Item
1 Would you say, in general, your health is:
integer
C0516984 (UMLS CUI [1])
Code List
1 Would you say, in general, your health is:
Item
2 Would you say your health compares to other persons your age?
integer
C0018759 (UMLS CUI [1,1])
C0027362 (UMLS CUI [1,2])
Code List
2 Would you say your health compares to other persons your age?
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)
days in bed because of injury
Item
3 During the past two weeks, how many days have you stayed in bed all or most of the day because of illness or injury?
integer
C0221423 (UMLS CUI [1,1])
C0004910 (UMLS CUI [1,2])
C0439228 (UMLS CUI [1,3])
Item
11 Have you stayed overnight as a patient in a nursing home or rehabilitation center since we spoke to you on the phone about six months ago?
integer
C0028688 (UMLS CUI [1])
C0034993 (UMLS CUI [2])
Code List
11 Have you stayed overnight as a patient in a nursing home or rehabilitation center since we spoke to you on the phone about six months ago?
reason for admission nursing home
Item
A. If you answered YES, record the reason you were admitted, the name of the hospital, and the month and year you were a patient for EACH time you stayed overnight in a nursing home or rehabilitation center. (Use another sheet of paper to list additional admissions.) Reason for admission:
text
C0028688 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
C0809949 (UMLS CUI [1,3])
C0034993 (UMLS CUI [2,1])
C0392360 (UMLS CUI [2,2])
C0809949 (UMLS CUI [2,3])
hospital name
Item
Hospital name:
text
C0019994 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
city
Item
City:
text
C0008848 (UMLS CUI [1])
date of hospitalization
Item
Date of hospitalization:
date
C0019993 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
length of stay
Item
text
C0023303 (UMLS CUI [1])
Item
B. Are you currently staying in a nursing home?
integer
C0028688 (UMLS CUI [1,1])
C0521116 (UMLS CUI [1,2])
Code List
B. Are you currently staying in a nursing home?
Item
12 Have you had pneumonia since we saw you last year?
integer
C0032285 (UMLS CUI [1])
Code List
12 Have you had pneumonia since we saw you last year?
Item
13 Have you had an attack of bronchitis since we saw you last year?
integer
C0006277 (UMLS CUI [1])
Code List
13 Have you had an attack of bronchitis since we saw you last year?
Item
A. Was it confirmed by a doctor?
integer
C0006277 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
Code List
A. Was it confirmed by a doctor?
Item
14 Has a doctor ever told you that you had any of the following conditions or diseases; and if so, when were you FIRST told that you had the condition? A. High blood pressure
integer
C0020538 (UMLS CUI [1])
Code List
14 Has a doctor ever told you that you had any of the following conditions or diseases; and if so, when were you FIRST told that you had the condition? A. High blood pressure
CL Item
First told during the past year (2)
CL Item
First told more than one year ago (3)
Item
14 Has a doctor ever told you that you had any of the following conditions or diseases; and if so, when were you FIRST told that you had the condition? B. Diabetes
integer
C0011849 (UMLS CUI [1])
Code List
14 Has a doctor ever told you that you had any of the following conditions or diseases; and if so, when were you FIRST told that you had the condition? B. Diabetes
CL Item
First told during the past year (2)
CL Item
First told more than one year ago (3)
Item
14 Has a doctor ever told you that you had any of the following conditions or diseases; and if so, when were you FIRST told that you had the condition? C. Atrial Fibrillation
integer
C0004238 (UMLS CUI [1])
Code List
14 Has a doctor ever told you that you had any of the following conditions or diseases; and if so, when were you FIRST told that you had the condition? C. Atrial Fibrillation
CL Item
First told during the past year (2)
CL Item
First told more than one year ago (3)
Item
14 Has a doctor ever told you that you had any of the following conditions or diseases; and if so, when were you FIRST told that you had the condition? D. Deep vein thrombosis (or blood clots in your legs)
integer
C0149871 (UMLS CUI [1])
Code List
14 Has a doctor ever told you that you had any of the following conditions or diseases; and if so, when were you FIRST told that you had the condition? D. Deep vein thrombosis (or blood clots in your legs)
CL Item
First told during the past year (2)
CL Item
First told more than one year ago (3)
Item
14 Has a doctor ever told you that you had any of the following conditions or diseases; and if so, when were you FIRST told that you had the condition? E. Rheumatic fever or heart valve problems
integer
C3536892 (UMLS CUI [1])
Code List
14 Has a doctor ever told you that you had any of the following conditions or diseases; and if so, when were you FIRST told that you had the condition? E. Rheumatic fever or heart valve problems
CL Item
First told during the past year (2)
CL Item
First told more than one year ago (3)
Item
15 Has a doctor ever told you that you had other heart or circulatory problems since we saw you last year?
integer
C0007222 (UMLS CUI [1])
Code List
15 Has a doctor ever told you that you had other heart or circulatory problems since we saw you last year?
other heart problem
Item
Specify:
text
C0795691 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Item
16 Are you currently taking medication prescribed by a doctor for any of the following conditions? A. High blood pressure
integer
C0013227 (UMLS CUI [1,1])
C0020538 (UMLS CUI [1,2])
Code List
16 Are you currently taking medication prescribed by a doctor for any of the following conditions? A. High blood pressure
Item
16 Are you currently taking medication prescribed by a doctor for any of the following conditions? B. Diabetes
integer
C0013227 (UMLS CUI [1,1])
C0011849 (UMLS CUI [1,2])
Code List
16 Are you currently taking medication prescribed by a doctor for any of the following conditions? B. Diabetes
Item
16 Are you currently taking medication prescribed by a doctor for any of the following conditions? C. Atrial Fibrillation
integer
C0013227 (UMLS CUI [1,1])
C0004238 (UMLS CUI [1,2])
Code List
16 Are you currently taking medication prescribed by a doctor for any of the following conditions? C. Atrial Fibrillation
Item
16 Are you currently taking medication prescribed by a doctor for any of the following conditions? D. Deep vein thrombosis (or blood clots in your legs)
integer
C0013227 (UMLS CUI [1,1])
C0149871 (UMLS CUI [1,2])
Code List
16 Are you currently taking medication prescribed by a doctor for any of the following conditions? D. Deep vein thrombosis (or blood clots in your legs)
Item
17 Have you had coronary angiography or heart catheterization as an out patient procedure since we saw you last year?
integer
C0085532 (UMLS CUI [1])
C0018795 (UMLS CUI [2])
Code List
17 Have you had coronary angiography or heart catheterization as an out patient procedure since we saw you last year?
pain in chest
Item
18 Have you ever had any pain or discomfort in your chest?
boolean
C0008031 (UMLS CUI [1])
Item
A. Do you feel pain when you walk uphill or hurry?
integer
C0008031 (UMLS CUI [1,1])
C3842654 (UMLS CUI [1,2])
Code List
A. Do you feel pain when you walk uphill or hurry?
CL Item
never walk uphill or hurry (9)
chest pain walking
Item
B. Do you feel the pain when you walk at an ordinary pace or level?
boolean
C0008031 (UMLS CUI [1,1])
C0080331 (UMLS CUI [1,2])
Item
C. What do you do if you feel it while you are walking?
integer
C0008031 (UMLS CUI [1])
Code List
C. What do you do if you feel it while you are walking?
CL Item
stop or slow down, or continue at same pace after taking nitroglycerine (1)
CL Item
continue at same pace (2)
Item
D. If you stand still, what happens to the pain?
integer
C0008031 (UMLS CUI [1,1])
C0035253 (UMLS CUI [1,2])
Code List
D. If you stand still, what happens to the pain?
CL Item
relieved in 10 minutes or less (1)
CL Item
takes longer than 10 minutes to be relieved (2)
Item
E. Where do you get this pain or discomfort?
text
C0008031 (UMLS CUI [1,1])
C0475264 (UMLS CUI [1,2])
Code List
E. Where do you get this pain or discomfort?
chest pain localization other
Item
Other, specify:
text
C0008031 (UMLS CUI [1,1])
C0475264 (UMLS CUI [1,2])
chest pain past two weeks
Item
F. Have you had this pain in the past two weeks?
boolean
C0008031 (UMLS CUI [1,1])
C0332185 (UMLS CUI [1,2])
chest pain frequency
Item
If yes, how many times in the past two weeks have you had this pain?
integer
C0008031 (UMLS CUI [1,1])
C0332185 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
worsening chest pain
Item
G. Has there been an increase in the frequency or severity in the past two weeks?
boolean
C0332271 (UMLS CUI [1,1])
C0008031 (UMLS CUI [1,2])
C0332185 (UMLS CUI [1,3])
chest pain seen by doctor
Item
H. Have you seen a doctor about this pain?
boolean
C0008031 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
severe chest pain
Item
I. Have you ever had a severe pain accross the front of your chest lasting for half an hour or more?
boolean
C0008031 (UMLS CUI [1,1])
C0205082 (UMLS CUI [1,2])
severe chest pain seen by doctor
Item
J. Did you see a doctor because of this pain?
boolean
C0008031 (UMLS CUI [1,1])
C0205082 (UMLS CUI [1,2])
C0583527 (UMLS CUI [1,3])
Item
K. If you saw a doctor, what did your doctor say it was?
integer
C0011900 (UMLS CUI [1])
Code List
K. If you saw a doctor, what did your doctor say it was?
other diagnosis
Item
K. If you saw a doctor, what did your doctor say it was?
text
C0011900 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Item
19 Have you had to sleep on 2 or more pillows to help you breathe since we saw you last year?
integer
C0182291 (UMLS CUI [1,1])
C0443302 (UMLS CUI [1,2])
Code List
19 Have you had to sleep on 2 or more pillows to help you breathe since we saw you last year?
Item
20 Have you been awakened at night by trouble breathing since we saw you last year?
integer
C3641913 (UMLS CUI [1,1])
C0240526 (UMLS CUI [1,2])
Code List
20 Have you been awakened at night by trouble breathing since we saw you last year?
Item
21 Do you get short of breath... A. While resting in a chair?
integer
C0013404 (UMLS CUI [1,1])
C0035253 (UMLS CUI [1,2])
C0179847 (UMLS CUI [1,3])
Code List
21 Do you get short of breath... A. While resting in a chair?
CL Item
never do this activity (2)
Item
21 Do you get short of breath... B. When walking on level ground?
integer
C0013404 (UMLS CUI [1,1])
C0080331 (UMLS CUI [1,2])
Code List
21 Do you get short of breath... B. When walking on level ground?
CL Item
never do this activity (2)
Item
21 Do you get short of breath... C. When walking quickly or uphill?
integer
C0013404 (UMLS CUI [1,1])
C3842654 (UMLS CUI [1,2])
Code List
21 Do you get short of breath... C. When walking quickly or uphill?
CL Item
never do this activity (2)
Item
21 Do you get short of breath... D. With light physical activity, such as walking down a flight of stairs, dressing or showering without stopping, cleaning windows, stripping and making the bed, mopping floors, hanging washed clothes, pushing a power lawn mower, bowling, or playing golf (walk and carry clubs)
integer
C0013404 (UMLS CUI [1,1])
C1517883 (UMLS CUI [1,2])
Code List
21 Do you get short of breath... D. With light physical activity, such as walking down a flight of stairs, dressing or showering without stopping, cleaning windows, stripping and making the bed, mopping floors, hanging washed clothes, pushing a power lawn mower, bowling, or playing golf (walk and carry clubs)
CL Item
never do this activity (2)
Item
21 Do you get short of breath... E. With moderate physical activity, such as carrying anything up a flight of stairs without stopping, dancing a foxtrot, gardening, raking, weeding, having sexual intercourse, or walking 4 miles an hour over level ground?
integer
C0013404 (UMLS CUI [1,1])
C0026606 (UMLS CUI [1,2])
C0205081 (UMLS CUI [1,3])
Code List
21 Do you get short of breath... E. With moderate physical activity, such as carrying anything up a flight of stairs without stopping, dancing a foxtrot, gardening, raking, weeding, having sexual intercourse, or walking 4 miles an hour over level ground?
CL Item
never do this activity (2)
Item
21 Do you get short of breath... F. With strenuous physical activity, such as doing outdoor work (shoveling snow, spading soil), playing squash or handball, jogging or walking 5 miles an hour, or carrying objects that weigh at least 80 pounds?
integer
C0013404 (UMLS CUI [1,1])
C1514989 (UMLS CUI [1,2])
Code List
21 Do you get short of breath... F. With strenuous physical activity, such as doing outdoor work (shoveling snow, spading soil), playing squash or handball, jogging or walking 5 miles an hour, or carrying objects that weigh at least 80 pounds?
CL Item
never do this activity (2)
Item
22 Have you had swelling of your feet or ankles since we saw you last year?
integer
C0574002 (UMLS CUI [1])
C0235439 (UMLS CUI [2])
Code List
22 Have you had swelling of your feet or ankles since we saw you last year?
Item
A. Did it tend to come on during the day and do down overnight?
integer
C0574002 (UMLS CUI [1,1])
C0585022 (UMLS CUI [1,2])
C0235439 (UMLS CUI [2,1])
C0585022 (UMLS CUI [2,2])
Code List
A. Did it tend to come on during the day and do down overnight?
Item
23 Do you get pain in either leg when walking?
integer
C0023222 (UMLS CUI [1,1])
C0080331 (UMLS CUI [1,2])
Code List
23 Do you get pain in either leg when walking?
Item
A. Does this pain ever begin when you are standing still or standing?
integer
C0023222 (UMLS CUI [1,1])
C0231472 (UMLS CUI [1,2])
Code List
A. Does this pain ever begin when you are standing still or standing?
Item
B. Do you feel this pain in your calf or calves?
integer
C0236040 (UMLS CUI [1])
Code List
B. Do you feel this pain in your calf or calves?
Item
C. Do you feel it when you walk uphill or hurry?
integer
C0023222 (UMLS CUI [1,1])
C3842654 (UMLS CUI [1,2])
Code List
C. Do you feel it when you walk uphill or hurry?
CL Item
never walk uphill or hurry (9)
Item
D. Do you feel it when you walk at an ordinary pace on the level?
integer
C0023222 (UMLS CUI [1,1])
C0080331 (UMLS CUI [1,2])
Code List
D. Do you feel it when you walk at an ordinary pace on the level?
Item
E. Does this pain ever disappear while you are walking?
integer
C0023222 (UMLS CUI [1,1])
C0080331 (UMLS CUI [1,2])
C2746065 (UMLS CUI [1,3])
Code List
E. Does this pain ever disappear while you are walking?
Item
F. What do you do if you feel it while you are walking?
text
C3266814 (UMLS CUI [1,1])
C0023222 (UMLS CUI [1,2])
C0080331 (UMLS CUI [1,3])
Code List
F. What do you do if you feel it while you are walking?
CL Item
stop or slow down (stop or slow down)
CL Item
continue at same pace (continue at same pace)
Item
G. What happens to the pain if you stand still?
text
C0023222 (UMLS CUI [1,1])
C0231472 (UMLS CUI [1,2])
Code List
G. What happens to the pain if you stand still?
CL Item
relieved in 10 minutes or less (relieved in 10 minutes or less)
CL Item
takes longer than 10 minutes to be relieved (takes longer than 10 minutes to be relieved)
CL Item
not relieved (not relieved)
CL Item
don't know (don't know)
Item
24 Have you been told by a doctor that you currently have any of the following? A. Arthritis of hands
integer
C0409208 (UMLS CUI [1])
Code List
24 Have you been told by a doctor that you currently have any of the following? A. Arthritis of hands
Item
24 Have you been told by a doctor that you currently have any of the following? B. Arthritis of shoulder
integer
C1298682 (UMLS CUI [1])
Code List
24 Have you been told by a doctor that you currently have any of the following? B. Arthritis of shoulder
Item
24 Have you been told by a doctor that you currently have any of the following? C. Arthritis of hips or knees
integer
C0263776 (UMLS CUI [1])
C0240111 (UMLS CUI [2])
Code List
24 Have you been told by a doctor that you currently have any of the following? C. Arthritis of hips or knees
Item
24 Have you been told by a doctor that you currently have any of the following? D. Osteoporosis
integer
C0029456 (UMLS CUI [1])
Code List
24 Have you been told by a doctor that you currently have any of the following? D. Osteoporosis
Item
24 Have you been told by a doctor that you currently have any of the following? E. Liver disease, cirrhosis or hepatitis
integer
C0023895 (UMLS CUI [1])
C0023890 (UMLS CUI [2])
C0019158 (UMLS CUI [3])
Code List
24 Have you been told by a doctor that you currently have any of the following? E. Liver disease, cirrhosis or hepatitis
Item
24 Have you been told by a doctor that you currently have any of the following? F. Kidney (renal) disease or failure
integer
C0022658 (UMLS CUI [1])
C0035078 (UMLS CUI [2])
Code List
24 Have you been told by a doctor that you currently have any of the following? F. Kidney (renal) disease or failure
Item
25 During the last year, have you had pain in any bones or joints for at least half the days of a month?
integer
C0151825 (UMLS CUI [1])
C0003862 (UMLS CUI [2])
Code List
25 During the last year, have you had pain in any bones or joints for at least half the days of a month?
Item
Please indicate where you had this pain: A. Hands
integer
C0151825 (UMLS CUI [1,1])
C0018563 (UMLS CUI [1,2])
C0003862 (UMLS CUI [2,1])
C0018563 (UMLS CUI [2,2])
Code List
Please indicate where you had this pain: A. Hands
Item
Please indicate where you had this pain: B. Feet
integer
C0151825 (UMLS CUI [1,1])
C0016504 (UMLS CUI [1,2])
C0003862 (UMLS CUI [2,1])
C0016504 (UMLS CUI [2,2])
Code List
Please indicate where you had this pain: B. Feet
Item
Please indicate where you had this pain: C. Knees
integer
C0151825 (UMLS CUI [1,1])
C0022742 (UMLS CUI [1,2])
C0003862 (UMLS CUI [2,1])
C0022742 (UMLS CUI [2,2])
Code List
Please indicate where you had this pain: C. Knees
Item
Please indicate where you had this pain: D. Hips
integer
C0151825 (UMLS CUI [1,1])
C0019552 (UMLS CUI [1,2])
C0003862 (UMLS CUI [2,1])
C0019552 (UMLS CUI [2,2])
Code List
Please indicate where you had this pain: D. Hips
Item
Please indicate where you had this pain: E. Neck
integer
C0151825 (UMLS CUI [1,1])
C0027530 (UMLS CUI [1,2])
C0003862 (UMLS CUI [2,1])
C0027530 (UMLS CUI [2,2])
Code List
Please indicate where you had this pain: E. Neck
Item
Please indicate where you had this pain: F. Back
integer
C0151825 (UMLS CUI [1,1])
C0004600 (UMLS CUI [1,2])
C0003862 (UMLS CUI [2,1])
C0004600 (UMLS CUI [2,2])
Code List
Please indicate where you had this pain: F. Back
Item
Please indicate where you had this pain: G. Shoulders
integer
C0151825 (UMLS CUI [1,1])
C0037004 (UMLS CUI [1,2])
C0003862 (UMLS CUI [2,1])
C0037004 (UMLS CUI [2,2])
Code List
Please indicate where you had this pain: G. Shoulders
Item
Please indicate where you had this pain: H. Other
integer
C0151825 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0003862 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
Code List
Please indicate where you had this pain: H. Other
other pain specify
Item
Please indicate where you had this pain: H. Other, specify:
text
C0151825 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0003862 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
cancer diagnosis
Item
26 Have you been told by a doctor that you currently have cancer?
integer
C0006826 (UMLS CUI [1])
Item
If you answered YES, please specify the kind of cancer(s): A. Breast cancer
integer
C0678222 (UMLS CUI [1])
Code List
If you answered YES, please specify the kind of cancer(s): A. Breast cancer
blood cancer
Item
If you answered YES, please specify the kind of cancer(s): B. Blood cancer, leukemia or lymphoma
integer
C0023418 (UMLS CUI [1])
C0024299 (UMLS CUI [2])
Item
If you answered YES, please specify the kind of cancer(s): C. Colon (bowel) or rectum cancer
integer
C0007102 (UMLS CUI [1])
C0007113 (UMLS CUI [2])
Code List
If you answered YES, please specify the kind of cancer(s): C. Colon (bowel) or rectum cancer
Item
If you answered YES, please specify the kind of cancer(s): D. Lung cancer
integer
C0242379 (UMLS CUI [1])
Code List
If you answered YES, please specify the kind of cancer(s): D. Lung cancer
Item
If you answered YES, please specify the kind of cancer(s): E. Malignant melanoma
integer
C0025202 (UMLS CUI [1])
Code List
If you answered YES, please specify the kind of cancer(s): E. Malignant melanoma
Item
If you answered YES, please specify the kind of cancer(s): F. Other skin cancer
integer
C0007114 (UMLS CUI [1])
Code List
If you answered YES, please specify the kind of cancer(s): F. Other skin cancer
Item
If you answered YES, please specify the kind of cancer(s): G. Prostate cancer
integer
C0600139 (UMLS CUI [1])
Code List
If you answered YES, please specify the kind of cancer(s): G. Prostate cancer
Item
If you answered YES, please specify the kind of cancer(s): H. Pancreatic cancer
integer
C0235974 (UMLS CUI [1])
Code List
If you answered YES, please specify the kind of cancer(s): H. Pancreatic cancer
Item
If you answered YES, please specify the kind of cancer(s): I. Esophageal cancer
integer
C0014859 (UMLS CUI [1])
Code List
If you answered YES, please specify the kind of cancer(s): I. Esophageal cancer
Item
If you answered YES, please specify the kind of cancer(s): J. Other cancer
integer
C1707251 (UMLS CUI [1])
Code List
If you answered YES, please specify the kind of cancer(s): J. Other cancer
other cancer specify
Item
If you answered YES, please specify the kind of cancer(s): J. Other cancer, specify:
text
C1707251 (UMLS CUI [1])
Item
27 Have you been treated by a doctor for any of the following since we saw you last year? A. Broken hip (fracture)
integer
C0019557 (UMLS CUI [1])
Code List
27 Have you been treated by a doctor for any of the following since we saw you last year? A. Broken hip (fracture)
Item
B. Broken lower leg (fracture)
integer
C1542178 (UMLS CUI [1])
Code List
B. Broken lower leg (fracture)
Item
C. Broken arm, wrist or shoulder (fracture)
integer
C0178316 (UMLS CUI [1])
C0435630 (UMLS CUI [2])
C0037006 (UMLS CUI [3])
Code List
C. Broken arm, wrist or shoulder (fracture)
Item
D. Spine (vertebral) compression fracture
integer
C0262431 (UMLS CUI [1])
Code List
D. Spine (vertebral) compression fracture
Item
E. Other injury
integer
Code List
E. Other injury
other injury specify
Item
Specify
text
Item
F. Did you have arthritis that was treated with medication?
integer
C0003864 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
Code List
F. Did you have arthritis that was treated with medication?
Item
28 During the last year, have you had any sudden spells of dizziness, loss of balance, or sensation of spinning?
integer
C0012833 (UMLS CUI [1])
C0241981 (UMLS CUI [2])
C0042571 (UMLS CUI [3])
Code List
28 During the last year, have you had any sudden spells of dizziness, loss of balance, or sensation of spinning?
Item
29 Have you ever accidentally lost control of your urine (wet yourself) more than one time in a month?
integer
C0042024 (UMLS CUI [1])
Code List
29 Have you ever accidentally lost control of your urine (wet yourself) more than one time in a month?
Item
30 Do you wake up to urinate more than three nights per week?
integer
C0085606 (UMLS CUI [1,1])
C0240526 (UMLS CUI [1,2])
Code List
30 Do you wake up to urinate more than three nights per week?
Item
31 During the last year, have you had a fall? )Do not include falls during skiing, skating or other activities that may affect balance.)
integer
C0085639 (UMLS CUI [1])
Code List
31 During the last year, have you had a fall? )Do not include falls during skiing, skating or other activities that may affect balance.)
times fallen
Item
A. How many times have you fallen during the last year?
integer
C0085639 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
Item
32 During the last year, have you gained or lost more than 10 pounds?
integer
C0005911 (UMLS CUI [1])
Code List
32 During the last year, have you gained or lost more than 10 pounds?
CL Item
lost more than 10 pounds (1)
CL Item
gained more than 10 pounds (2)
CL Item
both lost and gained more than 10 pounds (3)
Item
A. Was diet for the purpose of losing or gaining weight a major factor in your weight change?
integer
C0012155 (UMLS CUI [1,1])
C0005911 (UMLS CUI [1,2])
Code List
A. Was diet for the purpose of losing or gaining weight a major factor in your weight change?
Item
B. Was surgery, illness or medication a major factor in your weight change?
integer
C0221423 (UMLS CUI [1,1])
C0005911 (UMLS CUI [1,2])
Code List
B. Was surgery, illness or medication a major factor in your weight change?
Item
C. Was exercise a major factor in your weight change?
integer
C0015259 (UMLS CUI [1,1])
C0005911 (UMLS CUI [1,2])
Code List
C. Was exercise a major factor in your weight change?
Item
33 How would you compare your TOTAL average daily intake of food this year to your intake when we saw you last year?
integer
C2164132 (UMLS CUI [1,1])
C1707455 (UMLS CUI [1,2])
Code List
33 How would you compare your TOTAL average daily intake of food this year to your intake when we saw you last year?
CL Item
eat a lot more (1)
CL Item
eat a little more (2)
CL Item
eat about the same (3)
CL Item
eat a little less (4)
CL Item
eat a lot less (5)
Item
A. If you answered EAT A LOT MORE or EAT A LITTLE MORE, the main reason is:
text
C0458244 (UMLS CUI [1,1])
C0442805 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
Code List
A. If you answered EAT A LOT MORE or EAT A LITTLE MORE, the main reason is:
CL Item
a doctor recommended that I eat more (a doctor recommended that I eat more)
CL Item
I am taking medicine that increases my appetite (I am taking medicine that increases my appetite)
CL Item
my physical activity has increased (my physical activity has increased)
CL Item
I am more able to shop or prepare food than before (I am more able to shop or prepare food than before)
CL Item
a medical or dental problem has been resolved (a medical or dental problem has been resolved)
CL Item
my appetite has increased for other reasons (my appetite has increased for other reasons)
other reason change intake
Item
Other:
text
C0458244 (UMLS CUI [1,1])
C0442805 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
Item
B. If you answered EAT A LOT LESS or EAT A LITTLE LESS, the main reason is:
text
C0458244 (UMLS CUI [1,1])
C0547047 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
Code List
B. If you answered EAT A LOT LESS or EAT A LITTLE LESS, the main reason is:
CL Item
a doctor recommended that I eat less (a doctor recommended that I eat less)
CL Item
I am taking medicine that decreases my appetite (I am taking medicine that decreases my appetite)
CL Item
my physical activity has decrease (my physical activity has decrease)
CL Item
I am less able to shop or prepare food than before (I am less able to shop or prepare food than before)
CL Item
a medical or dental problem interferes with eating (a medical or dental problem interferes with eating)
CL Item
my appetite has decreased for other reasons (my appetite has decreased for other reasons)
other reason intake less
Item
Other:
text
C0458244 (UMLS CUI [1,1])
C0547047 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
Item
34 Are you following a special diet?
integer
C3164710 (UMLS CUI [1])
Code List
34 Are you following a special diet?
Item
A. What is the purpose of the diet? To lose weight
integer
C0012167 (UMLS CUI [1])
Code List
A. What is the purpose of the diet? To lose weight
Item
A. What is the purpose of the diet? To gain weight
integer
C0043094 (UMLS CUI [1,1])
C3164710 (UMLS CUI [1,2])
Code List
A. What is the purpose of the diet? To gain weight
Item
A. What is the purpose of the diet? For diabetes
integer
C0011849 (UMLS CUI [1,1])
C3164710 (UMLS CUI [1,2])
Code List
A. What is the purpose of the diet? For diabetes
Item
A. What is the purpose of the diet? For kidney failure
integer
C0035078 (UMLS CUI [1,1])
C3164710 (UMLS CUI [1,2])
Code List
A. What is the purpose of the diet? For kidney failure
Item
A. What is the purpose of the diet? For ulcers
integer
C0041582 (UMLS CUI [1,1])
C3164710 (UMLS CUI [1,2])
Code List
A. What is the purpose of the diet? For ulcers
Item
A. What is the purpose of the diet? For diverticulitits
integer
C0156163 (UMLS CUI [1,1])
C3164710 (UMLS CUI [1,2])
Code List
A. What is the purpose of the diet? For diverticulitits
Item
A. What is the purpose of the diet? For allergies
integer
C0020517 (UMLS CUI [1,1])
C3164710 (UMLS CUI [1,2])
Code List
A. What is the purpose of the diet? For allergies
Item
A. What is the purpose of the diet? For heart trouble
integer
C0018799 (UMLS CUI [1,1])
C3164710 (UMLS CUI [1,2])
Code List
A. What is the purpose of the diet? For heart trouble
Item
A. What is the purpose of the diet? For high blood pressure
integer
C0020538 (UMLS CUI [1,1])
C3164710 (UMLS CUI [1,2])
Code List
A. What is the purpose of the diet? For high blood pressure
Item
A. What is the purpose of the diet? For other reason
integer
C3840932 (UMLS CUI [1,1])
C3164710 (UMLS CUI [1,2])
Code List
A. What is the purpose of the diet? For other reason
diet for other reasons
Item
Other:
text
C3840932 (UMLS CUI [1,1])
C3164710 (UMLS CUI [1,2])
Item
B. What kind of diet is it? Low calorie
integer
C2930544 (UMLS CUI [1])
Code List
B. What kind of diet is it? Low calorie
Item
B. What kind of diet is it? High calorie
integer
C0301590 (UMLS CUI [1])
Code List
B. What kind of diet is it? High calorie
Item
B. What kind of diet is it? High protein
integer
C0425403 (UMLS CUI [1])
Code List
B. What kind of diet is it? High protein
Item
B. What kind of diet is it? Low fat
integer
C0242970 (UMLS CUI [1])
Code List
B. What kind of diet is it? Low fat
Item
B. What kind of diet is it? High fat
integer
C0521974 (UMLS CUI [1])
Code List
B. What kind of diet is it? High fat
Item
B. What kind of diet is it? Low carbohydrate
integer
C0259836 (UMLS CUI [1])
Code List
B. What kind of diet is it? Low carbohydrate
Item
B. What kind of diet is it? High carbohydrate
integer
C0259835 (UMLS CUI [1])
Code List
B. What kind of diet is it? High carbohydrate
Item
B. What kind of diet is it? Low sugar
integer
C0452316 (UMLS CUI [1])
Code List
B. What kind of diet is it? Low sugar
Item
B. What kind of diet is it? Low salt
integer
C0012169 (UMLS CUI [1])
Code List
B. What kind of diet is it? Low salt
Item
B. What kind of diet is it? Low cholesterol
integer
C2243019 (UMLS CUI [1])
Code List
B. What kind of diet is it? Low cholesterol
Item
B. What kind of diet is it? Low fiber
integer
C0344356 (UMLS CUI [1])
Code List
B. What kind of diet is it? Low fiber
Item
B. What kind of diet is it? High fiber
integer
C0301568 (UMLS CUI [1])
Code List
B. What kind of diet is it? High fiber
Item
B. What kind of diet is it? Bland diet
integer
C0301572 (UMLS CUI [1])
Code List
B. What kind of diet is it? Bland diet
Item
B. What kind of diet is it? Other diet
integer
C0012155 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Code List
B. What kind of diet is it? Other diet
other diet specify
Item
Other:
text
C0012155 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
diet duration
Item
C. About how long have you been following this diet? YEARS
integer
C0012155 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
diet duration
Item
C. About how long have you been following this diet? MONTHS
integer
C0012155 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
Item
D. Was this diet recommended by your physician?
integer
C0012155 (UMLS CUI [1,1])
C0583555 (UMLS CUI [1,2])
Code List
D. Was this diet recommended by your physician?
Item
35 Have you gone off a special diet since we saw you last year?
integer
C0012155 (UMLS CUI [1,1])
C2746065 (UMLS CUI [1,2])
Code List
35 Have you gone off a special diet since we saw you last year?
Item
4 Has a doctor ever told you that you had a myocardial infarction or heart attack?
integer
C0027051 (UMLS CUI [1])
Code List
4 Has a doctor ever told you that you had a myocardial infarction or heart attack?
name doctor
Item
A. What was the doctor's name and city? Name
text
C0031831 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
doctor address
Item
A. What was the doctor's name and city? Address
text
C0031831 (UMLS CUI [1,1])
C1442065 (UMLS CUI [1,2])
doctor city
Item
A. What was the doctor's name and city? City
text
C0031831 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
doctor state
Item
A. What was the doctor's name and city? State
text
C0031831 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
date of diagnosis myocardial infarction
Item
B. Date of event or diagnosis:
date
C0027051 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
see doctor myocardial infarction
Item
C. How many times altogether did you see a doctor for this condition since we last spoke to you?
text
C0027051 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
Item
D. Were you in the hospital at least one night for this condition since we last spoke to you?
integer
C0019993 (UMLS CUI [1,1])
C0027051 (UMLS CUI [1,2])
Code List
D. Were you in the hospital at least one night for this condition since we last spoke to you?
hospitalization myocardial infarction
Item
E. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0027051 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
date of hospitalization
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Date of Hospitalization:
date
C0011008 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
C0809949 (UMLS CUI [1,3])
hospital name
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Hospital name
text
C0019994 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
hospital city
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. City
text
C0019994 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
hospital state
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. State
text
C0019994 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
days altogether hospitalized
Item
G. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0027051 (UMLS CUI [1,2])
C0439228 (UMLS CUI [1,3])
Item
5 Has a doctor ever told you that you had a new incident of angina pectoris or chest pain due to heart disease since we spoke with you on the phone about six month ago?
integer
C0002962 (UMLS CUI [1])
Code List
5 Has a doctor ever told you that you had a new incident of angina pectoris or chest pain due to heart disease since we spoke with you on the phone about six month ago?
name doctor
Item
A. What was the doctor's name and city? Name
text
C0031831 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
doctor address
Item
A. What was the doctor's name and city? Address
text
C0031831 (UMLS CUI [1,1])
C1442065 (UMLS CUI [1,2])
doctor city
Item
A. What was the doctor's name and city? City
text
C0031831 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
doctor state
Item
A. What was the doctor's name and city? State
text
C0031831 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
date of diagnosis angina
Item
B. Date of event or diagnosis:
date
C0002962 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
see doctor angina
Item
C. How many times altogether did you see a doctor for this condition since we last spoke to you?
text
C0002962 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
Item
D. Were you in the hospital at least one night for this condition since we last spoke to you?
integer
C0019993 (UMLS CUI [1,1])
C0002962 (UMLS CUI [1,2])
Code List
D. Were you in the hospital at least one night for this condition since we last spoke to you?
hospitalization angina
Item
E. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0002962 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
date of hospitalization
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Date of Hospitalization:
date
C0011008 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
C0809949 (UMLS CUI [1,3])
hospital name
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Hospital name
text
C0019994 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
hospital city
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. City
text
C0019994 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
hospital state
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. State
text
C0019994 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
days altogether hospitalized angina
Item
G. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0002962 (UMLS CUI [1,2])
C0439228 (UMLS CUI [1,3])
Item
6 Has a doctor ever told you that you had a new incident of heart failure or congestive heart failure since we spoke with you on the phone about six month ago?
integer
C0018801 (UMLS CUI [1])
C0018802 (UMLS CUI [2])
Code List
6 Has a doctor ever told you that you had a new incident of heart failure or congestive heart failure since we spoke with you on the phone about six month ago?
name doctor
Item
A. What was the doctor's name and city? Name
text
C0031831 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
doctor address
Item
A. What was the doctor's name and city? Address
text
C0031831 (UMLS CUI [1,1])
C1442065 (UMLS CUI [1,2])
doctor city
Item
A. What was the doctor's name and city? City
text
C0031831 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
doctor state
Item
A. What was the doctor's name and city? State
text
C0031831 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
date of diagnosis congestive heart failure
Item
B. Date of event or diagnosis:
date
C0018802 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
see doctor congestive heart failure
Item
C. How many times altogether did you see a doctor for this condition since we last spoke to you?
text
C0018802 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
Item
D. Were you in the hospital at least one night for this condition since we last spoke to you?
integer
C0019993 (UMLS CUI [1,1])
C0018802 (UMLS CUI [1,2])
Code List
D. Were you in the hospital at least one night for this condition since we last spoke to you?
hospitalization congestive heart failure
Item
E. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0018802 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
date of hospitalization
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Date of Hospitalization:
date
C0011008 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
C0809949 (UMLS CUI [1,3])
hospital name
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Hospital name
text
C0019994 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
hospital city
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. City
text
C0019994 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
hospital state
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. State
text
C0019994 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
days altogether hospitalized congestive heart failure
Item
G. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0018802 (UMLS CUI [1,2])
C0439228 (UMLS CUI [1,3])
Item
7 Has a doctor ever told you that you had a new incident of intermittent claudication or pain in your legs from a blockage of the arteries since we spoke with you on the phone about six month ago?
integer
C0021775 (UMLS CUI [1])
Code List
7 Has a doctor ever told you that you had a new incident of intermittent claudication or pain in your legs from a blockage of the arteries since we spoke with you on the phone about six month ago?
name doctor
Item
A. What was the doctor's name and city? Name
text
C0031831 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
doctor address
Item
A. What was the doctor's name and city? Address
text
C0031831 (UMLS CUI [1,1])
C1442065 (UMLS CUI [1,2])
doctor city
Item
A. What was the doctor's name and city? City
text
C0031831 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
doctor state
Item
A. What was the doctor's name and city? State
text
C0031831 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
date of diagnosis intermittent claudication
Item
B. Date of event or diagnosis:
date
C0021775 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
see doctor intermittent claudication
Item
C. How many times altogether did you see a doctor for this condition since we last spoke to you?
text
C0021775 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
Item
D. Were you in the hospital at least one night for this condition since we last spoke to you?
integer
C0019993 (UMLS CUI [1,1])
C0021775 (UMLS CUI [1,2])
Code List
D. Were you in the hospital at least one night for this condition since we last spoke to you?
hospitalization intermittent claudication
Item
E. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0021775 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
date of hospitalization
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Date of Hospitalization:
date
C0011008 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
C0809949 (UMLS CUI [1,3])
hospital name
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Hospital name
text
C0019994 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
hospital city
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. City
text
C0019994 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
hospital state
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. State
text
C0019994 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
days altogether hospitalized intermittent claudication
Item
G. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0021775 (UMLS CUI [1,2])
C0439228 (UMLS CUI [1,3])
Item
8 Has a doctor ever told you that you had a new stroke or cerebrovascular accident since we spoke with you on the phone about six month ago?
integer
C0038454 (UMLS CUI [1])
Code List
8 Has a doctor ever told you that you had a new stroke or cerebrovascular accident since we spoke with you on the phone about six month ago?
name doctor
Item
A. What was the doctor's name and city? Name
text
C0031831 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
doctor address
Item
A. What was the doctor's name and city? Address
text
C0031831 (UMLS CUI [1,1])
C1442065 (UMLS CUI [1,2])
doctor city
Item
A. What was the doctor's name and city? City
text
C0031831 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
doctor state
Item
A. What was the doctor's name and city? State
text
C0031831 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
date of diagnosis cerebrovascular accident
Item
B. Date of event or diagnosis:
date
C0038454 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
see doctor cerebrovascular accident
Item
C. How many times altogether did you see a doctor for this condition since we last spoke to you?
text
C0038454 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
Item
D. Were you in the hospital at least one night for this condition since we last spoke to you?
integer
C0019993 (UMLS CUI [1,1])
C0038454 (UMLS CUI [1,2])
Code List
D. Were you in the hospital at least one night for this condition since we last spoke to you?
hospitalization cerebrovascular accident
Item
E. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0038454 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
date of hospitalization
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Date of Hospitalization:
date
C0011008 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
C0809949 (UMLS CUI [1,3])
hospital name
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Hospital name
text
C0019994 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
hospital city
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. City
text
C0019994 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
hospital state
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. State
text
C0019994 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
days altogether hospitalized cerebrovascular accident
Item
G. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0038454 (UMLS CUI [1,2])
C0439228 (UMLS CUI [1,3])
Item
9 Has a doctor ever told you that you had a new transient ischemic attack or TIA or silent stroke since we spoke with you on the phone about six month ago?
integer
C0007787 (UMLS CUI [1])
Code List
9 Has a doctor ever told you that you had a new transient ischemic attack or TIA or silent stroke since we spoke with you on the phone about six month ago?
name doctor
Item
A. What was the doctor's name and city? Name
text
C0031831 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
doctor address
Item
A. What was the doctor's name and city? Address
text
C0031831 (UMLS CUI [1,1])
C1442065 (UMLS CUI [1,2])
doctor city
Item
A. What was the doctor's name and city? City
text
C0031831 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
doctor state
Item
A. What was the doctor's name and city? State
text
C0031831 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
date of diagnosis TIA
Item
B. Date of event or diagnosis:
date
C0007787 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
see doctor TIA
Item
C. How many times altogether did you see a doctor for this condition since we last spoke to you?
text
C0007787 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
Item
D. Were you in the hospital at least one night for this condition since we last spoke to you?
integer
C0019993 (UMLS CUI [1,1])
C0007787 (UMLS CUI [1,2])
Code List
D. Were you in the hospital at least one night for this condition since we last spoke to you?
hospitalization TIA
Item
E. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0007787 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
date of hospitalization
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Date of Hospitalization:
date
C0011008 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
C0809949 (UMLS CUI [1,3])
hospital name
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. Hospital name
text
C0019994 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
hospital city
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. City
text
C0019994 (UMLS CUI [1,1])
C0008848 (UMLS CUI [1,2])
hospital state
Item
F. Please record the admission date of each hospitalization and the name and location of the hospital. State
text
C0019994 (UMLS CUI [1,1])
C1301808 (UMLS CUI [1,2])
days altogether hospitalized TIA
Item
G. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0007787 (UMLS CUI [1,2])
C0439228 (UMLS CUI [1,3])