Item
1 Hello, this is [your name] from the Cardiovascular Health Study. May I speak with [participant]
text
Code List
1 Hello, this is [your name] from the Cardiovascular Health Study. May I speak with [participant]
CL Item
participant answers (participant answers)
CL Item
participant not in (participant not in)
CL Item
participant deceased (participant deceased)
time call again
Item
Can you tell me when I should call for the interview?
datetime
participant received letter
Item
2 Did you receive our letter?
boolean
CL Item
interview started (interview started)
CL Item
participant refuses interview (participant refuses interview)
CL Item
participant wants to reschedule interview (participant wants to reschedule interview)
interview time started
Item
Interview started time:
time
C0021823 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
reason participant refused
Item
Reason:
text
C1136454 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
reschedule interview date time
Item
Participant wants to reschedule interview:
datetime
Item
4 Has the participant moved during the last six month?
integer
C0679646 (UMLS CUI [1,1])
C0560560 (UMLS CUI [1,2])
Code List
4 Has the participant moved during the last six month?
CL Item
excellent? (excellent?)
CL Item
very good? (very good?)
CL Item
refused/don't know (refused/don't know)
Item
Did you move during the last month?
integer
Code List
Did you move during the last month?
Item
5 I would like to ask you some questions that we also asked you 6 months ago. The reason for asking them again is that we are interested in possible changes that might have occurred. Would you say, in general, your health is:
text
C0516984 (UMLS CUI [1])
Code List
5 I would like to ask you some questions that we also asked you 6 months ago. The reason for asking them again is that we are interested in possible changes that might have occurred. Would you say, in general, your health is:
CL Item
excellent? (excellent?)
CL Item
very good? (very good?)
CL Item
refused/don't know (refused/don't know)
Item
6 How would you say your health compares to other persons of your age? Would you say your health is:
integer
C0018759 (UMLS CUI [1,1])
C0027362 (UMLS CUI [1,2])
Code List
6 How would you say your health compares to other persons of your age? Would you say your health is:
CL Item
Better than others of your age? (1)
CL Item
About the same as others your age? (2)
CL Item
Worse than others your age? (3)
Item
7 How does your to when we saw you in [month]? Would you say your health is?
text
Code List
7 How does your to when we saw you in [month]? Would you say your health is?
CL Item
about the same (about the same)
CL Item
don't know (don't know)
days in bed because of injury
Item
8 During the past two weeks, how many days have you stayed in bed all or most of the day because of illness or injury? Do not include past days in a hospital or nursing home?
integer
C0221423 (UMLS CUI [1,1])
C0004910 (UMLS CUI [1,2])
C0439228 (UMLS CUI [1,3])
Item
9 What illness caused you to stay in bed?
text
C0221423 (UMLS CUI [1,1])
C0425251 (UMLS CUI [1,2])
Code List
9 What illness caused you to stay in bed?
CL Item
heart attack/heart failure (heart attack/heart failure)
CL Item
diabetes (diabetes)
CL Item
arthritis (arthritis)
CL Item
mental illness (mental illness)
CL Item
cold or flu (cold or flu)
CL Item
general fatique or weakness (incl. old age) (general fatique or weakness (incl. old age))
CL Item
lung disease or emphysema, bronchitis (lung disease or emphysema, bronchitis)
CL Item
don't know (don't know)
heart failure
Item
10 Now I would like to find out if you had any major changes in your health since we saw you in [month]. Have you been told by a physician that you had: HEART FAILURE OR CONGESTIVE HEART FAILURE
boolean
C0018801 (UMLS CUI [1])
heart failure physician name
Item
Physician:
text
C2826892 (UMLS CUI [1])
heart failure physician address
Item
Physician address
text
C1442065 (UMLS CUI [1,1])
C0031831 (UMLS CUI [1,2])
heart failure physician phone number
Item
Phone
text
C1515258 (UMLS CUI [1,1])
C1320929 (UMLS CUI [1,2])
stroke or cerebrovascular accident
Item
Stroke or cerebrovascular accident
boolean
C0038454 (UMLS CUI [1])
stroke physician name
Item
Physician:
text
C2826892 (UMLS CUI [1])
stroke physician address
Item
Physician address
text
C1442065 (UMLS CUI [1,1])
C0031831 (UMLS CUI [1,2])
stroke physician phone number
Item
Phone
text
C1515258 (UMLS CUI [1,1])
C1320929 (UMLS CUI [1,2])
TIA
Item
Transient ischemic attack or TIA or silent stroke
boolean
C0007787 (UMLS CUI [1])
TIA physician name
Item
Physician:
text
C2826892 (UMLS CUI [1])
TIA physician address
Item
Physician address
text
C1442065 (UMLS CUI [1,1])
C0031831 (UMLS CUI [1,2])
TIA physician phone number
Item
Phone
text
C1515258 (UMLS CUI [1,1])
C1320929 (UMLS CUI [1,2])
myocardial infarction
Item
Myocardial infarction or heart attack
boolean
C0027051 (UMLS CUI [1])
myocardial infarction physician name
Item
Physician:
text
C2826892 (UMLS CUI [1])
myocardial infarction physician address
Item
Physician address
text
C1442065 (UMLS CUI [1,1])
C0031831 (UMLS CUI [1,2])
myocardial infarction physician phone number
Item
Phone
text
C1515258 (UMLS CUI [1,1])
C1320929 (UMLS CUI [1,2])
angina pectoris
Item
Angina pectoris or chest pain due to heart disease
boolean
C0002962 (UMLS CUI [1])
angina pectoris physician name
Item
Physician:
text
C2826892 (UMLS CUI [1])
angina pectoris physician address
Item
Physician address
text
C1442065 (UMLS CUI [1,1])
C0031831 (UMLS CUI [1,2])
angina pectoris physician phone number
Item
Phone
text
C1515258 (UMLS CUI [1,1])
C1320929 (UMLS CUI [1,2])
intermittent claudication
Item
Intermittent claudication or pain in your legs from a blockage of the arteries
boolean
C0021775 (UMLS CUI [1])
intermittent claudication physician name
Item
Physician:
text
C2826892 (UMLS CUI [1])
intermittent claudication physician address
Item
Physician address
text
C1442065 (UMLS CUI [1,1])
C0031831 (UMLS CUI [1,2])
intermittent claudication physician phone number
Item
Phone
text
C1515258 (UMLS CUI [1,1])
C1320929 (UMLS CUI [1,2])
hospitalization
Item
11 Have you stayed overnight as a patient in a hospital since we saw you in [month].
boolean
C0019993 (UMLS CUI [1])
stay in nursing home or rehab center
Item
13 Have you stayed overnight as a patient in a nursing home or rehabilitation center since [month]?
boolean
C0019860 (UMLS CUI [1])
C0034993 (UMLS CUI [2])
Item
15 I am now going to ask you about a number of events that commonly happen in peoples's lives and tha can affect your health. In some cases, I will ask whether the event has happened to you or a member of your familiy during the past 6 months. In other cases, I will ask only whether it happened to you. When I ask a question about your spouse, I am referring to both married spouses and unmarried partners who live together. Please respond YES if the event happened and NO if it didn't. Have you retired or changed or lost your job since we saw you in [month]?
integer
C0035345 (UMLS CUI [1])
C0425083 (UMLS CUI [2])
Code List
15 I am now going to ask you about a number of events that commonly happen in peoples's lives and tha can affect your health. In some cases, I will ask whether the event has happened to you or a member of your familiy during the past 6 months. In other cases, I will ask only whether it happened to you. When I ask a question about your spouse, I am referring to both married spouses and unmarried partners who live together. Please respond YES if the event happened and NO if it didn't. Have you retired or changed or lost your job since we saw you in [month]?
Item
When did this happen?
text
Code List
When did this happen?
CL Item
during last month (during last month)
CL Item
not during the last month (not during the last month)
CL Item
don't know (don't know)
Item
Was this job change, loss or retirement positive or negative?
text
C1280500 (UMLS CUI [1,1])
C0035345 (UMLS CUI [1,2])
C1280500 (UMLS CUI [2,1])
C0425083 (UMLS CUI [2,2])
Code List
Was this job change, loss or retirement positive or negative?
CL Item
don't know (don't know)
Item
16 Have you had a grandchild born since we saw you in [month]?
integer
C0005615 (UMLS CUI [1,1])
C0337548 (UMLS CUI [1,2])
Code List
16 Have you had a grandchild born since we saw you in [month]?
Item
17 Has caring for a sick or disabled relative become a significant problem for you since we saw you in [month]?
integer
C0850427 (UMLS CUI [1])
Code List
17 Has caring for a sick or disabled relative become a significant problem for you since we saw you in [month]?
Item
Has providing care become significantly harder than last month?
integer
C0848945 (UMLS CUI [1,1])
C1457868 (UMLS CUI [1,2])
Code List
Has providing care become significantly harder than last month?
Item
18 Has there been a significant change in your personal finances since we saw you in [month]?
integer
C0680123 (UMLS CUI [1])
Code List
18 Has there been a significant change in your personal finances since we saw you in [month]?
Item
When did this happen?
text
C0680123 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Code List
When did this happen?
CL Item
during last month (during last month)
CL Item
not during the last month (not during the last month)
CL Item
don't know (don't know)
Item
Was this change positive or negative?
integer
C1280500 (UMLS CUI [1,1])
C0680123 (UMLS CUI [1,2])
Code List
Was this change positive or negative?
CL Item
don't know (don't know)
Item
19 Did you or a very close friend or close family member have a serious accident or illness since we saw you in [month]?
integer
C2169536 (UMLS CUI [1])
Code List
19 Did you or a very close friend or close family member have a serious accident or illness since we saw you in [month]?
Item
When did this accident or illness occur?
text
C2169536 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Code List
When did this accident or illness occur?
CL Item
during last month (during last month)
CL Item
not during the last month (not during the last month)
CL Item
don't know (don't know)
Item
20 Have you, your spouse or partner, or a member of your immediate family been assaulted or robbed since we saw you in [month]?
integer
C0004063 (UMLS CUI [1,1])
C0086282 (UMLS CUI [1,2])
C0680502 (UMLS CUI [2,1])
C0086282 (UMLS CUI [2,2])
Code List
20 Have you, your spouse or partner, or a member of your immediate family been assaulted or robbed since we saw you in [month]?
Item
When did this assault or robbery happen?
text
C0004063 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Code List
When did this assault or robbery happen?
CL Item
during last month (during last month)
CL Item
not during the last month (not during the last month)
CL Item
don't know (don't know)
Item
21 Have you had any important relationship, for example with your spouse or a good friend, become significantly worse since we saw you in [month]?
integer
C2045651 (UMLS CUI [1])
Code List
21 Have you had any important relationship, for example with your spouse or a good friend, become significantly worse since we saw you in [month]?
Item
When did this relationship worsen?
text
C2045651 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Code List
When did this relationship worsen?
CL Item
during last month (during last month)
CL Item
not during the last month (not during the last month)
CL Item
don't know (don't know)
Item
22 Did someone you were close to die since we saw you in [month]?
integer
C0814602 (UMLS CUI [1])
Code List
22 Did someone you were close to die since we saw you in [month]?
Item
When did this person die?
integer
C0814602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Code List
When did this person die?
Item
23 Have any other important things happened to you or your spouse or partner since [month] that made this period significantly different from the previous six months?
integer
C0023670 (UMLS CUI [1])
Code List
23 Have any other important things happened to you or your spouse or partner since [month] that made this period significantly different from the previous six months?
significant event specify
Item
What happened?
text
C0023670 (UMLS CUI [1])
Item
Was it positive or negative?
text
C1280500 (UMLS CUI [1,1])
C0023670 (UMLS CUI [1,2])
Code List
Was it positive or negative?
CL Item
don't know (don't know)
information still correct
Item
25 You previously provided us with information about someone who could provide information and answer questions for you in the event that you were unable to answer yourself. Please tell me if the information I have is still correct.
boolean
information still correct
Item
26 You previously provided us with information about friends or relatives who you are likely to keep in touch with, but who do not live with you, and who are not planning to move anytime soon. Please tell me if the information I have is still correct.
boolean
plan to go out of the area
Item
27 Do you plan to be out of the area 6 months from now?
boolean
Item
Are you moving out of the area permanently or will you only be gone temporarily?
text
Code List
Are you moving out of the area permanently or will you only be gone temporarily?
CL Item
permanently (permanently)
CL Item
temporarily out of the area (vacation, business, etc.) (temporarily out of the area (vacation, business, etc.))
new address known
Item
Do you know what your new address and telephone number will be?
boolean
new address street
Item
Street:
text
C1301826 (UMLS CUI [1])
new address city
Item
City
text
C0008848 (UMLS CUI [1])
new address state
Item
State
text
C1442792 (UMLS CUI [1])
new telephone number
Item
Telephone number
text
C1515258 (UMLS CUI [1])
general area
Item
Do you know which general area you will be moving to?
text
time of return
Item
When will you return?
text
C0579192 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
time end of interview
Item
29 Time interview ended:
time
C0021822 (UMLS CUI [1,1])
Item
30 May I please speak with [name]?
text
Code List
30 May I please speak with [name]?
date time interview another participant
Item
Can you tell me when I should call [participant] to make the interview?
datetime
hospital address
Item
Name, city and state of the hospital
text
C0019994 (UMLS CUI [1,1])
C1442065 (UMLS CUI [1,2])
C0008848 (UMLS CUI [1,3])
reason for hospitalization
Item
12 Please tell me the reason you were admitted, the name and location of the hospital, and the month and year you were a patient for each time you stayed overnight in a hospital.
text
C1830395 (UMLS CUI [1])
date hospitalization
Item
Mo/Yr
text
C0011008 (UMLS CUI [1,1])
C0019993 (UMLS CUI [1,2])
reason for nursing home admission
Item
14 Please tell me the reason you were admitted, the name and location of the nursing home, and the month and year you were a patient for each time you stayed overnight in a nursing home or rehabilitation center. Reason for nursing home admission
text
C1830397 (UMLS CUI [1])
address nursing home
Item
Name, city and state of nursing home
text
C0028688 (UMLS CUI [1,1])
C1442065 (UMLS CUI [1,2])
date nursing home admission
Item
Mo/Yr
text
C0028688 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])