Blaise Codebook/Variable Search

Number of Blaise fields: 634

Seq #	Var	Question	Data Type/Coding
1	projid	MAP 2001 FOLLOW-UP Clinical Evaluation (Version: 03/02/2022) Enter project ID number.	String[8]
2	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]
3	baseyear	Enter year of baseline from face sheet:	1993 .. 2025
4	formno	Form Number	String[8]
5	version	Version Number	String[4]
6	autodate	Automatic Date.	Date type
7	autotime	Automatic Time.	TimeType
8	autolog	Automatic Logged Date.	Date type
9	intid	INTERVIEWER ID	100 .. 997
10	compid	Laptop ID	String[20]
11	dateint	Date of interview	Date type
12	datlas	Date of last clinical evaluation	Date type
13	sex	Subject's sex.	1= Male 2= Female
14	phone	Was this interview completed in person or over the telephone?	1= In-person Nurse 2= Telephone 3= In-person RA
15	autotm	[COMPUTER CLOCK TIME]	String[8]
16	q1drg	Now I would like to ask you about medicines. 1. During the past two weeks, HAVE YOU TAKEN ANY MEDICINE PRESCRIBED by a doctor?	1= Yes 2= No
17	q2drg	2. Now, about supplements not usually prescribed by a doctor such as vitamin preparations including multivitamins, vitamin C, vitamin A, vitamin D, or vitamin E . . . During the past two weeks have you taken any of these or any other vitamin preparations?	1= Yes 2= No
18	q3drg	3. We are also interested in other medicines or supplements not prescribed by a doctor such as aspirin, Tylenol, Bufferin, Anacin, headache pills or pain killers, laxatives or bowel medicines, cold medicines, cough medicines, sleep medicines, antacids or stomach medicines, ointments or salves . . . During the past two weeks have you taken any of these or any other medicines from the drug store?	1= Yes 2= No
19	q4drg	4. May I please see all these medicines for the past two weeks? [INTERVIEWER RECORD ALL MEDICINES TAKEN WITHIN THE PAST 2 WEEKS WHETHER AVAILABLE FOR INSPECTION OR NOT] [ENTER TOTAL NUMBER OF MEDICINES TO BE RECORDED]	0 .. 50
20	name00	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
21	stren00	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
22	drgnm00	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
23	seen00	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
24	dosage00	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
25	recd00	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
26	name01	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
27	stren01	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
28	drgnm01	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
29	seen01	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
30	dosage01	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
31	recd01	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
32	name02	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
33	stren02	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
34	drgnm02	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
35	seen02	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
36	dosage02	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
37	recd02	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
38	name03	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
39	stren03	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
40	drgnm03	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
41	seen03	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
42	dosage03	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
43	recd03	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
44	name04	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
45	stren04	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
46	drgnm04	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
47	seen04	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
48	dosage04	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
49	recd04	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
50	name05	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
51	stren05	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
52	drgnm05	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
53	seen05	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
54	dosage05	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
55	recd05	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
56	name06	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
57	stren06	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
58	drgnm06	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
59	seen06	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
60	dosage06	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
61	recd06	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
62	name07	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
63	stren07	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
64	drgnm07	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
65	seen07	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
66	dosage07	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
67	recd07	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
68	name08	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
69	stren08	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
70	drgnm08	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
71	seen08	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
72	dosage08	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
73	recd08	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
74	name09	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
75	stren09	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
76	drgnm09	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
77	seen09	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
78	dosage09	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
79	recd09	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
80	name10	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
81	stren10	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
82	drgnm10	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
83	seen10	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
84	dosage10	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
85	recd10	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
86	name11	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
87	stren11	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
88	drgnm11	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
89	seen11	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
90	dosage11	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
91	recd11	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
92	name12	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
93	stren12	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
94	drgnm12	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
95	seen12	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
96	dosage12	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
97	recd12	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
98	name13	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
99	stren13	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
100	drgnm13	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
101	seen13	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
102	dosage13	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
103	recd13	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
104	name14	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
105	stren14	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
106	drgnm14	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
107	seen14	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
108	dosage14	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
109	recd14	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
110	name15	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
111	stren15	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
112	drgnm15	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
113	seen15	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
114	dosage15	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
115	recd15	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
116	name16	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
117	stren16	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
118	drgnm16	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
119	seen16	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
120	dosage16	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
121	recd16	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
122	name17	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
123	stren17	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
124	drgnm17	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
125	seen17	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
126	dosage17	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
127	recd17	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
128	name18	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
129	stren18	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
130	drgnm18	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
131	seen18	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
132	dosage18	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
133	recd18	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
134	name19	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
135	stren19	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
136	drgnm19	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
137	seen19	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
138	dosage19	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
139	recd19	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
140	name20	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
141	stren20	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
142	drgnm20	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
143	seen20	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
144	dosage20	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
145	recd20	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
146	name21	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
147	stren21	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
148	drgnm21	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
149	seen21	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
150	dosage21	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
151	recd21	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
152	name22	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
153	stren22	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
154	drgnm22	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
155	seen22	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
156	dosage22	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
157	recd22	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
158	name23	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
159	stren23	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
160	drgnm23	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
161	seen23	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
162	dosage23	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
163	recd23	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
164	name24	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
165	stren24	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
166	drgnm24	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
167	seen24	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
168	dosage24	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
169	recd24	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
170	name25	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
171	stren25	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
172	drgnm25	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
173	seen25	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
174	dosage25	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
175	recd25	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
176	name26	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
177	stren26	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
178	drgnm26	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
179	seen26	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
180	dosage26	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
181	recd26	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
182	name27	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
183	stren27	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
184	drgnm27	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
185	seen27	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
186	dosage27	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
187	recd27	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
188	name28	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
189	stren28	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
190	drgnm28	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
191	seen28	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
192	dosage28	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
193	recd28	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
194	name29	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
195	stren29	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
196	drgnm29	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
197	seen29	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
198	dosage29	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
199	recd29	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
200	name30	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
201	stren30	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
202	drgnm30	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
203	seen30	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
204	dosage30	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
205	recd30	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
206	name31	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
207	stren31	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
208	drgnm31	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
209	seen31	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
210	dosage31	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
211	recd31	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
212	name32	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
213	stren32	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
214	drgnm32	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
215	seen32	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
216	dosage32	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
217	recd32	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
218	name33	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
219	stren33	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
220	drgnm33	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
221	seen33	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
222	dosage33	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
223	recd33	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
224	name34	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
225	stren34	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
226	drgnm34	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
227	seen34	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
228	dosage34	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
229	recd34	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
230	name35	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
231	stren35	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
232	drgnm35	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
233	seen35	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
234	dosage35	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
235	recd35	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
236	name36	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
237	stren36	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
238	drgnm36	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
239	seen36	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
240	dosage36	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
241	recd36	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
242	name37	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
243	stren37	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
244	drgnm37	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
245	seen37	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
246	dosage37	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
247	recd37	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
248	name38	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
249	stren38	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
250	drgnm38	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
251	seen38	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
252	dosage38	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
253	recd38	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
254	name39	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
255	stren39	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
256	drgnm39	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
257	seen39	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
258	dosage39	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
259	recd39	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
260	name40	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
261	stren40	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
262	drgnm40	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
263	seen40	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
264	dosage40	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
265	recd40	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
266	name41	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
267	stren41	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
268	drgnm41	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
269	seen41	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
270	dosage41	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
271	recd41	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
272	name42	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
273	stren42	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
274	drgnm42	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
275	seen42	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
276	dosage42	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
277	recd42	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
278	name43	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
279	stren43	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
280	drgnm43	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
281	seen43	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
282	dosage43	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
283	recd43	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
284	name44	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
285	stren44	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
286	drgnm44	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
287	seen44	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
288	dosage44	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
289	recd44	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
290	name45	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
291	stren45	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
292	drgnm45	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
293	seen45	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
294	dosage45	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
295	recd45	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
296	name46	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
297	stren46	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
298	drgnm46	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
299	seen46	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
300	dosage46	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
301	recd46	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
302	name47	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
303	stren47	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
304	drgnm47	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
305	seen47	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
306	dosage47	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
307	recd47	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
308	name48	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
309	stren48	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
310	drgnm48	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
311	seen48	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
312	dosage48	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
313	recd48	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
314	name49	a1. [INTERVIEWER: NAME OF MEDICINE]	String[50]
315	stren49	a2. [INTERVIEWER: ENTER STRENGTH]	String[10]
316	drgnm49	b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?]	1= Yes 2= No
317	seen49	c. [INTERVIEWER: IS DRUG SEEN?]	1= Yes 2= No
318	dosage49	d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY]	1 .. 66
319	recd49	e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED]	String[40]
320	strokefu	MEDICAL HISTORY First I would like to ask you a few questions about specific medical conditions such as stroke and Parkinson's disease. STROKE 1. Since your evaluation on [last interview date], have you been told by a doctor, nurse or therapist that you had a STROKE, TRANSIENT ISCHEMIC ATTACK (TIA) or BRAIN HEMORRHAGE?	1= Yes 2= Suspect or possible 3= No
321	faint0fu	At the time of this (last) event, did you you have . . . a. Fainting, blackout or loss of consciousness?	1= Yes 2= Suspect 3= No
322	dizzy0fu	b. Dizzyness or lightheadedness?	1= Yes 2= Suspect 3= No
323	memor0fu	c. Memory loss or forgetfulness?	1= Yes 2= Suspect 3= No
324	speec0fu	At the time of this (last) event, did you you have . . . d. Language or speech change?	1= Yes 2= Suspect 3= No
325	visio0fu	e. Loss of vision?	1= No 2= right only 3= left only 4= both
326	face0fu	f. Weakness or paralysis of your face?	1= No 2= right only 3= left only 4= both
327	weakl0fu	g. Weakness or paralysis of your arms or legs?	1= No 2= right only 3= left only 4= both
328	limse0fu	h. Loss or change of sensation in your arms or legs?	1= No 2= right only 3= left only 4= both
329	symps0fu	i. Specify any other signs or symptoms associated with this (last) event?	String[40]
330	samet0fu	j. Did the stroke occur around the same time as a SURGICAL OPERATION, HEART ATTACK, BREATHING DIFFICULTY, or ANOTHER SERIOUS MEDICAL PROBLEM?	1= Yes 2= Suspect 3= No
331	sames0fu	Specify:	String[60]
332	inhospfu	2. Since your evaluation on [last interview date], have you been HOSPITALIZED OVERNIGHT or longer because of a STROKE, a TIA or a BRAIN HEMORRHAGE?	1= Yes 2= Suspect 3= No
333	promp1fu	2a. Was this the same event we just spoke about?	1= Yes 2= No
334	hospnafu	2b. What was the name of the hospital?	String[30]
335	faint1fu	At the time of this (last) event, did you you have . . . a. Fainting, blackout or loss of consciousness?	1= Yes 2= Suspect 3= No
336	dizzy1fu	b. Dizzyness or lightheadedness?	1= Yes 2= Suspect 3= No
337	memor1fu	c. Memory loss or forgetfulness?	1= Yes 2= Suspect 3= No
338	speec1fu	At the time of this (last) event, did you have . . . [INTERVIEWER: `Last' refers to the most recent hospitalization event.] d. Language or speech change?	1= Yes 2= Suspect 3= No
339	visio1fu	e. Loss of vision?	1= No 2= right only 3= left only 4= both
340	face1fu	f. Weakness or paralysis of your face?	1= No 2= right only 3= left only 4= both
341	weakl1fu	g. Weakness or paralysis of your arms or legs?	1= No 2= right only 3= left only 4= both
342	limse1fu	h. Loss or change of sensation in your arms or legs?	1= No 2= right only 3= left only 4= both
343	symps1fu	i. Specify any other signs or symptoms associated with this (last) event?	String[40]
344	samet1fu	j. Did the stroke occur around the same time as a SURGICAL OPERATION, HEART ATTACK, BREATHING DIFFICULTY, or ANOTHER SERIOUS MEDICAL PROBLEM?	1= Yes 2= Suspect 3= No
345	sames1fu	Specify:	String[60]
346	stroksfu	3. Since [last interview date], have you had a CT, MRI or other type of brain scan because of a STROKE, a TIA or a BRAIN HEMORRHAGE?	1= Yes 2= Suspect 3= No
347	promp2fu	3a. Was this for ^event we just spoke about?	1= Yes 2= No
348	scanlofu	3b. What was the name of the place (doctor's office, hospital or other place) at which the scan was performed?	String[30]
349	faint2fu	At the time of this (last) event, did you you have . . . a. Fainting, blackout or loss of consciousness?	1= Yes 2= Suspect 3= No
350	dizzy2fu	b. Dizzyness or lightheadedness?	1= Yes 2= Suspect 3= No
351	memor2fu	c. Memory loss or forgetfulness?	1= Yes 2= Suspect 3= No
352	speec2fu	d. Language or speech change?	1= Yes 2= Suspect 3= No
353	visio2fu	e. Loss of vision?	1= No 2= right only 3= left only 4= both
354	face2fu	f. Weakness or paralysis of your face?	1= No 2= right only 3= left only 4= both
355	weakl2fu	g. Weakness or paralysis of your arms or legs?	1= No 2= right only 3= left only 4= both
356	limse2fu	h. Loss or change of sensation in your arms or legs?	1= No 2= right only 3= left only 4= both
357	symps2fu	i. Specify any other signs or symptoms associated with this (last) event?	String[40]
358	samet2fu	j. Did the stroke occur around the same time as a SURGICAL OPERATION, HEART ATTACK, BREATHING DIFFICULTY, or ANOTHER SERIOUS MEDICAL PROBLEM?	1= Yes 2= Suspect 3= No
359	sames2fu	Specify:	String[60]
360	multipfu	4. Since your last evaluation on [last interview date], did you have only ONE STROKE, TIA or BRAIN HEMORRHAGE, or more than one?	1= Only one 2= More than one
361	leftspfu	5. Specify leftover troubles from your stroke(s)?	String[60]
362	everscfu	6. Since [last interview date], have you had a CT, MRI or other type of brain scan?	1= Yes 2= Suspect 3= No
363	reasonfu	6c. Reason	String[60]
364	escanlfu	6d. What was the name of the place (doctor's office, hospital or other place) at which the scan was performed?	String[30]
365	parksfu	1. Since [last interview date], have you been told by a doctor, nurse or therapist that you had PARKINSONISM or PARKINSON'S DISEASE?	1= Yes 2= Suspect or possible 3= No
366	gaitfu	With the parkinsonism, did you have . . . 2. Shuffling or unsteady gait, or loss of balance?	1= Yes 2= Suspect 3= No
367	writinfu	3. A change in your handwriting?	1= Yes 2= Suspect 3= No
368	stifffu	4. Stiffness or rigidity of your arms or legs?	1= No 2= right only 3= left only 4= both
369	slowmofu	5. Slowness of movement of your arms, hands or legs?	1= No 2= right only 3= left only 4= both
370	tremorfu	6. Tremor of your hands or feet?	1= No 2= right only 3= left only 4= both
371	medicafu	7. Are you currently taking any medication for your parkinsonism or Parkinson's disease (some examples are Sinemet, Symmetrel, Parlodel, Bromocriptine, etc.)?	1= Yes 2= Suspect or possible 3= No
372	medspefu	7a. Specify	String[30]
373	histadfu	Since your last evaluation on [last interview date], have you been told by a doctor, nurse, or therapist that you had dementia, senility, or Alzheimer's disease?	1= Yes 2= Susupect 3= No
374	respqs	Will MEP/MIP data be entered directly into Blaise form?	1= Yes 2= No
375	expir1	EXPIRATORY RESPIRATORY PRESSURE TESTING [Use the Expiratory Respiratory Pressure Valve for the Micro MPM.] [Reset to 0. Enter 995.5 for tried, but unable.] MEP trial 1 ________ cm H20	1.0 .. 995.5
376	expir2	[Reset to 0. Enter 995.5 for tried, but unable.] MEP trial 2 ________ cm H20	1.0 .. 995.5
377	inspir1	INSPIRATORY RESPIRATORY PRESSURE TESTING [Use the Inspiratory Respiratory Pressure Valve for the Micro MPM.] [Reset to 0. Enter 995.5 for tried, but unable.] MIP trial 1 ________ cm H20	1.0 .. 995.5
378	inspir2	[Reset to 0. Enter 995.5 for tried, but unable.] MIP trial 2 ________ cm H20	1.0 .. 995.5
379	mepmipcm	MEP/MIP Enter any comments. [Press enter to continue if none.]	String[250]
380	spiroqs	Will spirometry data be entered directly into Blaise form?	1= Yes 2= No
381	fev11	RESET Spirometry device FEV1 Trial 1 [Enter 95.5 for tried but unable.] _____ liters	0.00 .. 95.50
382	pvc1	PVC Trial 1 _____ liters	0.00 .. 10.00
383	fer1	FER Trial 1 _____ percent	0 .. 100
384	pef1	PEF Trial 1 _____ liters/minute [If greater than 999, enter 999.]	0 .. 999
385	fev12	RESET Spirometry device FEV1 Trial 2 [Enter 95.5 for tried but unable.] _____ liters	0.00 .. 95.50
386	pvc2	PVC Trial 2 _____ liters	0.00 .. 10.00
387	fer2	FER Trial 2 _____ percent	0 .. 100
388	pef2	PEF Trial 2 _____ liters/minute [If greater than 999, enter 999.]	0 .. 999
389	spcom	Spirometry Enter any comment. [Press enter to continue if none.]	String[250]
390	q8atap	FINGER TAPPING [DEPRESS BUTTON UNTIL '--' APPEARS.] 1. Right index finger. 'I want to see how quickly you can tap this key. When I tell you to begin, tap this key as quickly as you can until I tell you to stop.' Record first trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	1 .. 97
391	q8ana	Specify reason.	String[40]
392	q8btap	FINGER TAPPING [RESET TAPPER] Left index finger. Record first trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	1 .. 97
393	q8bna	Specify reason.	String[40]
394	q8ctap	FINGER TAPPING [RESET TAPPER] Right index finger. Record second trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	1 .. 97
395	q8cna	Specify reason.	String[40]
396	q8dtap	FINGER TAPPING [RESET TAPPER] Left index finger. Record second trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	1 .. 97
397	q8dna	Specify reason.	String[40]
398	rhand1	HAND DYNAMOMETRY [SET RED NEEDLE TO 0.] 'I want to see how strongly you can squeeze this handle. When I say go, squeeze the handle as hard as you can until I tell you to stop.' Right Hand Trial 1 [RECORD IN POUNDS.] 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	0 .. 777
399	rhand1na	Specify reason.	String[40]
400	lhand1	HAND DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 1 [RECORED IN POUNDS]. 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	0 .. 777
401	lhand1na	Specify reason.	String[40]
402	rhand2	HAND DYNAMOMETRY [RESET NEEDLE TO 0.] Right Hand Trial 2 [RECORD IN POUNDS]. 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	0 .. 777
403	rhand2na	Specify reason.	String[40]
404	lhand2	HAND DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 2 [RECORD IN POUNDS]. 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	0 .. 777
405	lhand2na	Specify reason.	String[40]
406	rthand1	PINCH DYNAMOMETRY [SET RED NEEDLE TO 0.] 'I want to see how strongly you can pinch this plate. When I say go, squeeze the plate as hard as you can until I tell you to stop.' Right Hand Trial 1 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	0 .. 77
407	rthand1n	Specify reason.	String[40]
408	lthand1	PINCH DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 1 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	0 .. 77
409	lthand1n	Specify reason.	String[40]
410	rthand2	PINCH DYNAMOMETRY [RESET NEEDLE TO 0.] Right Hand Trial 2 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	0 .. 77
411	rthand2n	Specify reason.	String[40]
412	lthand2	PINCH DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 2 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ]	0 .. 77
413	lthand2n	Specify reason.	String[40]
414	nasorest	NEUROLOGICAL EXAMINATION The neurologic examination should begin with both the subject and examiner comfortably seated facing one another. Right and left are always referenced to the subject. FACIAL STRENGTH [EXAMINER: Observe facial symmetry at rest and with activation of facial muscle groups. Ask subject to raise eyebrows, close eyes, smile.] 1. Nasolabial fold at rest and or action	1= Symmetric 2= Right flatter than left 3= Left flatter than right 7= Unable to test
415	fissures	2. Palpebral fissures	1= Symmetric 2= Right wider than left 3= Left wider than right 7= Unable to test
416	rightsup	VISUAL FIELDS [EXAMINER: Test each quadrant separately by confrontation with both eyes open. Wiggle fingers in the middle of each quadrant for one second and ask the subject to look at the fingers. If the subject is unable to comply, note whether the subject attends the wiggling fingers.] 1. Right superior quadrant	1= No visual field defect 2= Possible visual field defect 3= Definite visual field defect 7= Unable to test
417	rightinf	2. Right inferior quadrant	1= No visual field defect 2= Possible visual field defect 3= Definite visual field defect 7= Unable to test
418	leftsup	3. Left superior quadrant	1= No visual field defect 2= Possible visual field defect 3= Definite visual field defect 7= Unable to test
419	leftinf	4. Left inferior quadrant	1= No visual field defect 2= Possible visual field defect 3= Definite visual field defect 7= Unable to test
420	rarmrest	RESTING TREMOR [EXAMINER: Instruct the subject to sit completely relaxed and to count aloud backwards from 10. Observe the hands and feet for rhythmic tremor.] 1. Right arm rest tremor	1= Absent 2= Possible rest tremor 3= Slight and infrequently present 4= Mild in amplitude and persistent, or moderate in amplitude, but only intermittently present 5= Moderate in amplitude and present most of the time 6= Marked in amplitude and present most of the time 7= Unable to test 8= Unable to determine
421	larmrest	2. Left arm rest tremor	1= Absent 2= Possible rest tremor 3= Slight and infrequently present 4= Mild in amplitude and persistent, or moderate in amplitude, but only intermittently present 5= Moderate in amplitude and present most of the time 6= Marked in amplitude and present most of the time 7= Unable to test 8= Unable to determine
422	rlegrest	3. Right leg rest tremor	1= Absent 2= Possible rest tremor 3= Slight and infrequently present 4= Mild in amplitude and persistent, or moderate in amplitude, but only intermittently present 5= Moderate in amplitude and present most of the time 6= Marked in amplitude and present most of the time 7= Unable to test 8= Unable to determine
423	llegrest	4. Left leg rest tremor	1= Absent 2= Possible rest tremor 3= Slight and infrequently present 4= Mild in amplitude and persistent, or moderate in amplitude, but only intermittently present 5= Moderate in amplitude and present most of the time 6= Marked in amplitude and present most of the time 7= Unable to test 8= Unable to determine
424	chinjaw	5. Chin/jaw rest tremor	1= Absent 2= Possible rest tremor 3= Slight and infrequently present 4= Mild in amplitude and persistent, or moderate in amplitude, but only intermittently present 5= Moderate in amplitude and present most of the time 6= Marked in amplitude and present most of the time 7= Unable to test 8= Unable to determine
425	rhanddys	FINGER-TO-FINGER [EXAMINER: Instruct the subject to touch his or her index finger to your finger. The subject should extend the arm completely. Observe for dysmetria and action tremor. Score action tremor in next question.] 1. Right hand	1= No dysmetria 2= Possible dysmetria 3= Definite dysmetria 4= Unable to assess due to weakness 7= Unable to test
426	lhanddys	2. Left hand	1= No dysmetria 2= Possible dysmetria 3= Definite dysmetria 4= Unable to assess due to weakness 7= Unable to test
427	rhandact	POSTURAL/ACTION TREMOR OF HANDS [EXAMINER: Instruct the subject to hold his or her arms perpendicular to body with the palms down and fingers spread apart for 10 seconds. Observe for postural tremor. Score both action and postural tremors. Record most severe tremor.] 3. Right hand	1= Absent 2= Possible 3= Present 4= Unable to test due to weakness
428	rhamp	3a. Amplitude	1= Slight 2= Mild 3= Moderate 4= Marked
429	rhaorp	3b. Posture/Action	1= Action only 2= Posture only 3= Action AND posture
430	rhfreq	3c. Frequency	1= Slow [<7 Hz] 2= Moderate [7-10 Hz] 3= Fast [>10 Hz]
431	lhandact	4. Left hand	1= Absent 2= Possible 3= Present 4= Unable to test due to weakness
432	lhamp	4a. Amplitude	1= Slight 2= Mild 3= Moderate 4= Marked
433	lhaorp	4b. Posture/Action	1= Action only 2= Posture only 3= Action AND posture
434	lhfreq	4c. Frequency	1= Slow [<7 Hz] 2= Moderate [7-10 Hz] 3= Fast [>10 Hz]
435	scptrem		0 .. 8
436	scrtrem		0 .. 30
437	ilptrem		String[6]
438	ilrtrem		String[6]
439	mposttrm		0 .. 2
440	mresttrm		0 .. 5
441	tapintro	BRADYKINESIA Finger taps [EXAMINER: Subject taps thumb with index finger in rapid succession with widest amplitude possible for 10 seconds. Observe amplitude and speed of movement.] [Press enter to continue.]	String[1]
442	rfingtap	BRADYKINESIA-Finger taps 1. Right	1= Normal 2= Slowing OR reduction in amplitude which could be normal 3= Mild slowing AND reduction in amplitude 4= Moderately impaired. Definite early fatiguing. May have occasional arrests in movement. 5= Severely impaired. Frequent hesitation in initiating movements. 6= Can barely perform the task. 7= Unable to test.
443	lfingtap	BRADYKINESIA-Finger taps 2. Left	1= Normal 2= Slowing OR reduction in amplitude which could be normal 3= Mild slowing AND reduction in amplitude 4= Moderately impaired. Definite early fatiguing. May have occasional arrests in movement. 5= Severely impaired. Frequent hesitation in initiating movements. 6= Can barely perform the task. 7= Unable to test.
444	rfist	Fist clench [EXAMINER: Subject opens and closes fist as widely and as rapidly as possible for 10 seconds. Observe for speed and amplitude of movement.] 3. Right	1= Normal 2= Slowing OR reduction in amplitude which could be normal 3= Mild slowing AND reduction in amplitude 4= Moderately impaired. Definite early fatiguing. May have occasional arrests in movement. 5= Severely impaired. Frequent hesitation in initiating movements. 6= Can barely perform the task. 7= Unable to test.
445	lfist	4. Left	1= Normal 2= Slowing OR reduction in amplitude which could be normal 3= Mild slowing AND reduction in amplitude 4= Moderately impaired. Definite early fatiguing. May have occasional arrests in movement. 5= Severely impaired. Frequent hesitation in initiating movements. 6= Can barely perform the task. 7= Unable to test.
446	rprosup	Pronation-Supination [EXAMINER: Instruct subject to alternately tap the front and back of his or her hand on his or her knee for 10 seconds. Observe for speed, amplitude and rhythmicity of movement.] 5. Right	1= Normal 2= Slowing OR reduction in amplitude which could be normal 3= Mild slowing AND reduction in amplitude 4= Moderately impaired. Definite early fatiguing. May have occasional arrests in movement. 5= Severely impaired. Frequent hesitation in initiating movements. 6= Can barely perform the task. 7= Unable to test.
447	lprosup	6. Left	1= Normal 2= Slowing OR reduction in amplitude which could be normal 3= Mild slowing AND reduction in amplitude 4= Moderately impaired. Definite early fatiguing. May have occasional arrests in movement. 5= Severely impaired. Frequent hesitation in initiating movements. 6= Can barely perform the task. 7= Unable to test.
448	rheeltap	Leg agility [EXAMINER: Subject taps heel on ground in rapid succession for 10 seconds. Picks up entire leg. Amplitude should be about three inches.] 7. Right heel tap	1= Normal 2= Slowing OR reduction in amplitude which could be normal 3= Mild slowing AND reduction in amplitude 4= Moderately impaired. Definite early fatiguing. May have occasional arrests in movement. 5= Severely impaired. Frequent hesitation in initiating movements. 6= Can barely perform the task. 7= Unable to test.
449	lheeltap	8. Left heel tap	1= Normal 2= Slowing OR reduction in amplitude which could be normal 3= Mild slowing AND reduction in amplitude 4= Moderately impaired. Definite early fatiguing. May have occasional arrests in movement. 5= Severely impaired. Frequent hesitation in initiating movements. 6= Can barely perform the task. 7= Unable to test.
450	scbrady		0 .. 70
451	ilbrady		String[6]
452	mbrady		0 .. 8
453	rarm	STRENGTH [EXAMINER: When testing strength, push or pull for 2 seconds] Arm strength [EXAMINER: Instruct the subject to sit with both arms extended in front of the body with the palms facing upward and the fingers spread apart for 10 seconds. Observe for weakness and asymmetry.] 1. Right arm drift *******NOTE: BE SURE YOU ARE CODING EVERYTHING ACCORDING TO THE >>SUBJECT'S<< RIGHT OR LEFT SIDE.	1= No weakness 2= Possible weakness 3= Definite weakness, but elevates arm 10 seconds 4= Elevates arm less than 10 seconds 5= Unable to elevate arm 7= Unable to test
454	larm	2. Left arm drift	1= No weakness 2= Possible weakness 3= Definite weakness, but elevates arm 10 seconds 4= Elevates arm less than 10 seconds 5= Unable to elevate arm 7= Unable to test
455	armsym	3. Arm drift symmetric	1= Yes 2= Right weaker than left 3= Left weaker than right 7= Unable to test
456	neckrig	HYPERTONICITY [EXAMINER: Judged on passive movement of the extremities with subject relaxed in a sitting position.] 1. Neck Rigidity	1= Absent 2= Slight, questionably present 3= Mild to moderate 4= Marked, but full range of motion achieved easily 5= Severe, full range of motion achieved with difficulty 7= Unable to test
457	neckcog	1a. Cogwheeling	1= Yes 2= Suspect 3= No 7= Unable to test
458	rarmrig	2. Right arm rigidity present in flexors AND extensors	1= Absent 2= Slight, questionably present 3= Mild to moderate 4= Marked, but full range of motion achieved easily 5= Severe, full range of motion achieved with difficulty 7= Unable to test
459	rarmcog	2a. Cogwheeling	1= Yes 2= Suspect 3= No 7= Unable to test
460	rarmspas	3. Spasticity.	1= Yes 2= Suspect 3= No 7= Unable to test
461	larmrig	5. Left arm rigidity present in flexors AND extensors	1= Absent 2= Slight, questionably present 3= Mild to moderate 4= Marked, but full range of motion achieved easily 5= Severe, full range of motion achieved with difficulty 7= Unable to test
462	larmcog	5a. Cogwheeling	1= Yes 2= Suspect 3= No 7= Unable to test
463	larmspas	6. Spasticity.	1= Yes 2= Suspect 3= No 7= Unable to test
464	rlegrig	8. Right leg rigidity present in flexors AND extensors	1= Absent 2= Slight, questionably present 3= Mild to moderate 4= Marked, but full range of motion achieved easily 5= Severe, full range of motion achieved with difficulty 7= Unable to test
465	rlegcog	8a. Cogwheeling	1= Yes 2= Suspect 3= No 7= Unable to test
466	rlegspas	9. Spasticity.	1= Yes 2= Suspect 3= No 7= Unable to test
467	llegrig	11. Left leg rigidity present in flexors AND extensors	1= Absent 2= Slight, questionably present 3= Mild to moderate 4= Marked, but full range of motion achieved easily 5= Severe, full range of motion achieved with difficulty 7= Unable to test
468	llegcog	11a. Cogwheeling	1= Yes 2= Suspect 3= No 7= Unable to test
469	llegspas	12. Spasticity.	1= Yes 2= Suspect 3= No 7= Unable to test
470	scrigid		0 .. 25
471	ilrigid		String[6]
472	mrigid		0 .. 5
473	rbiceps	DEEP TENDON REFLEXES 1. Right Biceps	1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 5= Possibly increased 6= Definitely increased 7= Unable to test
474	lbiceps	2. Left Biceps	1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 5= Possibly increased 6= Definitely increased 7= Unable to test
475	bicepsym	3. Biceps symmetric	1= Yes 2= Right greater than left 3= Left greater than right 7= Unable to test
476	rtriceps	7. Right Triceps	1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 5= Possibly increased 6= Definitely increased 7= Unable to test
477	ltriceps	8. Left Triceps	1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 5= Possibly increased 6= Definitely increased 7= Unable to test
478	tricpsym	9. Triceps symmetric	1= Yes 2= Right greater than left 3= Left greater than right 7= Unable to test
479	rpatella	10. Right Patella	1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 5= Possibly increased 6= Definitely increased 7= Unable to test
480	lpatella	11. Left Patella	1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 5= Possibly increased 6= Definitely increased 7= Unable to test
481	patelsym	12. Patella symmetric	1= Yes 2= Right greater than left 3= Left greater than right 7= Unable to test
482	rachill	13. Right achilles	1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 5= Possibly increased 6= Definitely increased 7= Unable to test
483	lachill	14. Left achilles	1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 5= Possibly increased 6= Definitely increased 7= Unable to test
484	achilsym	15. Achilles symmetric	1= Yes 2= Right greater than left 3= Left greater than right 7= Unable to test
485	rbigtoe	BABINSKI SIGN 1. Right big toe	1= Normal 2= Possible 3= Present 7= Unable to test
486	lbigtoe	2. Left big toe	1= Normal 2= Possible 3= Present 7= Unable to test
487	bmd1	Clinical Bone Sonometer Bone Mineral Density (BMD) Trial 1 _____ g/cm2 [Enter 7 for tried but unable.]	0.000 .. 7.000
488	tscore1	Trial 1 Record T score ______	-5.0 .. 4.0
489	qui1	Trial 1 Record Quality Ultrasound Index (QUI)/stiffness _____	-50.0 .. 200.0
490	bua1	Trial 1 Record broad band ultrasound attenuation (BUA) _____dB/MHz	0.0 .. 200.0
491	sos1	Trial 1 Record speed of sound (SOS) _____ m/sec	800.0 .. 2500.0
492	soncom	Clinical Bone Sonometer- Check scores and make comments. Bone Mineral Density(BMD) ^bmd1 T score**************** ^tscore1 QUI/stiffness********** ^qui1 BUA******************** ^bua1 SOS********************** ^sos1 Page up and re-enter if any values are not correct. Enter any comments.[Press enter to continue if none.]	String[250]
493	rtoevib	SENSORY FUNCTION Vibratory sensation 1. Right big toe [EXAMINER: First, make sure that subject understands the sensation. Tap tuning fork in palm of hand and test for ability to perceive vibration on the top of the large toe of each foot.]	1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 7= Unable to test
494	ltoevib	Vibratory sensation 2. Left big toe	1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 7= Unable to test
495	rlegvib	Stocking pattern of vibratory loss 3. Right Leg. [EXAMINER: Determine whether there is a greater sensory loss in the toe vs. the ankle]	1= Yes 2= Possible 3= No
496	ltlegvib	Stocking pattern of vibratory loss 4. Left leg. [EXAMINER: Determine whether there is a greater sensory loss in the toe vs. the ankle]	1= Yes 2= Possible 3= No
497	hpinsym	Pin sensation 1. Back of index fingers symmetric	1= Yes 2= Right with less sensation than left 3= Left with less sensation than right 7= Unable to test
498	rhandpin	Pin sensation 2. Right Index vs. Pinky [EXAMINER: Now instruct the subject that you will test the sensation of the index and pinky fingers. Ask the subject to tell you whether they feel the same; if they are different, where does he or she feel it more, the index finger or the small finger.]	1= Same 2= Index possible more than pinky 3= Index definitely more than pinky 4= Pinky possibly more than index 5= Pinky definitely more than index
499	lhandpin	Pin sensation 3. Left Index vs. Pinky	1= Same 2= Index possible more than pinky 3= Index definitely more than pinky 4= Pinky possibly more than index 5= Pinky definitely more than index
500	fpinsym	Pin sensation 4. Top of big toe symmetric	1= Yes 2= Right with less sensation than left 3= Left with less sensation than right 7= Unable to test
501	rlegpin	Stocking pattern of pin loss 5. Right Leg. [EXAMINER: Tell the subject that he or she will feel the pin on the toe and ankle. Determine whether it is the same or different -- consistent with a stocking pattern of sensory loss.]	1= Yes 2= Possible 3= No
502	ltlegpin	Stocking pattern of pin loss 6. Left leg.	1= Yes 2= Possible 3= No
503	rarmabd1	Nicholas MMT [CHECK CALIBRATION OR RESET INTSTRUMENT 1. Right arm abduction [DELTOID] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
504	larmabd1	2. Left arm abduction [DELTOID] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
505	rarmabd2	3. Right arm abduction [DELTOID] Trial 2 - Enter 95.5 for tried, but unable	0.1 .. 95.5
506	larmabd2	4. Left arm abduction [DELTOID] Trial 2 - Enter 95.5 for tried, but unable	0.1 .. 95.5
507	rarmflx1	Right arm flexion [BICEPS] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
508	larmflx1	Left arm flexion [BICEPS] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
509	rarmext1	Right arm extension [TRICEPS] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
510	larmext1	Left arm extension [TRICEPS] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
511	rhipflx1	5. Right hip flexion [ILIOPSOAS] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
512	lhipflx1	6. Left hip flexion [ILIOPSOAS] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
513	rhipflx2	7. Right hip flexion [ILIOPSOAS] Trial 2 - Enter 95.5 for tried, but unable	0.1 .. 95.5
514	lhipflx2	8. Left hip flexion [ILIOPSOAS] Trial 2 - Enter 95.5 for tried, but unable	0.1 .. 95.5
515	rlegext1	9. Right leg extension [QUADRICEPS] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
516	llegext1	10. Left leg extension [QUADRICEPS] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
517	rfotflx1	13. Right foot plantar flexion [GASTROCNEMIUS] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
518	lfotflx1	14. Left foot plantar flexion [GASTROCNEMIUS] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
519	rfotflx2	15. Right foot plantar flexion [GASTROCNEMIUS] Trial 2 - Enter 95.5 for tried, but unable	0.1 .. 95.5
520	lfotflx2	16. Left foot plantar flexion [GASTROCNEMIUS] Trial 2 - Enter 95.5 for tried, but unable	0.1 .. 95.5
521	rfotdor1	Right foot dorsiflexion [TIBIALIS ANTERIOR] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
522	lfotdor1	Left foot dorsiflexion [TIBIALIS ANTERIOR] Trial 1 - Enter 95.5 for tried, but unable	0.1 .. 95.5
523	rfotdor2	Right foot dorsiflexion [TIBIALIS ANTERIOR] Trial 2 - Enter 95.5 for tried, but unable	0.1 .. 95.5
524	lfotdor2	Left foot dorsiflexion [TIBIALIS ANTERIOR] Trial 2 - Enter 95.5 for tried, but unable	0.1 .. 95.5
525	muscls01	17. List all muscles you were unable to break	1= Right Deltoid 2= Left Deltoid 3= Right Bicep 4= Left Bicep 5= Right Tricep 6= Left Tricep 7= Right Hip Flexion 8= Left Hip Flexion 9= Right Leg Extension 10= Left Leg Extension 11= Right Plantar Flexion 12= Left Plantar Flexion 13= Right Dorsiflexion 14= Left Dorsiflexion 15= N/A
526	muscls02	17. List all muscles you were unable to break	See previous question
527	muscls03	17. List all muscles you were unable to break	See previous question
528	muscls04	17. List all muscles you were unable to break	See previous question
529	muscls05	17. List all muscles you were unable to break	See previous question
530	muscls06	17. List all muscles you were unable to break	See previous question
531	muscls07	17. List all muscles you were unable to break	See previous question
532	muscls08	17. List all muscles you were unable to break	See previous question
533	muscls09	17. List all muscles you were unable to break	See previous question
534	muscls10	17. List all muscles you were unable to break	See previous question
535	muscls11	17. List all muscles you were unable to break	See previous question
536	muscls12	17. List all muscles you were unable to break	See previous question
537	muscls13	17. List all muscles you were unable to break	See previous question
538	muscls14	17. List all muscles you were unable to break	See previous question
539	mmtcom	Nicholas MMT Enter any comments. [Press enter to continue if none.]	String[250]
540	chairup	POSTURE/GAIT 1. Arising from a chair [EXAMINER: Seat the subject in a straight back chair with arms. Instruct him or her to cross his or her arms across his or her chest, and to stand from the chair. If he or she is unable to do this, he or she may stand using his or her hands.]	1= Normal 2= Slow, could be normal 3= Needs more than 1 attempt, but does not push with arms 4= Pushes self up from arms of chair 5= Using arms, tends to fall back or requires more than one attempt, but able to stand without help 6= Unable to arise without help 7= Unable to test
541	basegait	Gait [EXAMINER: Ask the subject to walk as fast as possible (about 10 feet), turn around and walk back. Observe speed, associated movements and base.] 2. Base	1= Normal, medial malleoli within 3 inches 2= Slightly widened, medial malleoli 3-6 inches apart 3= Widened, medial melleoli > 6 inches apart 7= Unable to test
542	shufgait	3. Shuffling 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, unable to ambulate without assistance 6= Cannot walk at all due to shuffling gait, not even with assistance
543	armswing	3a. Reduced Armswing	1= Yes 2= Suspect 3= No 7= Unable to test
544	armside	3b. On which side is the armswing reduced?	1= Right 2= Left 3= Both
545	legcirc	4. Circumduction of Leg	1= Yes 2= Suspect 3= No 7= Unable to test
546	legside	4a. On which side is this?	1= Right 2= Left 3= Both
547	body	5. Body bradykinesia/hypokinesia [EXAMINER: This item represents a global view of the slowness and deliberateness of the subject's movements. During the examination, observe the rapidity of movements, also observe decrease in armswing and spontaneous movements.]	1= None 2= Minimal slowness, giving movement a deliberate character, possibly reduced amplitude 3= Mild degree of slowness and poverty of movement which is definitely abnormal, alternatively, some reduced amplitude 4= Moderate slowness, poverty or small amplitude of movement 5= Marked slowness, poverty or small amplitude of movement
548	turning	6. Turning	1= Pivots on narrow base 2= Hesitates or widens base, but steady 3= Turns slowly and awkwardly 4= Would likely fall without aid 5= Cannot turn 7= Unable to test
549	gaitspec	10. Other gait abnormality [Press enter to continue if none.]	String[40]
550	posture	1. Posture [EXAMINER: View the subject from the front and from the side.]	1= Normal erect 2= Slightly stooped posture, could be normal 3= Moderately stooped, can be leaning slightly to one side 4= Severely stooped with kyphosis, can be moderately leaning to one side 5= Marked flexion with extreme abnormality of posture 7= Unable to test
551	introstb	2. Postural Stability [EXAMINER: Instruct the subject to stand with the feet about 6 inches apart. Instruct him or her that you will be pulling back on his or her shoulders and that he or she should `try not to fall.' Standing behind the subject, pull on the shoulders with increasing strength until the subject loses his or her balance. Note the number of steps and the strength of the pull.] [PRESS ENTER TO SCORE.]	String[1]
552	stblpost	2. Postural Stability	1= Normal, takes 1 step to correct balance 2= Possible retropulsion, takes 2 steps to correct balance 3= Definite retropulsion, takes 3 or more steps, but recovers unaided 4= Would fall if not caught 5= Unstable, tends to lose balance spontaneously 6= Unable to stand without assistance
553	numsteps	2a. NUMBER OF STEPS	3 .. 20
554	pull	2b. Strength of pull	1= Very light pull 2= Mild to moderate pull 3= Moderate to strong pull 4= Strong pull
555	screflex		0 .. 35
556	ilreflex		String[6]
557	mreflex		0 .. 6
558	bedtime	Sleep Questionnaire 1. During the past month, when have you usually gone to bed at night? Time (hh:mm) [INTERVIEWER If P responds with a range of time for bedtime, take the average. For example, if P indicates a bedtime between 10:30 pm-11:00 pm, enter 10:45 pm as the average bedtime. ]	String[5]
559	bedtime_	1. During the past month, when have you usually gone to bed at night? 1a. [am/pm]	String[2]
560	min2slee	2. During the past month, how long (in minutes) has it usually taken you to fall asleep each night? [Number of minutes] [INTERVIEWER If P responds with a range of minutes, take the average.]	0 .. 999
561	getuptim	3. During the past month, when have you usually gotten up in the morning? Time (hh:mm) [INTERVIEWER If P responds with a range of time for getting up time, take the average. ]	String[5]
562	getupti2	3. During the past month, when have you usually gotten up in the morning? 3a. [am/pm]	String[2]
563	sleephrs	4. During the past month, how many hours did you usually sleep at night? [hours] [INTERVIEWER If P responds with a range of time, take the average. ]	0 .. 23
564	sleephr2	4. During the past month, how many hours did you usually sleep at night? 4a. [minutes]	0 .. 59
565	trsleep_	5. How often do you have trouble falling asleep?	1= Never 2= Rarely 3= Sometimes 4= Often 5= Very often
566	trsleep3	6. During the past month, how often did you have trouble falling asleep within 30 minutes?	1= Not at all 2= Less than once a week 3= Once or twice a week 4= Three or more times a week 5= Nearly every day
567	wakenigh	7. How often are you troubled by waking up during the night?	1= Never 2= Rarely 3= Sometimes 4= Often 5= Very often
568	wakenig2	8. During the past month, how often did you wake up in the middle of the night or early morning?	1= Not at all 2= Less than once a week 3= Once or twice a week 4= Three or more times a week 5= Nearly every day
569	rested_f	9. How often do you feel really rested when you wake up in the morning?	1= Never 2= Rarely 3= Sometimes 4= Often 5= Very often
570	tiredaft	10. During the past month, how often have you felt tired or fatigued after sleep?	1= Not at all 2= Less than once a week 3= Once or twice a week 4= Three or more times a week 5= Nearly every day
571	tiredwak	11. In the past month, during your waking time, how often have you felt tired, fatigued or not up to par?	1= Not at all 2= Less than once a week 3= Once or twice a week 4= Three or more times a week 5= Nearly every day
572	nap_freq	12. How often do you get so sleepy during the day or evening that you have to take a nap?	1= Never 2= Rarely 3= Sometimes 4= Often 5= Very often
573	sleepdri	13. Have you ever nodded off or fallen asleep while driving a vehicle?	0= No 1= Yes
574	sleepdr2	13a. Over the past month, how often has this occurred?	1= Not at all 2= Less than once a week 3= Once or twice a week 4= Three or more times a week 5= Nearly every day
575	psqi_med	14. Have you used sleeping medications in two weeks prior to this interview?	0= No 1= Yes
576	snore	15. Do you snore?	0= No 1= Yes 9= Don't know
577	snorebot	15a. Has your snoring ever bothered other people?	0= No 1= Yes 9= Don't know
578	snorerat	15b. If you snore, would you say your snoring is _____ ?	1= Slightly louder than breathing 2= As loud as talking 3= Louder than talking 4= Very loud - can be heard in adjacent rooms 99= DK
579	snore_fr	15c. Over the past month, how often have you been snoring?	1= NOT AT ALL 2= LESS THAN ONCE A WEEK 3= ONCE OR TWICE A WEEK 4= THREE OR MORE TIMES A WEEK 5= NEARLY EVERY DAY 99= DK
580	breathpa	16. During the past month, how often have others noticed that you quit breathing or have long pauses between breaths during sleep?	1= NOT AT ALL 2= LESS THAN ONCE A WEEK 3= ONCE OR TWICE A WEEK 4= THREE OR MORE TIMES A WEEK 5= NEARLY EVERY DAY 99= DK
581	sleepapn	17. Are you currently being treated for sleep apnea (e.g. CPAP)?	0= No 1= Yes
582	actdream	Mayo Sleep Questionnaire � Please mark �Yes� if the described event has occurred at least 3 times. 18 . Have you ever been told that you appear to 'act out your dreams' while sleeping? (Punched or flailed arms in the air, shouted or screamed)	0= No 1= Yes
583	actdrea2	18a. How many months or years has this been going on? [Years]	0 .. 99
584	actdrea3	18a. How many months or years has this been going on? [Months] 18a-1. [Months]	0 .. 11
585	actdrea4	18b. Have you ever been injured from these behaviors (bruises, cuts, broken bones)?	0= No 1= Yes
586	actdrea5	18c. Has your bed-partner ever been injured from these behaviors (bruises, blows, pulled hair)?	0= No 1= Yes
587	dreamatt	18d. Have you ever had dreams about being attacked, or that involved defending yourself?	0= No 1= Yes
588	movdream	18e. Have you ever been told that the movements you made matched the details of your dream?	0= No 1= Yes
589	sleepwal	19. Have you ever been told that you walked around the bedroom or house while asleep? (please mark Yes if the described event has occurred at least 3 times)	0= No 1= Yes
590	sleepwa2	19a. If yes, how often does this occur?	0= Almost never 2= Less than once a week 3= Once or twice a week 4= Three or more times a week 5= Nearly every day
591	legtwitc	20. During the past month, how often have your legs repeatedly jerked or twitched during sleep (not just while falling asleep)?	1= NOT AT ALL 2= LESS THAN ONCE A WEEK 3= ONCE OR TWICE A WEEK 4= THREE OR MORE TIMES A WEEK 5= NEARLY EVERY DAY 99= DK
592	legdisru	21. During the past month, how often have you had a restless, nervous, tingly, or creepy-crawly feeling in your legs that disrupts your ability to fall or stay asleep?	1= Not at all 2= Less than once a week 3= Once or twice a week 4= Three or more times a week 5= Nearly every day
593	legdisr2	21a. Do these leg sensations decrease when you walk around?	0= No 1= Yes
594	legdisr3	21b. When do these sensations seem to be the worst?	1= Before 6pm 2= After 6pm
595	cov1	Revised COVID FORM 2022 This form serves as an update to the original COVID-19 Survey released in summer 2020, and reflects on several important updates since that time, including vaccinations and evolving understanding of the long-term impacts of COVID-19 particularly on cognitive function. We are asking these questions because COVID-19 has presented multiple challenges for us all, and we would like to learn about your experience. 1. Have you been diagnosed with COVID-19 (you tested positive or were presumed to have COVID-19 by a healthcare provider)?	0= No 1= Yes, based on a positive test for acute infection 2= Yes, presumed COVID-19 diagnosis by healthcare provider but not tested 8= Decline to answer 9= Unsure/unknown
596	cov1a	Revised COVID FORM 2022 1a. How many times have you been diagnosed with COVID-19 (distinct episodes of illness)?	1= Once 2= Twice 3= Three or more times 9= Unsure/unknown
597	cov1b	Revised COVID FORM 2022 1b. When did your first COVID-19 infection begin (month/year)? [ 88/8888 = Decline to answer ]	String[7]
598	cov1c	Revised COVID FORM 2022 1c. What was the duration of your first COVID-infection?	1= <1 week 2= 1-2 weeks 3= 2-4 weeks 4= >4 weeks 5= Not yet recovered (symptoms persist to the present)
599	cov1d	Revised COVID FORM 2022 1d. During any of your COVID-19 infections, did you lose the ability to smell or taste, experience lower ability to determine smells or tastes, or experience episodes of unprovoked, unfamiliar, or strange smells or tastes?	0= No 1= Yes 8= Decline to answer 9= Unsure/unknown
600	cov1e	Revised COVID FORM 2022 1e. During any of your COVID-19 infections, did you experience new problems with thinking, remembering, or concentration (e.g., brain fog)?	0= No 1= Yes 8= Decline to answer 9= Unsure/unknown
601	cov1f	Revised COVID FORM 2022 1f. Did you ever seek medical care for COVID-19?	0= No 1= Yes 8= Decline to answer 9= Unsure/unknown
602	cov1g	Revised COVID FORM 2022 1g. What was the highest level of care received?	1= Physician or urgent care visit, including virtual care visit 2= Emergency department 3= Hospitalized but not the intensive care unit 4= Hospitalized, including a stay in the ICU and/or ventilator support (breathing tube in your throat) 8= Decline to answer 9= Unsure/unknown
603	cov1h	Revised COVID FORM 2022 1h. To what degree have you recovered from your COVID-19 symptoms (scale 1 to 5)?	1= No improvement 2= Slightly improved 3= Somewhat improved 4= Mostly improved 5= Totally recovered or never had symptoms 8= Decline to answer 9= Unsure/unknown
604	cov2	Revised COVID FORM 2022 2. Have you received at least one vaccination against COVID-19?	0= No 1= Yes 8= Decline to answer 9= Unsure/unknown
605	ivisit	visit
606	cuff	BLOODPRESSURE Now I would like to take some blood pressure readings. 3. IS CUFF SIZE AVAILABLE? [IF CUFF NOT AVAILABLE, AT END OF INTERVIEW SET UP TIME TO RETURN FOR BLOOD PRESSURE MEASUREMENT]	1= Yes 2= No
607	bp11	6. FIRST SITTING BLOOD PRESSURE READING [INTERVIEWER: The subject should be seated for five minutes prior to obtaining the seated blood pressure readings. ENTER SYSTOLIC/DIASTOLIC]	String[7]
608	bp2	7. SECOND SITTING BLOOD PRESSURE READING [INTERVIEWER: ENTER SYSTOLIC/DIASTOLIC]	String[7]
609	bp31	8. STANDING BLOOD PRESSURE READING [INTERVIEWER: ASK THE SUBJECT TO STAND. WAIT 60 SECONDS THEN REPEAT BLOOD PRESSURE READING. ENTER SYSTOLIC/DIASTOLIC]	String[7]
610	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
611	hearimp	2. Does the participant have a SUBSTANTIAL hearing impairment?	1= Yes 2= No
612	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
613	phyeffrt	4. How great an effort do you think the participant put into the examination?	1= A great deal 2= A considerable amount 3= A moderate amount 4= A little bit 5= Hardly any
614	comm	Comments.	String[120]
615	autotm1	[COMPUTER CLOCK TIME]	String[8]
616	report1	CLIN EVAL SUMMARY: SUBJECT ^intro.projid; Date: ^intro.dateint SUMM PG 1/10 AREA IMPAIRMENT LEVEL RANGE SCORE (Missing~) Bradykinesia ^VBrady 8-48 ^brady.ScBrady (^brady.mbrady of 8) Postural Reflex ^Vreflex 6-32 ^sensgait.Screflex^x1 (^sensgait.mreflex of 6) Rigidity ^Vrigid 5-25 ^hyper.ScRigid^x2 (^hyper.mrigid of 5) [~NOTE: If any data are missing, this will affect the computation of the impairment level.] >>>>> PRESS ENTER FOR NEXT SUMMARY SCREEN <<<<<
617	report2	CLIN EVAL SUMMARY: SUBJECT ^intro.projid; Date: ^intro.dateint SUMM PG 2/10 AREA IMPAIRMENT LEVEL RANGE SCORE (Missing~) Postural tremor ^Vptrem 0-8 ^tremor.Scptrem (^tremor.mposttrm of 2) Resting tremor ^Vrtrem 5-30 ^tremor.Scrtrem^x3 (^tremor.mresttrm of 5) Parkinsonism: ^Parkvar ^ps1^ps2^ps4^ps7^ps10 >>>>> PRESS ENTER FOR NEXT SUMMARY SCREEN <<<<<
618	report3	HISTORY FROM CLIN EVAL: SUBJECT ^intro.projid; Date: ^intro.dateint SUMM PG 3/10 Stroke: ^strovar ^s1^s2^s3^s4^s6^s9^s12^s15^cervasc.symps0fu^s17 Current Drugs: ^drugvar^drugs.RXs.medicine[1].name00 ^drugs.RXs.medicine[2].name00 ^drugs.RXs.medicine[3].name00 ^drugs.RXs.medicine[4].name00 ^drugs.RXs.medicine[5].name00 ^drugs.RXs.medicine[6].name00 ^drugs.RXs.medicine[7].name00 ^drugs.RXs. medicine[8].name00 ^drugs.RXs.medicine[9].name00 ^drugs.RXs.medicine[10].name00 ^drugs.RXs.medicine[11].name00 ^drugs.RXs.medicine[12].name00 ^drugs.RXs.medicine[13].name00 ^drugs.RXs.medicine[14].name00 ^drugs.RXs.medicine[15].name00 ^drugs.RXs. medicine[16].name00 ^drugs.RXs.medicine[17].name00 ^drugs.RXs.medicine[18].name00 ^drugs.RXs.medicine[19].name00 ^drugs.RXs.medicine[20].name00 PRESS ENTER FOR NEXT SUMMARY SCREEN
619	report3a	HISTORY FROM CLIN EVAL: SUBJECT ^intro.projid; Date: ^intro.dateint SUMM PG 3a/10 Stroke with hospitalization: ^strovar2 ^s201^s202^s203^s204^s205^s206^s208^s209^s211^s212^s214^s215 ^cervasc.symps1fu^s217 >>>>> PRESS ENTER FOR NEXT SUMMARY SCREEN <<<<<
620	report3b	HISTORY FROM CLIN EVAL: SUBJECT ^intro.projid; Date: ^intro.dateint SUMM PG 3b/10 Stroke with brain scan: ^strovar3 ^s301^s302^s303^s304^s305^s306^s308^s309^s311^s312^s314^s315 ^cervasc.symps2fu^s317 >>>>> PRESS ENTER FOR NEXT SUMMARY SCREEN <<<<<
621	report4	NEURO EXAM - FOCAL SIGNS: SUBJECT ^intro.projid Date: ^intro.dateint SUMM PG 4/10 CRANIAL NERVES ^normal^a5^a6^a7^a8 Brain scan: ^scanvar ^reason ^whyscan^cervasc.reasonfu PRESS ENTER FOR NEXT SUMMARY SCREEN
622	report5	NEURO EXAM - FOCAL SIGNS: SUBJECT ^intro.projid Date: ^intro.dateint SUMM PG 5/10 Seventh Nerve: ^normal ^c1^d1^c2^d2^c3^d3^c4^d4 Tongue: ^c5^d5 >>>>> PRESS ENTER FOR NEXT SUMMARY SCREEN <<<<<
623	report6	NEURO EXAM - FOCAL SIGNS: SUBJECT ^intro.projid Date: ^intro.dateint SUMM PG 6/10 FOCAL SIGNS: ARM STRENGTH SYMMETRY ^normal2^e1^f1^e2^f2^e3^f3^e4^e5^e6^g1^g2^g3 >>>>> PRESS ENTER FOR NEXT SUMMARY SCREEN <<<<<
624	report7	NEURO EXAM - FOCAL SIGNS: SUBJECT ^intro.projid Date: ^intro.dateint SUMM PG 7/10 FOCAL SIGNS: LEG STRENGTH SYMMETRY ^normal2^e2^g4^h4^g5^h5^g6^h6^i4^i5^i6^j4^j5^j6^a5 >>>>> PRESS ENTER FOR NEXT SUMMARY SCREEN <<<<<
625	report8	NEURO EXAM - FOCAL SIGNS: SUBJECT ^intro.projid Date: ^intro.dateint SUMM PG 8/10 DEEP TENDON REFLEXES: ^normal2 ^g4^h4^g5^h5^g6^h6^g7^h7^g8^h8 BABINSKI SIGN: ^normal3 ^k1^k2 >>>>> PRESS ENTER FOR NEXT SUMMARY SCREEN <<<<<
626	report9	NEURO EXAM-FOCAL SIGNS: SUBJECT ^intro.projid Date: ^intro.dateint SUMM PG 9/10 SENSORY FUNCTION Pin Sensation: ^normal1 ^a1^b1^a2^b2 Vibratory Sensation: ^normal3^a6 ^a7 >>>>> PRESS ENTER FOR NEXT SUMMARY SCREEN <<<<<
627	report10	NEURO EXAM-FOCAL SIGNS: SUBJECT ^intro.projid Date: ^intro.dateint SUMM PG 10/10 CEREBELLAR FUNCTION FINGER-TO-FINGER: ^normal1 ^a1^a2 HEEL-TO-SHIN TEST: ^normal2 ^a3^a4 GAIT: ^normal3^a5 ^a6^a7 >>>>> END OF SUMMARY SECTION <<<<
628	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
629	formpart	Was participant reluctant, and/or does participant have special needs?	1= Yes 2= No
630	formcomm	Please explain reluctance or any other factors which may have affected this data. [Press enter if no comment needed.]	String[120]
631	statid	Please enter you staff id.	100 .. 997
632	formch	Has the form been modified?	1= Yes 2= No
633	revidate	Enter the date that the form was modified.	Date type
634	revintd	Enter your staff id number.	100 .. 997

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Data Dictionary for mp2cevfu