= i2b2 Import from Onyx Mapping Version 1

The mapping is made up of 13 questionnaires.  These are:

1. Acute Verbal Consent for samples collection
1. Participant Consent
1. Paper Consent
1. Recruitment Context
1. Risk Factor
1. Patient-reported medical history
1. Samples Preliminary
1. Blood samples collection
1. Urine sample collection
1. End of patient contact
1. Notes-recorded medical history
1. Data submission
1. Conclusion

The mapping of each questionnaire is show in the sections below:

== Acute Verbal Consent for samples collection

Export folder: !VerbalConsentQuestionnaire

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||
|| Was acute verbal consent given ||  Radio button: yes,no  || n ||
|| Name of witness || Free text with radio button || y ||


== Participant Consent

Export folder: Consent ?

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||
|| Type of consent || Radio button: Electronic, Paper || n ||
|| Consent form language || Select: various languages || n ||
|| Consent Confirmation (paper only?) || Radio buttons: 'read and signed', 'refused to sign' || n ||


== Paper Consent

Export folder: Consent?

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||
|| Does the participant understand the request for consent? || Radio button: yes, no || y ||
|| Does the participant consent to donate blood and urine || Radio button: yes, no || y ||
|| Does the participant consent to entry in the BRICCS database? || Radio button: yes, no || y ||
|| Does the participant consent to further contact from BRU? || Radio button: yes, no || y ||
|| Does the participant understand the rules of withdrawal? || Radio button: yes, no || y ||

== Recruitment Context

Export folder: !RecruitmentContextQuestionnaire

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||
|| Interview Language || Select: languages || y ||
|| Recruitment episode type || Radio button: inpatient, outpatient, healthy control, study specific, don't know || y ||
|| Inpatient admission type || Radio button: Actute, Elective, Don't know || y ||
|| Hospital || Radio button: Glenfield, LGH, LRI, Don't know || y ||
|| Admitting Ward || Select: list of wards, and radio button: don't know || y ||
|| Admitting Consultant || Select: list of consultants, and radio button: don't know || y ||
|| Outpatient clinic attended || select: list of clinics, and radio button: don't know || y ||
|| Consultant || Select: list of consultants, and radio button: don't know || y ||
|| Study Reference || Radio button: !GeneFast AS Study, Study Reference2, Study Reference3, Don't know || y ||


== Risk Factor

Export folder: !RiskFactorQuestionnaire

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||
|| Have you ever smoked or used any tobacco or nicotine product? || Radio button: no, yes, prefer not to answer, don't know || y ||
|| Which of the following have you ever smoked or used? || tick boxes: cigarettes, cigars, pipe tobacco, snuff or chewing tobacco, any other|| y ||
|| Have you ever smoked cigarettes on most days? || Radio button: no, yes, prefer not to answer, Don't know || y ||
|| Do you currently smoke cigarettes || Radio button: y, n, pnta, dk || y ||
|| On average, how many cigarettes did you smoke per day when you were smoking the most || numeric box, pnta, dk || y ||
|| How old were you when you began smoking cigarettes on most days || numeric box, pnta, dk || y ||
|| How old were you when you stopped smoking cigarettes || numeric box, pnta, dk || y ||
|| On average, how many cigarettes do you currently smoke per day? || numeric box, pnta, dk || y ||
|| When was the last time you had a cigarette || Complex radio buttons: (Select: today, yesterday; Select: hour; Select: minute) or (More than 24 hours) || y ||
|| Have you ever smoked cigars regularly || Radio buttons: y, n, pnta, dk || y ||
|| Do you currently smoke  cigars || Radio buttons: y, n, pnta, dk || y ||
|| On average, how many cigars did you smoke per day when you were smoking the most || numeric box, pnta, dk || y ||
|| How old were you when you began smoking cigars on most days || numeric box, pnta, dk || y ||
|| How old were you when you stopped smoking cigars || numeric box, pnta, dk || y ||
|| On average, how many cigars do you currently smoke per day? || numeric box, pnta, dk || y ||
|| When was the last time you had a cigarette || Complex radio buttons: (Select: today, yesterday; Select: hour; Select: minute) or (More than 24 hours) || y ||
|| Have you ever smoked a pipe regularly || Radio buttons: y, n, pnta, dk || y ||
|| Do you currently smoke a pipe || Radio buttons: y, n, pnta, dk || y ||
|| How much tobacco did you smoke per day when you were smoking the most || numeric box, pnta, dk || y ||
|| How old were you when you began smoking a pipe on most days || numeric box, pnta, dk || y ||
|| How old were you when you stopped smoking a pipe || numeric box, pnta, dk || y ||
|| How much tobacco do you currently smoke per day? || numeric box, pnta, dk || y ||
|| When was the last time you smoked a pipe || Complex radio buttons: (Select: today, yesterday; Select: hour; Select: minute) or (More than 24 hours) || y ||
|| Have you ever used snuff or chewing tobacco regularly || Radio buttons: y, n, pnta, dk || y ||
|| Do you currently use snuff or chewing tobacco || Radio buttons: y, n, pnta, dk || y ||
|| How much snuff or chewing tobacco did you smoke per day when you were using the most || numeric box, pnta, dk || y ||
|| How old were you when you began using snuff or chewing tobacco || numeric box, pnta, dk || y ||
|| How old were you when you stopped using snuff or chewing tobacco || numeric box, pnta, dk || y ||
|| How much snuff or chewing tobacco do you use per week? || numeric box, pnta, dk || y ||
|| When was the last time you has snuff or chewing tobacco || Complex radio buttons: (Select: today, yesterday; Select: hour; Select: minute) or (More than 24 hours) || y ||
|| Have you ever used any other tobacco or nicotine product for at least 6 months || y, n, pnta, dk || y ||
|| Do you currently use any other tobacco or nicotine product || y, n, pnta, dk || y ||
|| How much of the tobacco or nicotine product per week did you use when you were using the most? || numeric box, pnta, dk || y ||
|| How old were you when you began using the tobacco or nicotine product? || numeric box, pnta, dk || y ||
|| How old were you when you stopped using the tobacco or nicotine product? || numeroc box, pnta, dk || y ||
|| How much of the tobacco or nicotine product do you use per week? || numeric box, pnta, dk || y ||
|| When was the last time you had any tobacco or nicotine? || Complex radio buttons: (Select: today, yesterday; Select: hour; Select: minute) or (More than 24 hours) || y ||
|| Have you ever drunk alcohol? || y, n, pnta, dk || y ||
|| Have you ever drunk alcohol at least once per week? || y, n, pnta, dk || y ||
|| Do you currently drink alcohol at least once per week? || y, n, pnta, dk || y ||
|| How many pints of beer do you drink in a typical week? || numeric box, pnta, dk || y ||
|| How many glasses of white wine do you drink in a typical week? || numeric box, pnta, dk || y ||
|| How many glasses of red wine do you drink in a typical week? || numeric box, pnta, dk || y ||
|| How many glasses of rose wine do you drink in a typical week? || numeric box, pnta, dk || y ||
|| How many measures of spirits do you drink in a typical week? || numeric box, pnta, dk || y ||
|| How old were you when you began drinking alcohol? || numeric box, pnta, dk || y ||
|| When was the last time you had a drink containing alcohol? || Complex radio buttons: (Select: today, yesterday; Select: hour; Select: minute) or (More than 24 hours) || y ||
|| How would you describe your diet? || Radio buttons: various diets || y ||
|| If you work, does your work involve any physical activity? || Radio buttons || y ||
|| Apart from work, do you undertake any regular physical exercise over and above that of daily living? || Radio buttons || y ||
|| Number of Family members || see below || y ||
|| How many brothers do you have? || numeric, pnta, dk || n ||
|| How many sisters do you have? || numeric, pnta, dk || n ||
|| How many children do you have? || numeric, pnta, dk || n ||
|| Have any of your relatives suffered angina or other Coronary Artery Disease? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| Have any of your relatives suffered a heart attack or Myocardial Infarction? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| Have any of your relatives ever been diagnosed with heart failure? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| Have any of your relatives ever suffered Atrial Fibrillation (AF)? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| Have any of your relatives ever suffered a stroke or CVA? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| Have any of your relatives been diagnosed with high blood pressure? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| Have any of your relatives been diagnosed with valvular heart disease? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| At what age did they first suffer from angina or Coronary Artery Disease? || see below || y ||
|| Father || numeric box, pnta, dk || n ||
|| Mother || numeric box, pnta, dk || n ||
|| Brother || numeric box, pnta, dk || n ||
|| Sister || numeric box, pnta, dk || n ||
|| Child || numeric box, pnta, dk || n ||
|| Have they received treatment for their angina or Coronary Artery Disease? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| At what age did they suffer their first heart attack or Myocardial Infarction? || see below || y ||
|| Father || numeric box, pnta, dk || n ||
|| Mother || numeric box, pnta, dk || n ||
|| Brother || numeric box, pnta, dk || n ||
|| Sister || numeric box, pnta, dk || n ||
|| Child || numeric box, pnta, dk || n ||
|| Have they received treatment for their angina or Coronary Artery Disease? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| At what age did they first suffer from heart failure? || see below || y ||
|| Father || numeric box, pnta, dk || n ||
|| Mother || numeric box, pnta, dk || n ||
|| Brother || numeric box, pnta, dk || n ||
|| Sister || numeric box, pnta, dk || n ||
|| Child || numeric box, pnta, dk || n ||
|| Have they received treatment for their heart failure? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| At what age did they first suffer from Atrial Fibrillation? || see below || y ||
|| Father || numeric box, pnta, dk || n ||
|| Mother || numeric box, pnta, dk || n ||
|| Brother || numeric box, pnta, dk || n ||
|| Sister || numeric box, pnta, dk || n ||
|| Child || numeric box, pnta, dk || n ||
|| Have they received treatment for their Atrial Fibrillation? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| At what age did they suffer their first stroke or CVA? || see below || y ||
|| Father || numeric box, pnta, dk || n ||
|| Mother || numeric box, pnta, dk || n ||
|| Brother || numeric box, pnta, dk || n ||
|| Sister || numeric box, pnta, dk || n ||
|| Child || numeric box, pnta, dk || n ||
|| Were they treated for the stroke or CVA? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| At what age did they first suffer from high blood pressure? || see below || y ||
|| Father || numeric box, pnta, dk || n ||
|| Mother || numeric box, pnta, dk || n ||
|| Brother || numeric box, pnta, dk || n ||
|| Sister || numeric box, pnta, dk || n ||
|| Child || numeric box, pnta, dk || n ||
|| Have they received treatment for their high blood pressure? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| At what age did they first suffer from valvular heart disease? || see below || y ||
|| Father || numeric box, pnta, dk || n ||
|| Mother || numeric box, pnta, dk || n ||
|| Brother || numeric box, pnta, dk || n ||
|| Sister || numeric box, pnta, dk || n ||
|| Child || numeric box, pnta, dk || n ||
|| Have they received treatment for their valvular heart disease? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| Are all of your relatives still alive? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| Do you know the cause of your father's death? || Radio buttons || y ||
|| Do you know the cause of your Mother's death? || Radio buttons || y ||
|| Do you know the cause of your brother's death? || Radio buttons || y ||
|| Do you know the cause of your sister's death? || Radio buttons || y ||
|| Do you know the cause of your child's death? || Radio buttons || y ||
|| At what age did they die? || see below || y ||
|| Father || numeric box, pnta, dk || n ||
|| Mother || numeric box, pnta, dk || n ||
|| Brother || numeric box, pnta, dk || n ||
|| Sister || numeric box, pnta, dk || n ||
|| Child || numeric box, pnta, dk || n ||
|| Was their death sudden and unexpected? || see below || y ||
|| Father || Radio buttons: y, n, pnta, dk || n ||
|| Mother || Radio buttons: y, n, pnta, dk || n ||
|| Brother || Radio buttons: y, n, pnta, dk || n ||
|| Sister || Radio buttons: y, n, pnta, dk || n ||
|| Child || Radio buttons: y, n, pnta, dk || n ||
|| What is your current marital status? || Radio buttons || y ||
|| Do you live with a spouse or partner? || Radio buttons || y ||
|| How many people live in your household? || Radio buttons || y ||
|| What is your current work status? || Radio buttons || y ||
|| What was the highest level of education you completed? || Radio buttons || y ||
|| Which of the following best describes the work you do or did?  || Radio buttons || y ||


== Patient-reported medical history

Export folder: 

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||

== Samples Preliminary

Export folder: 

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||

== Blood samples collection

Export folder: 

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||

== Urine sample collection

Export folder: 

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||

== End of patient contact

Export folder: 

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||

== Notes-recorded medical history

Export folder: 

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||

== Data submission

Export folder: 

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||

== Conclusion

Export folder: 

=== Visible fields on the form:

||=  Label =||=  Answer Type =||= Has comment =||