Data Dictionary for radcmotce
Number of Blaise fields: 196
| Seq # | Var | Question | Data Type/Coding |
|---|---|---|---|
| 1 | versiondate | Version Date | |
| 2 | formdescr | Form Description | |
| 3 | formno | Form Number | String[10] |
| 4 | version | Version Number | String[10] |
| 5 | spirobr | RADCMOT-CE Form 1. Spirometry 2. Finger Tap, Grip, Pinch 3. Pin Sensations 4. Rydel Tuning Fork Would you like to complete spirometry? | 1= Complete 2= Skip |
| 6 | fingtapbr | RADCMOT-CE Form 1. Spirometry 2. Finger Tap, Grip, Pinch 3. Pin Sensations 4. Rydel Tuning Fork Would you like to complete Finger Tap, Grip, Pinch? | 1= Complete 2= Skip |
| 7 | pinbr | RADCMOT-CE Form 1. Spirometry 2. Finger Tap, Grip, Pinch 3. Pin Sensations 4. Rydel Tuning Fork Would you like to complete Pin Sensations? | 1= Complete 2= Skip |
| 8 | tuningbr | RADCMOT-CE Form 1. Spirometry 2. Finger Tap, Grip, Pinch 3. Pin Sensations 4. Rydel Tuning Fork Would you like to complete Rydel Tuning Fork? | 1= Complete 2= Skip |
| 9 | projid | ^formdescr Form: ^formno Version: ^version (^versiondate) Enter project ID number. | String[8] |
| 10 | 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] |
| 11 | baseyear | Enter year of baseline from face sheet: | 1993 .. 2040 |
| 12 | autodate | Automatic Date. | Date type |
| 13 | autotime | Automatic Time. | TimeType |
| 14 | autolog | Automatic Logged Date. | Date type |
| 15 | intid | INTERVIEWER ID | 100 .. 997 |
| 16 | compid | Laptop ID | String[20] |
| 17 | dateint | Date of interview | Date type |
| 18 | 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 |
| 19 | formlang | What language will be used to administer this form? | 1= English 2= Español |
| 20 | spiroqs | Will spirometry data be entered directly into Blaise form? | 1= Yes 2= No |
| 21 | fev11 | RESET Spirometry device FEV1 Trial 1 [Enter 95.5 for tried but unable.] _____ liters | 0.00 .. 95.50 |
| 22 | pvc1 | PVC Trial 1 _____ liters | 0.00 .. 10.00 |
| 23 | fer1 | FER Trial 1 _____ percent | 0 .. 100 |
| 24 | pef1 | PEF Trial 1 _____ liters/minute [If greater than 999, enter 999.] | 0 .. 999 |
| 25 | fev12 | RESET Spirometry device FEV1 Trial 2 [Enter 95.5 for tried but unable.] _____ liters | 0.00 .. 95.50 |
| 26 | pvc2 | PVC Trial 2 _____ liters | 0.00 .. 10.00 |
| 27 | fer2 | FER Trial 2 _____ percent | 0 .. 100 |
| 28 | pef2 | PEF Trial 2 _____ liters/minute [If greater than 999, enter 999.] | 0 .. 999 |
| 29 | spcom | Spirometry Enter any comment. [Press enter to continue if none.] | String[250] |
| 30 | 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 |
| 31 | q8ana | Specify reason. | String[40] |
| 32 | 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 |
| 33 | q8bna | Specify reason. | String[40] |
| 34 | 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 |
| 35 | q8cna | Specify reason. | String[40] |
| 36 | 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 |
| 37 | q8dna | Specify reason. | String[40] |
| 38 | 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 |
| 39 | rhand1na | Specify reason. | String[40] |
| 40 | lhand1 | HAND DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 1 [RECORD IN POUNDS]. 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 777 |
| 41 | lhand1na | Specify reason. | String[40] |
| 42 | 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 |
| 43 | rhand2na | Specify reason. | String[40] |
| 44 | 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 |
| 45 | lhand2na | Specify reason. | String[40] |
| 46 | 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 |
| 47 | rthand1n | Specify reason. | String[40] |
| 48 | 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 |
| 49 | lthand1n | Specify reason. | String[40] |
| 50 | 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 |
| 51 | rthand2n | Specify reason. | String[40] |
| 52 | 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 |
| 53 | lthand2n | Specify reason. | String[40] |
| 54 | 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 |
| 55 | 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/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 |
| 56 | 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 |
| 57 | 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 |
| 58 | rlegpin | Stocking pattern of pin loss 5. Right Leg. [EXAMINER: Tell the subject that he/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 |
| 59 | ltlegpin | Stocking pattern of pin loss 6. Left leg. | 1= Yes 2= Possible 3= No |
| 60 | rtoe | Tuning Fork - Right toe [Enter 0 for absent] | 0 .. 100 |
| 61 | ltoe | Tuning Fork - Left toe [Enter 0 for absent] | 0 .. 100 |
| 62 | rankle | Tuning Fork - Right ankle [Enter 0 for absent] | 0 .. 100 |
| 63 | lankle | Tuning Fork - Left ankle [Enter 0 for absent] | 0 .. 100 |
| 64 | 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 |
| 65 | hearimp | 2. Does the participant have a SUBSTANTIAL hearing impairment? | 1= Yes 2= No |
| 66 | 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 |
| 67 | phyeffrt | 4. How great an effort do you think the participant put into the physical function items? | 1= A great deal 2= A considerable amount 3= A moderate amount 4= A little bit 5= Hardly any |
| 68 | 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 |
| 69 | formpart | Was participant reluctant, and/or does participant have special needs? | 1= Yes 2= No |
| 70 | formcomm | Please explain reluctance or any other factors which may have affected this data. [Press enter if no comment needed.] | String[120] |
| 71 | statid | Please enter you staff id. | 100 .. 997 |
| 72 | formch | Has the form been modified? | 1= Yes 2= No |
| 73 | revidate | Enter the date that the form was modified. | Date type |
| 74 | revintd | Enter your staff id number. | 100 .. 997 |
| 75 | anydev | Are there any protocol deviations or missing data items to enter? | 1= Yes 2= No |
| 76 | numdev | How many total protocol deviations and tests with missing items to enter? | 1 .. 20 |
| 77 | reas00 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 78 | test00 | Enter test or procedure. | String[15] |
| 79 | item00 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 80 | code00 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 81 | oth00 | Enter other code used. | String[20] |
| 82 | expl00 | Explain what happened | String[100] |
| 83 | reas01 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 84 | test01 | Enter test or procedure. | String[15] |
| 85 | item01 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 86 | code01 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 87 | oth01 | Enter other code used. | String[20] |
| 88 | expl01 | Explain what happened | String[100] |
| 89 | reas02 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 90 | test02 | Enter test or procedure. | String[15] |
| 91 | item02 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 92 | code02 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 93 | oth02 | Enter other code used. | String[20] |
| 94 | expl02 | Explain what happened | String[100] |
| 95 | reas03 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 96 | test03 | Enter test or procedure. | String[15] |
| 97 | item03 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 98 | code03 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 99 | oth03 | Enter other code used. | String[20] |
| 100 | expl03 | Explain what happened | String[100] |
| 101 | reas04 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 102 | test04 | Enter test or procedure. | String[15] |
| 103 | item04 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 104 | code04 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 105 | oth04 | Enter other code used. | String[20] |
| 106 | expl04 | Explain what happened | String[100] |
| 107 | reas05 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 108 | test05 | Enter test or procedure. | String[15] |
| 109 | item05 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 110 | code05 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 111 | oth05 | Enter other code used. | String[20] |
| 112 | expl05 | Explain what happened | String[100] |
| 113 | reas06 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 114 | test06 | Enter test or procedure. | String[15] |
| 115 | item06 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 116 | code06 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 117 | oth06 | Enter other code used. | String[20] |
| 118 | expl06 | Explain what happened | String[100] |
| 119 | reas07 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 120 | test07 | Enter test or procedure. | String[15] |
| 121 | item07 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 122 | code07 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 123 | oth07 | Enter other code used. | String[20] |
| 124 | expl07 | Explain what happened | String[100] |
| 125 | reas08 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 126 | test08 | Enter test or procedure. | String[15] |
| 127 | item08 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 128 | code08 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 129 | oth08 | Enter other code used. | String[20] |
| 130 | expl08 | Explain what happened | String[100] |
| 131 | reas09 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 132 | test09 | Enter test or procedure. | String[15] |
| 133 | item09 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 134 | code09 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 135 | oth09 | Enter other code used. | String[20] |
| 136 | expl09 | Explain what happened | String[100] |
| 137 | reas10 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 138 | test10 | Enter test or procedure. | String[15] |
| 139 | item10 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 140 | code10 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 141 | oth10 | Enter other code used. | String[20] |
| 142 | expl10 | Explain what happened | String[100] |
| 143 | reas11 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 144 | test11 | Enter test or procedure. | String[15] |
| 145 | item11 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 146 | code11 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 147 | oth11 | Enter other code used. | String[20] |
| 148 | expl11 | Explain what happened | String[100] |
| 149 | reas12 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 150 | test12 | Enter test or procedure. | String[15] |
| 151 | item12 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 152 | code12 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 153 | oth12 | Enter other code used. | String[20] |
| 154 | expl12 | Explain what happened | String[100] |
| 155 | reas13 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 156 | test13 | Enter test or procedure. | String[15] |
| 157 | item13 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 158 | code13 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 159 | oth13 | Enter other code used. | String[20] |
| 160 | expl13 | Explain what happened | String[100] |
| 161 | reas14 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 162 | test14 | Enter test or procedure. | String[15] |
| 163 | item14 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 164 | code14 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 165 | oth14 | Enter other code used. | String[20] |
| 166 | expl14 | Explain what happened | String[100] |
| 167 | reas15 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 168 | test15 | Enter test or procedure. | String[15] |
| 169 | item15 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 170 | code15 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 171 | oth15 | Enter other code used. | String[20] |
| 172 | expl15 | Explain what happened | String[100] |
| 173 | reas16 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 174 | test16 | Enter test or procedure. | String[15] |
| 175 | item16 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 176 | code16 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 177 | oth16 | Enter other code used. | String[20] |
| 178 | expl16 | Explain what happened | String[100] |
| 179 | reas17 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 180 | test17 | Enter test or procedure. | String[15] |
| 181 | item17 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 182 | code17 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 183 | oth17 | Enter other code used. | String[20] |
| 184 | expl17 | Explain what happened | String[100] |
| 185 | reas18 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 186 | test18 | Enter test or procedure. | String[15] |
| 187 | item18 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 188 | code18 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 189 | oth18 | Enter other code used. | String[20] |
| 190 | expl18 | Explain what happened | String[100] |
| 191 | reas19 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 192 | test19 | Enter test or procedure. | String[15] |
| 193 | item19 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 194 | code19 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 195 | oth19 | Enter other code used. | String[20] |
| 196 | expl19 | Explain what happened | String[100] |