ID

44382

Description

ICHOM Older Person data collection Version 1.0.4 Revised: July 12, 2017 International Consortium for Health Outcomes Measurement (ICHOM), Source: http://www.ichom.org/ Notice: This work was conducted using resources from ICHOM, the International Consortium for Health Outcomes Measurement (www.ICHOM.org). The content is solely the responsibility of the authors and does not necessarily represent the official views of ICHOM. For Older Persons, the following treatment approaches are covered by our Standard Set. Treatment approaches: These have not been defined due to the wide range of management options and interventions for an older population. A number of potentially inappropriate medications have been listed as ‘medication variables’. This document contains the Baseline and Follow-up - Patient-reported Form. It has to be filled in at Patient's entry into this set. NOTE: One Item (LEVEDC) only is scheduled for Baseline. All other Items are for both Baseline- and Follow-up-form- For Follow-up: fill in at least annually, but may be filled in more often (annually for a 69 year old person not admitted to hospital within 1 year, but 6-monthly for a 84 year old person). Collecting Patient-Reported Outcome Measures: Medical Outcomes Study: 36-Item Short Form Survey Instrument Version 1 (SF-36). RAND owns the copyright. All of the surveys and tools from RAND Health are public documents, available without charge. No further written permission is needed for use of this Health Survey. For more information see http://www. rand.org/health/surveys_tools/mos/mos_ core_36item_survey.html UCLA 3-Item Loneliness Scale. Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT (2004) A short scale for measuring loneliness in large surveys: Results from two population-based studies. Res Aging 26(6):655–672. Barthel Index. The Maryland State Medical Society holds the copyright for the Barthel Index. It may be used freely for non- commercial purposes with the following citation: Mahoney FI, Barthel D. “Functional evaluation: the Barthel Index.” Maryland State Med Journal 1965;14:56-61. Permission is required to modify the Barthel Index or to use it for commercial purposes. ASCOT Toolkit. As a license agreement is needed for use of this questionaire, the used question will not be included in this version of the standard set word-for-word. Canadian Study on Health & Aging Clinical Frailty Scale. As a permission is needed for use, the scale will not be included in this version of the standard set word-for-word. Zarit Burden Interview: A license agreement might be neccessary for use of the long version of this questionnaire, for more information: https://eprovide.mapi-trust.org/instruments/zarit-burden-interview . For the used 4-item version (Questions 2, 3, 9, 19) see: Michel Bédard, D. William Molloy, Larry Squire, Sacha Dubois, Judith A. Lever, Martin O'Donnell, The Zarit Burden Interview: A New Short Version and Screening Version, The Gerontologist, Volume 41, Issue 5, 1 October 2001, Pages 652–657, https://doi.org/10.1093/geront/41.5.652 . As license for use of this questionaire is not certain at the moment, only the total score will be included in this version of the standard set. Reference: Akpan A, Roberts C, Bandeen-Roche K, et al. Standard set of health outcome measures for older persons. BMC Geriatr. 2018;18(1):36. Published 2018 Feb 2. doi:10.1186/s12877-017-0701-3 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797357/) The Standard set of ICHOM was supported by NHS England. For this version of the standard set, semantic annotation with UMLS CUIs has been added.

Link

http://www.ichom.org/

Keywords

Versions (5)
  1. 7/1/19 7/1/19 -
  2. 7/25/19 7/25/19 -
  3. 7/26/19 7/26/19 - Sarah Riepenhausen
  4. 4/30/20 4/30/20 - Sarah Riepenhausen
  5. 9/20/21 9/20/21 -
Copyright Holder

ICHOM

Uploaded on

September 20, 2021

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License

Creative Commons BY-NC 4.0
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ICHOM Older Person

English

Baseline and Follow-up - Patient-reported

1 forms  
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Patient ID
Description

Supporting definition: This number will not be shared with ICHOM. In the case patient-level data is submitted to ICHOM for benchmarking or research purposes, a separate ICHOM Patient Identifier will be created and cross-linking between the ICHOM Patient Identifier and the medical record number will only be known at the treating institution Inclusion criteria: All patients Timing: On all forms Reporting Source: Administrative or clinical Type: Numerical Response options: According to institution

Data type

integer

Alias
UMLS CUI [1]
C2348585
Indicate whether a proxy or carer filled in patient reported items on behalf of the patient
Description

Inclusion Criteria: All patients Timing: On all forms Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0600420
UMLS CUI [1,2]
C4038447
UMLS CUI [2,1]
C0030705
UMLS CUI [2,2]
C4038447
Time Relative to Baseline
Description

This Item does not exist in the original standard set, instead it is asked to do the following: Please timestamp all variables. Some Standard Set variables are collected at multiple timepoints, and we will ask you to submit these variables in a concatenated VARIABLEID_TIMESTAMP form for future analyses. For example, VARIABLEID_AT (After treatment); VARIABLEID_AS (After surgery); VARIABLEID_UPDATE (Update at least annually), etc.

Data type

text

Alias
UMLS CUI [1,1]
C0439564
UMLS CUI [1,2]
C1442488
Demographic factors
Description

Demographic factors

Alias
UMLS CUI-1
C1704791
What is the highest level of schooling the patient has completed?
Description

Supporting definition: The level of schooling is defined in each country as per ISCED [International Standard Classification] Inclusion criteria: All patients Timing: Baseline Reporting Source: Patient reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0013658
Which statement best describes the patient's living arrangement?
Description

Supporting Definition: Item is phrased as a patient/caregiver reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline Annually Reporting Source: Patient reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C2184149
Smoking status (of cigarettes, cigars or tobacco)
Description

Supporting Definition: Item is phrased as a patient/caregiver reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C1519386
Which statement best matches the amount of alcohol consumed regularly (in units) by the patient?
Description

Supporting Definition: One alcohol unit is measured as 10ml or 8g of pure alcohol. This equals one 25ml single measure of whisky (ABV 40%), or a third of a pint of beer (ABV 5-6%) or half a standard (175ml) glass of red wine (ABV 12%). Item is phrased as a patient/caregiver reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0001948
Have you ever been told by a doctor that you have any of the following? (select all that apply) 0=The patient has no other diseases
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C1298908
Have you ever been told by a doctor that you have any of the following? (select all that apply) 1=Heart disease (for example angina, heart attack or heart failure)
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0018799
UMLS CUI [3]
C0002962
UMLS CUI [4]
C0027051
UMLS CUI [5]
C0018801
Have you ever been told by a doctor that you have any of the following? (select all that apply) 2=High blood pressure (sometimes referred to as 'hypertension')
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0020538
Have you ever been told by a doctor that you have any of the following? (select all that apply) 3=Lung disease (for example asthma, chronic bronchitis or emphysema)
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0024115
UMLS CUI [3]
C0004096
UMLS CUI [4]
C0008677
UMLS CUI [5]
C0034067
Have you ever been told by a doctor that you have any of the following? (select all that apply) 4=Leg pain when walking due to poor circulation
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C1306889
Have you ever been told by a doctor that you have any of the following? (select all that apply) 5=Diabetes (Type I or Type II)
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0011854
UMLS CUI [3]
C0011860
Have you ever been told by a doctor that you have any of the following? (select all that apply) 6=Kidney disease
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0022658
Have you ever been told by a doctor that you have any of the following? (select all that apply) 7=Disease of the nervous system (for example Parkinson's disease or multiple sclerosis)
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0027765
UMLS CUI [3]
C0030567
UMLS CUI [4]
C0026769
Have you ever been told by a doctor that you have any of the following? (select all that apply) 8=Liver disease
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0023895
Have you ever been told by a doctor that you have any of the following? (select all that apply) 9=Cancer (within the last 5 years)
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0006826
Have you ever been told by a doctor that you have any of the following? (select all that apply) 10=Depression
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0011581
Have you ever been told by a doctor that you have any of the following? (select all that apply) 11=High cholesterol (sometimes referred to as hyperlipidemia)
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0020443
Have you ever been told by a doctor that you have any of the following? (select all that apply) 12=Problems caused by stroke
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2,1]
C0038454
UMLS CUI [2,2]
C0678227
UMLS CUI [2,3]
C0033213
Have you ever been told by a doctor that you have any of the following? (select all that apply) 13=Osteoarthritis, or degenerative arthritis
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0003864
UMLS CUI [3]
C0029408
Have you ever been told by a doctor that you have any of the following? (select all that apply) 14=Back pain
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0004604
Have you ever been told by a doctor that you have any of the following? (select all that apply) 15=Rheumatoid arthritis
Description

Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Multiple answers

Data type

boolean

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0003873
ADL using the Barthel Index: Total score
Description

Supporting Definition: Total score Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Numerical value Response Options: 0-20

Data type

integer

Alias
UMLS CUI [1]
C0001288
UMLS CUI [2]
C2964552
ADL using the Barthel Index: Bowels
Description

Supporting Definition: Bowels Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0001288
UMLS CUI [2]
C0021853
ADL using the Barthel Index: Bladder
Description

Supporting Definition: Bladder Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0001288
UMLS CUI [2]
C0005682
ADL using the Barthel Index: Grooming
Description

Supporting Definition: Grooming Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0001288
UMLS CUI [2]
C0474417
ADL using the Barthel Index: Toilet use
Description

Supporting Definition: Toilet use Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0001288
UMLS CUI [2]
C0562816
ADL using the Barthel Index: Feeding
Description

Supporting Definition: Feeding Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0001288
UMLS CUI [2]
C0013470
ADL using the Barthel Index: Transfer
Description

Supporting Definition: Transfer Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0001288
UMLS CUI [2]
C0030704
ADL using the Barthel Index: Mobility
Description

Supporting Definition: Mobility Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0001288
UMLS CUI [2]
C0449580
ADL using the Barthel Index: Dressing
Description

Supporting Definition: Dressing Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0001288
UMLS CUI [2]
C0085671
ADL using the Barthel Index: Stairs
Description

Supporting Definition: Stairs Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0001288
UMLS CUI [2]
C0429980
ADL using the Barthel Index: Bathing
Description

Supporting Definition: Bathing Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0001288
UMLS CUI [2]
C0150141
Indicate what level of care the patient routinely receives
Description

Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported data Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C1547668
Disutility of care
Description

Disutility of care

Alias
UMLS CUI-1
C0231185
UMLS CUI-2
C0086388
What is the total number of prescribed medications regularly (on a daily/weekly basis) taken? (Please do not include over-the-counter medications, creams, lotions or ointments)
Description

Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported Type: Numerical

Data type

integer

Alias
UMLS CUI [1]
C2922974
Do you think any of your medications are making you unwell?
Description

Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C2922974
UMLS CUI [1,2]
C0678227
UMLS CUI [1,3]
C0231218
How many falls have you had in the last 12 months?
Description

Supporting Definition: Using the WHO (2007) definition of a fall; “In- advertently coming to rest on the ground, floor or other lower level, excluding intentional change in position to rest in furniture, wall or other objects” Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient reported Type: Numerical

Data type

integer

Alias
UMLS CUI [1,1]
C0085639
UMLS CUI [1,2]
C4086728
Symptoms, functioning and quality of life
Description

Symptoms, functioning and quality of life

Alias
UMLS CUI-1
C1457887
UMLS CUI-2
C0516981
UMLS CUI-3
C0034380
How often do you feel that you lack companionship?
Description

Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Numerical

Data type

integer

Alias
UMLS CUI [1]
C4285296
UMLS CUI [2]
C3259663
How often do you feel left out?
Description

Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C4285296
UMLS CUI [2]
C3259932
How often do you feel isolated from others?
Description

Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C4285296
UMLS CUI [2]
C3259938
How often do you feel lonely?
Description

By creating this item the "sample questionnaire" of ICHOM has been taken as basis (in the originial standard set this item is scheduled for the Clinical form). Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Clinical Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C4285296
UMLS CUI [2]
C0023974
In general, would you say your health is:
Description

Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C0018759
Compared to one year ago, how would your rate your health in general now?
Description

Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C1707455
UMLS CUI [2,2]
C0018759
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
Description

Supporting Definition: Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0018759
UMLS CUI [2,2]
C0439801
UMLS CUI [2,3]
C4060778
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
Description

Supporting Definition: Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0018759
UMLS CUI [2,2]
C0439801
UMLS CUI [2,3]
C1513375
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
Description

Supporting Definition: Lifting or carrying groceries Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0018759
UMLS CUI [2,2]
C0439801
UMLS CUI [2,3]
C3829286
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
Description

Supporting Definition: Climbing several flights of stairs Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0018759
UMLS CUI [2,2]
C0439801
UMLS CUI [2,3]
C3831080
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
Description

Supporting Definition: Climbing one flight of stairs Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0018759
UMLS CUI [2,2]
C0439801
UMLS CUI [2,3]
C3831081
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
Description

Supporting Definition: Bending, kneeling, or stooping Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0018759
UMLS CUI [2,2]
C0439801
UMLS CUI [2,3]
C3831371
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
Description

Supporting Definition: Walking more than a mile Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0018759
UMLS CUI [2,2]
C0439801
UMLS CUI [2,3]
C3827523
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
Description

Supporting Definition: Walking several blocks Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0018759
UMLS CUI [2,2]
C0439801
UMLS CUI [2,3]
C3827521
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
Description

Supporting Definition: Walking one block Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0018759
UMLS CUI [2,2]
C0439801
UMLS CUI [2,3]
C3827522
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
Description

Supporting Definition: Bathing or dressing yourself Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0018759
UMLS CUI [2,2]
C0439801
UMLS CUI [2,3]
C3831396
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
Description

Supporting Definition: Cut down the amount of time you spent on work or other activities Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C1546466
UMLS CUI [2,2]
C0043227
UMLS CUI [2,3]
C0332282
UMLS CUI [2,4]
C0018759
UMLS CUI [3,1]
C1546466
UMLS CUI [3,2]
C0001288
UMLS CUI [3,3]
C0332282
UMLS CUI [3,4]
C0018759
UMLS CUI [4]
C3899484
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
Description

Supporting Definition: Accomplished less than you would like Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C1546466
UMLS CUI [2,2]
C0043227
UMLS CUI [2,3]
C0332282
UMLS CUI [2,4]
C0018759
UMLS CUI [3,1]
C1546466
UMLS CUI [3,2]
C0001288
UMLS CUI [3,3]
C0332282
UMLS CUI [3,4]
C0018759
UMLS CUI [4]
C3900126
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
Description

Supporting Definition: Were limited in the kind of work or other activities Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C1546466
UMLS CUI [2,2]
C0043227
UMLS CUI [2,3]
C0332282
UMLS CUI [2,4]
C0018759
UMLS CUI [3,1]
C1546466
UMLS CUI [3,2]
C0001288
UMLS CUI [3,3]
C0332282
UMLS CUI [3,4]
C0018759
UMLS CUI [4]
C3641747
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
Description

Supporting Definition: Had difficulty performing the work or other activities (for example, it took extra effort) Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C1546466
UMLS CUI [2,2]
C0043227
UMLS CUI [2,3]
C0332282
UMLS CUI [2,4]
C0018759
UMLS CUI [3,1]
C1546466
UMLS CUI [3,2]
C0001288
UMLS CUI [3,3]
C0332282
UMLS CUI [3,4]
C0018759
UMLS CUI [4]
C3898961
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?
Description

Supporting Definition: Cut down the amount of time you spent on work or other activities Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C1546466
UMLS CUI [2,2]
C0043227
UMLS CUI [2,3]
C0332282
UMLS CUI [2,4]
C0677660
UMLS CUI [3,1]
C1546466
UMLS CUI [3,2]
C0001288
UMLS CUI [3,3]
C0332282
UMLS CUI [3,4]
C0677660
UMLS CUI [4]
C3899484
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?
Description

Supporting Definition: Accomplished less than you would like Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C1546466
UMLS CUI [2,2]
C0043227
UMLS CUI [2,3]
C0332282
UMLS CUI [2,4]
C0677660
UMLS CUI [3,1]
C1546466
UMLS CUI [3,2]
C0001288
UMLS CUI [3,3]
C0332282
UMLS CUI [3,4]
C0677660
UMLS CUI [4]
C3900126
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?
Description

Supporting Definition: Didn't do work or other activities as carefully as usual Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C1546466
UMLS CUI [2,2]
C0043227
UMLS CUI [2,3]
C0332282
UMLS CUI [2,4]
C0677660
UMLS CUI [3,1]
C1546466
UMLS CUI [3,2]
C0001288
UMLS CUI [3,3]
C0332282
UMLS CUI [3,4]
C0677660
UMLS CUI [4]
C3484287
During the past 4 weeks, to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbors, or groups?
Description

Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0677660
UMLS CUI [2,2]
C0521102
UMLS CUI [2,3]
C0814554
UMLS CUI [3,1]
C0018759
UMLS CUI [3,2]
C0521102
UMLS CUI [3,3]
C0814554
How much bodily pain have you had during the past 4 weeks?
Description

Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C3890602
During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?
Description

Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C3898033
UMLS CUI [2,2]
C1265611
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
Description

Supporting Definition: Did you feel full of pep? Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C2051663
UMLS CUI [3]
C3484313
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
Description

Supporting Definition: Have you been a very nervous person? Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C2051663
UMLS CUI [3]
C3829750
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
Description

Supporting Definition: Have you felt so down in the dumps that nothing could cheer you up? Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C2051663
UMLS CUI [3]
C3829738
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
Description

Supporting Definition: Have you felt calm and peaceful? Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C2051663
UMLS CUI [3]
C0522165
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
Description

Supporting Definition: Did you have a lot of energy? Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C2051663
UMLS CUI [3]
C3898912
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
Description

Supporting Definition: Have you felt downhearted and blue? Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C2051663
UMLS CUI [3]
C3829743
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
Description

Supporting Definition: Did you feel worn out? Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C2051663
UMLS CUI [3]
C3899145
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
Description

Supporting Definition: Have you been a happy person? Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C2051663
UMLS CUI [3]
C0018592
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
Description

Supporting Definition: Did you feel tired? Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C2051663
UMLS CUI [3]
C0849970
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)?
Description

Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2,1]
C0677660
UMLS CUI [2,2]
C0521102
UMLS CUI [2,3]
C0814554
UMLS CUI [3,1]
C0018759
UMLS CUI [3,2]
C0521102
UMLS CUI [3,3]
C0814554
How TRUE or FALSE is each of the following statements for you.
Description

Supporting Definition: I seem to get sick a little easier than other people Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C1710187
UMLS CUI [3,1]
C3899028
UMLS CUI [3,2]
C2984078
How TRUE or FALSE is each of the following statements for you.
Description

Supporting Definition: I am as healthy as anybody I know Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C1710187
UMLS CUI [3]
C3900054
How TRUE or FALSE is each of the following statements for you.
Description

Supporting Definition: I expect my health to get worse Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C1710187
UMLS CUI [3]
C3475697
How TRUE or FALSE is each of the following statements for you.
Description

Supporting Definition: My health is excellent Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0451287
UMLS CUI [2]
C1710187
UMLS CUI [3]
C3476206
Question from the Adult Social Care Outcomes Toolkit, total score
Description

By creating this item the "sample questionnaire" of ICHOM has been taken as basis (in the originial standard set this item is scheduled for the Caregiver form). As a license agreement is needed for use of this questionnaire, only the total score is included in this version of the standard set. Inclusion Criteria: All patients Timing: Baseline and annually Reporting Source: Caregiver-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0001675
UMLS CUI [1,2]
C0037438
UMLS CUI [1,3]
C0086749
UMLS CUI [1,4]
C0243148
UMLS CUI [1,5]
C0001288
Participation and decision making
Description

Participation and decision making

Alias
UMLS CUI-1
C0679823
UMLS CUI-2
C0679006
After an admission or readmission to hospital, were you discharged to your place of choice? (if there have been multiple admissions, please refer to the most recent admission)
Description

Inclusion Criteria: Patients who have had any hospital admission Timing: Baseline, Annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0332282
UMLS CUI [1,2]
C0680254
UMLS CUI [2,1]
C0332282
UMLS CUI [2,2]
C0600290
UMLS CUI [3,1]
C0030685
UMLS CUI [3,2]
C0442504
UMLS CUI [3,3]
C3841966
Do you agree with the following statement?
Description

Supporting Definition: Regarding discharge planning, I was as involved in discussions and decisions about my care, support and treatment as I wanted to be Inclusion Criteria: Patients who have had any hospital admission Timing: Baseline, Annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0332282
UMLS CUI [1,2]
C0680254
UMLS CUI [2,1]
C0332282
UMLS CUI [2,2]
C0600290
UMLS CUI [3,1]
C1314939
UMLS CUI [3,2]
C0012622
Do you agree with the following statement?
Description

Supporting Definition: I was given enough information about my condition or treatment Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C1704726
UMLS CUI [1,2]
C2364069
UMLS CUI [1,3]
C0012634
UMLS CUI [1,4]
C1710187
UMLS CUI [1,5]
C0680240
UMLS CUI [2,1]
C1514756
UMLS CUI [2,2]
C0205410
UMLS CUI [2,3]
C1533716
UMLS CUI [2,4]
C0012634
UMLS CUI [3,1]
C1514756
UMLS CUI [3,2]
C0205410
UMLS CUI [3,3]
C1533716
UMLS CUI [3,4]
C0087111
Do you agree with the following statement?
Description

Supporting Definition: Staff gave my family or someone close to me all the information they needed to help care for me Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C1704726
UMLS CUI [1,2]
C2364069
UMLS CUI [1,3]
C0012634
UMLS CUI [1,4]
C1710187
UMLS CUI [1,5]
C0680240
UMLS CUI [2,1]
C0080103
UMLS CUI [2,2]
C1514756
UMLS CUI [2,3]
C1955348
UMLS CUI [3,1]
C0682339
UMLS CUI [3,2]
C1514756
UMLS CUI [3,3]
C1955348
During the delivery of your healthcare, were you able to participate in decision-making about your care?
Description

Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C1704726
UMLS CUI [1,2]
C0035820
UMLS CUI [1,3]
C0679646
UMLS CUI [1,4]
C0086388
UMLS CUI [2,1]
C0679646
UMLS CUI [2,2]
C0679006
Do you agree with the following statement?
Description

Supporting Definition: I was as involved in discussions and decisions about my care, support and treatment as I wanted to be Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C1704726
UMLS CUI [1,2]
C0035820
UMLS CUI [1,3]
C0679646
UMLS CUI [1,4]
C0086388
UMLS CUI [1,5]
C1710187
UMLS CUI [1,6]
C0680240
UMLS CUI [2,1]
C0679646
UMLS CUI [2,2]
C0679006
Do you agree with the following statement?
Description

Supporting Definition: My family or carer was also involved in these decisions as much as I wanted them to be Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C1704726
UMLS CUI [1,2]
C0035820
UMLS CUI [1,3]
C0679646
UMLS CUI [1,4]
C0086388
UMLS CUI [1,5]
C1710187
UMLS CUI [1,6]
C0680240
UMLS CUI [2,1]
C0086282
UMLS CUI [2,2]
C0679006
UMLS CUI [3,1]
C0085537
UMLS CUI [3,2]
C0679006
Did you have confidence and trust in the healthcare staff treating or supporting you?
Description

Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C1704726
UMLS CUI [1,2]
C0086388
UMLS CUI [2,1]
C0237935
UMLS CUI [2,2]
C1704312
Do you agree with the following statement?
Description

Supporting Definition: Overall, I felt I was treated with respect and dignity while I was receiving my care from this service Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C1710187
UMLS CUI [1,2]
C0680240
UMLS CUI [1,3]
C0087111
UMLS CUI [1,4]
C2713415
UMLS CUI [2,1]
C1710187
UMLS CUI [2,2]
C0680240
UMLS CUI [2,3]
C0087111
UMLS CUI [2,4]
C0679133
Do you agree with the following statement?
Description

Supporting Definition: The staff that cared for me had been given all the necessary information about my condition or illness from the person who referred me Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0017313
UMLS CUI [1,2]
C0700114
UMLS CUI [1,3]
C1710187
UMLS CUI [1,4]
C0680240
Do you agree with the following statement?
Description

By creating this item the "sample questionnaire" of ICHOM has been taken as basis (in the originial standard set this item is scheduled for the Clinical form). Supporting Definition: I always know who was coordinating my care Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Clinical Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0017313
UMLS CUI [1,2]
C0700114
UMLS CUI [1,3]
C0205309
UMLS CUI [1,4]
C0027361
UMLS CUI [1,5]
C1710187
UMLS CUI [1,6]
C0680240
Place of death
Description

Place of death

Alias
UMLS CUI-1
C0421611
Please indicate whether you would like to express a preferred place to die?
Description

Inclusion Criteria: All patients Timing: Baseline, Annually Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0421611
UMLS CUI [1,2]
C0558295
UMLS CUI [1,3]
C1710187
Please indicate where you would prefer to die?
Description

By creating this item the "sample questionnaire" of ICHOM has been taken as basis (in the originial standard set this item is scheduled for the Caregiver form). Inclusion Criteria: Patient who would like to express a preferred place of death Timing: Baseline, Annually Reporting Source: Carer-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C0421611
UMLS CUI [1,2]
C0558295
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Similar models

Baseline and Follow-up - Patient-reported

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Patient ID
Item
Patient ID
integer
C2348585 (UMLS CUI [1])
Item
Indicate whether a proxy or carer filled in patient reported items on behalf of the patient
integer
C0600420 (UMLS CUI [1,1])
C4038447 (UMLS CUI [1,2])
C0030705 (UMLS CUI [2,1])
C4038447 (UMLS CUI [2,2])
Patient/proxy reporting
Code List
Indicate whether a proxy or carer filled in patient reported items on behalf of the patient
CL Item
Patient reported (0)
C0030705 (UMLS CUI-1)
C4038447 (UMLS CUI-2)
(Comment:en)
CL Item
Proxy reported (1)
C0600420 (UMLS CUI-1)
C4038447 (UMLS CUI-2)
(Comment:en)
Time Relative to Baseline
Item
Time Relative to Baseline
text
C0439564 (UMLS CUI [1,1])
C1442488 (UMLS CUI [1,2])
Item Group
Demographic factors
C1704791 (UMLS CUI-1)
Item
What is the highest level of schooling the patient has completed?
integer
C0013658 (UMLS CUI [1])
Education level
Code List
What is the highest level of schooling the patient has completed?
CL Item
None (0)
C0557286 (UMLS CUI-1)
(Comment:en)
CL Item
Primary (1)
C0013658 (UMLS CUI-1)
C0033145 (UMLS CUI-2)
(Comment:en)
CL Item
Secondary (2)
C0557289 (UMLS CUI-1)
(Comment:en)
CL Item
Tertiary  (3)
C0557291 (UMLS CUI-1)
(Comment:en)
Item
Which statement best describes the patient's living arrangement?
integer
C2184149 (UMLS CUI [1])
Living status and location
Code List
Which statement best describes the patient's living arrangement?
CL Item
Lives alone in own residence (0)
C0439044 (UMLS CUI-1)
C0425078 (UMLS CUI-2)
(Comment:en)
CL Item
Lives with partner/spouse/family/friends (1)
C1443355 (UMLS CUI-1)
C2184147 (UMLS CUI-2)
C0557130 (UMLS CUI-3)
C0557128 (UMLS CUI-4)
(Comment:en)
CL Item
Lives in nursing home, hospital or long-term care home (2)
C0028688 (UMLS CUI-1)
C0259945 (UMLS CUI-2)
C0023977 (UMLS CUI-3)
(Comment:en)
CL Item
Other (888)
C0205394 (UMLS CUI-1)
C0337645 (UMLS CUI-2)
(Comment:en)
Item
Smoking status (of cigarettes, cigars or tobacco)
integer
C1519386 (UMLS CUI [1])
Smoking status
Code List
Smoking status (of cigarettes, cigars or tobacco)
CL Item
Never smoked (0)
C3472670 (UMLS CUI-1)
(Comment:en)
CL Item
Ex-smoker (1)
C0337671 (UMLS CUI-1)
(Comment:en)
CL Item
Current smoker (2)
C3241966 (UMLS CUI-1)
(Comment:en)
Item
Which statement best matches the amount of alcohol consumed regularly (in units) by the patient?
integer
C0001948 (UMLS CUI [1])
Alcohol use
Code List
Which statement best matches the amount of alcohol consumed regularly (in units) by the patient?
CL Item
0-14 units of alcohol per week (1)
C0001948 (UMLS CUI-1)
C0919414 (UMLS CUI-2)
C3715152 (UMLS CUI-3)
C0560579 (UMLS CUI-4)
(Comment:en)
CL Item
14-21 units of alcohol per week (2)
C0001948 (UMLS CUI-1)
C3715152 (UMLS CUI-2)
C3715213 (UMLS CUI-3)
C0560579 (UMLS CUI-4)
(Comment:en)
CL Item
>21 units of alcohol per week (3)
C0001948 (UMLS CUI-1)
C0205172 (UMLS CUI-2)
C3715213 (UMLS CUI-3)
C0560579 (UMLS CUI-4)
(Comment:en)
Co-morbid conditions: No
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 0=The patient has no other diseases
boolean
C0009488 (UMLS CUI [1])
C1298908 (UMLS CUI [2])
Co-morbid conditions: Heart disease
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 1=Heart disease (for example angina, heart attack or heart failure)
boolean
C0009488 (UMLS CUI [1])
C0018799 (UMLS CUI [2])
C0002962 (UMLS CUI [3])
C0027051 (UMLS CUI [4])
C0018801 (UMLS CUI [5])
Co-morbid conditions: High blood pressure
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 2=High blood pressure (sometimes referred to as 'hypertension')
boolean
C0009488 (UMLS CUI [1])
C0020538 (UMLS CUI [2])
Co-morbid conditions: Lung disease
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 3=Lung disease (for example asthma, chronic bronchitis or emphysema)
boolean
C0009488 (UMLS CUI [1])
C0024115 (UMLS CUI [2])
C0004096 (UMLS CUI [3])
C0008677 (UMLS CUI [4])
C0034067 (UMLS CUI [5])
Co-morbid conditions: Leg pain
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 4=Leg pain when walking due to poor circulation
boolean
C0009488 (UMLS CUI [1])
C1306889 (UMLS CUI [2])
Co-morbid conditions: Diabetes (Type I or Type II)
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 5=Diabetes (Type I or Type II)
boolean
C0009488 (UMLS CUI [1])
C0011854 (UMLS CUI [2])
C0011860 (UMLS CUI [3])
Co-morbid conditions: Kidney disease
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 6=Kidney disease
boolean
C0009488 (UMLS CUI [1])
C0022658 (UMLS CUI [2])
Co-morbid conditions: Disease of the nervous system
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 7=Disease of the nervous system (for example Parkinson's disease or multiple sclerosis)
boolean
C0009488 (UMLS CUI [1])
C0027765 (UMLS CUI [2])
C0030567 (UMLS CUI [3])
C0026769 (UMLS CUI [4])
Co-morbid conditions: Liver disease
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 8=Liver disease
boolean
C0009488 (UMLS CUI [1])
C0023895 (UMLS CUI [2])
Co-morbid conditions: Cancer
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 9=Cancer (within the last 5 years)
boolean
C0009488 (UMLS CUI [1])
C0006826 (UMLS CUI [2])
Co-morbid conditions: Depression
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 10=Depression
boolean
C0009488 (UMLS CUI [1])
C0011581 (UMLS CUI [2])
Co-morbid conditions: High cholesterol
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 11=High cholesterol (sometimes referred to as hyperlipidemia)
boolean
C0009488 (UMLS CUI [1])
C0020443 (UMLS CUI [2])
Co-morbid conditions: Problems caused by stroke
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 12=Problems caused by stroke
boolean
C0009488 (UMLS CUI [1])
C0038454 (UMLS CUI [2,1])
C0678227 (UMLS CUI [2,2])
C0033213 (UMLS CUI [2,3])
Co-morbid conditions: Osteoarthritis, or degenerative arthritis
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 13=Osteoarthritis, or degenerative arthritis
boolean
C0009488 (UMLS CUI [1])
C0003864 (UMLS CUI [2])
C0029408 (UMLS CUI [3])
Co-morbid conditions: Back pain
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 14=Back pain
boolean
C0009488 (UMLS CUI [1])
C0004604 (UMLS CUI [2])
Co-morbid conditions: Rheumatoid arthritis
Item
Have you ever been told by a doctor that you have any of the following? (select all that apply) 15=Rheumatoid arthritis
boolean
C0009488 (UMLS CUI [1])
C0003873 (UMLS CUI [2])
Activities of daily living function: Total score
Item
ADL using the Barthel Index: Total score
integer
C0001288 (UMLS CUI [1])
C2964552 (UMLS CUI [2])
Item
ADL using the Barthel Index: Bowels
integer
C0001288 (UMLS CUI [1])
C0021853 (UMLS CUI [2])
Activities of daily living function
Code List
ADL using the Barthel Index: Bowels
CL Item
incontinent (or needs to be given enemata) (0)
C4329974 (UMLS CUI-1)
(Comment:en)
CL Item
occasional accident (once/week) (1)
C0015732 (UMLS CUI-1)
C3900130 (UMLS CUI-2)
(Comment:en)
CL Item
continent (2)
C0429956 (UMLS CUI-1)
(Comment:en)
Item
ADL using the Barthel Index: Bladder
integer
C0001288 (UMLS CUI [1])
C0005682 (UMLS CUI [2])
Activities of daily living function: Bladder
Code List
ADL using the Barthel Index: Bladder
CL Item
incontinent, or catheterized and unable to manage (0)
C0042024 (UMLS CUI-1)
C1547945 (UMLS CUI-2)
C1299582 (UMLS CUI-3)
(Comment:en)
CL Item
occasional accident (max. once per 24 hours) (1)
C0042024 (UMLS CUI-1)
C3843680 (UMLS CUI-2)
(Comment:en)
CL Item
continent (for over 7 days) (2)
C0542565 (UMLS CUI-1)
C0205307 (UMLS CUI-2)
(Comment:en)
Item
ADL using the Barthel Index: Grooming
integer
C0001288 (UMLS CUI [1])
C0474417 (UMLS CUI [2])
Activities of daily living function: Grooming
Code List
ADL using the Barthel Index: Grooming
CL Item
needs help with personal care (0)
C2586184 (UMLS CUI-1)
C1521721 (UMLS CUI-2)
(Comment:en)
CL Item
independent face/hair/teeth/shaving (implements provided) (1)
C0680212 (UMLS CUI-1)
C0015450 (UMLS CUI-2)
C0018494 (UMLS CUI-3)
C0040426 (UMLS CUI-4)
C2828367 (UMLS CUI-5)
(Comment:en)
Item
ADL using the Barthel Index: Toilet use
integer
C0001288 (UMLS CUI [1])
C0562816 (UMLS CUI [2])
Activities of daily living function: Grooming
Code List
ADL using the Barthel Index: Toilet use
CL Item
dependent (0)
C3244310 (UMLS CUI-1)
C0562816 (UMLS CUI-2)
(Comment:en)
CL Item
needs some help, but can do something alone (1)
C0429974 (UMLS CUI-1)
(Comment:en)
CL Item
independent (on and off, dressing, wiping) (2)
C0680212 (UMLS CUI-1)
C0562816 (UMLS CUI-2)
(Comment:en)
Item
ADL using the Barthel Index: Feeding
integer
C0001288 (UMLS CUI [1])
C0013470 (UMLS CUI [2])
Activities of daily living function: Grooming
Code List
ADL using the Barthel Index: Feeding
CL Item
unable (0)
C1299582 (UMLS CUI-1)
C0013470 (UMLS CUI-2)
(Comment:en)
CL Item
needs help cutting, spreading butter, etc (1)
C0429946 (UMLS CUI-1)
(Comment:en)
CL Item
independent (food provided within reach) (2)
C0680212 (UMLS CUI-1)
C0013470 (UMLS CUI-2)
(Comment:en)
Item
ADL using the Barthel Index: Transfer
integer
C0001288 (UMLS CUI [1])
C0030704 (UMLS CUI [2])
Activities of daily living function: Grooming
Code List
ADL using the Barthel Index: Transfer
CL Item
unable - no sitting balance (0)
C0030704 (UMLS CUI-1)
C1299582 (UMLS CUI-2)
C0277814 (UMLS CUI-3)
C1298908 (UMLS CUI-4)
C0560184 (UMLS CUI-5)
(Comment:en)
CL Item
major help (one or two people, physical), can sit (1)
C0030704 (UMLS CUI-1)
C0205164 (UMLS CUI-2)
C1521721 (UMLS CUI-3)
C0277814 (UMLS CUI-4)
(Comment:en)
CL Item
minor help (verbal or phsyical) (2)
C0030704 (UMLS CUI-1)
C0205165 (UMLS CUI-2)
C1521721 (UMLS CUI-3)
(Comment:en)
CL Item
independent (3)
C0030704 (UMLS CUI-1)
C0680212 (UMLS CUI-2)
(Comment:en)
Item
ADL using the Barthel Index: Mobility
integer
C0001288 (UMLS CUI [1])
C0449580 (UMLS CUI [2])
Activities of daily living function: Grooming
Code List
ADL using the Barthel Index: Mobility
CL Item
immobile (0)
C0686759 (UMLS CUI-1)
(Comment:en)
CL Item
wheelchair independent, including corners, etc (1)
C0429977 (UMLS CUI-1)
(Comment:en)
CL Item
walks with help of one person (verbal or physical) (2)
C0449580 (UMLS CUI-1)
C2712089 (UMLS CUI-2)
C1269765 (UMLS CUI-3)
(Comment:en)
CL Item
independent (but may use any aid, e.g., stick) (3)
C0680212 (UMLS CUI-1)
(Comment:en)
Item
ADL using the Barthel Index: Dressing
integer
C0001288 (UMLS CUI [1])
C0085671 (UMLS CUI [2])
Activities of daily living function: Grooming
Code List
ADL using the Barthel Index: Dressing
CL Item
dependent (0)
C3244310 (UMLS CUI-1)
C0518459 (UMLS CUI-2)
(Comment:en)
CL Item
needs help, but can do about half unaided (1)
C0429965 (UMLS CUI-1)
C2984078 (UMLS CUI-2)
(Comment:en)
CL Item
independent (including buttons, zips, laces, etc) (2)
C0680212 (UMLS CUI-1)
C0518459 (UMLS CUI-2)
(Comment:en)
Item
ADL using the Barthel Index: Stairs
integer
C0001288 (UMLS CUI [1])
C0429980 (UMLS CUI [2])
Activities of daily living function: Grooming
Code List
ADL using the Barthel Index: Stairs
CL Item
unable (0)
C1299582 (UMLS CUI-1)
C0429980 (UMLS CUI-2)
(Comment:en)
CL Item
needs help (verbal, physical, carrying aid) (1)
C0429982 (UMLS CUI-1)
(Comment:en)
CL Item
independent up and down (2)
C0680212 (UMLS CUI-1)
C0429980 (UMLS CUI-2)
(Comment:en)
Item
ADL using the Barthel Index: Bathing
integer
C0001288 (UMLS CUI [1])
C0150141 (UMLS CUI [2])
Activities of daily living function: Grooming
Code List
ADL using the Barthel Index: Bathing
CL Item
dependent (0)
C3244310 (UMLS CUI-1)
C0150141 (UMLS CUI-2)
(Comment:en)
CL Item
independent (or in shower) (1)
C0680212 (UMLS CUI-1)
C0150141 (UMLS CUI-2)
(Comment:en)
Item
Indicate what level of care the patient routinely receives
integer
C1547668 (UMLS CUI [1])
Level of care received
Code List
Indicate what level of care the patient routinely receives
CL Item
No care required (0)
C1298908 (UMLS CUI-1)
C0018724 (UMLS CUI-2)
C1514873 (UMLS CUI-3)
(Comment:en)
CL Item
Weekly care required (1)
C0332174 (UMLS CUI-1)
C0018724 (UMLS CUI-2)
C1514873 (UMLS CUI-3)
(Comment:en)
CL Item
Daily care required (2)
C0332173 (UMLS CUI-1)
C0018724 (UMLS CUI-2)
C1514873 (UMLS CUI-3)
(Comment:en)
CL Item
Multiple times a day care required (3)
C0439064 (UMLS CUI-1)
C0439511 (UMLS CUI-2)
C0018724 (UMLS CUI-3)
C1514873 (UMLS CUI-4)
(Comment:en)
CL Item
24 hour care required (4)
C1442770 (UMLS CUI-1)
C0018724 (UMLS CUI-2)
C1514873 (UMLS CUI-3)
(Comment:en)
Item Group
Disutility of care
C0231185 (UMLS CUI-1)
C0086388 (UMLS CUI-2)
Polypharmacy
Item
What is the total number of prescribed medications regularly (on a daily/weekly basis) taken? (Please do not include over-the-counter medications, creams, lotions or ointments)
integer
C2922974 (UMLS CUI [1])
Item
Do you think any of your medications are making you unwell?
integer
C2922974 (UMLS CUI [1,1])
C0678227 (UMLS CUI [1,2])
C0231218 (UMLS CUI [1,3])
Polypharmacy
Code List
Do you think any of your medications are making you unwell?
CL Item
Yes (0)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No (1)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Maybe (2)
C3844350 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (3)
C0439673 (UMLS CUI-1)
(Comment:en)
Falls
Item
How many falls have you had in the last 12 months?
integer
C0085639 (UMLS CUI [1,1])
C4086728 (UMLS CUI [1,2])
Item Group
Symptoms, functioning and quality of life
C1457887 (UMLS CUI-1)
C0516981 (UMLS CUI-2)
C0034380 (UMLS CUI-3)
Item
How often do you feel that you lack companionship?
integer
C4285296 (UMLS CUI [1])
C3259663 (UMLS CUI [2])
Question 1 of the UCLA 3-item Loneliness Scale
Code List
How often do you feel that you lack companionship?
CL Item
Hardly ever (1)
C3275031 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (2)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
Often (3)
C0332183 (UMLS CUI-1)
(Comment:en)
Item
How often do you feel left out?
integer
C4285296 (UMLS CUI [1])
C3259932 (UMLS CUI [2])
Question 1 of the UCLA 3-item Loneliness Scale
Code List
How often do you feel left out?
CL Item
Hardly ever (1)
C3275031 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (2)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
Often (3)
C0332183 (UMLS CUI-1)
(Comment:en)
Item
How often do you feel isolated from others?
integer
C4285296 (UMLS CUI [1])
C3259938 (UMLS CUI [2])
Question 1 of the UCLA 3-item Loneliness Scale
Code List
How often do you feel isolated from others?
CL Item
Hardly ever (1)
C3275031 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (2)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
Often (3)
C0332183 (UMLS CUI-1)
(Comment:en)
Item
How often do you feel lonely?
integer
C4285296 (UMLS CUI [1])
C0023974 (UMLS CUI [2])
Question 1 of the UCLA 3-item Loneliness Scale
Code List
How often do you feel lonely?
CL Item
Hardly ever (1)
C3275031 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (2)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
Often (3)
C0332183 (UMLS CUI-1)
(Comment:en)
Item
In general, would you say your health is:
integer
C0451287 (UMLS CUI [1])
C0018759 (UMLS CUI [2])
Question 1 of the 36-Item Health Survey 1.0
Code List
In general, would you say your health is:
CL Item
Excellent (1)
C1961136 (UMLS CUI-1)
(Comment:en)
CL Item
Very good (2)
C3641222 (UMLS CUI-1)
(Comment:en)
CL Item
Good (3)
C0205170 (UMLS CUI-1)
(Comment:en)
CL Item
Fair (4)
C2911689 (UMLS CUI-1)
(Comment:en)
CL Item
Poor (5)
C2700379 (UMLS CUI-1)
(Comment:en)
Item
Compared to one year ago, how would your rate your health in general now?
integer
C0451287 (UMLS CUI [1])
C1707455 (UMLS CUI [2,1])
C0018759 (UMLS CUI [2,2])
Question 1 of the 36-Item Health Survey 1.0
Code List
Compared to one year ago, how would your rate your health in general now?
CL Item
Much better now than one year ago (1)
C3841449 (UMLS CUI-1)
(Comment:en)
CL Item
Somewhat better now than one year ago (2)
C3841646 (UMLS CUI-1)
(Comment:en)
CL Item
About the same (3)
C0442739 (UMLS CUI-1)
(Comment:en)
CL Item
Somewhat worse now than one year ago (4)
C3897551 (UMLS CUI-1)
(Comment:en)
CL Item
Much worse now than one year ago (5)
C3841448 (UMLS CUI-1)
(Comment:en)
Item
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
integer
C0451287 (UMLS CUI [1])
C0018759 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C4060778 (UMLS CUI [2,3])
Question 1 of the 36-Item Health Survey 1.0
Code List
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
CL Item
Yes, limited a lot (1)
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, limited a little (2)
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
No, not limited at all (3)
C3845941 (UMLS CUI-1)
(Comment:en)
Item
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
integer
C0451287 (UMLS CUI [1])
C0018759 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C1513375 (UMLS CUI [2,3])
Question 1 of the 36-Item Health Survey 1.0
Code List
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
CL Item
Yes, limited a lot (1)
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, limited a little (2)
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
No, not limited at all (3)
C3845941 (UMLS CUI-1)
(Comment:en)
Item
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
integer
C0451287 (UMLS CUI [1])
C0018759 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C3829286 (UMLS CUI [2,3])
Question 1 of the 36-Item Health Survey 1.0
Code List
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
CL Item
Yes, limited a lot (1)
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, limited a little (2)
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
No, not limited at all (3)
C3845941 (UMLS CUI-1)
(Comment:en)
Item
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
integer
C0451287 (UMLS CUI [1])
C0018759 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C3831080 (UMLS CUI [2,3])
Question 1 of the 36-Item Health Survey 1.0
Code List
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
CL Item
Yes, limited a lot (1)
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, limited a little (2)
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
No, not limited at all (3)
C3845941 (UMLS CUI-1)
(Comment:en)
Item
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
integer
C0451287 (UMLS CUI [1])
C0018759 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C3831081 (UMLS CUI [2,3])
Question 1 of the 36-Item Health Survey 1.0
Code List
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
CL Item
Yes, limited a lot (1)
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, limited a little (2)
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
No, not limited at all (3)
C3845941 (UMLS CUI-1)
(Comment:en)
Item
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
integer
C0451287 (UMLS CUI [1])
C0018759 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C3831371 (UMLS CUI [2,3])
Question 1 of the 36-Item Health Survey 1.0
Code List
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
CL Item
Yes, limited a lot (1)
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, limited a little (2)
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
No, not limited at all (3)
C3845941 (UMLS CUI-1)
(Comment:en)
Item
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
integer
C0451287 (UMLS CUI [1])
C0018759 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C3827523 (UMLS CUI [2,3])
Question 1 of the 36-Item Health Survey 1.0
Code List
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
CL Item
Yes, limited a lot (1)
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, limited a little (2)
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
No, not limited at all (3)
C3845941 (UMLS CUI-1)
(Comment:en)
Item
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
integer
C0451287 (UMLS CUI [1])
C0018759 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C3827521 (UMLS CUI [2,3])
Question 1 of the 36-Item Health Survey 1.0
Code List
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
CL Item
Yes, limited a lot (1)
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, limited a little (2)
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
No, not limited at all (3)
C3845941 (UMLS CUI-1)
(Comment:en)
Item
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
integer
C0451287 (UMLS CUI [1])
C0018759 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C3827522 (UMLS CUI [2,3])
Question 1 of the 36-Item Health Survey 1.0
Code List
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
CL Item
Yes, limited a lot (1)
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, limited a little (2)
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
No, not limited at all (3)
C3845941 (UMLS CUI-1)
(Comment:en)
Item
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
integer
C0451287 (UMLS CUI [1])
C0018759 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C3831396 (UMLS CUI [2,3])
Question 1 of the 36-Item Health Survey 1.0
Code List
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
CL Item
Yes, limited a lot (1)
C3829282 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, limited a little (2)
C3829283 (UMLS CUI-1)
(Comment:en)
CL Item
No, not limited at all (3)
C3845941 (UMLS CUI-1)
(Comment:en)
Item
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
integer
C0451287 (UMLS CUI [1])
C1546466 (UMLS CUI [2,1])
C0043227 (UMLS CUI [2,2])
C0332282 (UMLS CUI [2,3])
C0018759 (UMLS CUI [2,4])
C1546466 (UMLS CUI [3,1])
C0001288 (UMLS CUI [3,2])
C0332282 (UMLS CUI [3,3])
C0018759 (UMLS CUI [3,4])
C3899484 (UMLS CUI [4])
Question 13 of the 36-Item Health Survey 1.8
Code List
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No (2)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
integer
C0451287 (UMLS CUI [1])
C1546466 (UMLS CUI [2,1])
C0043227 (UMLS CUI [2,2])
C0332282 (UMLS CUI [2,3])
C0018759 (UMLS CUI [2,4])
C1546466 (UMLS CUI [3,1])
C0001288 (UMLS CUI [3,2])
C0332282 (UMLS CUI [3,3])
C0018759 (UMLS CUI [3,4])
C3900126 (UMLS CUI [4])
Question 13 of the 36-Item Health Survey 1.8
Code List
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No (2)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
integer
C0451287 (UMLS CUI [1])
C1546466 (UMLS CUI [2,1])
C0043227 (UMLS CUI [2,2])
C0332282 (UMLS CUI [2,3])
C0018759 (UMLS CUI [2,4])
C1546466 (UMLS CUI [3,1])
C0001288 (UMLS CUI [3,2])
C0332282 (UMLS CUI [3,3])
C0018759 (UMLS CUI [3,4])
C3641747 (UMLS CUI [4])
Question 13 of the 36-Item Health Survey 1.8
Code List
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No (2)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
integer
C0451287 (UMLS CUI [1])
C1546466 (UMLS CUI [2,1])
C0043227 (UMLS CUI [2,2])
C0332282 (UMLS CUI [2,3])
C0018759 (UMLS CUI [2,4])
C1546466 (UMLS CUI [3,1])
C0001288 (UMLS CUI [3,2])
C0332282 (UMLS CUI [3,3])
C0018759 (UMLS CUI [3,4])
C3898961 (UMLS CUI [4])
Question 13 of the 36-Item Health Survey 1.8
Code List
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No (2)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?
integer
C0451287 (UMLS CUI [1])
C1546466 (UMLS CUI [2,1])
C0043227 (UMLS CUI [2,2])
C0332282 (UMLS CUI [2,3])
C0677660 (UMLS CUI [2,4])
C1546466 (UMLS CUI [3,1])
C0001288 (UMLS CUI [3,2])
C0332282 (UMLS CUI [3,3])
C0677660 (UMLS CUI [3,4])
C3899484 (UMLS CUI [4])
Question 13 of the 36-Item Health Survey 1.8
Code List
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No (2)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?
integer
C0451287 (UMLS CUI [1])
C1546466 (UMLS CUI [2,1])
C0043227 (UMLS CUI [2,2])
C0332282 (UMLS CUI [2,3])
C0677660 (UMLS CUI [2,4])
C1546466 (UMLS CUI [3,1])
C0001288 (UMLS CUI [3,2])
C0332282 (UMLS CUI [3,3])
C0677660 (UMLS CUI [3,4])
C3900126 (UMLS CUI [4])
Question 13 of the 36-Item Health Survey 1.8
Code List
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No (2)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?
integer
C0451287 (UMLS CUI [1])
C1546466 (UMLS CUI [2,1])
C0043227 (UMLS CUI [2,2])
C0332282 (UMLS CUI [2,3])
C0677660 (UMLS CUI [2,4])
C1546466 (UMLS CUI [3,1])
C0001288 (UMLS CUI [3,2])
C0332282 (UMLS CUI [3,3])
C0677660 (UMLS CUI [3,4])
C3484287 (UMLS CUI [4])
Question 13 of the 36-Item Health Survey 1.8
Code List
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No (2)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
During the past 4 weeks, to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbors, or groups?
integer
C0451287 (UMLS CUI [1])
C0677660 (UMLS CUI [2,1])
C0521102 (UMLS CUI [2,2])
C0814554 (UMLS CUI [2,3])
C0018759 (UMLS CUI [3,1])
C0521102 (UMLS CUI [3,2])
C0814554 (UMLS CUI [3,3])
Question 13 of the 36-Item Health Survey 1.8
Code List
During the past 4 weeks, to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbors, or groups?
CL Item
Not at all (1)
C2003901 (UMLS CUI-1)
(Comment:en)
CL Item
Slightly  (2)
C0750482 (UMLS CUI-1)
(Comment:en)
CL Item
Moderately  (3)
C0205081 (UMLS CUI-1)
(Comment:en)
CL Item
Quite a bit  (4)
C2984080 (UMLS CUI-1)
(Comment:en)
CL Item
Extremely (5)
C0205403 (UMLS CUI-1)
(Comment:en)
Item
How much bodily pain have you had during the past 4 weeks?
integer
C0451287 (UMLS CUI [1])
C3890602 (UMLS CUI [2])
Question 13 of the 36-Item Health Survey 1.8
Code List
How much bodily pain have you had during the past 4 weeks?
CL Item
None (1)
C0549184 (UMLS CUI-1)
(Comment:en)
CL Item
Very mild (2)
C4036115 (UMLS CUI-1)
(Comment:en)
CL Item
Mild (3)
C2945599 (UMLS CUI-1)
(Comment:en)
CL Item
Moderate (4)
C0205081 (UMLS CUI-1)
(Comment:en)
CL Item
Severe (5)
C0205082 (UMLS CUI-1)
(Comment:en)
CL Item
Very severe (6)
C3641272 (UMLS CUI-1)
(Comment:en)
Item
During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?
integer
C0451287 (UMLS CUI [1])
C3898033 (UMLS CUI [2,1])
C1265611 (UMLS CUI [2,2])
Question 13 of the 36-Item Health Survey 1.8
Code List
During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?
CL Item
Not at all (1)
C2003901 (UMLS CUI-1)
(Comment:en)
CL Item
Slightly  (2)
C0750482 (UMLS CUI-1)
(Comment:en)
CL Item
Moderately  (3)
C0205081 (UMLS CUI-1)
(Comment:en)
CL Item
Quite a bit  (4)
C2984080 (UMLS CUI-1)
(Comment:en)
CL Item
Extremely (5)
C0205403 (UMLS CUI-1)
(Comment:en)
Item
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
integer
C0451287 (UMLS CUI [1])
C2051663 (UMLS CUI [2])
C3484313 (UMLS CUI [3])
Question 13 of the 36-Item Health Survey 1.8
Code List
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
CL Item
All of the time (1)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (2)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
A good bit of the time (3)
C3831592 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (4)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
A little of the time (5)
C3831570 (UMLS CUI-1)
(Comment:en)
CL Item
None of the time (6)
C3812882 (UMLS CUI-1)
(Comment:en)
Item
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
integer
C0451287 (UMLS CUI [1])
C2051663 (UMLS CUI [2])
C3829750 (UMLS CUI [3])
Question 13 of the 36-Item Health Survey 1.8
Code List
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
CL Item
All of the time (1)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (2)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
A good bit of the time (3)
C3831592 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (4)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
A little of the time (5)
C3831570 (UMLS CUI-1)
(Comment:en)
CL Item
None of the time (6)
C3812882 (UMLS CUI-1)
(Comment:en)
Item
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
integer
C0451287 (UMLS CUI [1])
C2051663 (UMLS CUI [2])
C3829738 (UMLS CUI [3])
Question 13 of the 36-Item Health Survey 1.8
Code List
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
CL Item
All of the time (1)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (2)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
A good bit of the time (3)
C3831592 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (4)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
A little of the time (5)
C3831570 (UMLS CUI-1)
(Comment:en)
CL Item
None of the time (6)
C3812882 (UMLS CUI-1)
(Comment:en)
Item
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
integer
C0451287 (UMLS CUI [1])
C2051663 (UMLS CUI [2])
C0522165 (UMLS CUI [3])
Question 13 of the 36-Item Health Survey 1.8
Code List
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
CL Item
All of the time (1)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (2)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
A good bit of the time (3)
C3831592 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (4)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
A little of the time (5)
C3831570 (UMLS CUI-1)
(Comment:en)
CL Item
None of the time (6)
C3812882 (UMLS CUI-1)
(Comment:en)
Item
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
integer
C0451287 (UMLS CUI [1])
C2051663 (UMLS CUI [2])
C3898912 (UMLS CUI [3])
Question 13 of the 36-Item Health Survey 1.8
Code List
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
CL Item
All of the time (1)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (2)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
A good bit of the time (3)
C3831592 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (4)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
A little of the time (5)
C3831570 (UMLS CUI-1)
(Comment:en)
CL Item
None of the time (6)
C3812882 (UMLS CUI-1)
(Comment:en)
Item
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
integer
C0451287 (UMLS CUI [1])
C2051663 (UMLS CUI [2])
C3829743 (UMLS CUI [3])
Question 13 of the 36-Item Health Survey 1.8
Code List
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
CL Item
All of the time (1)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (2)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
A good bit of the time (3)
C3831592 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (4)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
A little of the time (5)
C3831570 (UMLS CUI-1)
(Comment:en)
CL Item
None of the time (6)
C3812882 (UMLS CUI-1)
(Comment:en)
Item
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
integer
C0451287 (UMLS CUI [1])
C2051663 (UMLS CUI [2])
C3899145 (UMLS CUI [3])
Question 13 of the 36-Item Health Survey 1.8
Code List
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
CL Item
All of the time (1)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (2)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
A good bit of the time (3)
C3831592 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (4)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
A little of the time (5)
C3831570 (UMLS CUI-1)
(Comment:en)
CL Item
None of the time (6)
C3812882 (UMLS CUI-1)
(Comment:en)
Item
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
integer
C0451287 (UMLS CUI [1])
C2051663 (UMLS CUI [2])
C0018592 (UMLS CUI [3])
Question 13 of the 36-Item Health Survey 1.8
Code List
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
CL Item
All of the time (1)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (2)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
A good bit of the time (3)
C3831592 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (4)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
A little of the time (5)
C3831570 (UMLS CUI-1)
(Comment:en)
CL Item
None of the time (6)
C3812882 (UMLS CUI-1)
(Comment:en)
Item
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
integer
C0451287 (UMLS CUI [1])
C2051663 (UMLS CUI [2])
C0849970 (UMLS CUI [3])
Question 13 of the 36-Item Health Survey 1.8
Code List
"These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks . . ."
CL Item
All of the time (1)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (2)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
A good bit of the time (3)
C3831592 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (4)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
A little of the time (5)
C3831570 (UMLS CUI-1)
(Comment:en)
CL Item
None of the time (6)
C3812882 (UMLS CUI-1)
(Comment:en)
Item
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)?
integer
C0451287 (UMLS CUI [1])
C0677660 (UMLS CUI [2,1])
C0521102 (UMLS CUI [2,2])
C0814554 (UMLS CUI [2,3])
C0018759 (UMLS CUI [3,1])
C0521102 (UMLS CUI [3,2])
C0814554 (UMLS CUI [3,3])
Question 13 of the 36-Item Health Survey 1.8
Code List
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)?
CL Item
All of the time (1)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (2)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
A good bit of the time (3)
C3831592 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (4)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
A little of the time (5)
C3831570 (UMLS CUI-1)
(Comment:en)
CL Item
None of the time (6)
C3812882 (UMLS CUI-1)
(Comment:en)
Item
How TRUE or FALSE is each of the following statements for you.
integer
C0451287 (UMLS CUI [1])
C1710187 (UMLS CUI [2])
C3899028 (UMLS CUI [3,1])
C2984078 (UMLS CUI [3,2])
Question 33 of the 36-Item Health Survey 1.22
Code List
How TRUE or FALSE is each of the following statements for you.
CL Item
Definitely true (1)
C3842804 (UMLS CUI-1)
(Comment:en)
CL Item
Mostly true (2)
C3842803 (UMLS CUI-1)
(Comment:en)
CL Item
Don't know (3)
C3843613 (UMLS CUI-1)
(Comment:en)
CL Item
Mostly false (4)
C3840595 (UMLS CUI-1)
(Comment:en)
CL Item
Definitely false (5)
C3842802 (UMLS CUI-1)
(Comment:en)
Item
How TRUE or FALSE is each of the following statements for you.
integer
C0451287 (UMLS CUI [1])
C1710187 (UMLS CUI [2])
C3900054 (UMLS CUI [3])
Question 33 of the 36-Item Health Survey 1.22
Code List
How TRUE or FALSE is each of the following statements for you.
CL Item
Definitely true (1)
C3842804 (UMLS CUI-1)
(Comment:en)
CL Item
Mostly true (2)
C3842803 (UMLS CUI-1)
(Comment:en)
CL Item
Don't know (3)
C3843613 (UMLS CUI-1)
(Comment:en)
CL Item
Mostly false (4)
C3840595 (UMLS CUI-1)
(Comment:en)
CL Item
Definitely false (5)
C3842802 (UMLS CUI-1)
(Comment:en)
Item
How TRUE or FALSE is each of the following statements for you.
integer
C0451287 (UMLS CUI [1])
C1710187 (UMLS CUI [2])
C3475697 (UMLS CUI [3])
Question 33 of the 36-Item Health Survey 1.22
Code List
How TRUE or FALSE is each of the following statements for you.
CL Item
Definitely true (1)
C3842804 (UMLS CUI-1)
(Comment:en)
CL Item
Mostly true (2)
C3842803 (UMLS CUI-1)
(Comment:en)
CL Item
Don't know (3)
C3843613 (UMLS CUI-1)
(Comment:en)
CL Item
Mostly false (4)
C3840595 (UMLS CUI-1)
(Comment:en)
CL Item
Definitely false (5)
C3842802 (UMLS CUI-1)
(Comment:en)
Item
How TRUE or FALSE is each of the following statements for you.
integer
C0451287 (UMLS CUI [1])
C1710187 (UMLS CUI [2])
C3476206 (UMLS CUI [3])
Question 33 of the 36-Item Health Survey 1.22
Code List
How TRUE or FALSE is each of the following statements for you.
CL Item
Definitely true (1)
C3842804 (UMLS CUI-1)
(Comment:en)
CL Item
Mostly true (2)
C3842803 (UMLS CUI-1)
(Comment:en)
CL Item
Don't know (3)
C3843613 (UMLS CUI-1)
(Comment:en)
CL Item
Mostly false (4)
C3840595 (UMLS CUI-1)
(Comment:en)
CL Item
Definitely false (5)
C3842802 (UMLS CUI-1)
(Comment:en)
Question from the Adult Social Care Outcomes Toolkit, total score
Item
Question from the Adult Social Care Outcomes Toolkit, total score
integer
C0001675 (UMLS CUI [1,1])
C0037438 (UMLS CUI [1,2])
C0086749 (UMLS CUI [1,3])
C0243148 (UMLS CUI [1,4])
C0001288 (UMLS CUI [1,5])
Item Group
Participation and decision making
C0679823 (UMLS CUI-1)
C0679006 (UMLS CUI-2)
Item
After an admission or readmission to hospital, were you discharged to your place of choice? (if there have been multiple admissions, please refer to the most recent admission)
integer
C0332282 (UMLS CUI [1,1])
C0680254 (UMLS CUI [1,2])
C0332282 (UMLS CUI [2,1])
C0600290 (UMLS CUI [2,2])
C0030685 (UMLS CUI [3,1])
C0442504 (UMLS CUI [3,2])
C3841966 (UMLS CUI [3,3])
Discharge to place of choice
Code List
After an admission or readmission to hospital, were you discharged to your place of choice? (if there have been multiple admissions, please refer to the most recent admission)
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No (2)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Don't know (3)
C3843613 (UMLS CUI-1)
(Comment:en)
Item
Do you agree with the following statement?
integer
C0332282 (UMLS CUI [1,1])
C0680254 (UMLS CUI [1,2])
C0332282 (UMLS CUI [2,1])
C0600290 (UMLS CUI [2,2])
C1314939 (UMLS CUI [3,1])
C0012622 (UMLS CUI [3,2])
Discharge to place of choice
Code List
Do you agree with the following statement?
CL Item
Yes, definitely (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, to some extent (2)
C1705108 (UMLS CUI-1)
C0205392 (UMLS CUI-2)
C0439792 (UMLS CUI-3)
(Comment:en)
CL Item
No (3)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
Do you agree with the following statement?
integer
C1704726 (UMLS CUI [1,1])
C2364069 (UMLS CUI [1,2])
C0012634 (UMLS CUI [1,3])
C1710187 (UMLS CUI [1,4])
C0680240 (UMLS CUI [1,5])
C1514756 (UMLS CUI [2,1])
C0205410 (UMLS CUI [2,2])
C1533716 (UMLS CUI [2,3])
C0012634 (UMLS CUI [2,4])
C1514756 (UMLS CUI [3,1])
C0205410 (UMLS CUI [3,2])
C1533716 (UMLS CUI [3,3])
C0087111 (UMLS CUI [3,4])
Confidence in ability to cope with own health problems Question 1
Code List
Do you agree with the following statement?
CL Item
Not enough (1)
C1298908 (UMLS CUI-1)
C0205410 (UMLS CUI-2)
(Comment:en)
CL Item
The right amount (2)
C2349182 (UMLS CUI-1)
C1265611 (UMLS CUI-2)
(Comment:en)
CL Item
Too much (3)
C3843660 (UMLS CUI-1)
(Comment:en)
Item
Do you agree with the following statement?
integer
C1704726 (UMLS CUI [1,1])
C2364069 (UMLS CUI [1,2])
C0012634 (UMLS CUI [1,3])
C1710187 (UMLS CUI [1,4])
C0680240 (UMLS CUI [1,5])
C0080103 (UMLS CUI [2,1])
C1514756 (UMLS CUI [2,2])
C1955348 (UMLS CUI [2,3])
C0682339 (UMLS CUI [3,1])
C1514756 (UMLS CUI [3,2])
C1955348 (UMLS CUI [3,3])
Confidence in ability to cope with own health problems Question 1
Code List
Do you agree with the following statement?
CL Item
Yes, definitely (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, to some extent (2)
C1705108 (UMLS CUI-1)
C0205392 (UMLS CUI-2)
C0439792 (UMLS CUI-3)
(Comment:en)
CL Item
No, I did not want or need them to (3)
C1298908 (UMLS CUI-1)
C0558080 (UMLS CUI-2)
(Comment:en)
Item
During the delivery of your healthcare, were you able to participate in decision-making about your care?
integer
C1704726 (UMLS CUI [1,1])
C0035820 (UMLS CUI [1,2])
C0679646 (UMLS CUI [1,3])
C0086388 (UMLS CUI [1,4])
C0679646 (UMLS CUI [2,1])
C0679006 (UMLS CUI [2,2])
Discharge to place of choice
Code List
During the delivery of your healthcare, were you able to participate in decision-making about your care?
CL Item
Yes, definitely (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, to some extent (2)
C1705108 (UMLS CUI-1)
C0205392 (UMLS CUI-2)
C0439792 (UMLS CUI-3)
(Comment:en)
CL Item
No (3)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
Do you agree with the following statement?
integer
C1704726 (UMLS CUI [1,1])
C0035820 (UMLS CUI [1,2])
C0679646 (UMLS CUI [1,3])
C0086388 (UMLS CUI [1,4])
C1710187 (UMLS CUI [1,5])
C0680240 (UMLS CUI [1,6])
C0679646 (UMLS CUI [2,1])
C0679006 (UMLS CUI [2,2])
Discharge to place of choice
Code List
Do you agree with the following statement?
CL Item
Yes, definitely (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, to some extent (2)
C1705108 (UMLS CUI-1)
C0205392 (UMLS CUI-2)
C0439792 (UMLS CUI-3)
(Comment:en)
CL Item
No (3)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
Do you agree with the following statement?
integer
C1704726 (UMLS CUI [1,1])
C0035820 (UMLS CUI [1,2])
C0679646 (UMLS CUI [1,3])
C0086388 (UMLS CUI [1,4])
C1710187 (UMLS CUI [1,5])
C0680240 (UMLS CUI [1,6])
C0086282 (UMLS CUI [2,1])
C0679006 (UMLS CUI [2,2])
C0085537 (UMLS CUI [3,1])
C0679006 (UMLS CUI [3,2])
Discharge to place of choice
Code List
Do you agree with the following statement?
CL Item
Yes, definitely (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
Yes, to some extent (2)
C1705108 (UMLS CUI-1)
C0205392 (UMLS CUI-2)
C0439792 (UMLS CUI-3)
(Comment:en)
CL Item
No (3)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
Did you have confidence and trust in the healthcare staff treating or supporting you?
integer
C1704726 (UMLS CUI [1,1])
C0086388 (UMLS CUI [1,2])
C0237935 (UMLS CUI [2,1])
C1704312 (UMLS CUI [2,2])
Confidence in healthcare professionals
Code List
Did you have confidence and trust in the healthcare staff treating or supporting you?
CL Item
Yes, always (1)
C1705108 (UMLS CUI-1)
C2003902 (UMLS CUI-2)
(Comment:en)
CL Item
Yes, sometimes (2)
C1705108 (UMLS CUI-1)
C1998882 (UMLS CUI-2)
(Comment:en)
CL Item
No (3)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
Do you agree with the following statement?
integer
C1710187 (UMLS CUI [1,1])
C0680240 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,3])
C2713415 (UMLS CUI [1,4])
C1710187 (UMLS CUI [2,1])
C0680240 (UMLS CUI [2,2])
C0087111 (UMLS CUI [2,3])
C0679133 (UMLS CUI [2,4])
Confidence in healthcare professionals
Code List
Do you agree with the following statement?
CL Item
Yes, always (1)
C1705108 (UMLS CUI-1)
C2003902 (UMLS CUI-2)
(Comment:en)
CL Item
Yes, sometimes (2)
C1705108 (UMLS CUI-1)
C1998882 (UMLS CUI-2)
(Comment:en)
CL Item
No (3)
C1298908 (UMLS CUI-1)
(Comment:en)
Item
Do you agree with the following statement?
integer
C0017313 (UMLS CUI [1,1])
C0700114 (UMLS CUI [1,2])
C1710187 (UMLS CUI [1,3])
C0680240 (UMLS CUI [1,4])
Discharge to place of choice
Code List
Do you agree with the following statement?
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No (2)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Don't know (3)
C3843613 (UMLS CUI-1)
(Comment:en)
Item
Do you agree with the following statement?
integer
C0017313 (UMLS CUI [1,1])
C0700114 (UMLS CUI [1,2])
C0205309 (UMLS CUI [1,3])
C0027361 (UMLS CUI [1,4])
C1710187 (UMLS CUI [1,5])
C0680240 (UMLS CUI [1,6])
Coordination of care Question 2
Code List
Do you agree with the following statement?
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No - I co-ordinate my own care and support (2)
C0036588 (UMLS CUI-1)
C0017313 (UMLS CUI-2)
C0700114 (UMLS CUI-3)
(Comment:en)
CL Item
Don't know (3)
C3843613 (UMLS CUI-1)
(Comment:en)
CL Item
Not sure (4)
C3844332 (UMLS CUI-1)
(Comment:en)
Item Group
Place of death
C0421611 (UMLS CUI-1)
Item
Please indicate whether you would like to express a preferred place to die?
integer
C0421611 (UMLS CUI [1,1])
C0558295 (UMLS CUI [1,2])
C1710187 (UMLS CUI [1,3])
Desire to express preferred place of death
Code List
Please indicate whether you would like to express a preferred place to die?
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
No, would prefer not to say (2)
C4697925 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (3)
C0439673 (UMLS CUI-1)
(Comment:en)
Item
Please indicate where you would prefer to die?
integer
C0421611 (UMLS CUI [1,1])
C0558295 (UMLS CUI [1,2])
Preferred place of death
Code List
Please indicate where you would prefer to die?
CL Item
Acute hospital (1)
C1552466 (UMLS CUI-1)
(Comment:en)
CL Item
Community hospitals (2)
C0020003 (UMLS CUI-1)
(Comment:en)
CL Item
Own residence (3)
C0030705 (UMLS CUI-1)
C0237096 (UMLS CUI-2)
(Comment:en)
CL Item
Care/nursing home (4)
C0028688 (UMLS CUI-1)
(Comment:en)
CL Item
Hospice (5)
C0019947 (UMLS CUI-1)
(Comment:en)
CL Item
Other residence (e.g. carer/family) (6)
C0205394 (UMLS CUI-1)
C0237096 (UMLS CUI-2)
(Comment:en)
CL Item
Other (7)
C0205394 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (8)
C0439673 (UMLS CUI-1)
(Comment:en)
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