Data Dictionary for radcdcf
Number of Blaise fields: 150
| Seq # | Var | Question | Data Type/Coding |
|---|---|---|---|
| 1 | versiondate | Version Date | |
| 2 | formdescr | Form Description | |
| 3 | formno | Form Number | String[8] |
| 4 | version | Version Number | String[10] |
| 5 | projid | ^formdescr Form: ^formno Version: ^version (^versiondate) Enter project ID number. | String[8] |
| 6 | 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 31 = 30th F/U ... 50 = 50th F/U | String[2] |
| 7 | baseyear | Enter year of baseline from face sheet: | 1993 .. 2025 |
| 8 | autodate | Automatic Date. | Date type |
| 9 | autotime | Automatic Time. | TimeType |
| 10 | autolog | Automatic Logged Date. | Date type |
| 11 | intid | INTERVIEWER ID | 100 .. 997 |
| 12 | compid | Laptop ID | String[20] |
| 13 | dateint | Date of interview | Date type |
| 14 | 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 |
| 15 | ivisit | visit | |
| 16 | cogloss | NEUROLOGISTS IMPRESSION OF CLINICAL EVALUATION DATA [EXAMINER: REVIEW CLINICAL EVALUATION SUMMARY DATA PRIOR TO SEEING SUBJECT.] Record whether subject asserts that (s)he has experienced loss of memory or other cognitive function(s). | 1= Yes 2= No |
| 17 | cogdom | Record number of [POSSIBLE, MILD, MODERATE or SEVERE] impaired cognitive domains. | 1= NO impaired or possible impaired domains 2= ONE or more possible impaired domains with NO impaired domains 3= ONE impaired domain 4= TWO impaired domains 5= THREE impaired domains 6= FOUR impaired domains 7= FIVE impaired domains |
| 18 | memimp | Record the presence of memory impairment. | 1= No memory impairment 2= Possible memory impairment 3= MILD, MODERATE OR SEVERE memory impairment |
| 19 | parkdom | Record the number of impaired parkinsonian domains. | 1= None 2= One 3= Two 4= Three or four |
| 20 | bradtrem | Record the presence of bradykinesia and or resting tremor. | 1= Both bradykinesia and resting tremor 2= Bradykinesia only 3= Resting tremor only 4= Neither brady nor resting tremor |
| 21 | potndrg | Is the subject taking a drug with the potential to cause parkinsonism? | 1= Yes 2= No |
| 22 | amelidrg | Is the subject taking a drug with the potential to ameliorate parkinsonian signs? | 1= Yes 2= No |
| 23 | strkhist | Based on review of the signs and symptoms associated with the subject's most recent stroke, is the history, in your opinion, consistent with stroke(s)? | 1= Yes 2= Possible 3= No |
| 24 | langimp | Based on review of the signs and symptoms associated with the subject's stroke(s), in your opinion, DID the subject have impairment of memory, language or other cognitive function(s) temporally related to his/her reported history of stroke(s)? | 1= Yes 2= Possible 3= No |
| 25 | neurdef1 | Based on review of the neurologic examination data, in your opinion, DOES the subject [currently] have a neurologic deficit(s) consistent with stroke(s)? | 1= Yes 2= Possible 3= No |
| 26 | neurptrn | In your opinion, are the neurologic examination findings consistent with a stroke which causes or contributes to cognitive impairment? | 1= Yes 2= Possible 3= No |
| 27 | depmood | Record presence of depressed mood. | 1= Yes 2= No |
| 28 | vegsign | Record the number of vegetative signs. | 1= 0-3 2= 4-5 3= 6-8 |
| 29 | gaitdist | GAIT DISTURBANCE. Shuffling (Parkinsonian) gait. [EXAMINER: LOSS OF HEEL-TOE WALK WITH LOW FOOT CLEARANCE.] | 1= None 2= Walks slowly, may take short steps. Could be normal 3= Walks slowly, shuffles, no festination or propulsion 4= Walks with difficulty, shuffles, may festinate or propulse, requires no assistance 5= Severe disturbance of gait, shuffles, may festinate or propulse 6= Can not walk at all due to shuffling gait, not even with assistance |
| 30 | othgait | Other gait abnormality: Antalgic gait. [EXAMINER: LIMP, MAY BE DUE TO PAIN IN BACK, HIP(S), KNEE(S), ANKLE(S), FOOT/FEET AND/OR TOE(S).] | 1= Yes 2= Suspect 3= No |
| 31 | gaitspec | Specify. | String[40] |
| 32 | ataxic | Ataxic gait. [EXAMINER: DISDIADOCHOKINESIA OF GAIT, LOSS OF GAIT RHYTHMICITY.] | 1= Yes 2= Suspect 3= No |
| 33 | npath | Neuropathic gait. [EXAMINER: STEPPAGE (EQUINE) GAIT WITH HIGH FOOT CLEARANCE.] | 1= Yes 2= Suspect 3= No |
| 34 | hemipa | Hemiparetic gait. [EXAMINER: REDUCED FLEXION, WITH CIRCUMDUCTION OF RIGHT OR LEFT LEG.] | 1= No hemiparesis 2= Possible right hemiparesis 3= Definite right hemiparesis 4= Possible left hemiparesis 5= Definite left hemiparesis |
| 35 | parap | Paraparetic gait. [EXAMINER: ADDUCTION, AND REDUCED FLEXION OF BOTH LOWER LEGS.] | 1= Yes 2= Suspect 3= No |
| 36 | abnorm | Other gait abnormality. | 1= Yes 2= Suspect 3= No |
| 37 | descabn | Describe gait. | String[40] |
| 38 | rtatr1 | Right Hand Atrophy [EXAMINER: OBSERVE THE RIGHT HAND FOR ATROPHY BETWEEN THE THUMB AND INDEX FINGER. (FDI)] | 1= None 2= Possible 3= Mild 4= Moderate 5= Severe |
| 39 | rtatr2 | [EXAMINER: OBSERVE THE RIGHT THENAR EMINANCE FOR ATROPHY.] | 1= None 2= Possible 3= Mild 4= Moderate 5= Severe |
| 40 | ltatr1 | Left Hand Atrophy [EXAMINER: OBSERVE THE LEFT HAND FOR ATROPHY BETWEEN THE THUMB AND INDEX FINGER. (FDI)] | 1= None 2= Possible 3= Mild 4= Moderate 5= Severe |
| 41 | ltatr2 | [EXAMINER: OBSERVE THE LEFT THENAR EMINANCE FOR ATROPHY. | 1= None 2= Possible 3= Mild 4= Moderate 5= Severe |
| 42 | rtleg | Right leg atrophy [EXAMINER: PALPATE THE RIGHT ANTERIOR SHIN FOR ATROPHY] | 1= None 2= Possible 3= Mild 4= Moderate 5= Severe |
| 43 | ltleg | Left leg atrophy [EXAMINER: PALPATE THE LEFT ANTERIOR SHIN FOR ATROPHY] | 1= None 2= Possible 3= Mild 4= Moderate 5= Severe |
| 44 | myelopat | BILATERAL Hyper-reflexia | 1= No 2= Upper extremities only 3= Lower extremities only 4= Upper and lower extremities |
| 45 | babin | Babinski sign(s). | 1= None 2= Right only 3= Left Only 4= Both |
| 46 | meanfdec | [EXAMINER: RENDER YOUR OPINION REGARDING COGNITIVE DECLINE AFTER REVIEWING THE CLINICAL EVALUATION SUMMARY DATA AND SPEAKING WITH SUBJECT] Based on review of all available data and your interaction with the subject, in your opinion, has (s)he experienced a meaningful decline in cognitive function relative to a previous level of performance? | 1= Yes 2= Possible 3= No |
| 47 | dementia | DIAGNOSTIC IMPRESSION [EXAMINER: complete the diagnostic impression for each diagnosis independent of all other diagnoses. Using clinical judgement, you may clarify, repeat or expand upon any part of the history or examination. If your clinical diagnosis differs from the algorithmic diagnosis, dictate a note of explanation.] DEMENTIA. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 48 | dement1 | For Dementia: the algorithmic diagnosis is ^a1^a2^a3^a4 Do you agree with it? ^note | 1= Yes 2= No |
| 49 | dement2 | For Dementia, please enter your own diagnosis. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 50 | dement3 | For DEMENTIA: The Algorithmic Diagnosis is: ^a1^a2^a3^a4 Doctor's Diagnosis is: ^k1^k2^k3^k4 PLEASE specify why your diagnosis is different. | String[40] |
| 51 | scdement | String[20] | |
| 52 | alzhm | ALZHEIMER'S DISEASE. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 53 | alzhm1 | For Alzheimer's disease: the algorithmic diagnosis is ^a5^a6^a7^a8 Do you agree with it? ^note | 1= Yes 2= No |
| 54 | alzhm2 | For Alzheimer's disease, please enter your own diagnosis. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 55 | alzhm3 | For ALZHEIMER's DISEASE: The Algorithmic Diagnosis is: ^a5^a6^a7^a8 Doctor's Diagnosis is: ^k5^k6^k7^k8 PLEASE specify why your diagnosis is different. | String[40] |
| 56 | scalzhm | String[20] | |
| 57 | parkism | PARKINSONISM. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 58 | parkism1 | For Parkinsonism: the algorithmic diagnosis is ^a9^a10^a11^a12 Do you agree with it? | 1= Yes 2= No |
| 59 | parkism2 | For Parkinsonism, please enter your own diagnosis. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 60 | parkism9 | For PARKINSONISM: The Algorithmic Diagnosis is: ^a9^a10^a11^a12 Doctor's Diagnosis is: ^l1^l2^l3^l4 PLEASE specify why your diagnosis is different. | String[150] |
| 61 | scprkism | String[20] | |
| 62 | parkins | PARKINSON'S DISEASE. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 63 | parkins1 | For Parkinson's disease: the algorithmic diagnosis is ^b1^b2^b3^b4 Do you agree with it? | 1= Yes 2= No |
| 64 | parkins2 | For Parkinson's disease, please enter your own diagnosis. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 65 | parkins9 | For PARKINSON's DISEASE: The Algorithmic Diagnosis is: ^b1^b2^b3^b4 Doctor's Diagnosis is: ^l5^l6^l7^l8 PLEASE specify why your diagnosis is different. | String[150] |
| 66 | cipark | COGNITIVE IMPAIRMENT DUE TO PARKINSON'S DISEASE? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 67 | dipark | DRUG-INDUCED PARKINSONISM. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 68 | lewydis | LEWY BODY DISEASE. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 69 | psp | PROGRESSIVE SUPRANUCLEAR PALSY (PSP). | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 70 | msa | MULTI-SYMPTOM ATROPHY (MSA). | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 71 | parkstrk | PARKINSONISM DUE TO STROKE (CEREBROVASCULAR DISEASE)? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 72 | parkoth | OTHER CAUSE OF PARKINSONISM (I.E. SEVERE APRAXIA, ARTHRITIS)? | 1= Yes 2= Suspect 3= No |
| 73 | parkoth2 | Specify: | String[250] |
| 74 | trem2 | Do you think this person's parkinsonism would improve with sinemet or another agent used to treat Parkinson's disease, i.e. DO YOU THINK THIS PERSON MEETS COMMONLY ACCEPTED CRITERIA FOR IDIOPATHIC PARKINSON'S DISEASE? | 1= Yes 2= Possible 3= No |
| 75 | scprkins | String[20] | |
| 76 | stk1 | STROKE Based on your evaluation, is the history, in your opinion, consistent with stroke(s)? | 1= Yes 2= Possible 3= No |
| 77 | stk2 | Based on your evaluation, DID the subject, in your opinion, have impairment of memory, language, or other cognitive function(s) temporally related to his/her reported history of stroke(s)? | 1= Yes 2= Possible 3= No |
| 78 | stk3 | Based on your neurologic examination, DOES the subject [currently], in your opinion, have a neurologic deficit(s) consistent with stroke(s)? | 1= Yes 2= Possible 3= No |
| 79 | stroke | STROKE. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 80 | stroke1 | For Stroke: the algorithmic diagnosis is ^b5^b6^b7^b8 Based on the review of the stroke history and neurologic examination from this evaluation and previous evaluations, and review of the brain scan, if applicable, do you agree with it? | 1= Yes 2= No |
| 81 | stroke2 | For Stroke, please enter your own diagnosis. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 82 | stroke3 | For STROKE: The Algorithmic Diagnosis is: ^b5^b6^b7^b8 Doctor's Diagnosis is: ^m1^m2^m3^m4 PLEASE specify why your diagnosis is different. | String[40] |
| 83 | scstroke | String[20] | |
| 84 | summary | SUMMARY OF ALL ALGORITHMIC DIAGNOSES FOR: ^IntroBlock.projid Eval. Date: ^IntroBlock.dateint Disease Algorithmic Dx Doc Agreed? Doc's Dx 1. Dementia ^a1^a2^a3^a4 ^ce.dement1 ^ce.scDEMENT 2. Alzheimers Disease ^a5^a6^a7^a8 ^ce.alzhm1 ^ce.scALZHM 3. Parkinsonism ^a9^a10^a11^a12 ^ce.parkism1 ^ce.scPRKISM 4. Parkinson's Disease ^b1^b2^b3^b4 ^ce.parkins1 ^ce.scPRKINS 5. Stroke ^b5^b6^b7^b8 ^ce.stroke1 ^ce.scSTROKE 6. CI due to Stroke ^b9^b10^b11^b12 ^cistrk1 ^scCISTRK 7. Depression ^c1^c2^c3^c4 ^dep1 ^scDEP Cog. Impairment: ^impcog Mem. Impairment: ^impmem Pcpnt. evaluated: ^yn <<<< Hit ENTER to go to comment screen >>>> | |
| 85 | cistroke | COGNITIVE IMPAIRMENT DUE TO STROKE? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 86 | cistrk1 | For Cognitive Impairment due to stroke: the algorithmic diagnosis is ^b9^b10^b11^b12 Based on the review of the stroke history and neurologic examination from this evaluation and previous evaluations, and review of the brain scan, if applicable, do you agree with it? | 1= Yes 2= No |
| 87 | cistrk2 | For Cognitive Impairment due to stroke, please enter your own diagnosis. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 88 | cistrk3 | For CI DUE TO STROKE: The Algorithmic Diagnosis is: ^b9^b10^b11^b12 Doctor's Diagnosis is: ^m5^m6^m7^m8 PLEASE specify why your diagnosis is different. | String[40] |
| 89 | newex | Based on the review of the stroke history and neurologic examination from this evaluation and previous evaluations, and review of the brain scan, if applicable, in your opinion, did the subject have one or more stroke(s) since the last evaluation? | 1= One stroke 2= Two strokes 3= Three strokes 4= More than three strokes |
| 90 | clinone | Clinical impression of stroke one. | 1= Aphasia with hemiparesis, hemisensory loss, and/or homonymous hemianopia. 2= Non-dominant hemispheral syndrome with hemiparesis, hemisensory loss, and/or homonymous hemianopia. 3= Anterior cerebral syndrome. 4= Aphasia without other signs. 5= Homonymous hemianopia without other signs. 6= Homonymous hemianopia with associated behavioral signs. 7= Non-dominant behavioral signs. 8= Pure motor hemiparesis. 9= Pure sensory-motor stroke. 10= Ataxic-hemiparesis. 11= Dysarthria-clumsy hand. 12= Brainstem and/or cerebellar syndrome. 13= Other 77= Not applicable |
| 91 | clinspf1 | Specify. | String[30] |
| 92 | clintwo | Clinical impression of stroke two. | 1= Aphasia with hemiparesis, hemisensory loss, and/or homonymous hemianopia. 2= Non-dominant hemispheral syndrome with hemiparesis, hemisensory loss, and/or homonymous hemianopia. 3= Anterior cerebral syndrome. 4= Aphasia without other signs. 5= Homonymous hemianopia without other signs. 6= Homonymous hemianopia with associated behavioral signs. 7= Non-dominant behavioral signs. 8= Pure motor hemiparesis. 9= Pure sensory-motor stroke. 10= Ataxic-hemiparesis. 11= Dysarthria-clumsy hand. 12= Brainstem and/or cerebellar syndrome. 13= Other 77= Not applicable |
| 93 | clinspf2 | Specify. | String[30] |
| 94 | clinthre | Clinical impression of stroke three. | 1= Aphasia with hemiparesis, hemisensory loss, and/or homonymous hemianopia. 2= Non-dominant hemispheral syndrome with hemiparesis, hemisensory loss, and/or homonymous hemianopia. 3= Anterior cerebral syndrome. 4= Aphasia without other signs. 5= Homonymous hemianopia without other signs. 6= Homonymous hemianopia with associated behavioral signs. 7= Non-dominant behavioral signs. 8= Pure motor hemiparesis. 9= Pure sensory-motor stroke. 10= Ataxic-hemiparesis. 11= Dysarthria-clumsy hand. 12= Brainstem and/or cerebellar syndrome. 13= Other 77= Not applicable |
| 95 | clinspf3 | Specify. | String[30] |
| 96 | sccistrk | String[20] | |
| 97 | dep | DEPRESSION. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 98 | dep1 | For Depression: the algorithmic diagnosis is ^c1^c2^c3^c4 Do you agree with it? | 1= Yes 2= No |
| 99 | dep2 | For Depression, please enter your own diagnosis. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 100 | dep3 | For DEPRESSION: The Algorithmic Diagnosis is: ^c1^c2^c3^c4 Doctor's Diagnosis is: ^n1^n2^n3^n4 PLEASE specify why your diagnosis is different. | String[40] |
| 101 | cidep | COGNITIVE IMPAIRMENT DUE TO DEPRESSION? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 102 | scdep | String[20] | |
| 103 | alcabuse | ALCOHOL ABUSE. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 104 | cialc | COGNITIVE IMPAIRMENT DUE TO ALCOHOL ABUSE? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 105 | hypothy | HYPOTHYROIDISM. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 106 | cihypoth | COGNITIVE IMPAIRMENT DUE TO HYPOTHYROIDISM? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 107 | subcd | SUBACUTE COMBINED DEGENERATION. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 108 | cisubcd | COGNITIVE IMPAIRMENT DUE TO SUBACUTE COMBINED DEGENERATION? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 109 | braindam | TRAUMATIC BRAIN DAMAGE. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 110 | cibrain | COGNITIVE IMPAIRMENT DUE TO TRAUMATIC BRAIN DAMAGE? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 111 | symhydr | SYMPTOMATIC HYDROCEPHALUS. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 112 | cisymhyd | COGNITIVE IMPAIRMENT DUE TO SYMPTOMATIC HYDROCEPHALUS? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 113 | picks | PICK'S/FRONTAL LOBE DISEASE OR PROGRESSIVE APHASIA. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 114 | cipicks | COGNITIVE IMPAIRMENT DUE TO PICK'S/FRONTAL LOBE DISEASE OR PROGRESSIVE APHASIA? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 115 | mentalr | MENTAL RETARDATION. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 116 | neusyph | NEUROSYPHILIS. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 117 | cineusyp | COGNITIVE IMPAIRMENT DUE TO NEUROSYPHILIS? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 118 | multisc | MULTIPLE SCLEROSIS. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 119 | cimulti | COGNITIVE IMPAIRMENT DUE TO MULTIPLE SCLEROSIS? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 120 | braintum | BRAIN TUMOR. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 121 | cibraint | COGNITIVE IMPAIRMENT DUE TO BRAIN TUMOR? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 122 | hunt | HUNTINGTON'S DISEASE. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 123 | jakob | CREUTZFELDT-JAKOB DISEASE. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 124 | hiv | HIV. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 125 | cihiv | COGNITIVE IMPAIRMENT DUE TO HIV? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 126 | othdiag1 | OTHER NEUROLOGIC DIAGNOSIS? | 1= Yes 2= No |
| 127 | othspe1 | SPECIFY | String[30] |
| 128 | othcat1 | ^othspe1. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 129 | ciothsp1 | COGNITIVE IMPAIRMENT DUE TO ^othspe1? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 130 | pkotsp1 | PARKINSONISM DUE TO ^othspe1? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 131 | othdiag2 | OTHER NEUROLOGIC DIAGNOSIS? | 1= Yes 2= No |
| 132 | othspe2 | SPECIFY | String[30] |
| 133 | othcat2 | ^othspe2. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 134 | ciothsp2 | COGNITIVE IMPAIRMENT DUE TO ^othspe2? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 135 | pkotsp2 | PARKINSONISM DUE TO ^othspe2? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 136 | othdiag3 | OTHER NEUROLOGIC DIAGNOSIS? | 1= Yes 2= No |
| 137 | othspe3 | SPECIFY | String[30] |
| 138 | othcat3 | ^othspe3. | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 139 | ciothsp3 | COGNITIVE IMPAIRMENT DUE TO ^othspe3? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 140 | pkotsp3 | PARKINSONISM DUE TO ^othspe3? | 1= Highly Probable 2= Probable 3= Possible 4= Not Present |
| 141 | evaldcf | Did clinician evaluate participant for DCF? | 1= yes 2= no |
| 142 | comments | Please enter your comments here: | String[150] |
| 143 | autoedtm | [COMPUTER CLOCK TIME] | String[8] |
| 144 | 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 |
| 145 | formpart | Was participant reluctant, and/or does participant have special needs? | 1= Yes 2= No |
| 146 | formcomm | Please explain reluctance or any other factors which may have affected this data. [Press enter if no comment needed.] | String[120] |
| 147 | statid | Please enter you staff id. | 100 .. 997 |
| 148 | formch | Has the form been modified? | 1= Yes 2= No |
| 149 | revidate | Enter the date that the form was modified. | Date type |
| 150 | revintd | Enter your staff id number. | 100 .. 997 |