Nov 9, 2010

Cardiovascular Health Study

Data Request Form

Please complete all shaded areas of this form and return by e-mail, mail or fax to:

Tony Wilsdon

CHSCC

6200 NE 74th Street

Building 29, Suite 310

Seattle, WA98115

E-mail:

Fax: 206-616-4075

1. Requestor Information
Name & Contact (Please include Institution/Affiliation and email address):
CHS Sponsor Name:
(CHS Investigators may leave this field blank)
CHS Sponsor has reviewed and approved this request. (REQUIRED)
2. Funding Information: Please check ONE of the following
I have received a quote from the CHSCC for this request and have approved it for invoicing
I have received a quote from the CHSCC for this request and I am currently seeking funding
I need a quote prepared for this request, please
This request is covered via a subcontract, Ancillary Study or other arrangement with the CC and need not be invoiced. Please specify:
Does above arrangement include any for-profit industry involvement? yes no
I am a new CHS Collaborator without funding and this is my first request for CC services
I am an active CHS Investigator
Other. Please specify:
3. Request: Please check ONE of the following
This is a request for a data summary (proceed to item 4)
This is a request for a data file (skip to item 5)
4. Data Summary Request
4a. Please indicate the purpose of your request
Background for a proposal
Hypothesis generation/power exploration
Summary statistics
Other, Please specify:
4b. Please specify the summaries you would like to see. Please indicate any exclusions, subsets, etc. that should be used when selecting participants. Consider submitting one or more tables for completion.
5. Data File Request
In order to receive a data file you must first:
  • Have a fully approved CHS manuscript proposal
  • Have a completed CHS Data and Materials Distribution Agreement
If you do not meet the above criteria above your data request can be added to the queue; no data will be sent until all the above criteria are met.
5a. Please indicate the purpose of your request
CHS Paper #andTitle:
Does this paper originate from an Ancillary Study involving new data collection? No Yes
If yes, please confirm that data from this Ancillary Study have been forwarded to the Coordinating Center: (required before main study data may be accessed)
Other, Please specify:
5b. Please specify the format in which you would like to receive the data (SPSS, SAS, Stata, Excel, etc.)
5c. Variables needed
  • If you are unfamiliar with CHS data please see our web site ( for CHS data documentation. Ask your CHS sponsor how to access the internal website, where the documentation is located. Variables requested should be considered carefully to minimize the necessity for future follow-up requests. Variables such as age, gender and race should almost always be included.
  • Please list specific variables needed. Rather than general terms like “lipids”, please list “total cholesterol”, “HDL”, “LDL”, etc. if possible.
  • Please specify which exam(s) or timeframe should be used for all variables. The CHS Timeline is included at the end of this file for reference.

Variable list

Variable name/description / Year of study/timeframe

If additional space is required please contact Tony Wilsdon ()

CHS Timeline

Original cohort baseline (Year 2) / 1989-1990
Year 3, 1st follow-up, original cohort / 1990-1991
Year 4, 2nd follow-up, original cohort / 1991-1992
Year 5, 3rd follow-up, original cohort
African-American cohort baseline (new cohort) / 1992-1993
Year 6, 4th follow-up, original cohort
1st follow-up, new cohort / 1993-1994
Year 7, 5th follow-up, original cohort
2nd follow-up, new cohort / 1994-1995
Year 8, 6th follow-up, original cohort
3rd follow-up, new cohort / 1995-1996
Year 9, 7th follow-up, original cohort
4th follow-up, new cohort / 1996-1997
Year 10, 8th follow-up, original cohort
5th follow-up, new cohort / 1997-1998
Year 11, 9th follow-up, original cohort
6th follow-up, new cohort
END OF CLINIC VISITS / 1998-1999
Years 12+, phone follow-up and events ascertainment only / 1999-present