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Protocol - Personal and Family History of Respiratory Symptoms/Diseases - Child

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Protocol Name from Source:

The International Study of Asthma and Allergies in Childhood (ISAAC) Manual

Availability:

Publicly available

Description:

Age-specific questions are asked in this protocol to two different age ranges of children. For children ages 13 and 14, questions are asked directly to the child. For children 6 or 7 years old, questions are asked of the parents.

Protocol:

Questionnaire for 13 and 14 year olds

1. Have you ever had wheezing or whistling in the chest at any time in the past?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 6.

2. Have you had wheezing or whistling in the chest in the last 12 months?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 6.

3. How many attacks of wheezing have you had in the last 12 months?

[ ] None

[ ] 1 to 3

[ ] 4 to 12

[ ] More than 12

4. In the last 12 months, how often, on average, has your sleep been disturbed due to wheezing?

[ ] Never woken with wheezing

[ ] Less than one night per week

[ ] One or more nights per week

5. In the last 12 months, has wheezing ever been severe enough to limit your speech to only one or two words at a time between breaths?

[ ] Yes

[ ] No

6. Have you ever had asthma?

[ ] Yes

[ ] No

7. In the last 12 months, has your chest sounded wheezy during or after exercise?

[ ] Yes

[ ] No

8. In the last 12 months, have you had a dry cough at night, apart from a cough associated with a cold or chest infection?

[ ] Yes

[ ] No

All questions are about problems which occur when you DO NOT have a cold or the flu.

9. Have you ever had a problem with sneezing, or a runny or blocked nose, when you DID NOT have a cold or the flu?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 14.

10. In the past 12 months, have you had a problem with sneezing, or a runny or blocked nose, when you DID NOT have a cold or the flu?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 14.

11. In the past 12 months, has this nose problem been accompanied by itchy or watery eyes?

[ ] Yes

[ ] No

12. In which of the past 12 months did this nose problem occur? (Please tick any which apply.)

[ ] January

[ ] February

[ ] March

[ ] April

[ ] May

[ ] June

[ ] July

[ ] August

[ ] September

[ ] October

[ ] November

[ ] December

13. In the past 12 months, how much did this nose problem interfere with your daily activities?

[ ] Not at all

[ ] A little

[ ] A moderate amount

[ ] A lot

14. Have you ever had hay fever?

[ ] Yes

[ ] No

15. Have you ever had an itchy rash which was coming and going for at least six months?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 20.

16. Have you had this itchy rash at any time in the last 12 months?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 20.

17. Has this itchy rash at any time affected any of the following places: the folds of the elbows, behind the knees, in front of the ankles, under the buttocks, or around the neck, ears, or eyes?

[ ] Yes

[ ] No

18. Has this rash cleared completely at any time during the last 12 months?

[ ] Yes

[ ] No

19. In the last 12 months, how often, on average, have you been kept awake at night by this itchy rash?

[ ] Never in the last 12 months

[ ] Less than one night per week

[ ] One or more nights per week

20. Have you ever had eczema?

[ ] Yes

[ ] No

Questionnaire for 6 and 7 year olds

21. Has your child ever had wheezing or whistling in the chest at any time in the past?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 26.

22. Has your child had wheezing or whistling in the chest in the last 12 months?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 26.

23. How many attacks of wheezing has your child had in the last 12 months?

[ ] None

[ ] 1 to 3

[ ] 4 to 12

[ ] More than 12

24. In the last 12 months, how often, on average, has your child’s sleep been disturbed due to wheezing?

[ ] Never woken with wheezing

[ ] Less than one night per week

[ ] One or more nights per week

25. In the last 12 months, has wheezing ever been severe enough to limit your child’s speech to only one or two words at a time between breaths?

[ ] Yes

[ ] No

26. Has your child ever had asthma?

[ ] Yes

[ ] No

27. In the last 12 months, has your child’s chest sounded wheezy during or after exercise?

[ ] Yes

[ ] No

28. In the last 12 months, has your child had a dry cough at night, apart from a cough associated with a cold or chest infection?

[ ] Yes

[ ] No

29. Has your child ever had a problem with sneezing, or a runny or blocked nose, when he/she DID NOT have a cold or the flu?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 34.

30. In the past 12 months, has your child had a problem with sneezing, or a runny or blocked nose, when he/she DID NOT have a cold or the flu?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 34.

31. In the past 12 months, has this nose problem been accompanied by itchy, watery eyes?

[ ] Yes

[ ] No

32. In which of the past 12 months did this nose problem occur? (Please tick any which apply)

[ ] January

[ ] February

[ ] March

[ ] April

[ ] May

[ ] June

[ ] July

[ ] August

[ ] September

[ ] October

[ ] November

[ ] December

33. In the past 12 months, how much did this nose problem interfere with your child’s daily activities?

[ ] Not at all

[ ] A little

[ ] A moderate amount

[ ] A lot

34. Has your child ever had hay fever?

[ ] Yes

[ ] No

35. Has your child ever had an itchy rash that was coming and going for at least 6 months?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 40.

36. Has your child had this itchy rash at any time in the last 12 months?

[ ] Yes

[ ] No

IF YOU HAVE ANSWERED "NO," PLEASE SKIP TO QUESTION 40.

37. Has this itchy rash at any time affected any of the following places: the folds of the elbows, behind the knees, in front of the ankles, under the buttocks, or around the neck, ears, or eyes?

[ ] Yes

[ ] No

38. At what age did this itchy rash first occur?

[ ] Under 2 years

[ ] Age 2-4 years

[ ] Age 5 or more

39. Has this rash cleared completely at any time during the last 12 months?

[ ] Yes

[ ] No

40. In the last 12 months, how often, on average, has your child been kept awake at night by this itchy rash?

[ ] Never in the last 12 months

[ ] Less than one night per week

[ ] One or more nights per week

41. Has your child ever had eczema?

[ ] Yes

[ ] No

Personnel and Training Required

None

Equipment Needs

None

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Self-administered

Life Stage:

Child, Adolescent

Specific Instructions:

The parental questionnaire was used in a study of parents of children aged 6 to 7 years. The Respiratory Working Group deems the questionnaire appropriate to use with parents of children under the age of 14.

Research Domain Information

Release Date:

November 28, 2017

Definition

This measure assesses the history of respiratory symptoms (i.e., cough, phlegm, shortness of breath, wheezing) and respiratory diseases.

Purpose

Personal and family histories of respiratory symptoms and diseases are important to assess for overall health and quality of life. Standardized approaches to assess respiratory symptoms and diseases are required to define many respiratory phenotypes.

Selection Rationale

The International Study of Asthma and Allergies in Childhood (ISAAC) was founded to maximize the value of epidemiological research into asthma and allergic disease by establishing a standardized methodology and facilitating international collaboration.

Language

English

Standards

StandardNameIDSource
Common Data Elements (CDE)Person Respiratory Symptom Family And Personal Medical History Text2969935CDE Browser
Logical Observation Identifiers Names and Codes (LOINC)Resp fam hx resp sympt child proto62626-7LOINC

Process and Review

[link[phenx.org/node/118|Expert Review Panel #6]] (ERP 6) reviewed the measures in the Respiratory domain.

Guidance from ERP 6 includes:

• No significant changes to measure

Back-compatible: no changes to Data Dictionary

Source

The International Study of Asthma and Allergies in Childhood (ISAAC) Manual. December 1993, 2nd Edition. Module 1.1, questions 1-8 (questions 1-8 and 21-28); Module 1.2, questions 1-6 (questions 9-14 and 29-34); and Module 1.3, questions 1-7 (questions 15-20 and 35-41).

General References

Beasley, R. (1998). Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The Lancet, 351(9111), 1225-1232.

Protocol ID:

90902

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX090902_Itchy_Rash_Often_Awake_Night_6PX090902400000In the last 12 months, how often, on average, has your child been kept awake at night by this itchy rash?4N/A
PX090902_Eczema_Ever_6PX090902410000Has your child ever had eczema?4N/A
PX090902_Wheezing_Whistling_Chest_Ever_13PX090902010000Have you ever had wheezing or whistling in the chest at any time in the past?4N/A
PX090902_Wheezing_Whistling_Chest_12_Months_13PX090902020000Have you had wheezing or whistling in the chest in the last 12 months?4N/A
PX090902_Wheezing_Attack_Times_12_Months_13PX090902030000How many attacks of wheezing have you had in the last 12 months?4N/A
PX090902_Wheezing_Sleep_Disturbed_12_Months_13PX090902040000In the last 12 months, how often, on average, has your sleep been disturbed due to wheezing?4N/A
PX090902_Wheezing_Limit_Speech_12_Months_13PX090902050000In the last 12 months, has wheezing ever been severe enough to limit your speech to only one or two words at a time between breaths?4N/A
PX090902_Asthma_Ever_13PX090902060000Have you ever had asthma?4N/A
PX090902_Wheezy_Chest_Exercise_12_Months_13PX090902070000In the last 12 months, has your chest sounded wheezy during or after exercise?4N/A
PX090902_Dry_Cough_Night_12_Months_13PX090902080000In the last 12 months, have you had a dry cough at night, apart from a cough associated with a cold or chest infection?4N/A
PX090902_Sneezing_Runny_Nose_Ever_13PX090902090000Have you ever had a problem with sneezing, or a runny or blocked nose, when you DID NOT have a cold or the flu?4N/A
PX090902_Sneezing_Runny_Nose_12_Months_13PX090902100000In the past 12 months, have you had a problem with sneezing, or a runny or blocked nose, when you DID NOT have a cold or the flu?4N/A
PX090902_Nose_Itchy_Eyes_12_Months_13PX090902110000In the past 12 months, has this nose problem been accompanied by itchy or watery eyes?4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_JanuaryPX090902120100In which of the past 12 months did this nose problem occur? January4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_FebruaryPX090902120200In which of the past 12 months did this nose problem occur? February4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_MarchPX090902120300In which of the past 12 months did this nose problem occur? March4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_AprilPX090902120400In which of the past 12 months did this nose problem occur? April4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_MayPX090902120500In which of the past 12 months did this nose problem occur? May4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_JunePX090902120600In which of the past 12 months did this nose problem occur? June4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_JulyPX090902120700In which of the past 12 months did this nose problem occur? July4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_AugustPX090902120800In which of the past 12 months did this nose problem occur? August4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_SeptemberPX090902120900In which of the past 12 months did this nose problem occur? September4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_OctoberPX090902121000In which of the past 12 months did this nose problem occur? October4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_NovemberPX090902121100In which of the past 12 months did this nose problem occur? November4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_13_DecemberPX090902121200In which of the past 12 months did this nose problem occur? December4N/A
PX090902_Nose_Interfere_Activities_12_Months_13PX090902130000In the past 12 months, how much did this nose problem interfere with your daily activities?4N/A
PX090902_Hay_Fever_Ever_13PX090902140000Have you ever had hay fever?4N/A
PX090902_Itchy_Rash_Ever_13PX090902150000Have you ever had an itchy rash which was coming and going for at least six months?4N/A
PX090902_Itchy_Rash_12_Months_13PX090902160000Have you had this itchy rash at any time in the last 12 months?4N/A
PX090902_Itchy_Rash_Affected_Sites_Places_13PX090902170000Has this itchy rash at any time affected any of the following places: the folds of the elbows, behind the knees, in front of the ankles, under the buttocks, or around the neck, ears, or eyes?4N/A
PX090902_Itchy_Rash_Cleared_Completely_13PX090902180000Has this rash cleared completely at any time during the last 12 months?4N/A
PX090902_Itchy_Rash_Often_Awake_Night_13PX090902190000In the last 12 months, how often, on average, have you been kept awake at night by this itchy rash?4N/A
PX090902_Eczema_Ever_13PX090902200000Have you ever had eczema?4N/A
PX090902_Wheezing_Whistling_Chest_Ever_6PX090902210000Has your child ever had wheezing or whistling in the chest at any time in the past?4N/A
PX090902_Wheezing_Whistling_Chest_12_Months_6PX090902220000Has your child had wheezing or whistling in the chest in the last 12 months?4N/A
PX090902_Wheezing_Attack_Times_12_Months_6PX090902230000How many attacks of wheezing has your child had in the last 12 months?4N/A
PX090902_Wheezing_Sleep_Disturbed_12_Months_6PX090902240000In the last 12 months, how often, on average, has your child's sleep been disturbed due to wheezing?4N/A
PX090902_Wheezing_Limit_Speech_12_Months_6PX090902250000In the last 12 months, has wheezing ever been severe enough to limit your child's speech to only one or two words at a time between breaths?4N/A
PX090902_Asthma_Ever_6PX090902260000Has your child ever had asthma?4N/A
PX090902_Wheezy_Chest_Exercise_12_Months_6PX090902270000In the last 12 months, has your child's chest sounded wheezy during or after exercise?4N/A
PX090902_Dry_Cough_Night_12_Months_6PX090902280000In the last 12 months, has your child had a dry cough at night, apart from a cough associated with a cold or chest infection?4N/A
PX090902_Sneezing_Runny_Nose_Ever_6PX090902290000Has your child ever had a problem with sneezing, or a runny or blocked nose, when he/she DID NOT have a cold or the flu?4N/A
PX090902_Sneezing_Runny_Nose_12_Months_6PX090902300000In the past 12 months, has your child had a problem with sneezing, or a runny or blocked nose, when he/she DID NOT have a cold or the flu?4N/A
PX090902_Nose_Itchy_Eyes_12_Months_6PX090902310000In the past 12 months, has this nose problem been accompanied by itchy, watery eyes?4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_JanuaryPX090902320100In which of the past 12 months did this nose problem occur? January4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_FebruaryPX090902320200In which of the past 12 months did this nose problem occur? February4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_MarchPX090902320300In which of the past 12 months did this nose problem occur? March4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_AprilPX090902320400In which of the past 12 months did this nose problem occur? April4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_MayPX090902320500In which of the past 12 months did this nose problem occur? May4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_JunePX090902320600In which of the past 12 months did this nose problem occur? June4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_JulyPX090902320700In which of the past 12 months did this nose problem occur? July4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_AugustPX090902320800In which of the past 12 months did this nose problem occur? August4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_SeptemberPX090902320900In which of the past 12 months did this nose problem occur? September4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_OctoberPX090902321000In which of the past 12 months did this nose problem occur? October4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_NovemberPX090902321100In which of the past 12 months did this nose problem occur? November4N/A
PX090902_Sneezing_Runny_Nose_Occurrence_Months_6_DecemberPX090902321200In which of the past 12 months did this nose problem occur? December4N/A
PX090902_Nose_Interfere_Activities_12_Months_6PX090902330000In the past 12 months, how much did this nose problem interfere with your child's daily activities?4N/A
PX090902_Hay_Fever_Ever_6PX090902340000Has your child ever had hay fever?4N/A
PX090902_Itchy_Rash_Ever_6PX090902350000Has your child ever had an itchy rash that was coming and going for at least 6 months?4N/A
PX090902_Itchy_Rash_12_Months_6PX090902360000Has your child had this itchy rash at any time in the last 12 months?4N/A
PX090902_Itchy_Rash_Affected_Sites_Places_6PX090902370000Has this itchy rash at any time affected any of the following places: the folds of the elbows, behind the knees, in front of the ankles, under the buttocks, or around the neck, ears, or eyes?4N/A
PX090902_Itchy_Rash_First_Age_6PX090902380000At what age did this itchy rash first occur?4N/A
PX090902_Itchy_Rash_Cleared_Completely_6PX090902390000Has this rash cleared completely at any time during the last 12 months?4N/A