, dancing, swimming or house cleaning
Description

hours per week

Data type

integer

Alias
UMLS CUI [1]
C1513375
26. Doing VIGOROUS physical activity such as running, lifting heavy objects, playing strenuous sports or strenuous work
Description

hours per week

Data type

integer

Alias
UMLS CUI [1]
C4060778
27. How active are you at work?
Description

physical activity at work

Data type

text

Alias
UMLS CUI [1]
C0026606
28. How active are you during leisure time?
Description

physical activity during leisure time

Data type

text

Alias
UMLS CUI [1,1]
C0023292
UMLS CUI [1,2]
C0026606
Does your health limit you in the following activities?
Description

Does your health limit you in the following activities?

29. Walking 100 meters (or 100 yards)
Description

Walking short distance

Data type

text

Alias
UMLS CUI [1]
C0429886
30. Climbing one flight of stairs
Description

Climbing one flight of stairs

Data type

text

Alias
UMLS CUI [1]
C3831080
31. Walking more than one kilometer (or half a mile)
Description

Walking long distance

Data type

text

Alias
UMLS CUI [1]
C0429886
32. Moderate physical activities
Description

Moderate physical activities

Data type

text

Alias
UMLS CUI [1]
C3833417
33. Vigorous physical activities
Description

Vigorous physical activities

Data type

text

Alias
UMLS CUI [1]
C4060778
Are your activities limited by the following symptoms?
Description

Are your activities limited by the following symptoms?

34. Shortness of breath
Description

Shortness of breath

Data type

text

Alias
UMLS CUI [1]
C0013404
35. Chest discomfort or tightness (angina)
Description

Chest discomfort or tightness

Data type

text

Alias
UMLS CUI [1,1]
C0232292
UMLS CUI [1,2]
C0013404
36. Dizziness
Description

Dizziness

Data type

text

Alias
UMLS CUI [1]
C0012833
37. Fatigue or tiredness
Description

Fatigue or tiredness

Data type

text

Alias
UMLS CUI [1]
C0848717
38. Arthritis
Description

Arthritis

Data type

text

Alias
UMLS CUI [1]
C0003864
39. Muscle weakness
Description

Muscle weakness

Data type

text

Alias
UMLS CUI [1]
C0151786
40. Do your gums bleed when brushing your teeth or at other times?
Description

Bleeding gums

Data type

text

Alias
UMLS CUI [1]
C0017565
41. How many teeth do you have in your mouth?
Description

Number of teeth

Data type

text

Alias
UMLS CUI [1,1]
C0040426
UMLS CUI [1,2]
C0750480
Choose one answer for each question to describe your sleep pattern OVER THE LAST YEAR
Description

Choose one answer for each question to describe your sleep pattern OVER THE LAST YEAR

42. When sleeping, have you been told you snore loudly?
Description

Snoring

Data type

text

Alias
UMLS CUI [1]
C0037384
43. Do you wake up more than once a night?
Description

Waking up at night

Data type

text

Alias
UMLS CUI [1]
C1170730
44. Are you tired first thing in the morning?
Description

Tiredness in the morning

Data type

text

Alias
UMLS CUI [1]
C0541994
45. Are you sleepy during the day?
Description

Sleepiness during the day

Data type

text

Alias
UMLS CUI [1]
C0013144
46. Have you been told you gasp, choke or stop breathing when asleep?
Description

gasping, choking, no breathing when asleep

Data type

text

Alias
UMLS CUI [1]
C0008301
Choose one answer for each question to describe your condition over the last year
Description

Choose one answer for each question to describe your condition over the last year

47. Have you felt stress at work?
Description

Stress at work

Data type

text

Alias
UMLS CUI [1]
C0814090
48. Have you felt stress at home?
Description

Stress at home

Data type

text

Alias
UMLS CUI [1]
C0558919
49. Have you been under financial stress?
Description

Financial stress

Data type

text

Alias
UMLS CUI [1]
C0549106
50. When at work, have you felt control over what happens?
Description

Control at work

Data type

text

Alias
UMLS CUI [1]
C0425101
51. At home, have you felt control over what happens?
Description

Control at home

Data type

text

Alias
UMLS CUI [1,1]
C0243148
UMLS CUI [1,2]
C0026606
52. Have you felt sad, low in your spirits or depressed?
Description

Feeling depressed

Data type

text

Alias
UMLS CUI [1]
C0497307
53. Have you lost interest in hobbies, work or activities that previously gave you pleasure?
Description

Loss of interest

Data type

text

Alias
UMLS CUI [1]
C0679474
Comparing your current lifestyle to your lifestyle before your first heart problem, DO YOU
Description

Comparing your current lifestyle to your lifestyle before your first heart problem, DO YOU

54. Exercise
Description

Exercise

Data type

text

Alias
UMLS CUI [1]
C0015259
55. Have stress
Description

Stress level

Data type

text

Alias
UMLS CUI [1]
C0038435
56. Eat meat/poultry
Description

Eat meat/poultry

Data type

text

Alias
UMLS CUI [1,1]
C0025017
UMLS CUI [1,2]
C0012171
57. Eat fish
Description

Eat fish

Data type

text

Alias
UMLS CUI [1,1]
C0566305
UMLS CUI [1,2]
C0016158
58. Eat fruit/vegetable
Description

Eat fruit/vegetable

Data type

text

Alias
UMLS CUI [1]
C0016767
59. Have desserts/sweet snacks/sugared drinks
Description

Sugar intake

Data type

text

Alias
UMLS CUI [1,1]
C1512806
UMLS CUI [1,2]
C0242209
60. Eat deep fried food
Description

Eat deep fried food

Data type

text

Alias
UMLS CUI [1]
C0559579
61. Eat salty food
Description

Eat salty food

Data type

text

Alias
UMLS CUI [1]
C0453862
62. Eat high fat food
Description

Eat high fat food

Data type

text

Alias
UMLS CUI [1]
C0521974
63. Eat dairy products
Description

Eat dairy products

Data type

text

Alias
UMLS CUI [1,1]
C0009830
UMLS CUI [1,2]
C0010947
Since your first heart problem
Description

Since your first heart problem

64. Have you
Description

Smoking

Data type

text

Alias
UMLS CUI [1]
C0543414
65. Has your body weight
Description

Body weight

Data type

text

Alias
UMLS CUI [1]
C0005910
66. Have you ever participated in a cardiac rehabilitation program?
Description

Cardiac rehabilitation program

Data type

boolean

Alias
UMLS CUI [1]
C0700431
67. Overall, how do you feel your general health is now?
Description

General health

Data type

text

Alias
UMLS CUI [1]
C0424575
Socio-economic
Description

Socio-economic

68. What is your current marital status?
Description

marital status

Data type

text

Alias
UMLS CUI [1]
C0024819
69. Are you living alone?
Description

living alone

Data type

boolean

Alias
UMLS CUI [1]
C0439044
70. How many years of formal education have you completed?
Description

years of formal education

Data type

text

Alias
UMLS CUI [1]
C0557280
71. Do you have access to the internet?
Description

internet access

Data type

boolean

Alias
UMLS CUI [1]
C0282111
72. What is your current employment?
Description

current employment

Data type

text

Alias
UMLS CUI [1]
C0552390
73. Postal code / ZIP code
Description

Postal code / ZIP code

Data type

integer

Alias
UMLS CUI [1]
C0421454
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Similar models

Lifestyle Questionnaire GSK study Chronic Coronary Heart Disease NCT00799903

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
How much do you eat the following types of food?
Item
1. Meat/poultry (e.g. beef, pork, lamb, chicken)
text
C0025017 (UMLS CUI [1,1])
C0013470 (UMLS CUI [1,2])
Cognitive Function substudy entry criteria met
Code List
1. Meat/poultry (e.g. beef, pork, lamb, chicken)
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
2. Fish (fresh-water and ocean fish, including dried and canned fish)
text
C0327606 (UMLS CUI [1])
Cognitive Function substudy entry criteria met
Code List
2. Fish (fresh-water and ocean fish, including dried and canned fish)
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
3. Eggs
text
C0013710 (UMLS CUI [1])
Cognitive Function substudy entry criteria met
Code List
3. Eggs
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
4. Dairy products (Milk, yogurt, cheese, etc.)
text
C0009830 (UMLS CUI [1,1])
C0010947 (UMLS CUI [1,2])
Cognitive Function substudy entry criteria met
Code List
4. Dairy products (Milk, yogurt, cheese, etc.)
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
5. Whole grains (whole wheat flour, brown/white rice, corn, oats, etc.)
text
C4042940 (UMLS CUI [1])
Cognitive Function substudy entry criteria met
Code List
5. Whole grains (whole wheat flour, brown/white rice, corn, oats, etc.)
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
6. Refined/milled grains (white flour, white rice, pasta, noodles, etc.)
text
C0086369 (UMLS CUI [1])
Cognitive Function substudy entry criteria met
Code List
6. Refined/milled grains (white flour, white rice, pasta, noodles, etc.)
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
7. Tofu/soybean curd (textured vegetable protein, soya milk, etc.)
text
C0453233 (UMLS CUI [1])
Cognitive Function substudy entry criteria met
Code List
7. Tofu/soybean curd (textured vegetable protein, soya milk, etc.)
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
8. Legumes (beans, lentils, peas, etc.)
text
C4065479 (UMLS CUI [1])
Cognitive Function substudy entry criteria met
Code List
8. Legumes (beans, lentils, peas, etc.)
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
9. Fruits
text
C0016767 (UMLS CUI [1])
Cognitive Function substudy entry criteria met
Code List
9. Fruits
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
10. Vegetables (excluding potatoes)
text
C0042440 (UMLS CUI [1])
Cognitive Function substudy entry criteria met
Code List
10. Vegetables (excluding potatoes)
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
11. Deep fried food (e.g. French fries, potato chips, samosas, egg rolls, etc.)
text
C0559579 (UMLS CUI [1])
Cognitive Function substudy entry criteria met
Code List
11. Deep fried food (e.g. French fries, potato chips, samosas, egg rolls, etc.)
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
12. Dessert/sweet snacks (cake, cookie, pie, chocolates, etc.)
text
C2008798 (UMLS CUI [1])
Cognitive Function substudy entry criteria met
Code List
12. Dessert/sweet snacks (cake, cookie, pie, chocolates, etc.)
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item
13. Sweetened drinks (excluding diet drinks)
text
C3262404 (UMLS CUI [1])
Cognitive Function substudy entry criteria met
Code List
13. Sweetened drinks (excluding diet drinks)
CL Item
Never or rarely (<1/week) ([A00])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 servings each week ([A01])
C0558293 (UMLS CUI-1)
(Comment:en)
CL Item
Several servings each week ([A02])
C3844034 (UMLS CUI-1)
(Comment:en)
CL Item
1-2 servings each day ([A03])
C1519269 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more servings each day ([A04])
C1519269 (UMLS CUI-1)
(Comment:en)
Item Group
During a typical week, how much of the following alcoholic drinks do you have?
Beers
Item
14. Beers
integer
C0559430 (UMLS CUI [1])
Red wine
Item
15. Red wine
integer
C0349371 (UMLS CUI [1])
White wine
Item
16. White wine
integer
C0349372 (UMLS CUI [1])
Spirits or liquor
Item
17. Spirits or liquor (gin, rum, vodka, whisky, etc)
integer
C0301611 (UMLS CUI [1])
Item
18. How often do you have six or more standard drinks on one occasion?
text
C3698589 (UMLS CUI [1])
number of standard drinks on one occasion
Code List
18. How often do you have six or more standard drinks on one occasion?
CL Item
Never ([B00])
C2003901 (UMLS CUI-1)
(Comment:en)
CL Item
Less than monthly ([B01])
C0332177 (UMLS CUI-1)
C0439092 (UMLS CUI-2)
(Comment:en)
CL Item
Monthly ([B02])
C0332177 (UMLS CUI-1)
(Comment:en)
CL Item
Weekly ([B03])
C0332174 (UMLS CUI-1)
(Comment:en)
CL Item
Daily or almost daily ([B04])
C0332173 (UMLS CUI-1)
(Comment:en)
Item Group
How many hours during a TYPICAL WEEK do you spend on the following activities?
travelling time
Item
19. Travelling by car, motorcycle, bus, train or other vehicle (including your routine commute)
integer
C0040802 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
Relaxation
Item
20. Relaxing while talking with friends or family
integer
C0035028 (UMLS CUI [1])
exposure to cigarette smoke
Item
21. In an environment where someone is smoking
integer
C1948106 (UMLS CUI [1])
Watching TV
Item
22. Watching TV
integer
C0871498 (UMLS CUI [1])
time spent on computer
Item
23. On the computer (including time spent at work and during leisure time)
integer
C3842632 (UMLS CUI [1])
Item Group
How many hours during a TYPICAL WEEK do you spend doing the following physical activities for 10 minutes or more?
mild physical activity
Item
24. Doing MILD physical activity such as easy walking, yoga or Tai Chi
integer
C0026606 (UMLS CUI [1])
moderate physical activity
Item
Doing MODERATE physical activity such as fast walking, jogging, aerobics, gardening, bicycling, dancing, swimming or house cleaning
integer
C1513375 (UMLS CUI [1])
vigorous physical activity
Item
26. Doing VIGOROUS physical activity such as running, lifting heavy objects, playing strenuous sports or strenuous work
integer
C4060778 (UMLS CUI [1])
Item
27. How active are you at work?
text
C0026606 (UMLS CUI [1])
physical activity at work
Code List
27. How active are you at work?
CL Item
Mainly sedentary ([C00])
CL Item
Predominantly walking on one level, no heavy lifting ([C01])
CL Item
Mainly walking, including climbing stairs, or walking uphill or lifting heavy objects ([C02])
CL Item
Heavy physical activity ([C03])
CL Item
I do not work ([C04])
Item
28. How active are you during leisure time?
text
C0023292 (UMLS CUI [1,1])
C0026606 (UMLS CUI [1,2])
physical activity during leisure time
Code List
28. How active are you during leisure time?
CL Item
Mainly sedentary ([C00])
CL Item
Mild exercise ([C05])
CL Item
Moderate exercise ([C06])
CL Item
Strenuous physical exercise ([C07])
Item Group
Does your health limit you in the following activities?
Item
29. Walking 100 meters (or 100 yards)
text
C0429886 (UMLS CUI [1])
Walking
Code List
29. Walking 100 meters (or 100 yards)
CL Item
Not limited ([C08])
C3845941 (UMLS CUI-1)
(Comment:en)
CL Item
Limited a little ([C09])
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
Limited a lot ([C10])
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Do not do for non-health reasons ([C20])
C3840932 (UMLS CUI-1)
(Comment:en)
Item
30. Climbing one flight of stairs
text
C3831080 (UMLS CUI [1])
Walking
Code List
30. Climbing one flight of stairs
CL Item
Not limited ([C08])
C3845941 (UMLS CUI-1)
(Comment:en)
CL Item
Limited a little ([C09])
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
Limited a lot ([C10])
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Do not do for non-health reasons ([C20])
C3840932 (UMLS CUI-1)
(Comment:en)
Item
31. Walking more than one kilometer (or half a mile)
text
C0429886 (UMLS CUI [1])
Walking
Code List
31. Walking more than one kilometer (or half a mile)
CL Item
Not limited ([C08])
C3845941 (UMLS CUI-1)
(Comment:en)
CL Item
Limited a little ([C09])
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
Limited a lot ([C10])
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Do not do for non-health reasons ([C20])
C3840932 (UMLS CUI-1)
(Comment:en)
Item
32. Moderate physical activities
text
C3833417 (UMLS CUI [1])
Walking
Code List
32. Moderate physical activities
CL Item
Not limited ([C08])
C3845941 (UMLS CUI-1)
(Comment:en)
CL Item
Limited a little ([C09])
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
Limited a lot ([C10])
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Do not do for non-health reasons ([C20])
C3840932 (UMLS CUI-1)
(Comment:en)
Item
33. Vigorous physical activities
text
C4060778 (UMLS CUI [1])
Walking
Code List
33. Vigorous physical activities
CL Item
Not limited ([C08])
C3845941 (UMLS CUI-1)
(Comment:en)
CL Item
Limited a little ([C09])
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
Limited a lot ([C10])
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Do not do for non-health reasons ([C20])
C3840932 (UMLS CUI-1)
(Comment:en)
Item Group
Are your activities limited by the following symptoms?
Item
34. Shortness of breath
text
C0013404 (UMLS CUI [1])
Shortness of breath
Code List
34. Shortness of breath
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
Item
35. Chest discomfort or tightness (angina)
text
C0232292 (UMLS CUI [1,1])
C0013404 (UMLS CUI [1,2])
Shortness of breath
Code List
35. Chest discomfort or tightness (angina)
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
Item
36. Dizziness
text
C0012833 (UMLS CUI [1])
Shortness of breath
Code List
36. Dizziness
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
Item
37. Fatigue or tiredness
text
C0848717 (UMLS CUI [1])
Shortness of breath
Code List
37. Fatigue or tiredness
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
Item
38. Arthritis
text
C0003864 (UMLS CUI [1])
Shortness of breath
Code List
38. Arthritis
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
Item
39. Muscle weakness
text
C0151786 (UMLS CUI [1])
Shortness of breath
Code List
39. Muscle weakness
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
Item
40. Do your gums bleed when brushing your teeth or at other times?
text
C0017565 (UMLS CUI [1])
Bleeding gums
Code List
40. Do your gums bleed when brushing your teeth or at other times?
CL Item
Never/rarely ([C11])
CL Item
Sometimes ([C12])
CL Item
Often ([C13])
CL Item
Always ([C14])
Item
41. How many teeth do you have in your mouth?
text
C0040426 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
Number of teeth
Code List
41. How many teeth do you have in your mouth?
CL Item
26-32 (all) ([C15])
CL Item
20 to 25 ([C16])
CL Item
15 to 19 ([C17])
CL Item
Less than 15 ([C18])
CL Item
No teeth ([C19])
Item Group
Choose one answer for each question to describe your sleep pattern OVER THE LAST YEAR
Item
42. When sleeping, have you been told you snore loudly?
text
C0037384 (UMLS CUI [1])
Snoring
Code List
42. When sleeping, have you been told you snore loudly?
CL Item
Never/rarely ([D01])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
Sometimes ([D02])
C1998882 (UMLS CUI-1)
(Comment:en)
CL Item
Often ([D03])
C0332183 (UMLS CUI-1)
(Comment:en)
CL Item
Always ([D04])
C2003902 (UMLS CUI-1)
(Comment:en)
Item
43. Do you wake up more than once a night?
text
C1170730 (UMLS CUI [1])
Snoring
Code List
43. Do you wake up more than once a night?
CL Item
Never/rarely ([D01])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
Sometimes ([D02])
C1998882 (UMLS CUI-1)
(Comment:en)
CL Item
Often ([D03])
C0332183 (UMLS CUI-1)
(Comment:en)
CL Item
Always ([D04])
C2003902 (UMLS CUI-1)
(Comment:en)
Item
44. Are you tired first thing in the morning?
text
C0541994 (UMLS CUI [1])
Snoring
Code List
44. Are you tired first thing in the morning?
CL Item
Never/rarely ([D01])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
Sometimes ([D02])
C1998882 (UMLS CUI-1)
(Comment:en)
CL Item
Often ([D03])
C0332183 (UMLS CUI-1)
(Comment:en)
CL Item
Always ([D04])
C2003902 (UMLS CUI-1)
(Comment:en)
Item
45. Are you sleepy during the day?
text
C0013144 (UMLS CUI [1])
Snoring
Code List
45. Are you sleepy during the day?
CL Item
Never/rarely ([D01])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
Sometimes ([D02])
C1998882 (UMLS CUI-1)
(Comment:en)
CL Item
Often ([D03])
C0332183 (UMLS CUI-1)
(Comment:en)
CL Item
Always ([D04])
C2003902 (UMLS CUI-1)
(Comment:en)
Item
46. Have you been told you gasp, choke or stop breathing when asleep?
text
C0008301 (UMLS CUI [1])
Snoring
Code List
46. Have you been told you gasp, choke or stop breathing when asleep?
CL Item
Never/rarely ([D01])
C0522498 (UMLS CUI-1)
(Comment:en)
CL Item
Sometimes ([D02])
C1998882 (UMLS CUI-1)
(Comment:en)
CL Item
Often ([D03])
C0332183 (UMLS CUI-1)
(Comment:en)
CL Item
Always ([D04])
C2003902 (UMLS CUI-1)
(Comment:en)
Item Group
Choose one answer for each question to describe your condition over the last year
Item
47. Have you felt stress at work?
text
C0814090 (UMLS CUI [1])
Stress at work
Code List
47. Have you felt stress at work?
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
CL Item
Don't work ([E05])
Item
48. Have you felt stress at home?
text
C0558919 (UMLS CUI [1])
Stress at home
Code List
48. Have you felt stress at home?
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
Item
49. Have you been under financial stress?
text
C0549106 (UMLS CUI [1])
Stress at home
Code List
49. Have you been under financial stress?
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
Item
50. When at work, have you felt control over what happens?
text
C0425101 (UMLS CUI [1])
Stress at work
Code List
50. When at work, have you felt control over what happens?
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
CL Item
Don't work ([E05])
Item
51. At home, have you felt control over what happens?
text
C0243148 (UMLS CUI [1,1])
C0026606 (UMLS CUI [1,2])
Stress at home
Code List
51. At home, have you felt control over what happens?
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
Item
52. Have you felt sad, low in your spirits or depressed?
text
C0497307 (UMLS CUI [1])
Stress at home
Code List
52. Have you felt sad, low in your spirits or depressed?
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
Item
53. Have you lost interest in hobbies, work or activities that previously gave you pleasure?
text
C0679474 (UMLS CUI [1])
Stress at home
Code List
53. Have you lost interest in hobbies, work or activities that previously gave you pleasure?
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
Item Group
Comparing your current lifestyle to your lifestyle before your first heart problem, DO YOU
Item
54. Exercise
text
C0015259 (UMLS CUI [1])
Exercise
Code List
54. Exercise
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
Item
55. Have stress
text
C0038435 (UMLS CUI [1])
Exercise
Code List
55. Have stress
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
Item
56. Eat meat/poultry
text
C0025017 (UMLS CUI [1,1])
C0012171 (UMLS CUI [1,2])
Exercise
Code List
56. Eat meat/poultry
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
Item
57. Eat fish
text
C0566305 (UMLS CUI [1,1])
C0016158 (UMLS CUI [1,2])
Exercise
Code List
57. Eat fish
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
Item
58. Eat fruit/vegetable
text
C0016767 (UMLS CUI [1])
Exercise
Code List
58. Eat fruit/vegetable
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
Item
59. Have desserts/sweet snacks/sugared drinks
text
C1512806 (UMLS CUI [1,1])
C0242209 (UMLS CUI [1,2])
Exercise
Code List
59. Have desserts/sweet snacks/sugared drinks
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
Item
60. Eat deep fried food
text
C0559579 (UMLS CUI [1])
Exercise
Code List
60. Eat deep fried food
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
Item
61. Eat salty food
text
C0453862 (UMLS CUI [1])
Exercise
Code List
61. Eat salty food
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
Item
62. Eat high fat food
text
C0521974 (UMLS CUI [1])
Exercise
Code List
62. Eat high fat food
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
Item
63. Eat dairy products
text
C0009830 (UMLS CUI [1,1])
C0010947 (UMLS CUI [1,2])
Exercise
Code List
63. Eat dairy products
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
Item Group
Since your first heart problem
Item
64. Have you
text
C0543414 (UMLS CUI [1])
Smoking
Code List
64. Have you
CL Item
Stopped smoking completely ([E09])
C0425310 (UMLS CUI-1)
(Comment:en)
CL Item
Smoked intermittently ([E10])
C1608325 (UMLS CUI-1)
(Comment:en)
CL Item
Continued to smoke ([E11])
C0439994 (UMLS CUI-1)
C0549178 (UMLS CUI-2)
(Comment:en)
CL Item
Did not smoke at the time ([E12])
C0337672 (UMLS CUI-1)
(Comment:en)
Item
65. Has your body weight
text
C0005910 (UMLS CUI [1])
Body weight
Code List
65. Has your body weight
CL Item
Decreased ([E13])
C1262477 (UMLS CUI-1)
(Comment:en)
CL Item
Fluctuated/varied ([E14])
C0005910 (UMLS CUI-1)
C0231239 (UMLS CUI-2)
(Comment:en)
CL Item
Stayed about the same ([E15])
C0442739 (UMLS CUI-1)
C0005910 (UMLS CUI-2)
(Comment:en)
CL Item
Increased ([E16])
C0005911 (UMLS CUI-1)
C0442805 (UMLS CUI-2)
(Comment:en)
Cardiac rehabilitation program
Item
66. Have you ever participated in a cardiac rehabilitation program?
boolean
C0700431 (UMLS CUI [1])
Item
67. Overall, how do you feel your general health is now?
text
C0424575 (UMLS CUI [1])
General health
Code List
67. Overall, how do you feel your general health is now?
CL Item
Excellent ([E17])
C1961136 (UMLS CUI-1)
(Comment:en)
CL Item
Very good ([E18])
C3641222 (UMLS CUI-1)
(Comment:en)
CL Item
Good ([E19])
C0205170 (UMLS CUI-1)
(Comment:en)
CL Item
Fair ([E20])
C2911689 (UMLS CUI-1)
(Comment:en)
CL Item
Poor ([E21])
C2700379 (UMLS CUI-1)
(Comment:en)
Item Group
Socio-economic
Item
68. What is your current marital status?
text
C0024819 (UMLS CUI [1])
marital status
Code List
68. What is your current marital status?
CL Item
Single ([F01])
C0037179 (UMLS CUI-1)
(Comment:en)
CL Item
Married or living with a partner ([F02])
C0555047 (UMLS CUI-1)
(Comment:en)
CL Item
Divorced or separated ([F03])
C0682073 (UMLS CUI-1)
(Comment:en)
CL Item
Widowed ([F04])
C0206275 (UMLS CUI-1)
(Comment:en)
living alone
Item
69. Are you living alone?
boolean
C0439044 (UMLS CUI [1])
Item
70. How many years of formal education have you completed?
text
C0557280 (UMLS CUI [1])
years of formal education
Code List
70. How many years of formal education have you completed?
CL Item
None ([F05])
C0549184 (UMLS CUI-1)
(Comment:en)
CL Item
1-8 years ([F06])
(Comment:en)
CL Item
9-12 years ([F07])
(Comment:en)
CL Item
Trade school ([F08])
C0036375 (UMLS CUI-1)
(Comment:en)
CL Item
College/university ([F09])
C0041740 (UMLS CUI-1)
(Comment:en)
internet access
Item
71. Do you have access to the internet?
boolean
C0282111 (UMLS CUI [1])
Item
72. What is your current employment?
text
C0552390 (UMLS CUI [1])
undefined item
Code List
72. What is your current employment?
CL Item
[F10] I am in paid employment - full time. ([F10] I am in paid employment - full time.)
CL Item
I am in paid employment - part time. ([F11])
CL Item
I am self employed. ([F12])
CL Item
I am unemployed. ([F13])
CL Item
I am not working because of my health. ([F14])
CL Item
I choose not to work. ([F15])
CL Item
I am retired. ([F16])
Postal code / ZIP code
Item
73. Postal code / ZIP code
integer
C0421454 (UMLS CUI [1])
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