Data Dictionary for radcmotint

Number of Blaise fields: 264

Seq # Var Question Data Type/Coding
1 versiondate Version Date
2 formdescr Form Description
3 formno Form Number String[10]
4 version Version Number String[10]
5 gaitremind For each exercise: Say, 'Remember to look straight ahead and stay as still as possible until I say, Begin. Ready? Begin.' Say, 'Begin' and press the forward button on the remote to start the measurement (time will start on the program) Count Steps (when applicable) Say, 'Stop' and press the Forward button a second time to end the measurement. Stop Stopwatch (when applicable) If the measurement was accurately performed, press the Slideshow button on the remote to move onto the next measurement (once Slideshow button is pressed, you CANNOT repeat the measurement) If the measurement needs to be repeated, press the Back button on the remote or select 'cancel current trial' on the computer screen. Check device to ensure green light is still flashing. [Press enter to continue]
6 dynaintro Say I'm going to place this belt around your waist. The belt contains a recording device that will track your movements. I'm going to press a button on a remote before and after each task. It is important that you don't begin the task until I say 'Begin' and don't stop until I say 'stop'. Before starting each task I want you to look straight ahead and stay as still as possibel until I say 'Begin' [Press enter to continue]
7 walkint1 8 foot walk (trial 1) Place the DynaPort device around the waist of the participant, like a belt. DynaPort device should be located on the waistline, in center of the participant's back. Insert the scan disk with the participant's ID number labeled on it into the DynaPort device. Check that the green light on the DynaPort is on and then slide the device into the belt. Open the Dyrector MT program on your computer. Select the Perform tab. Make sure the COM port is selected and you have selected 'gait' under protocol. When you are ready to begin the gait test, select 'Start Measurement'. Check that the green light on the DynaPort is blinking. [Press enter to continue]
8 walkint2 8 foot walk (trial 1) Now I am going to observe how you walk at your normal pace. This is our walking course. I want you to walk to the other end of the course at your usual speed, just as if you were walking to the store. I want you to walk all the way past this line until I say 'Stop.' Let me show you what my normal pace would be if I were to walk the course. [Demonstrate and then ask the participant:] Do you feel it would be safe for you to walk this course with me? [Have the participant stand with both feet together on top of the line.] Remember to look straight ahead and stay as still as possible until I say 'Begin'. Ready? Begin. [Press enter to continue]
9 sidebysintro POSTURAL STANDS: SIDE BY SIDE STAND-EYES OPEN For the next exercise, I would like you to place one foot beside the other in a comfortable position in front of this line. [Demonstrate the position.] [Optional prompt if needed:] You may use your arms, bend your knees, or move your body to maintain your balance, but try not to move your feet. Now you try it. [Extend hands palm side up for the participant to use for balance.] I'm going to support your arms while you get into the position. Try to hold this position until I say 'Stop'. [Once the position is attained, the examiner's place is to the side and slightly behind the participant.] [Press enter to continue]
10 turn1intro 360° TURN Now I would like you to make a complete turn at your normal walking pace and turn until you reach your starting point. [Demonstrate] Now you try it. Line your feet on top of the tape and begin turning when I say 'Begin' and turn until you reach your starting point. Remember to look straight ahead and stay as still as possible until I say 'Begin'. Ready? Begin. [Press enter to continue]
11 poststndintro POSTURAL STANDS: SIDE BY SIDE STAND-EYES CLOSED Now I want you to do this again, but this time I want you to do it with your eyes closed. I'm going to support your arms while you get into the position. Try to hold the position until I say 'Stop.' [Press enter to continue]
12 getup1intro GET UP AND GO (trial 1) Place a chair behind the start line for the eight foot walk. Now I'm going to have you walk this course again but this time you're going to be seated in this chair with your back rested agains the back of the chair. Then, you're going to stand up from this chair, walk to the other end of the course at your normal pace past the line, turn around, walk back to the chair and sit down. [Demonstrate exercise] [Press enter to continue]
13 tandemintro TANDEM WALK (HEEL-TOE WALK) Now I want you to walk this course again but this time I want you to place one foot in front of the other with the heel touching the toe of the other foot like this, alternating feet. [Demonstrate exercise.] If you feel you are losing your balance, step out like this and then resume walking again. I want you to continue this walk all the way past this line before you stop. Participant should start with both feet on top of the line of tape. Remind participant to stay as still as possible until you say 'begin'. Ready? Begin [Press enter to continue]
14 walk8intro BACK AND FORTH 8 FOOT WALK TWICE I would like you to walk this course again. I want you to walk to the other end of the course at your usual speed, just as if you were walking to the store. This time, however, I want you to walk all the way past this line, turn around and walk back to the starting line. When you pass the starting line I want you to turn around and walk to the other end of the course, turn around and walk back. [Demonstrate] Do you feel it would be safe for you to walk this course with me? Participant should start with both feet on top of the line of tape. Remember to look straight ahead and stay as still as possible until I say 'Begin'. Ready? Begin. [Press enter to continue]
15 ser3intro 14. Serial 3s while Sitting A. RA DEMONSTRATION: Next we are going to examine some subtraction, for example if we started with the number 50 and you took away 3 you would have 47. Then if you continue and take away 3 from 47 you would have 44. The taking away 3 again would leave 41. Some people find this very difficult and some do not. If you have difficulty just keep going and don't be concerned if you think you have made a mistake.
16 ser3note NOTE: since the purpose of the serial 3s in 15 and 16 is to divide attention on a cognitive task but not to use a rote task, anyone who tries performance 14 and is willing should continue to 15 even if they make errors and do not get any of the 5 subtractions correct. A person who is unable to do any math or is uncomfortable doing these tasks and prefers not to do it but has done the TUG above should be labeled as 'unable' and not labeled as 'refused'.
17 gaitquip Is the Gait Test Equipment Available? 1= Yes 2= No
18 domove2 [Interviewer, Is the Gait Test Equipment being worn by the participant during these exercises?] 1= Yes 2= No
19 dynaid DynaPort Device id String[10]
20 diskid Disk ID String[10]
21 defer Do you want to defer Gait data entry? 1= Yes 2= No
22 walk1 8 foot Walk (trial 1) Press M on the DynaPort device to start recording Say, 'Ready? Begin.' Start Stopwatch Count Steps Say, 'Stop'. Press M to stop recording Check device to ensure green light is still flashing. Is test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
23 move7b Time (seconds): 1.0 .. 60.0
24 move7c Number of steps taken: 1 .. 60
25 walk2 8 foot Walk (trial 2) Is test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
26 move7d Time (seconds): 1.0 .. 60.0
27 move7e Number of steps taken: 1 .. 60
28 move7a Record Aid used for 8 foot walk: 1= No Aid 2= Quad Cane 3= Other Cane 4= Walker 5= Wheelchair as walking aid 6= Other
29 move7a1 [SPECIFY] String[20]
30 sidebys POSTURAL STANDS: SIDE BY SIDE STAND-EYES OPEN Press M on the DynaPort device to start recording Say, 'Ready? Begin.' Start timing with the stopwatch Say, 'Stop'. Stop the stopwatch after 20 seconds or participant falls out of position. Press M on the DynaPort device when move has ended. Check device to ensure green light is still flashing. Is the test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
31 turn1 360° TURN Press M on the DynaPort device to start recording Say, 'Ready? Begin.' Start timing with the stopwatch Say, 'Stop'. Press M on the DynaPort device when the turn is completed. Check device to ensure green light is still flashing. Is the test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
32 move6f Number of steps taken: 1 .. 60
33 move6e Time (seconds): 1.0 .. 60.0
34 turn2 360° TURN Second trial Is test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
35 move6h Number of steps: 1 .. 60
36 move6g Time (seconds): 1.0 .. 60.0
37 move6i Record Aid used for 360 turn: 1= No Aid 2= Quad Cane 3= Other Cane 4= Walker 5= Wheelchair 6= Other
38 move6i1 [SPECIFY] String[20]
39 poststnd POSTURAL STANDS: SIDE BY SIDE STAND-EYES CLOSED Press M on the DynaPort device to start recording Say, 'Ready? Begin.' Start timing with the stopwatch Say, 'Stop'. Stop the stopwatch after 20 seconds or participant falls out of position. Press M on the DynaPort device when move has ended. Check device to ensure green light is still flashing. Is the test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
40 getup1 GET UP AND GO (trial 1) Press M on the DynaPort device to begin recording Say, 'Ready? Begin.' Press M on the DynaPort device when the participant has returned and sat back down in the chair. Check device to ensure green light is still flashing. Is the test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
41 getup2 GET UP AND GO (trial 2) Is the test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
42 getaid Record Aid used for GET UP AND GO: 1= No Aid 2= Quad Cane 3= Other Cane 4= Walker 5= Wheelchair 6= Other
43 getaid_specify [SPECIFY] String[20]
44 tandem TANDEM WALK (HEEL-TOE WALK) Press M on the DynaPort device to begin recording Say, 'Ready? Begin.' Say, 'Stop' when participant has returned to starting point Press M on the DynaPort to stop recording Check device to ensure green light is still flashing. Is the test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
45 move8 Interviewer: Record number of errors, e.g. Sidesteps: 0 .. 60
46 tandaid Record Aid used for Tandem Walk: 1= No Aid 2= Quad Cane 3= Other Cane 4= Walker 5= Wheelchair 6= Other
47 tandaid_specify [SPECIFY] String[20]
48 walk8 BACK AND FORTH 8 FOOT WALK TWICE Press M on the DynaPort device to begin recording Say, 'Ready? Begin.' Say, 'Stop' when participant has returned to starting point Press M on the DynaPort to stop recording Check device to ensure green light is still flashing. Is the test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
49 walk8aid Record Aid used for BACK AND FORTH WALK: 1= No Aid 2= Quad Cane 3= Other Cane 4= Walker 5= Wheelchair 6= Other
50 walk8aid_specify [SPECIFY] String[20]
51 sttoeopen Toe Stand (Eyes Open) Describe the position while demonstrating. Once the participant is ready: Press M on the DynaPort device to begin recording Say, 'Ready? Begin.' Start timing with stopwatch Stop timing if the participant falls out of position or max time of 10 seconds is reached. Press M on the DynaPort device Maximum time is 10 seconds. Is the test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
52 move6 Time (seconds) : 1.0 .. 10.0
53 strlopen Standing on Right Leg (Eyes Open) Describe the position and demonstrate. Once the participant is ready: Press M on the DynaPort device to begin recording Say, 'Ready? Begin.' Start timing with stopwatch Stop timing if the participant falls out of position or max time of 10 seconds is reached. Press M on the DynaPort device Maximum time is 10 seconds. Is the test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
54 move6a Time (seconds) : 1.0 .. 10.0
55 stllopen Standing on Left Leg (Eyes Open) Describe the position and demonstrate. Once the participant is ready: Press M on the DynaPort device to begin recording Say, 'Ready? Begin.' Start timing with stopwatch Stop timing if the participant falls out of position or max time of 10 seconds is reached. Press M on the DynaPort device Maximum time is 10 seconds. Is the test performed? 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
56 move6c Time (seconds) : 1.0 .. 10.0
57 s3gug Will performances 14 (sit serial 3's), 15 (GUG Task 1) and 16 (GUG Task 2) be collected? 1= Yes 2= No
58 ser3prac B. PARTICIPANT #1: PRACTICE TRIAL : Please start with the number 100 and take away 3. Continue to take away 3 from what is left until I tell you to stop. TRY THIS TO SEE IF THE PERSON UNDERSTANDS THE TASK DO NOT RECORD NUMBERS THIS FIRST TIME. 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
59 ser3respcnt C. PARTICIPANT #2: RECORD TRIAL : Then repeat again and record all the numbers: HOW MANY RESPONSES WERE GIVEN, 0 to 5? 0 .. 5
60 ser3resp1 0 .. 1000
61 ser3resp2 0 .. 1000
62 ser3resp3 0 .. 1000
63 ser3resp4 0 .. 1000
64 ser3resp5 0 .. 1000
65 gugcog1 15. Get-Up-And-Go + Cognitive Math Task Now I am going to repeat the Get Up and Go Task which you performed before. However, now you are going to count backward by 3 while you are performing this task. Please start to count OUT LOUD SO I CAN HEAR YOU backward starting from 100 by 3 and continue counting while you perform this task. When I say BEGIN, you are going to stand up from this chair, walk to the other end of the course at your normal pace past the line, turn around, walk back to the chair and sit down. Continue to count while you are performing this task [Demonstrate exercise] Remember to look straight ahead and stay as still as possible until I say 'Begin counting'. Ready? BEGIN. 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
66 gugcog1cnt How many number responses were given during the first trial? *Note: Record protocol deviation if the only available chair is atypical. 0 .. 20
67 gugcog1resp01 0 .. 1000
68 gugcog1resp02 0 .. 1000
69 gugcog1resp03 0 .. 1000
70 gugcog1resp04 0 .. 1000
71 gugcog1resp05 0 .. 1000
72 gugcog1resp06 0 .. 1000
73 gugcog1resp07 0 .. 1000
74 gugcog1resp08 0 .. 1000
75 gugcog1resp09 0 .. 1000
76 gugcog1resp10 0 .. 1000
77 gugcog1resp11 0 .. 1000
78 gugcog1resp12 0 .. 1000
79 gugcog1resp13 0 .. 1000
80 gugcog1resp14 0 .. 1000
81 gugcog1resp15 0 .. 1000
82 gugcog1resp16 0 .. 1000
83 gugcog1resp17 0 .. 1000
84 gugcog1resp18 0 .. 1000
85 gugcog1resp19 0 .. 1000
86 gugcog1resp20 0 .. 1000
87 gugcog2 16. Get-Up-And-Go + Cognitive Math Task Now I am going to repeat the Get Up and Go Task which you performed before. However, now you are going to count backward by 3 while you are performing this task. Please start to count OUT LOUD SO I CAN HEAR YOU backward starting from 100 by 3 and continue counting while you perform this task. When I say BEGIN, you are going to stand up from this chair, walk to the other end of the course at your normal pace past the line, turn around, walk back to the chair and sit down. Continue to count while you are performing this task [Demonstrate exercise] Remember to look straight ahead and stay as still as possible until I say 'Begin counting'. Ready? BEGIN 1= Yes (Pt. completed gait test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
88 gugcog2cnt How many number responses were given during the second trial? *Note: Record protocol deviation if the only available chair is atypical. 0 .. 20
89 gugcog2resp01 0 .. 1000
90 gugcog2resp02 0 .. 1000
91 gugcog2resp03 0 .. 1000
92 gugcog2resp04 0 .. 1000
93 gugcog2resp05 0 .. 1000
94 gugcog2resp06 0 .. 1000
95 gugcog2resp07 0 .. 1000
96 gugcog2resp08 0 .. 1000
97 gugcog2resp09 0 .. 1000
98 gugcog2resp10 0 .. 1000
99 gugcog2resp11 0 .. 1000
100 gugcog2resp12 0 .. 1000
101 gugcog2resp13 0 .. 1000
102 gugcog2resp14 0 .. 1000
103 gugcog2resp15 0 .. 1000
104 gugcog2resp16 0 .. 1000
105 gugcog2resp17 0 .. 1000
106 gugcog2resp18 0 .. 1000
107 gugcog2resp19 0 .. 1000
108 gugcog2resp20 0 .. 1000
109 gugcogaid Record Aid used for Get Up and Go Cog Task: 1= No Aid 2= Quad Cane 3= Other Cane 4= Walker 5= Wheelchair 6= Other
110 gugcogaid_specify [SPECIFY] String[20]
111 pegboardrt PURDUE PEGBOARD Is the test performed with right hand? 1= Yes (Pt. completed test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
112 pegboardlt PURDUE PEGBOARD Is the test performed with left hand? 1= Yes (Pt. completed test) 2= Refused (Pt is able, but refused to complete test), 3= Unable (Pt. is physically/mentally unable to complete test)
113 admin1 PURDUE PEGBOARD -- ADMINISTRATION: [PLACE PEGBOARD IN FRONT OF R, WITH WELLS AT TOP AND PEGS IN FIRST AND LAST WELLS. SAY:] `I want to see how quickly you can place these pegs [POINT] into these holes [POINT] - like this without skipping any holes. [EXAMINER PLACES 4 PEGS WITH RIGHT HAND IN RIGHT-HAND COLUMN.] Now for practice you try it with your right hand.' [ALLOW SUBJECT TO PLACE 4 PEGS IN RIGHT COLUMN; ENCOURAGE WITH `good;' REPEAT PROCESS IF SUBJECT DOES NOT COMPLETE PRACTICE ITEMS SATISFACTORILY. THEN REPLACE PEGS.] >>>>> PRESS ENTER TO CONTINUE <<<<< String[1]
114 admin2 [SAY: ]`Good. You have the idea. Now, when I tell you to begin, pick up the pegs one at a time and place them in this column [POINT TO RIGHT-HAND COLUMN] with your RIGHT HAND as quickly as you can. Again, please do not skip any holes. Ready? Begin. '[START TIMER AS YOU SAY `BEGIN;' EACH TRIAL IS *30 SECONDS*. WATCH R; PROMPT TO PICK UP ONLY ONE PEG AT A TIME, TO USE ONLY ONE HAND AT A TIME, AND NOT TO SKIPHOLES, AS NECESSARY; IF R MAKES SIGNIFICANT ERRORS DURING TRIAL (E.G., USING BOTH HANDS, PLACING PEGS IN WRONG COLUMN, SKIPPING HOLES, ETC.) **IT IS PERMISSIBLE TO REPEAT 1 TRIAL**. IF NECESSARY, COVER ONE COLUMN OF HOLES WITH THE PANEL THAT SLIDES OVER THE WELLS. ONLY VERBALLY REMIND BEYOND THIS, HOWEVER. AT 30 SECONDS SAY:] `stop'. >>>>> PRESS ENTER FOR FIRST TRIAL <<<<< String[1]
115 admin3 PURDUE PEGBOARD -- ADMINISTRATION: [PLACE PEGBOARD IN FRONT OF R, WITH WELLS AT TOP AND PEGS IN FIRST AND LAST WELLS. SAY:] `I want to see how quickly you can place these pegs [POINT] into these holes [POINT] - like this without skipping any holes. [EXAMINER PLACES 4 PEGS WITH LEFT HAND IN LEFT-HAND COLUMN.] Now for practice you try it with your left hand.' [ALLOW SUBJECT TO PLACE 4 PEGS IN RIGHT COLUMN; ENCOURAGE WITH `good;' REPEAT PROCESS IF SUBJECT DOES NOT COMPLETE PRACTICE ITEMS SATISFACTORILY. THEN REPLACE PEGS.] >>>>> PRESS ENTER TO CONTINUE <<<<< String[1]
116 admin4 [SAY: ]`Good. You have the idea. Now, when I tell you to begin, pick up the pegs one at a time and place them in this column [POINT TO LEFT-HAND COLUMN] with your LEFT HAND as quickly as you can. Again, please do not skip any holes. Ready? Begin. '[START TIMER AS YOU SAY `BEGIN;' EACH TRIAL IS *30 SECONDS*. WATCH R; PROMPT TO PICK UP ONLY ONE PEG AT A TIME, TO USE ONLY ONE HAND AT A TIME, AND NOT TO SKIPHOLES, AS NECESSARY; IF R MAKES SIGNIFICANT ERRORS DURING TRIAL (E.G., USING BOTH HANDS, PLACING PEGS IN WRONG COLUMN, SKIPPING HOLES, ETC.) **IT IS PERMISSIBLE TO REPEAT 1 TRIAL**. IF NECESSARY, COVER ONE COLUMN OF HOLES WITH THE PANEL THAT SLIDES OVER THE WELLS. ONLY VERBALLY REMIND BEYOND THIS, HOWEVER. AT 30 SECONDS SAY:] `stop'. >>>>> PRESS ENTER FOR FIRST TRIAL <<<<< String[1]
117 trial11 1. Trial 1, Right Hand [ENTER NUMBER OF PEGS CORRECTLY PLACED] 0 .. 25
118 trial21 [AT COMPLETION OF TRIAL 1, REPLACE PEGS AND SAY:] `Now I want you to do the same thing with your LEFT HAND. Pick up the pegs one at a time and place them in this column [POINT TO LEFT-HAND COLUMN] with your left hand. Work as quickly as you can and do not skip any holes. Ready? Begin.' [TRIAL IS 30 SECONDS WITH SAME PROCEDURES AS TRIAL 1.] 2. Trial 2, Left Hand [ENTER NUMBER OF PEGS CORRECTLY PLACED] 0 .. 25
119 trial301 [AT COMPLETION OF TRIAL 2, REPLACE PEGS AND SAY:] `Now I want you to do this again with your RIGHT HAND. Place the pegs one at a time in this column [POINT TO RIGHT-HAND COLUMN COLUMN] with your right hand. Work as quickly as you can and do not skip any holes. Ready? Begin.' [TRIAL IS 30 SECONDS WITH SAME PROCEDURES AS TRIAL 1.] 3. Trial 3, Right Hand [ENTER NUMBER OF PEGS CORRECTLY PLACED] 0 .. 25
120 trial4 [AT COMPLETION OF TRIAL 3, REPLACE PEGS AND SAY:] `Now I want you to do this again with your LEFT HAND. Place the pegs one at a time in this column [POINT TO LEFT-HAND COLUMN] with your left hand. Work as quickly as you can and do not skip any holes. Ready? Begin.' [TRIAL IS 30 SECONDS WITH SAME PROCEDURES AS TRIAL 1.] 4. Trial 4, Left Hand [ENTER NUMBER OF PEGS CORRECTLY PLACED] 0 .. 25
121 projid ^formdescr Form: ^formno Version: ^version (^versiondate) Enter project ID number. String[8]
122 visit Enter curent visit code from face sheet: CODE F/U Year CODE F/U Year CODE F/U Year CODE F/U Year 00 = Baseline 08 = 8th F/U 16 = 16th F/U 24 = 24th F/U 01 = 1st F/U 09 = 9th F/U 17 = 17th F/U 25 = 25th F/U 02 = 2nd F/U 10 = 10th F/U 18 = 18th F/U 26 = 26th F/U 03 = 3rd F/U 11 = 11th F/U 19 = 19th F/U 27 = 27th F/U 04 = 4th F/U 12 = 12th F/U 20 = 20th F/U 28 = 28th F/U 05 = 5th F/U 13 = 13th F/U 21 = 21th F/U 29 = 29th F/U 06 = 6th F/U 14 = 14th F/U 22 = 22th F/U 30 = 30th F/U 07 = 7th F/U 15 = 15th F/U 23 = 23th F/U String[2]
123 baseyear Enter year of baseline from face sheet: 1993 .. 2025
124 autodate Automatic Date. Date type
125 autotime Automatic Time. TimeType
126 autolog Automatic Logged Date. Date type
127 intid INTERVIEWER ID 100 .. 997
128 compid Laptop ID String[20]
129 dateint Date of interview Date type
130 educ ^educ_question Elementary 0 1 2 3 4 5 6 7 8 High School 9 10 11 12 College 13 14 15 16 Graduate Professional 17 18 19 20 21 ... 0 .. 30
131 formlang What language will be used to administer this form? 1= English 2= Español
132 howwell 1. INTERVIEWER OBSERVATIONS How well do you think the participant understood the questions? 1= Quite well 2= Fairly well 3= Somewhat 4= Very Little 5= Not at all
133 hearimp 2. Does the participant have a SUBSTANTIAL hearing impairment? 1= Yes 2= No
134 visimp 3. Does the participant have a SUBSTANTIAL visual impariment? 1= Yes, completely blind 2= Yes, very poor 3= Yes, poor 4= No, not substantial
135 phyeffrt 4. How great an effort do you think the participant put into the physical function items? 1= A great deal 2= A considerable amount 3= A moderate amount 4= A little bit 5= Hardly any
136 formcode Please enter status code. 11 = COMPLETE 13 = COMPLETE, portion with proxy 12 = INCOMPLETE, refused 14 = INCOMPLETE, too impaired 21 = INCOMPLETE interim, complete later 73 = NOT TESTED, out of town 31 = NOT TESTED, moved 33 = NOT TESTED, refused 75 = NOT TESTED, hospitalized 76 = NOT TESTED, other 42 = DECEASED 43 = WITHDRAWN 44 = WITHDRAWN, Autopsy OK 11 .. 76
137 formpart Was participant reluctant, and/or does participant have special needs? 1= Yes 2= No
138 formcomm Please explain reluctance or any other factors which may have affected this data. [Press enter if no comment needed.] String[120]
139 statid Please enter you staff id. 100 .. 997
140 formch Has the form been modified? 1= Yes 2= No
141 revidate Enter the date that the form was modified. Date type
142 revintd Enter your staff id number. 100 .. 997
143 anydev Are there any protocol deviations or missing data items to enter? 1= Yes 2= No
144 numdev How many total protocol deviations and tests with missing items to enter? 1 .. 20
145 reas00 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
146 test00 Enter test or procedure. String[15]
147 item00 List items involved. [SEPARATE BY A COMMA] String[20]
148 code00 Enter data code used. 1= Don't Know 2= Refusal 3= other
149 oth00 Enter other code used. String[20]
150 expl00 Explain what happened String[100]
151 reas01 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
152 test01 Enter test or procedure. String[15]
153 item01 List items involved. [SEPARATE BY A COMMA] String[20]
154 code01 Enter data code used. 1= Don't Know 2= Refusal 3= other
155 oth01 Enter other code used. String[20]
156 expl01 Explain what happened String[100]
157 reas02 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
158 test02 Enter test or procedure. String[15]
159 item02 List items involved. [SEPARATE BY A COMMA] String[20]
160 code02 Enter data code used. 1= Don't Know 2= Refusal 3= other
161 oth02 Enter other code used. String[20]
162 expl02 Explain what happened String[100]
163 reas03 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
164 test03 Enter test or procedure. String[15]
165 item03 List items involved. [SEPARATE BY A COMMA] String[20]
166 code03 Enter data code used. 1= Don't Know 2= Refusal 3= other
167 oth03 Enter other code used. String[20]
168 expl03 Explain what happened String[100]
169 reas04 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
170 test04 Enter test or procedure. String[15]
171 item04 List items involved. [SEPARATE BY A COMMA] String[20]
172 code04 Enter data code used. 1= Don't Know 2= Refusal 3= other
173 oth04 Enter other code used. String[20]
174 expl04 Explain what happened String[100]
175 reas05 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
176 test05 Enter test or procedure. String[15]
177 item05 List items involved. [SEPARATE BY A COMMA] String[20]
178 code05 Enter data code used. 1= Don't Know 2= Refusal 3= other
179 oth05 Enter other code used. String[20]
180 expl05 Explain what happened String[100]
181 reas06 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
182 test06 Enter test or procedure. String[15]
183 item06 List items involved. [SEPARATE BY A COMMA] String[20]
184 code06 Enter data code used. 1= Don't Know 2= Refusal 3= other
185 oth06 Enter other code used. String[20]
186 expl06 Explain what happened String[100]
187 reas07 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
188 test07 Enter test or procedure. String[15]
189 item07 List items involved. [SEPARATE BY A COMMA] String[20]
190 code07 Enter data code used. 1= Don't Know 2= Refusal 3= other
191 oth07 Enter other code used. String[20]
192 expl07 Explain what happened String[100]
193 reas08 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
194 test08 Enter test or procedure. String[15]
195 item08 List items involved. [SEPARATE BY A COMMA] String[20]
196 code08 Enter data code used. 1= Don't Know 2= Refusal 3= other
197 oth08 Enter other code used. String[20]
198 expl08 Explain what happened String[100]
199 reas09 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
200 test09 Enter test or procedure. String[15]
201 item09 List items involved. [SEPARATE BY A COMMA] String[20]
202 code09 Enter data code used. 1= Don't Know 2= Refusal 3= other
203 oth09 Enter other code used. String[20]
204 expl09 Explain what happened String[100]
205 reas10 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
206 test10 Enter test or procedure. String[15]
207 item10 List items involved. [SEPARATE BY A COMMA] String[20]
208 code10 Enter data code used. 1= Don't Know 2= Refusal 3= other
209 oth10 Enter other code used. String[20]
210 expl10 Explain what happened String[100]
211 reas11 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
212 test11 Enter test or procedure. String[15]
213 item11 List items involved. [SEPARATE BY A COMMA] String[20]
214 code11 Enter data code used. 1= Don't Know 2= Refusal 3= other
215 oth11 Enter other code used. String[20]
216 expl11 Explain what happened String[100]
217 reas12 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
218 test12 Enter test or procedure. String[15]
219 item12 List items involved. [SEPARATE BY A COMMA] String[20]
220 code12 Enter data code used. 1= Don't Know 2= Refusal 3= other
221 oth12 Enter other code used. String[20]
222 expl12 Explain what happened String[100]
223 reas13 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
224 test13 Enter test or procedure. String[15]
225 item13 List items involved. [SEPARATE BY A COMMA] String[20]
226 code13 Enter data code used. 1= Don't Know 2= Refusal 3= other
227 oth13 Enter other code used. String[20]
228 expl13 Explain what happened String[100]
229 reas14 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
230 test14 Enter test or procedure. String[15]
231 item14 List items involved. [SEPARATE BY A COMMA] String[20]
232 code14 Enter data code used. 1= Don't Know 2= Refusal 3= other
233 oth14 Enter other code used. String[20]
234 expl14 Explain what happened String[100]
235 reas15 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
236 test15 Enter test or procedure. String[15]
237 item15 List items involved. [SEPARATE BY A COMMA] String[20]
238 code15 Enter data code used. 1= Don't Know 2= Refusal 3= other
239 oth15 Enter other code used. String[20]
240 expl15 Explain what happened String[100]
241 reas16 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
242 test16 Enter test or procedure. String[15]
243 item16 List items involved. [SEPARATE BY A COMMA] String[20]
244 code16 Enter data code used. 1= Don't Know 2= Refusal 3= other
245 oth16 Enter other code used. String[20]
246 expl16 Explain what happened String[100]
247 reas17 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
248 test17 Enter test or procedure. String[15]
249 item17 List items involved. [SEPARATE BY A COMMA] String[20]
250 code17 Enter data code used. 1= Don't Know 2= Refusal 3= other
251 oth17 Enter other code used. String[20]
252 expl17 Explain what happened String[100]
253 reas18 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
254 test18 Enter test or procedure. String[15]
255 item18 List items involved. [SEPARATE BY A COMMA] String[20]
256 code18 Enter data code used. 1= Don't Know 2= Refusal 3= other
257 oth18 Enter other code used. String[20]
258 expl18 Explain what happened String[100]
259 reas19 Protocol Deviation or Missing Data? 1= Protocol Deviation 2= Missing Data
260 test19 Enter test or procedure. String[15]
261 item19 List items involved. [SEPARATE BY A COMMA] String[20]
262 code19 Enter data code used. 1= Don't Know 2= Refusal 3= other
263 oth19 Enter other code used. String[20]
264 expl19 Explain what happened String[100]

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