LTR

Metadata Report

Family History Questionnaire(FHQ)
Version 1.00

Key FieldField NameFull NameQuestion TextTypeLength and DecimalsExpected
*SITECenterC5Yes
*PROTProtocolC5Yes
*PROJIDParticipant IDC5Yes
*PROTSEGSegmentC1Yes
*DTASSESSDate of assessmentD8Yes
FHQBLDREBlood relativeDoes the participant know at least one first degree blood relative (parent, sibling, half-sibling, or child)?C1Yes
FHQPARNTBirth parentsDo you know who at least one of your birth parents are?C1Yes
FHQSIBLNumber of blood siblingsHow many blood siblings do you have (include half siblings)?N2(0)Yes
FHQSUKNumber siblings unknownC1No
FHQCHILDNumber of childrenHow many children do you have?N2(0)Yes
FHQCUKNumber children unknownC1No
FHQCOPDCOPDCOPD:C1Yes
FHQBRONCChronic bronchitisChronic bronchitis:C1Yes
FHQEMPHEmphysemaEmphysema:C1Yes
FHQASTHAsthmaAsthma:C1Yes
FHQALPHAAlpha-1 antitrypsin defHave any of your first degree blood relatives (parent, sibling, child) had alpha-1 antitrypsin deficiency?C1Yes
FHQFIBROFibrotic lung diseaseHave any of your first degree blood relatives (parent, sibling, child) developed a fibrotic lung disease?C1Yes
FHQBIOPSFibrotic lung documentedWas a fibrotic lung disease documented by biopsy in any of these relatives?C1Yes
FHQRARheumatoid arthritisRheumatoid arthritis:C1Yes
FHQSCLERSclerodermaScleroderma:C1Yes
FHQLUPUSLupusLupus:C1Yes
FHQPOLYMPolymyositisPolymyositis:C1Yes
FHQOTCOLOther collagen vascularOther collagen vascular disease:C1Yes
FHQCOLSPOther collagen specifyIf Yes, specify:C50Yes
FHQPLHTNPulmonary hypertensionPulmonary hypertension:C1Yes
FHQCOMMCommentsComments:M4No