Colive Voice
Language
  • English (US)
  • Français
  • German (Germany)
  • Español
  • Portuguese (Portugal)
  • Arabic‬‎

  • Welcome!

  • Monitoring your health thanks to your voice will soon be possible

    Colive Voice is an international academic research study, led by the Luxembourg Institute of Health. It aims to identify vocal biomarkers to improve and simplify the regular monitoring of serious diseases such as cancer, diabetes, COVID-19, mental health, multiple sclerosis, inflammatory bowel diseases... Thus, we can shape the future of digital health and telemedicine for millions of patients.

    To achieve this goal, we need many participants worldwide who speak different languages, are healthy or have various health conditions.

  •  

    Why should you take part in Colive Voice?

    By helping us, you contribute to the development of augmented healthcare thanks to better and easier remote disease monitoring using voice. Your input will ultimately help millions of patients daily!

    Voice-based monitoring is:

    • Non-invasive
    • Executed at home
    • Allows early diagnosis
    • Voice-based medical data can be transmitted in real-time to your healthcare professional
    • Safer for medical teams in case of contagious disease

    Vocal biomarkers will enable easier life, with less pain, less fatigue, and less waiting for an appointment.

     

  • If you want to participate, read the consent information below

    Read consent information

    X

    Information and Consent

    The present information is directed to the participants of the survey submitting their recordings via the website.

    What is Colive Voice?

    The Colive Voice research project aims to see if we can identify vocal biomarkers of severe conditions and frequent health symptoms. This is a Luxembourgish initiative aiming to collect data from participants of several countries. The project is based on digital technologies and statistical algorithms. This research initiative is handled by the Deep Digital Phenotyping Research Unit from the Luxembourg Institute of Health.

    What is a vocal biomarker?

    A "vocal biomarker" is a feature in your voice, or a combination of features that can help to detect a health condition or to monitor a specific symptom. Thanks to this research, one day, we may be able to easily monitor our health, for example by talking to our smartphone.

    How to identify vocal biomarkers?

    To achieve this objective, the researchers need to build a large multilingual database of vocal records combined with health data. Based on this, they will detect specific health characteristics from the voice, using machine learning techniques i.e. algorithms that can learn from data and identify patterns (biomarkers) with minimal human intervention. The accuracy of the algorithms is improving over time, with the addition of more data from other participants.

    How do I participate?

    Donate your voice! Participation is anonymous. Once you have consented to participate you will have to answer a few questions related to your health and then perform consecutive voice recordings.

    How can I contribute more to medical research?

    Your participation is very important for this research, we thank you in advance for it. The more participants there are, the more precise the results will be, so please share this link to your friends, family and on social media. We will provide you a link to share the project at the end of the survey.

    Categories of data collected

    Your participation in the study involves collecting personal data about you to the extent that it is necessary to meet the scientific objectives of the study. Data will be collected just once, when completing this survey, we will not revert back to you for additional requests.

    In particular will be collected:

    • Basic information: demographic factors (age, gender, language, ...), lifestyle factors (alcohol, smoking...) and anthropometric factors (weight, height, ...)
    • Health data: health status (symptoms, treatments, diseases), psychological health
    • Voice records (please note that your device will ask you to access to your microphone and that you have to acept in order to perform the voice records)
    • Technical data: date and time of completion of the survey. Upon submission of the survey, your IP address alone will be securely transferred to ipstack.com, an external service provider, whose only purpose is to determine the country of origin of your current IP address. Your country of origin will be storred in our database. Your IP address will not be stored by ipstack.com and will not be stored in the Colive database.

    No personal data is collected which would allow us directly to identify an individual. We do not collect any identifying data such as your name, email address, date of birth or any other unique piece of identification. The data that we collect is held so it cannot be put together ("linked") to identify a user specifically.

    Data controller

    The Luxembourg Institute of Health (LIH), having its registered address at 1A-B, rue Thomas Edison L-1445 Strassen, LUXEMBOURG, is data controller of the research project "Colive Voice" in the meaning of the European General Data Protection Regulation (GDPR).

    This means that LIH is responsible for the collection, analysis and more generally for processing your personal data and ensures their protection, in accordance with the GDPR and any subsequent text replacing or supplementing this text (in particular the law of August 1, 2018 on the organization of the National Commission for Data Protection and GDPR Implementation).

    Purpose and legal basis for data processing

    The use of your personal data is necessary to enable us to achieve the aims of the study, which we are conducting in the public interest and for the purposes of scientific research (art. 6.1e and art. 9.2j of the GDPR).

    Data sharing

    The data collected in the frame of this project may be shared in the future for research purposes in similar health research areas but only in an anonymous form.

    Data hosting

    All study data is collected using the Jotform, Inc. electronic tool (USA), which allows for the creation of secure online questionnaires to collect data. Data collected via Jotform, Inc. is securely stored in Europe (Germany). Questionnaires are encrypted for additional security. Jotform, Inc. is the Data Processor of LIH, which is conducting the study and is used to collect data from the survey questionnaire. Once collected, the data is transferred to LIH’s secure servers and permanently deleted from Jotform, Inc.'s servers. Under no circumstances do Jotform, Inc. employees have access to data collected on Jotform, Inc.'s servers, except in exceptional cases following an explicit request from the study manager to resolve a problem.

    Data security and integrity

    LIH takes appropriate security measures, depending on the sensitivity of the data concerned, to protect your data from the risk of unauthorised access, loss, fraudulent use, disclosure, modification and destruction. Your data will be treated as strictly confidential.

    Retention periods

    LIH will retain the data collected via the application for 15 years following the date of collection.

    Your rights

    As we are not collecting data that enable us to identify you, your rights are limited. The exercise of such rights would require to identify study participants, which would considerably weaken the security and confidentiality of data collected for our survey.

    However, you have the right to lodge a complaint with Luxembourg's National Commission for Data Protection (CNPD) in relation to the processing of your personal data.

    For any question or information about how LIH processes your personal data, please contact LIH’s Data Protection Officer by email at dpo@lih.lu or by post at the following address:

    LUXEMBOURG INSTITUTE OF HEALTH
    Data Protection Office
    1A-B, rue Thomas Edison
    L-1445 Strassen
    LUXEMBOURG

  • Welcome! First, let us check whether you are eligible to participate in Colive Voice or Colive Diabetes.

  • What is your gender?*
  • Have you ever been diagnosed with diabetes?*
  • What type of diabetes do you have?*

  • Welcome to Colive Voice!

  • Welcome to Colive Diabetes, the Colive Voice sub-study dedicated to diabetes!

  • This questionnaire is about you (demographics, education, ...) and your lifestyle (quality of life, smoking habits, alcohol consumption, ...).
    Please answer all questions.

  • What is your weight?
    N.B. Change the unit by clicking on it (default value: 'KGs')

  • Value must be between 40-220kg (or 88-440lbs).

  • What is your height?
    N.B. Change the unit by clicking on it (default value: 'CM')

  • Regarding smoking, you are...*
  • During the last 12 months, how often did you usually have any kind of drink containing alcohol?*
  • How frequently do you exercise?*
  • Do you have menstrual periods?*
  • Are your periods...*
  • Which hormonal method of contraception are you currently using?*
  • Do you know which type of contraceptive pill are you taking?*
  • How is your pill pack usually taken?*
  • Which phase of your pill pack are you currently in?*
  • For approximately how long in total have you used contraceptive pills in your life?*
  • When was your last period?*
  • I don't have my periods because...*

  • My personality: I see myself as someone who...

  • ... Is reserved*
  • … is generally trusting*
  • … tends to be lazy*
  • … is relaxed, handles stress well*
  • … has few artistic interests*
  • … is outgoing, sociable*
  • … tends to find fault with others*
  • … does a thorough job*
  • … gets nervous easily*
  • … has an active imagination*

  • You reached the end of this section. Please press "Next page" to continue.

  • Current symptoms

    In this section, we’ll ask you about the symptoms you are experiencing right now. Please answer based on how you feel at this moment.

  • Please rate how much pain you have right now

    0 = No pain

    10 = Pain as bad as you can imagine

  • Please rate how much stress you have right now

    0 = No stress

    10 = Stress as bad as you can imagine

  • Please rate how much anxiety you feel right now

    0 = No anxiety

    10 = The worst anxiety you can imagine

  • Please rate how depressed you feel right now

    0 = Not at all

    10 = The worst you can imagine

  • Do you have a sore throat?*
  • Do you feel thirsty or have dry mouth?*
  • What emotion best describes your feeling at the moment?*

  • Symptoms in the past few weeks

    In this section, we’ll ask you about symptoms or experiences you’ve had over the past days or weeks. Please think back to your usual or recent experiences when answering.
  • Do you have balance disorders or walking difficulties?*
  • Have you - unintentionally - lost weight in the last 3 months?*
  • How often do you experience acid reflux or heartburn?*

  • The following questions are about your mood.
    Answer as accurately as possible. There are no right or wrong answers.

  • How often have you been bothered by the following over the past 2 weeks?

  • Little interest or pleasure in doing things*
  • Feeling down, depressed, or hopeless*
  • Trouble falling or staying asleep, or sleeping too much*
  • Which sleep problem bothers you more?*
  • Feeling tired or having little energy*
  • Poor appetite or overeating*
  • Feeling bad about yourself — or that you are a failure or have let yourself or your family down*
  • Trouble concentrating on things, such as reading the newspaper or watching television*
  • Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual*
  • Thoughts that you would be better off dead or of hurting yourself in some way*

  • The following questions are about your sleep.
    Answer as accurately as possible. There are no right or wrong answers.

  • During the past month, how often have you had trouble sleeping because you...

  • Cannot get to sleep within 30 minutes?*
  • Wake up in the middle of the night or early morning?*
  • Cannot breathe comfortably?*
  • Cough or snore loudly?*
  • Feel too hot?*
  • Have bad dreams?*
  • Have pain?*
  • During the past month, how often have you had trouble staying awake while driving, eating meals, or engaging in social activity?*
  • During the past month, how much of a problem has it been for you to keep up enthusiasm to get things done?*

  • The following statements are about your current fatigue status.
    Answer as accurately as possible. There are no right or wrong answers.

  •

  • The following statements are about your respiratory quality of life.
    Answer as accurately as possible. There are no right or wrong answers.

  • Which of the following best describes your cough during daytime?*
  • Which of the following best describes your cough during nighttime?*

  • Symptoms in the past few weeks

    In this section, we’ll ask you about symptoms or experiences you’ve had over the past days or weeks. Please think back to your usual or recent experiences when answering.

  • The following statements are about your stress levels.
    Answer as accurately as possible. There are no right or wrong answers.

  • In the last month, how often have you been upset because of something that happened unexpectedly?*
  • In the last month, how often have you felt that you were unable to control the important things in your life?*
  • In the last month, how often have you felt nervous and stressed?*
  • In the last month, how often have you felt confident about your ability to handle your personal problems?*
  • In the last month, how often have you felt that things were going your way?*
  • In the last month, how often have you found that you could not cope with all the things that you had to do?*
  • In the last month, how often have you been able to control irritations in your life?*
  • In the last month, how often have you felt that you were on top of things?*
  • In the last month, how often have you been angered because of things that happened that were outside of your control?*
  • In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?*

  • The following statements are about your anxiety levels.
    Answer as accurately as possible. There are no right or wrong answers.

  • Over the last two weeks, how often have you been bothered by the following problems?

  • Feeling nervous, anxious, or on edge*
  • Not being able to stop or control worrying*
  • Worrying too much about different things*
  • Trouble relaxing*
  • Being so restless that it is hard to sit still*
  • Becoming easily annoyed or irritable*
  • Feeling afraid, as if something awful might happen*

  • The following statements are about your voice.
    Answer as accurately as possible. There are no right or wrong answers.

  • How often do you use your voice during a typical day, for example in your work or daily activities (teaching, singing, etc.)?*
  • My voice makes it difficult for people to hear me*
  • People have difficulty understanding me in a noisy room*
  • My voice difficulties restrict personal and social life*
  • I feel left out of conversations because of my voice*
  • My voice problem causes me to lose income*
  • I feel as though I have to strain to produce voice*
  • The clarity of my voice is unpredictable*
  • My voice problem upsets me*
  • My voice makes me feel handicapped*
  • People ask, “What’s wrong with your voice?”*

  • The following statements are about your thinking and concentration.
    Answer as accurately as possible. There are no right or wrong answers.

  • In the past 7 days... My thinking has been slow*
  • It has seemed like my brain was not working as well as usual*
  • I have had to work harder than usual to keep track of what I was doing*
  • I have had trouble shifting back and forth between different activities that require thinking*
  • I have had trouble concentrating*
  • I have had to work really hard to pay attention or I would make a mistake*
  • I have had trouble forming thoughts*
  • I have had trouble adding or subtracting numbers in my head*

  • You reached the end of this section. Please press "Next page" to continue.

  • Family history

    The next question is about your family health history.
  • Does anyone in your family (parents, siblings, children) have diabetes?*

  • Diseases

    The next part is about all the diseases you could have had in your life.
  • Have you ever been diagnosed with cancer?*
  • Have you ever been diagnosed with one or several of the following mental health conditions?*

  • If "None of the above" is selected, please ensure that no other options are selected.

  • Have you ever been diagnosed with one or several of the following cardiovascular diseases?*

  • If "None of the above" is selected, please ensure that no other options are selected.

  • Have you ever been diagnosed with one or several of the following respiratory conditions?*

  • If "None of the above" is selected, please ensure that no other options are selected.

  • Have you ever been diagnosed with one or several of the following autoimmune diseases?*

  • If "None of the above" is selected, please ensure that no other options are selected.

  • Have you ever been diagnosed with one or several of the following gastrointestinal diseases?*

  • If "None of the above" is selected, please ensure that no other options are selected.

  • Have you ever been diagnosed with one or several of the following diseases?*

  • If "None of the above" is selected, please ensure that no other options are selected.

  • Have you ever been diagnosed with one or several of the following voice disorders or conditions?*

  • If "None of the above" is selected, please ensure that no other options are selected.

  • Have you ever been diagnosed with one or several of the following reproductive health conditions?*

  • If "None of the above" is selected, please ensure that no other options are selected.

  • You reached the end of this section. Please press "Next page" to continue.

  • Medication

    The following questionnaire is about the treatments or medication you are taking at the moment.
  • Are you taking any medications (excluding contraception) more than 3 times per week?*
  • Are you currently taking any of the following medication?*
  • Are you currently taking any hormonal treatment (contraception, menopause, medical condition, transition...)?*
  • Please specify the goal of the hormonal treatment*
  • Are you currently taking any hormonal treatment (medical condition, transition...)?*
  • Please specify the goal of the hormonal treatment*

  • You reached the end of this section. Please press "Next page" to continue.

  • You mentioned previously that you have a diabetes or that you currently take a treatment for diabetes.
    This questionnaire is about your diabetes itself but also on how you live with this disease.

  • Value must be between 0 and your actual age.

  •
  • Do you use a continuous or flash glucose monitoring device?*

  • Your GMI score can be found on your AGP Report, as shown below
    (This AGP may be visually different, depending on the brand of your sensor)

  • Your TIR score can be found on your AGP Report, as shown below
    (This AGP may be visually different, depending on the brand of your sensor)     

  • Your TBR score can be found on your AGP Report, as shown below
    (This AGP may be visually different, depending on the brand of your sensor)

     

  • Your TAR score can be found on your AGP Report, as shown below
    (This AGP may be visually different, depending on the brand of your sensor)

     

  • Do you use tablets to treat your diabetes?*
  • Do you use insulin to treat your diabetes?*
  • How do you use insulin?*
  • Do you have any of the following diabetes-related complications?*

  • The following questions are about the problems you may have in relation with your diabetes.
    Answer as accurately as possible. There are no right or wrong answers.

  • Which of the following diabetes issues are currently a problem for you?

  • Not having clear and concrete goals for your diabetes care*
  • Feeling discouraged with your diabetes treatment plan*
  • Feeling scared when you think about living with diabetes*
  • Uncomfortable social situations related to your diabetes care (eg people telling you what to eat)*
  • Feelings of deprivation regarding food and meals*
  • Feeling depressed when you think about living with diabetes*
  • Not knowing if your mood or feelings are related to your diabetes*
  • Feeling overwhelmed by your diabetes*
  • Worrying about low blood sugar reactions*
  • Feeling angry when you think about living with diabetes*
  • Feeling constantly concerned about food and eating*
  • Worrying about the future and the possibility of serious diabetes complications*
  • Feelings of guilt or anxiety when you get off track with your diabetes management*
  • Not ‘accepting' your diabetes*
  • Feeling unsatisfied with your diabetes physician*
  • Feeling that diabetes is taking up too much of your mental and physical energy every day*
  • Feeling alone with your diabetes*
  • Feeling that your friends and family are not supportive of your diabetes management efforts*
  • Coping with complications of diabetes*
  • Feeling ‘burned out’ by the constant effort needed to manage diabetes*

  • The following questions are about the problems you may have in relation with hypoglycemia.
    Answer as accurately as possible. There are no right or wrong answers.

  • How often do you fear not recognizing the symptoms of hypoglycemia?*
  • How often are you afraid of not knowing what to do in the event of hypoglycemia?*
  • How often are you afraid of having hypoglycemia at work?*
  • How often are you afraid of having hypoglycemia outside of a hospital/health care setting?*
  • How often are you afraid of having hypoglycemia while alone?*
  • How often do you avoid social situations (meetings, outings, etc.) due to fear of having a hypoglycemic episode?*
  • How often do you stop doing things you used to do for fear of having a hypoglycemic episode?*
  • How often do you have hypoglycemia that makes you unable to drive or use machinery?*
  • How often you have hypoglycemia that makes you unable to work?*
  • How often do you have hypoglycemia that interferes with your leisure activities?*
  • How often do you have hypoglycemia that interferes with your family life?*
  • How often do you have hypoglycemia that interferes with your social life?*
  • How often do you worry about losing consciousness due to hypoglycemia?*
  • How often are you afraid of falling asleep for fear of having hypoglycemia at night?*
  • How often are you afraid of taking a trip/holiday for fear of experiencing hypoglycemia?*

  • The following questions are about the various discomforting physical and mental symptoms related to your disease.

    You may notice that some are similar to questions you answered earlier, but these are specifically about your experience with diabetes. Please answer as accurately as possible, there are no right or wrong answers.

  • Did the following symptoms occur over the last month?

  • Lack of energy?*
  • How troublesome was it to you?*
  • Aching calves when walking?*
  • How troublesome was it to you?*
  • Numbness (loss of sensation) in the feet?*
  • How troublesome was it to you?*
  • An overall sense of fatigue?*
  • How troublesome was it to you?*
  • Shortness of breath at night?*
  • How troublesome was it to you?*
  • Sleepiness or drowsiness?*
  • How troublesome was it to you?*
  • Difficulty concentrating?*
  • How troublesome was it to you?*
  • Moodiness?*
  • How troublesome was it to you?*
  • Numbness (loss of sensation) in the hands?*
  • How troublesome was it to you?*
  • Persistently blurred vision (even with glasses on)?*
  • How troublesome was it to you?*
  • Tingling sensations in the limbs at night?*
  • How troublesome was it to you?*
  • Very thirsty?*
  • How troublesome was it to you?*
  • Palpitations or pounding in the heart region?*
  • How troublesome was it to you?*
  • Deteriorating vision?*
  • How troublesome was it to you?*
  • Burning pain in the calves at night?*
  • How troublesome was it to you?*
  • Dry mouth?*
  • How troublesome was it to you?*
  • Increasing fatigue during the course of the day?*
  • How troublesome was it to you?*
  • Flashes or black spots in the field of vision?*
  • How troublesome was it to you?*
  • Irritability just before a meal?*
  • How troublesome was it to you?*
  • Fatigue in the morning when getting up?*
  • How troublesome was it to you?*
  • Shooting pains in the legs?*
  • How troublesome was it to you?*
  • Alternating clear and blurred vision?*
  • How troublesome was it to you?*
  • Frequent need to empty your bladder?*
  • How troublesome was it to you?*
  • Pains in the chest or heart region?*
  • How troublesome was it to you?*
  • Burning pain in the legs during the day?*
  • How troublesome was it to you?*
  • Tingling or prickling sensations in the hands or fingers?*
  • How troublesome was it to you?*
  • Easily irritated or annoyed?*
  • How troublesome was it to you?*
  • Sudden deterioration of vision?*
  • How troublesome was it to you?*
  • Odd feeling in the (lower) legs or feet when touched?*
  • How troublesome was it to you?*
  • Shortness of breath during physical exertion?*
  • How troublesome was it to you?*
  • Fuzzy feeling in your head (difficulty thinking clearly)?*
  • How troublesome was it to you?*
  • Drinking a lot (all sorts of beverages)?*
  • How troublesome was it to you?*
  • Difficulty paying attention?*
  • How troublesome was it to you?*
  • Tingling or prickling sensations in the lower legs or feet?*
  • How troublesome was it to you?*

  • You mentioned previously that you have Long COVID.
    This questionnaire is about the most persistent symptoms you are experiencing following your initial COVID-19 infection.

  • Which specific persistent Long COVID symptoms are most impactful on your daily life?*

  • You mentioned previously that you have multiple sclerosis.

  • Value must be between 0 and your actual age.

  • You mentioned previously that you have Crohn's disease.

  • Value must be between 0 and your actual age.

  • The following questions are related to your quality of life with Crohn's disease.
    Answer as accurately as possible. There are no right or wrong answers.

  • How often has the feeling of fatigue or being tired and worn out been a problem for you during the past 2 weeks?*
  • How often during the last 2 weeks have you delayed or canceled a social engagement because of your bowel problem?*
  • As a result of your bowel problems, how much difficulty did you experience doing leisure or sports activities you would liked to have done during the past 2 weeks?*
  • How often during the past 2 weeks have you been troubled by pain in the abdomen?*
  • How often during the past 2 weeks have you felt depressed or discouraged?*
  • Overall, in the past 2 weeks, how much of a problem have you had with passing large amounts of gas?*
  • Overall, in the past 2 weeks, how much of a problem have you had maintaining or getting to the weight you would like to be?*
  • How often during the past 2 weeks have you felt relaxed and free of tension?*
  • How much of the time during the past 2 weeks have you been troubled by a feeling of having to go to the bathroom even though your bowels were empty?*
  • How often during the past 2 weeks have you felt angry as a result of your bowel problem?*
  • How have you been feeling the last seven days?*
  • How would you define the abdominal pain that was currently affecting you?*
  • Do you notice you have an abdominal mass?*
  • Do you have any of these complications?*
  • Are you currently taking other anti-inflammatory drugs such as aminosalicylates (sulfasalazine (Azulfidine) or mesalamine (Asacol HD, Delzicol)?*
  • Are you currently taking immune system suppressors such as azathioprine (Azasan, Imuran) or mercaptopurine (Purinethol, Purixan)?*
  • Are you currently taking other immune system suppressors such as methotrexate (Trexall)?*
  • Are you currently taking biologic medication such as infliximab (Remicade), adalimumab (Humira), golimumab (Simponi) or vedolizumab (Entyvio)?*
  • Are you currently taking antibiotics such as ciprofloxacin (Cipro) and metronidazole (Flagyl)?*

  • You mentioned previously that you have ulcerative colitis.
    The next questionnaire will detail the symptoms, treatment and how you live with this disease.

  • Value must be between 0 and your actual age.

  • The following questions are related to your quality of life with ulcerative colitis.
    Answer as accurately as possible. There are no right or wrong answers.

  • On average per day (24 hours), how many times did you use the toilet for defecation during the previous week? Blood and slime discharge is also considered as defecation*
  • On average per night, how many times did you get out of bed to use the toilet for defecation during the previous week?*
  • During the previous week, were you able to hold up your stool for 15 minutes or longer, when you felt the urge to use the toilet?*
  • During the previous week, did you have to make adjustments to your activities, to ensure that there was a toilet nearby?*
  • During the previous week, have you found stool in your underwear?*
  • During the previous week, how many times did you see blood in your stool?*
  • During the previous week, did you have joint pain which was worse at rest than after activity?*
  • During the previous week, were your joints red or swollen?*
  • During the previous week, have you ever woken up from joint pain?*
  • During the previous week, have you had a skin disorder that has been diagnosed as erythema nodosum by your treating specialist?*
  • During the previous week, have you had a skin disorder that has been diagnosed as pyoderma by your treating specialist?*
  • Do you momentarily have an eye infection, that you have seen an eye-specialist for and which your treating specialist diagnosed as uveïtis?*
  • Are you currently taking aminosalicylates, such as sulfasalazine (Azulfidine) or Mesalamine, mesalamine (Asacol HD, Delzicol, others)?*
  • Are you currently taking balsalazide (Colazal)?*
  • Are you currently taking olsalazine (Dipentum)?*
  • Are you currently taking immunosuppressant drugs (Azathioprine, Infliximab, Methotrexate, Natalizumab, Ustekinumab)?*
  • Are you currently taking biologic medication (Infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi), vedolizumab (Entyvio)?*

  • You mentioned previously that you have or had cancer.
    Please answer few more detailed questions about your cancer.

  • What kind of cancer is/was it?*

  • Value must be between 0 and your actual age.

  • Are you currently undergoing cancer treatment?*
  • What was the type of cancer treatment you have received or are currently receiving?*
  • With which type of lung cancer were you diagnosed?*
  • How long ago were you diagnosed with lung cancer?*
  • At what stage were you diagnosed?*
  • Which of the following best describes your current condition?*

  • You mentioned previously that you have allergies or that you currently take a treatment for allergies.
    Please answer few more detailed questions about your allergies.

  • What type of allergy do you have?*
  • What type of food allergy do you have?*
  • Do you usually experience nose/eyes symptoms related to your allergies (also called allergic rhinitis)?*

  • Please complete all questions by ticking the answer that best describes how troubled you have been during the last week as a result of your nose/eye symptoms.

  • Regular activities at home and at work (your occupation or tasks that you have to do regularly around your home and/or garden)*
  • Recreational activities (indoor and outdoor activities with friends and family, sports, social activities, hobbies)*
  • Sleep (difficulties getting a good night's sleep and/or getting to sleep at night)*
  • Need to rub nose/eyes*
  • Need to blow nose repeatedly*
  • Sneezing*
  • Stuffy blocked nose*
  • Runny nose*
  • Itchy eyes*
  • Sore eyes*
  • Watery eyes*
  • Tiredness and/or fatigue*
  • Thirst*
  • Feeling irritable*

  • You mentioned previously that you have asthma.
    Please answer few more detailed questions about your asthma.

  • During the last 4 weeks, how much of the time has your asthma kept you from getting as much done at work, school or home?*
  • During the last 4 weeks, how often have you had shortness of breath?*
  • During the last 4 weeks, how often have your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) woken you up at night or earlier than usual in the morning?*
  • During the last 4 weeks, how often have you used your rescue inhaler or nebuliser medication (such as Salbutamol)?*
  • How would you rate your asthma control during the last 4 weeks?*

  • You mentioned previously that you have COPD.
    Please answer few more detailed questions about it.

  • For each item below, thick the box that best describes you currently.

  •

  • You mentioned previously that you have hypertension or that you currently take a treatment for hypertension.
    Please answer few more detailed questions about your hypertension.

  • How frequently do you check your blood pressure?*
  • Where do you usually check your blood pressure?*
  • When did you last check your blood pressure?*

  • You mentioned previously that you are in peri-menopause or menopause.
    Please answer few more detailed questions about it.

  • Which stage are you currently in?*

  • Value must be between 0 and your actual age.

  • How did you reach this stage?*

  • Which of the following symptoms apply to you at this time?

  • Hot flashes, sweating (episodes of sweating)*
  • Heart discomfort (unusual awareness of heart beat, heart skipping, heart racing, tightness)*
  • Sleep problems (difficulty in falling asleep, difficulty in sleeping through the night, waking up early)*
  • Depressive mood (feeling down, sad, on the verge of tears, lack of drive, mood swings)*
  • Irritability (feeling nervous, inner tension, feeling aggressive)*
  • Anxiety (inner restlessness, feeling panicky)*
  • Physical and mental exhaustion (general decrease in performance, impaired memory, decrease in concentration, forgetfulness)*
  • Sexual problems (change in sexual desire, in sexual activity and satisfaction)*
  • Bladder problems (difficulty in urinating, increased need to urinate, bladder incontinence)*
  • Dryness of vagina (sensation of dryness or burning in the vagina, difficulty with sexual intercourse)*
  • Joint and muscular discomfort (pain in the joints, rheumatoid complaints)*

  •   

     

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