ID

17178

Beschreibung

Documentation part: Record 31 Baseline Phone Follow up The Cardiovascular Health Study (CHS) was initiated by the National Heart, Lung and Blood Institute (NHLBI) in 1987 to determine the risk factors for development and progression of cardiovascular disease (CVD) in older adults, with an emphasis on subclinical measures. The study recruited 5,888 adults aged 65 or older at entry in four U.S. communities and conducted extensive annual clinical exams between 1989-1999 along with semi-annual phone calls, events adjudication, and subsequent data analyses and publications. Additional data were collected by studies ancillary to CHS. With the exception of annual clinic visits, these activities are still ongoing. Data obtained from: https://chs-nhlbi.org/ Permission granted by: Erika Enright.

Link

https://chs-nhlbi.org/

Stichworte

  1. 30.08.16 30.08.16 -
Hochgeladen am

30. August 2016

DOI

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Baseline Phone Follow up Cardiovascular Health Study (CHS)

Baseline Phone Follow up Cardiovascular Health Study (CHS)

Surveillance telephone interview
Beschreibung

Surveillance telephone interview

1 Hello, this is [your name] from the Cardiovascular Health Study. May I speak with [participant]
Beschreibung

telephone interview response

Datentyp

text

Can you tell me when I should call for the interview?
Beschreibung

time call again

Datentyp

datetime

2 Did you receive our letter?
Beschreibung

participant received letter

Datentyp

boolean

Interview:
Beschreibung

interview started

Datentyp

text

Interview started time:
Beschreibung

interview time started

Datentyp

time

Alias
UMLS CUI [1,1]
C0021823
UMLS CUI [1,2]
C0040223
Reason:
Beschreibung

reason participant refused

Datentyp

text

Alias
UMLS CUI [1,1]
C1136454
UMLS CUI [1,2]
C0392360
Participant wants to reschedule interview:
Beschreibung

reschedule interview date time

Datentyp

datetime

4 Has the participant moved during the last six month?
Beschreibung

participant moved

Datentyp

integer

Alias
UMLS CUI [1,1]
C0679646
UMLS CUI [1,2]
C0560560
Did you move during the last month?
Beschreibung

participant moved last month

Datentyp

integer

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:
Beschreibung

general Health

Datentyp

text

Alias
UMLS CUI [1]
C0516984
6 How would you say your health compares to other persons of your age? Would you say your health is:
Beschreibung

health status compared

Datentyp

integer

Alias
UMLS CUI [1,1]
C0018759
UMLS CUI [1,2]
C0027362
7 How does your to when we saw you in [month]? Would you say your health is?
Beschreibung

health status previous visit

Datentyp

text

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?
Beschreibung

days in bed because of injury

Datentyp

integer

Maßeinheiten
  • days
Alias
UMLS CUI [1,1]
C0221423
UMLS CUI [1,2]
C0004910
UMLS CUI [1,3]
C0439228
days
9 What illness caused you to stay in bed?
Beschreibung

illness caused staying in bed

Datentyp

text

Alias
UMLS CUI [1,1]
C0221423
UMLS CUI [1,2]
C0425251
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
Beschreibung

heart failure

Datentyp

boolean

Alias
UMLS CUI [1]
C0018801
Physician:
Beschreibung

heart failure physician name

Datentyp

text

Alias
UMLS CUI [1]
C2826892
Physician address
Beschreibung

heart failure physician address

Datentyp

text

Alias
UMLS CUI [1,1]
C1442065
UMLS CUI [1,2]
C0031831
Phone
Beschreibung

heart failure physician phone number

Datentyp

text

Alias
UMLS CUI [1,1]
C1515258
UMLS CUI [1,2]
C1320929
Stroke or cerebrovascular accident
Beschreibung

stroke or cerebrovascular accident

Datentyp

boolean

Alias
UMLS CUI [1]
C0038454
Physician:
Beschreibung

stroke physician name

Datentyp

text

Alias
UMLS CUI [1]
C2826892
Physician address
Beschreibung

stroke physician address

Datentyp

text

Alias
UMLS CUI [1,1]
C1442065
UMLS CUI [1,2]
C0031831
Phone
Beschreibung

stroke physician phone number

Datentyp

text

Alias
UMLS CUI [1,1]
C1515258
UMLS CUI [1,2]
C1320929
Transient ischemic attack or TIA or silent stroke
Beschreibung

TIA

Datentyp

boolean

Alias
UMLS CUI [1]
C0007787
Physician:
Beschreibung

TIA physician name

Datentyp

text

Alias
UMLS CUI [1]
C2826892
Physician address
Beschreibung

TIA physician address

Datentyp

text

Alias
UMLS CUI [1,1]
C1442065
UMLS CUI [1,2]
C0031831
Phone
Beschreibung

TIA physician phone number

Datentyp

text

Alias
UMLS CUI [1,1]
C1515258
UMLS CUI [1,2]
C1320929
Myocardial infarction or heart attack
Beschreibung

myocardial infarction

Datentyp

boolean

Alias
UMLS CUI [1]
C0027051
Physician:
Beschreibung

myocardial infarction physician name

Datentyp

text

Alias
UMLS CUI [1]
C2826892
Physician address
Beschreibung

myocardial infarction physician address

Datentyp

text

Alias
UMLS CUI [1,1]
C1442065
UMLS CUI [1,2]
C0031831
Phone
Beschreibung

myocardial infarction physician phone number

Datentyp

text

Alias
UMLS CUI [1,1]
C1515258
UMLS CUI [1,2]
C1320929
Angina pectoris or chest pain due to heart disease
Beschreibung

angina pectoris

Datentyp

boolean

Alias
UMLS CUI [1]
C0002962
Physician:
Beschreibung

angina pectoris physician name

Datentyp

text

Alias
UMLS CUI [1]
C2826892
Physician address
Beschreibung

angina pectoris physician address

Datentyp

text

Alias
UMLS CUI [1,1]
C1442065
UMLS CUI [1,2]
C0031831
Phone
Beschreibung

angina pectoris physician phone number

Datentyp

text

Alias
UMLS CUI [1,1]
C1515258
UMLS CUI [1,2]
C1320929
Intermittent claudication or pain in your legs from a blockage of the arteries
Beschreibung

intermittent claudication

Datentyp

boolean

Alias
UMLS CUI [1]
C0021775
Physician:
Beschreibung

intermittent claudication physician name

Datentyp

text

Alias
UMLS CUI [1]
C2826892
Physician address
Beschreibung

intermittent claudication physician address

Datentyp

text

Alias
UMLS CUI [1,1]
C1442065
UMLS CUI [1,2]
C0031831
Phone
Beschreibung

intermittent claudication physician phone number

Datentyp

text

Alias
UMLS CUI [1,1]
C1515258
UMLS CUI [1,2]
C1320929
11 Have you stayed overnight as a patient in a hospital since we saw you in [month].
Beschreibung

hospitalization

Datentyp

boolean

Alias
UMLS CUI [1]
C0019993
13 Have you stayed overnight as a patient in a nursing home or rehabilitation center since [month]?
Beschreibung

stay in nursing home or rehab center

Datentyp

boolean

Alias
UMLS CUI [1]
C0019860
UMLS CUI [2]
C0034993
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]?
Beschreibung

retired or job loss

Datentyp

integer

Alias
UMLS CUI [1]
C0035345
UMLS CUI [2]
C0425083
When did this happen?
Beschreibung

when job loss

Datentyp

text

Was this job change, loss or retirement positive or negative?
Beschreibung

job loss or retirement effect

Datentyp

text

Alias
UMLS CUI [1,1]
C1280500
UMLS CUI [1,2]
C0035345
UMLS CUI [2,1]
C1280500
UMLS CUI [2,2]
C0425083
16 Have you had a grandchild born since we saw you in [month]?
Beschreibung

grandchild born

Datentyp

integer

Alias
UMLS CUI [1,1]
C0005615
UMLS CUI [1,2]
C0337548
17 Has caring for a sick or disabled relative become a significant problem for you since we saw you in [month]?
Beschreibung

caring for sick or disabled relative

Datentyp

integer

Alias
UMLS CUI [1]
C0850427
Has providing care become significantly harder than last month?
Beschreibung

providing care became harder

Datentyp

integer

Alias
UMLS CUI [1,1]
C0848945
UMLS CUI [1,2]
C1457868
18 Has there been a significant change in your personal finances since we saw you in [month]?
Beschreibung

change in personal finances

Datentyp

integer

Alias
UMLS CUI [1]
C0680123
When did this happen?
Beschreibung

time financial changes

Datentyp

text

Alias
UMLS CUI [1,1]
C0680123
UMLS CUI [1,2]
C0040223
Was this change positive or negative?
Beschreibung

financial change positive

Datentyp

integer

Alias
UMLS CUI [1,1]
C1280500
UMLS CUI [1,2]
C0680123
19 Did you or a very close friend or close family member have a serious accident or illness since we saw you in [month]?
Beschreibung

serious illness or accident of relative

Datentyp

integer

Alias
UMLS CUI [1]
C2169536
When did this accident or illness occur?
Beschreibung

illness of relative time

Datentyp

text

Alias
UMLS CUI [1,1]
C2169536
UMLS CUI [1,2]
C0040223
20 Have you, your spouse or partner, or a member of your immediate family been assaulted or robbed since we saw you in [month]?
Beschreibung

assault or robbery in family

Datentyp

integer

Alias
UMLS CUI [1,1]
C0004063
UMLS CUI [1,2]
C0086282
UMLS CUI [2,1]
C0680502
UMLS CUI [2,2]
C0086282
When did this assault or robbery happen?
Beschreibung

assault time

Datentyp

text

Alias
UMLS CUI [1,1]
C0004063
UMLS CUI [1,2]
C0040223
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]?
Beschreibung

change in important relationship

Datentyp

integer

Alias
UMLS CUI [1]
C2045651
When did this relationship worsen?
Beschreibung

change in relationship time

Datentyp

text

Alias
UMLS CUI [1,1]
C2045651
UMLS CUI [1,2]
C0040223
22 Did someone you were close to die since we saw you in [month]?
Beschreibung

death of close person

Datentyp

integer

Alias
UMLS CUI [1]
C0814602
When did this person die?
Beschreibung

death of close of person

Datentyp

integer

Alias
UMLS CUI [1,1]
C0814602
UMLS CUI [1,2]
C0040223
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?
Beschreibung

significant event

Datentyp

integer

Alias
UMLS CUI [1]
C0023670
What happened?
Beschreibung

significant event specify

Datentyp

text

Alias
UMLS CUI [1]
C0023670
Was it positive or negative?
Beschreibung

significant event positive

Datentyp

text

Alias
UMLS CUI [1,1]
C1280500
UMLS CUI [1,2]
C0023670
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.
Beschreibung

information still correct

Datentyp

boolean

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.
Beschreibung

information still correct

Datentyp

boolean

27 Do you plan to be out of the area 6 months from now?
Beschreibung

plan to go out of the area

Datentyp

boolean

Are you moving out of the area permanently or will you only be gone temporarily?
Beschreibung

move out of the area

Datentyp

text

Do you know what your new address and telephone number will be?
Beschreibung

new address known

Datentyp

boolean

Street:
Beschreibung

new address street

Datentyp

text

Alias
UMLS CUI [1]
C1301826
City
Beschreibung

new address city

Datentyp

text

Alias
UMLS CUI [1]
C0008848
State
Beschreibung

new address state

Datentyp

text

Alias
UMLS CUI [1]
C1442792
Telephone number
Beschreibung

new telephone number

Datentyp

text

Alias
UMLS CUI [1]
C1515258
Do you know which general area you will be moving to?
Beschreibung

general area

Datentyp

text

When will you return?
Beschreibung

time of return

Datentyp

text

Maßeinheiten
  • mo/yr
Alias
UMLS CUI [1,1]
C0579192
UMLS CUI [1,2]
C0040223
mo/yr
29 Time interview ended:
Beschreibung

time end of interview

Datentyp

time

Alias
UMLS CUI [1,1]
C0021822
30 May I please speak with [name]?
Beschreibung

If another participant at this telephone number is scheduled to be interviewed, ask:

Datentyp

text

Can you tell me when I should call [participant] to make the interview?
Beschreibung

date time interview another participant

Datentyp

datetime

Hospitalizatiuon
Beschreibung

Hospitalizatiuon

Name, city and state of the hospital
Beschreibung

hospital address

Datentyp

text

Alias
UMLS CUI [1,1]
C0019994
UMLS CUI [1,2]
C1442065
UMLS CUI [1,3]
C0008848
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.
Beschreibung

reason for hospitalization

Datentyp

text

Alias
UMLS CUI [1]
C1830395
Mo/Yr
Beschreibung

date hospitalization

Datentyp

text

Maßeinheiten
  • mo/yr
Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0019993
mo/yr
Nursing home admission
Beschreibung

Nursing home admission

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
Beschreibung

reason for nursing home admission

Datentyp

text

Alias
UMLS CUI [1]
C1830397
Name, city and state of nursing home
Beschreibung

address nursing home

Datentyp

text

Alias
UMLS CUI [1,1]
C0028688
UMLS CUI [1,2]
C1442065
Mo/Yr
Beschreibung

date nursing home admission

Datentyp

text

Maßeinheiten
  • mo/yr
Alias
UMLS CUI [1,1]
C0028688
UMLS CUI [1,2]
C0011008
mo/yr

Ähnliche Modelle

Baseline Phone Follow up Cardiovascular Health Study (CHS)

Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Surveillance telephone interview
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
Item
Interview:
text
Code List
Interview:
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
good? (good?)
CL Item
fair? (fair?)
CL Item
poor? (poor?)
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?
CL Item
yes (1)
CL Item
no (0)
CL Item
unknown (9)
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
good? (good?)
CL Item
fair? (fair?)
CL Item
poor? (poor?)
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)
CL Item
Don´t know (9)
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
better (better)
CL Item
about the same (about the same)
CL Item
worse (worse)
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
stroke (stroke)
CL Item
mental illness (mental illness)
CL Item
cold or flu (cold or flu)
CL Item
cancer (cancer)
CL Item
injury (injury)
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
other (other)
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]?
CL Item
yes (1)
CL Item
no (0)
CL Item
unknown (9)
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
pos (pos)
CL Item
neg (neg)
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]?
CL Item
yes (1)
CL Item
no (0)
CL Item
unknown (9)
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]?
CL Item
yes (1)
CL Item
no (0)
CL Item
unknown (9)
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?
CL Item
yes (1)
CL Item
no (0)
CL Item
unknown (9)
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]?
CL Item
yes (1)
CL Item
no (0)
CL Item
unknown (9)
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
pos (pos)
CL Item
neg (neg)
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]?
CL Item
yes (1)
CL Item
no (0)
CL Item
unknown (9)
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]?
CL Item
no (0)
CL Item
yes (1)
CL Item
unknown (9)
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]?
CL Item
yes (1)
CL Item
no (0)
CL Item
unknown (9)
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]?
CL Item
yes (1)
CL Item
no (0)
CL Item
unknown (9)
Item
When did this person die?
integer
C0814602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Code List
When did this person die?
CL Item
no (0)
CL Item
yes (1)
CL Item
unknown (9)
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?
CL Item
yes (1)
CL Item
no (0)
CL Item
unknown (9)
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
pos (pos)
CL Item
neg (neg)
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]?
CL Item
Not in (Not in)
date time interview another participant
Item
Can you tell me when I should call [participant] to make the interview?
datetime
Item Group
Hospitalizatiuon
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])
Item Group
Nursing home admission
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])

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