| CDE ID | CDE Description | | * 421 | EDRN Participant ID (Go To: 1219) |
| * 1219 | Date of contact (MM/DD/YYYY): (Go To: 423) |
| * 423 | EDRN Protocol ID (Go To: 422) |
| * 422 | EDRN Site ID (Go To: 929) |
| * 929 | EDRN Staff ID of the person who collected the data: (Go To: 2176) |
| * 2176 | Visit code (Go To: 2232) |
| | | Permissible Values (value): | Y1V06 (20) |
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| * 2232 | Has medication use changed since the participant's last study contact? (Go To: 1097) |
| | | Permissible Values (value): | No (0) |
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| * 1417 | Has participant ever taken any of the following statin medications? (Have you ever taken any of the following statin medications?) (Go To: 2202) |
| | | Permissible Values (value): | Atorvastatin (Lipitor) (1) |
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| | | | Pravastatin (Pravachol) (4) |
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| | | | Rosuvastatin calcium (Crestor) (6) |
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| | | | Lovastatin with niacin (Advicor) (8) |
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| | | | Niacin/imvastatin (Simcor) (9) |
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| | | | Atorvastatin with amlodipine (Norvasc) (Caduet) (10) |
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| | | | Ezetimibe/simvastatin (Vytorin) (11) |
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| | | | Pitavastatin (Livalo) (12) |
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| * 2467 | Has participant taken any of the following diabetes medications? (Go To: 2202) |
| | | Permissible Values (value): | Alpha-glucosidase inhibitors: Acarbose (Precose), Miglitol (Glyset) (1) |
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| | | | Biguanides: Metformin (Glucophage, Glucophage XR, Fortamet, Riomet, Glumetza) (2) |
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| | | | Combination therapy: Avandamet (Rosiglitazone and Metformin), Glucovance (Glyburide and Metformin), Metaglip (Glipizide and Metformin) (3) |
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| | | | Dipeptidyl peptidase IV (DPP-IV) inhibitors: Sitagliptin (Januvia) (4) |
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| | | | Meglitinides: Nateglinide (Starlix) Repaglinide (Prandin) (6) |
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| | | | Sulfonylureas: Acetohexamide (Dymelor), Chlorpropamide (Diabinese), Glimepiride (Amaryl), Glipizide (Glucotrol, Glucotol XL), Glyburide (Micronase, DiaBeta, Glynase), Tolazamide (Tolinase), Tolbutamide (Orinase) (7) |
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| | | | Thiazolidinediones or Glitazones: Pioglitazone (Actos), Rosiglitazone (Avandia) (8) |
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| | | | DPP-4 Inhibitors [Sitagliptin (Januvia), Saxagliptin (Onglyza), Linagliptin ( Tradjenta)] (9) |
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| | | | Bile Acid Sequestrants Colesevelam (Welchol) (12) |
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| | | | Co-Transporter 2 (SGLT2) Inhibitor (Jardiance) (13) |
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| | | | Incretin mimetics (exenatide (Byetta, Bydureon), liraglutide (Victoza), dulaglutide (Trulicity), lixisenatide (Adlyxin), semaglutide (Ozempic)) (14) |
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| * 2468 | Has the participant taken any of the following medications with hormonal effects? (Go To: 2202) |
| | | Permissible Values (value): | 5α-reductase inhibitors: Dutasteride (Avodart), Finasteride (Proscar) (1) |
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| | | | Anti-androgens: Biclutamide (Casodex), Flutamide (Eulexin), Nilutamide (Nilandron) (2) |
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| | | | Luteinizing hormone releasing hormone (LHRH) agonists: Leuprolide (Eligard, Lupron, Viadur), Goserelin (Zoladex), Triptorelin (Trelstar) (3) |
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| | | | Nandrolone (Deca-Durabolin, Durabolin, Nandrolin) (4) |
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| | | | Testosterone replacement: (Testim, Androgel) (5) |
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| * 2469 | Has the participant taken any of the following non-steroidal anti-inflammatory drugs (NSAIDS)? (Go To: 2202) |
| | | Permissible Values (value): | Aspirin (Anacin, Ascriptin, Bayer, Bufferin, Ecotrin, Excedrin) (1) |
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| | | | Diclofenac (Cataflam, Voltaren, Voltaren XR, Arthrotec) (2) |
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| | | | Etodolac (Lodine, Lodine XL) (4) |
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| | | | Fenoprofen calcium (Nalfon) (5) |
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| | | | Flurbiprofen (Ansaid) (6) |
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| | | | Ibuprofen (Advil, Motrin, Motrin IB, Nuprin) (7) |
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| | | | Indomethacin (Indocin, Indocin SR) (8) |
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| | | | Ketoprofen (Actron, Orudis, Orudis KT, Oruvail) (9) |
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| | | | Meclofenamate sodium (Meclomen) (10) |
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| | | | Mefenamic acid (Ponstel) (11) |
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| | | | Nabumetone (Relafen) (13) |
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| | | | Naproxen (Aleve, Anaprox, Naprosyn, Naprelan) (14) |
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| | | | Salicylate (Arthropan, Arthritab, Bayer Select, CMT, Doan's Pills, Magan, Mobidin, Mobogesic, Tricosal, Trilisate, various generics) (17) |
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| | | | Salsalate (Amigesic, Anaflex 750, Disalcid, Marthritic, Mono-Gesic, Salflex, Salsitab) (18) |
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| | | | Tolmetin sodium (Tolectin) (20) |
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| 2470 | Has the participant taken any of the following COX-2 selective non-steroidal anti-inflammatory drugs (NSAIDS)? (Go To: 2202) |
| | | Permissible Values (value): | Celecoxib (Celebrex) (1) |
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| 1873 | Medication Name: (Go To: 2202) |
| * 2202 | Is this medication currently taken? (Go To: 2201) |
| | | Permissible Values (value): | No (0) |
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| * 2201 | How often is/was this medication taken? (Go To: 1097) |
| | | Permissible Values (value): | less than 1 day per week (0) |
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| 1097 | Comments (do not include any participant identifiers) (Go To: End of Form) |