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pdfPriority Conditions Enumeration (PE) Section
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LOOP_01
FOR EACH ELEMENT IN THE RU-MEMBERS-ROSTER, ASK PE00A-END_LP01
LOOP DEFINITION: LOOP_01 COLLECTS GENERAL HEALTH RATINGS AND ENUMERATES
THE PRIORITY HEALTH CONDITIONS OF EACH PERSON IN THE RU. THIS LOOP CYCLES
ON EACH PERSON IN THE RU-MEMBERS-ROSTER WHO MEETS THE FOLLOWING CONDITIONS:
-
PERSON IS A CURRENT OR INSTITUTIONALIZED RU MEMBER
PERSON IS NOT DECEASED
PE00A
Help Enabled
Variable Name
PRND.PHEALTH
Comment Enabled
Jump Back Enabled
Label
Size
2
PERSONS HEALTH GENERAL RATING
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}{END-DT}
Please think about (PERSON)'s health between (START DATE) and (END
DATE).
In general, compared to other people of (PERSON)'s age, would you say that
(PERSON)'s health is excellent, very good, good, fair, or poor?
EXCELLENT
1
{PE00B}
VERY GOOD
GOOD
FAIR
POOR
2
3
4
5
{PE00B}
{PE00B}
{PE00B}
{PE00B}
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1
{PE00B}
{PE00B}
Priority Conditions Enumeration (PE) Section
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PE00B
Help Enabled
Variable Name
PRND.PMENTAL
Comment Enabled
Jump Back Enabled
Label
PERSONS MENTAL HEALTH GENERAL RATING
Size
2
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}{END-DT}
In general, would you say that (PERSON)'s mental health is excellent, very
good, good, fair, or poor?
EXCELLENT
VERY GOOD
1
2
{BOX_00}
{BOX_00}
GOOD
FAIR
3
4
{BOX_00}
{BOX_00}
POOR
5
{BOX_00}
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{BOX_00}
{BOX_00}
BOX_00
IF:
- ROUND 1, 3 OR 5
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
CONTINUE WITH PE01
OTHERWISE, GO TO END_LP01
2
Priority Conditions Enumeration (PE) Section
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PE01
Help Enabled
Comment Enabled
Jump Back Enabled
{PERSON'S FIRST MIDDLE AND LAST NAME}
Now I’m going to ask you about certain medical conditions (PERSON) may
have had. For these questions, please think about (PERSON)’s health over
(his/her) lifetime.
PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.
BOX_01
IF PERSON IS > OR = 18 YEARS OF AGE OR IN AGE CATEGORIES 4-9, CONTINUE
WITH BOX_02
OTHERWISE, GO TO BOX_14
BOX_02
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
OR
- ROUND 3 OR 5 AND 'HYPERTENSION-HI BLOOD PRESSURE' (FLAGGED AS COLLECTED
IN PE SECTION)
NOT ON PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A
PREVIOUS ROUND
CONTINUE WITH PE02
OTHERWISE, GO TO BOX_03
3
Priority Conditions Enumeration (PE) Section
Beta
PE02
Help Enabled (PE02Help)
Comment Enabled
Jump Back Enabled
Variable Name
COND.PRIOLIST
Label
IS THE CONDITION ON JOB AIDE LIST?
Size
2
PRND.HGHBLOOD
CRND.CRNDRURN
PERS HAS HIGH BLOOD PRESSURE HYPERTENSIO
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Other than during pregnancy, (have/has)/(Have/Has)} (PERSON) ever been
told by a doctor or other health professional that (PERSON) had hypertension,
also called high blood pressure?
YES
1
{PE03}
NO
2
{BOX_03}
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{BOX_03}
{BOX_03}
HELP AVAILABLE FOR DEFINITION OF HYPERTENSION.
DISPLAY INSTRUCTIONS:
DISPLAY ‘Other than during pregnancy, (have/has)’ IF PERSON
BEING ASKED ABOUT IS FEMALE. DISPLAY ‘(Have/Has)’ IF PERSON
BEING ASKED ABOUT IS MALE.
PROGRAMMER NOTES:
IF CODED ‘1’ (YES), ADD ‘HYPERTENSION-HI BLOOD PRESSURE’ TO
PERSON’S-MEDICAL-CONDITIONS-ROSTER. FLAG CONDITION AS
COLLECTED IN PE SECTION.
4
Priority Conditions Enumeration (PE) Section
Beta
PE03
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the hypertension, also called high blood
pressure, was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{PE04}
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Refused
Don't Know
Hard CHECK:
RANGE CHECK:
RF
DK
0 TO PERSON’S CURRENT AGE
5
{PE04}
{PE04}
Priority Conditions Enumeration (PE) Section
Beta
PE04
Help Enabled
Variable Name
PRND.HGHBLD2X
Comment Enabled
Jump Back Enabled
Label
Size
2
HYPERTENSION 2 OR MORE TIMES
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Were/Was) (PERSON) told on two or more different visits that (PERSON)
had hypertension, also called high blood pressure?
YES
1
{BOX_03}
NO
2
{BOX_03}
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{BOX_03}
{BOX_03}
BOX_03
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
OR
- ROUND 3 OR 5 AND 'CORONARY HEART DISEASE' (FLAGGED AS COLLECTED IN PE
SECTION) NOT ON PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS
ROUND
CONTINUE WITH PE05
OTHERWISE, GO TO BOX_04
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Priority Conditions Enumeration (PE) Section
Beta
PE05
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PRND.CORHRTDX
CORONARY HEART DISEASE
Label
Size
2
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) ever been told by a doctor or other health professional
that (PERSON) had coronary heart disease?
YES
NO
1
2
{PE06}
{BOX_04}
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{BOX_04}
{BOX_04}
PROGRAMMER NOTES:
IF CODED ‘1’ (YES), ADD ‘CORONARY HEART DISEASE’ TO PERSON’SMEDICAL-CONDITIONS-ROSTER. FLAG CONDITION AS COLLECTED IN PE
SECTION.
7
Priority Conditions Enumeration (PE) Section
Beta
PE06
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the coronary heart disease was first
diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{BOX_04}
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Refused
Don't Know
Hard CHECK:
RANGE CHECK:
RF
DK
{BOX_04}
{BOX_04}
0 TO PERSON’S CURRENT AGE
BOX_04
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
OR
- ROUND 3 OR 5 AND 'ANGINA' (FLAGGED AS COLLECTED IN PE SECTION) NOT ON
PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS ROUND
CONTINUE WITH PE07
OTHERWISE, GO TO BOX_05
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Priority Conditions Enumeration (PE) Section
Beta
PE07
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PRND.ANGINA
ANGINA PECTORIS
Label
Size
2
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) ever been told by a doctor or other health professional
that (PERSON) had angina, also called angina pectoris?
YES
1
{PE08}
NO
2
{BOX_05}
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{BOX_05}
{BOX_05}
PROGRAMMER NOTES:
IF CODED ‘1’ (YES), ADD ‘ANGINA’ TO PERSON’S-MEDICALCONDITIONS-ROSTER. FLAG CONDITION AS COLLECTED IN PE SECTION.
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Priority Conditions Enumeration (PE) Section
Beta
PE08
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the angina, also called angina pectoris,
was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{BOX_05}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
Hard CHECK:
RANGE CHECK:
RF
DK
{BOX_05}
{BOX_05}
0 TO PERSON’S CURRENT AGE
BOX_05
IF:
- ROUND
OR
- ROUND
ROUND
OR
- ROUND
IN PE
ROUND
1
2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
3 OR 5 AND 'HEART ATTACK-MYOCARDIAL INFARC' (FLAGGED AS COLLECTED
SECTION) NOT ON PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS
CONTINUE WITH PE09
OTHERWISE, GO TO BOX_06
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Priority Conditions Enumeration (PE) Section
Beta
PE09
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PRND.HRTATTK
HEART ATTACK
Label
Size
2
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) ever been told by a doctor or other health professional
that (PERSON) had a heart attack, also called myocardial infarction or MI?
YES
NO
1
2
{PE10}
{BOX_06}
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{BOX_06}
{BOX_06}
PROGRAMMER NOTES:
IF CODED ‘1’ (YES), ADD ‘HEART ATTACK-MYOCARDIAL INFARC’ TO
PERSON’S-MEDICAL-CONDITIONS-ROSTER. FLAG CONDITION AS
COLLECTED IN PE SECTION.
11
Priority Conditions Enumeration (PE) Section
Beta
PE10
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the heart attack, also called myocardial
infarction or MI, was first diagnosed?
IF MORE THAN ONE HEART ATTACK, PROBE FOR AGE WHEN FIRST
HEART ATTACK DIAGNOSED.
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{BOX_06}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
Hard CHECK:
RANGE CHECK:
RF
DK
{BOX_06}
{BOX_06}
0 TO PERSON’S CURRENT AGE
BOX_06
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
OR
- ROUND 3 OR 5 AND 'OTH HRT COND-{SPECIFY TEXT......}' (FLAGGED AS
COLLECTED IN
PE SECTION) NOT ON PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS
ROUND
CONTINUE WITH PE11
OTHERWISE, GO TO BOX_07
12
Priority Conditions Enumeration (PE) Section
Beta
PE11
Help Enabled
Variable Name
PRND.OTHRTCND
Comment Enabled
Jump Back Enabled
Label
Size
2
OTHER HEART CONDITION
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) ever been told by a doctor or other health professional
that (PERSON) had any other kind of heart condition or heart disease, other
than coronary heart disease, angina, or heart attack?
YES
NO
1
2
{PE11OV}
{BOX_07}
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13
{BOX_07}
{BOX_07}
Priority Conditions Enumeration (PE) Section
Beta
PE11OV
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PRND.HRTCNDOS
OTHER HEART CONDITION SPECIFY
Label
Size
45
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
What did the doctor or other health professional call it?
SPECIFY HEART _______________________
CONDITION:
{PE12}
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{PE12}
{PE12}
PROGRAMMER NOTES:
IF CODED ‘1’ (YES) AT PE11, ADD ‘OTH HRT COND-{SPECIFY
TEXT.....}’ TO PERSON’S-MEDICAL-CONDITIONS-ROSTER. USE THE
FIRST 17 CHARACTERS OF THE OTHER SPECIFY TEXT ENTERED AT
PE11OV AS PART OF THE CONDITION NAME. FLAG CONDITION AS
COLLECTED IN PE SECTION.
14
Priority Conditions Enumeration (PE) Section
Beta
PE12
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the other kind of heart condition, that is
the {OTHER HEART CONDITION SPECIFY TEXT}, was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{BOX_07}
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RF
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{BOX_07}
{BOX_07}
DISPLAY INSTRUCTIONS:
FOR ‘OTHER HEART CONDITION SPECIFY TEXT’, DISPLAY THE TEXT
ENTERED AT PE11OV.
Hard CHECK:
RANGE CHECK:
0 TO PERSON’S CURRENT AGE
BOX_07
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
OR
- ROUND 3 OR 5 AND 'STROKE-TIA' (FLAGGED AS COLLECTED IN PE SECTION) NOT
ON PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS ROUND
CONTINUE WITH PE13
OTHERWISE, GO TO BOX_08
15
Priority Conditions Enumeration (PE) Section
Beta
PE13
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PRND.PCSTROKE
STROKE
Label
Size
2
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) ever been told by a doctor or other health professional
that (PERSON) had a stroke or TIA? A TIA is a transient ischemic attack
which is sometimes referred to as a ministroke.
YES
NO
1
2
{PE14}
{BOX_08}
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RF
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{BOX_08}
{BOX_08}
PROGRAMMER NOTES:
IF CODED ‘1’ (YES), ADD ‘STROKE-TIA’ TO PERSON’S-MEDICALCONDITIONS-ROSTER. FLAG CONDITION AS COLLECTED IN PE SECTION.
16
Priority Conditions Enumeration (PE) Section
Beta
PE14
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the stroke or TIA was first diagnosed?
IF MORE THAN ONE STROKE, PROBE FOR AGE WHEN FIRST STROKE
DIAGNOSED.
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{BOX_08}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
Hard CHECK:
RANGE CHECK:
RF
DK
{BOX_08}
{BOX_08}
0 TO PERSON’S CURRENT AGE
BOX_08
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
OR
- ROUND 3 OR 5 AND 'EMPHYSEMA' (FLAGGED AS COLLECTED IN PE SECTION) NOT ON
PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS ROUND
CONTINUE WITH PE15
OTHERWISE, GO TO BOX_09
17
Priority Conditions Enumeration (PE) Section
Beta
PE15
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PRND.EMPHYSMA
EMPHYSEMA
Label
Size
2
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) ever been told by a doctor or other health professional
that (PERSON) had emphysema?
YES
1
{PE16}
NO
2
{BOX_09}
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Don't Know
RF
DK
{BOX_09}
{BOX_09}
PROGRAMMER NOTES:
IF CODED ‘1’ (YES), ADD ‘EMPHYSEMA’ TO PERSON’S-MEDICALCONDITIONS-ROSTER. FLAG CONDITION AS COLLECTED IN PE SECTION.
18
Priority Conditions Enumeration (PE) Section
Beta
PE16
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the emphysema was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{BOX_09}
----------------------------------------------------------------------------------------------------------------------------------
HARD CHECK:
RANGE CHECK:
Refused
RF
{BOX_09}
Don't Know
DK
{BOX_09}
0 TO PERSON’S CURRENT AGE
BOX_09
IF:
- ROUND 1, 3 OR 5
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
CONTINUE WITH PE17
OTHERWISE, GO TO BOX_10
19
Priority Conditions Enumeration (PE) Section
Beta
PE17
Help Enabled (PE17Help)
Comment Enabled
Jump Back Enabled
Variable Name
PRND.CHROBRON
CHRONIC BRONCHITIS
Label
Size
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
During the past 12 months, (have/has) (PERSON) been told by a doctor or
other health professional that (PERSON) had chronic bronchitis?
Please do not include isolated instances of acute bronchitis.
YES
1
NO
2
{BOX_10}
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RF
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{BOX_10}
{BOX_10}
HELP AVAILABLE FOR DEFINITION OF ACUTE AND CHRONIC
BRONCHITIS.
PROGRAMMER NOTES:
IF CODED ‘1’ (YES), ADD ‘CHRONIC BRONCHITIS’ TO PERSON’SMEDICAL-CONDITIONS-ROSTER. FLAG CONDITION AS COLLECTED IN PE
SECTION.
20
Priority Conditions Enumeration (PE) Section
Beta
ROUTING INSTRUCTION:
IF:
- PE17 IS CODED ‘1’ (YES)
AND
- ROUND 1 OR [NOT ROUND 1 AND PE18 NOT ASKED IN A PREVIOUS
ROUND]
CONTINUE WITH PE18
OTHERWISE, GO TO BOX_10
PE18
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the chronic bronchitis was first
diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{BOX_10}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
HARD CHECK:
RANGE CHECK:
RF
DK
0 TO PERSON’S CURRENT AGE
21
{BOX_10}
{BOX_10}
Priority Conditions Enumeration (PE) Section
Beta
BOX_10
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
OR
- ROUND 3 OR 5 AND 'HIGH CHOLESTEROL' (FLAGGED AS COLLECTED IN PE SECTION)
NOT ON PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS ROUND,
CONTINUE WITH PE19
OTHERWISE, GO TO BOX_11
22
Priority Conditions Enumeration (PE) Section
Beta
PE19
Help Enabled
Comment Enabled
Variable Name
PRND.CHOLHIGH
Jump Back Enabled
Label
Size
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) ever been told by a doctor or other health professional
that (PERSON) had high cholesterol?
YES
1
{PE20}
NO
2
{BOX_11}
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Refused
Don't Know
RF
DK
{BOX_11}
{BOX_11}
PROGRAMMER NOTES:
IF CODED ‘1’ (YES), ADD ‘HIGH CHOLESTEROL’ TO PERSON’S-MEDICALCONDITIONS-ROSTER. FLAG CONDITION AS COLLECTED IN PE SECTION.
23
Priority Conditions Enumeration (PE) Section
Beta
PE20
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the high cholesterol was first
diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{BOX_11}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
HARD CHECK:
RANGE CHECK:
RF
DK
{BOX_11}
{BOX_11}
0 TO PERSON’S CURRENT AGE
BOX_11
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
OR
- ROUND 3 OR 5 AND 'CANCER-{ANY TYPE}' (FLAGGED AS COLLECTED IN PE SECTION)
NOT ON PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS ROUND (THAT IS,
PERSON DID NOT REPORT ANY CANCER AT PE22 OR PE22OV IN ANY PREVIOUS
ROUND),
CONTINUE WITH PE21
OTHERWISE, GO TO BOX_12
24
Priority Conditions Enumeration (PE) Section
Beta
PE21
Help Enabled
Variable Name
PRND.CANCERML
Comment Enabled
Jump Back Enabled
Label
Size
MALIGNANT CANCER
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) ever been told by a doctor or other health professional
that (PERSON) had cancer or a malignancy of any kind?
YES
1
{PE22}
NO
2
{BOX_12}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
25
{BOX_12}
{BOX_12}
Priority Conditions Enumeration (PE) Section
Beta
PE22
Help Enabled
Comment Enabled
Variable Name
PRND.CRCOLON
Label
Jump Back Enabled
Size
2
PRND.CRMELANO
PRND.CRLUNG
2
2
PRND.CRLEUKEM
PRND.CRLARYNX
2
2
PRND.CRKIDNEY
2
PRND.CRMOUTH
PRND.CRESOPH
2
2
PRND.CRLYMPH
2
PRND.CRCERVIX
PRND.CRBREAST
2
2
PRND.CRBRAIN
PRND.CRBONE
2
2
PRND.CRBLOOD
2
PRND.CRBLADDR
PRND.CRGALLBL
2
2
PRND.CRPANCRS
2
PRND.CRSTOMCH
PRND.CRSKINNM
2
2
PRND.CRLIVER
PRND.CRTHROAT
2
2
PRND.CRMUSCLE
2
PRND.CRTESTIS
PRND.CRPROSTA
2
2
PRND.CRSKINDK
2
PRND.CROVARY
PRND.CROTHER
2
2
PRND.CRTHYROID
PRND.CRUTERUS
2
2
PRND.CRRECTUM
2
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
CRND.CREATEQ
CREATION STAMP
2
COND.CONDID
CRND.CRNDRURN
COND ID KEY: PERSID + COUNTER(3) + CD
ROUND STAMP: RU LETTER + ROUND NUMBER
12
2
COND.PRIOLIST
CRND.CRNDID
IS THE CONDITION ON JOB AIDE LIST?
CRND ID KEY: CONDID + ROUND NUMBER
2
13
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
{PERSON’S FIRST MIDDLE AND LAST NAME}
What kind of cancer was it?
26
2
30
Priority Conditions Enumeration (PE) Section
Beta
CHECK ALL THAT APPLY.
BLADDER
1
BLOOD
BONE
2
3
BRAIN
4
BREAST
CERVIX
5
6
COLON
ESOPHAGUS
GALLBLADDER
7
8
9
KIDNEY
LARYNX-WINDPIPE
10
11
LEUKEMIA
LIVER
12
13
LUNG
LYMPHOMA
14
15
MELANOMA
16
MOUTH/TONGUE/LIP
OVARY
17
18
PANCREAS
PROSTATE
19
20
RECTUM
21
SKIN (NON-MELANOMA)
SKIN (DK WHAT KIND)
22
23
SOFT TISSUE (MUSCLE OR FAT)
STOMACH
24
25
TESTIS
THROAT-PHARYNX
26
27
THYROID
28
UTERUS
OTHER
29
91
{PE22OV}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
27
{LOOP_02}
{LOOP_02}
Priority Conditions Enumeration (PE) Section
Beta
PROGRAMMER NOTES:
FOR EACH TYPE OF CANCER SELECTED AT PE22, ADD ‘CANCER-{SPECIFY
TYPE...........}’ TO PERSON’S-MEDICAL-CONDITIONS-ROSTER, WHERE
'SPECIFY' TYPE IS THE NAME OF THE CANCER TYPE SELECTED. SINCE
THE LENGTH OF THE CONDNAM IS LIMITED TO 30 CHARACTERS,
AABREVIATE 'SOFT SISSUE' OPTION TO 'CANCER-SOFT TISSUE
(MUCL/FAT) FLAG EACH CONDITION CREATED AT PE22 AS COLLECTED IN
PE SECTION. FOR EACH TYPE FO CANCER SELECTED, CREATE A COND
AND CRND RECORD.
ROUTING INSTRUCTION:
IF 'OTHER' SELECTED ALONE OR IN COMBINATION WITH ANY OTHER
RESPONSE, CONTINUE WITH PE22OV.
OTHERWISE, GO TO LOOP_02.
28
Priority Conditions Enumeration (PE) Section
Beta
PE22OV
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
COND.PRIOLIST
Label
IS THE CONDITION ON JOB AIDE LIST?
Size
2
CRND.CRNDRURN
CRND.CRNDID
ROUND STAMP: RU LETTER + ROUND NUMBER
CRND ID KEY: CONDID + ROUND NUMBER
2
13
CRND.CREATEQ
COND.CREATEQ
CREATION STAMP
QUESTION THAT CREATED COND SEGMENT
2
4
COND.CONDRURN
ROUND STAMP: RU LETTER + ROUND NUMBER
2
COND.CONDNAM
COND.CONDID
NAME OF CONDITION
COND ID KEY: PERSID + COUNTER(3) + CD
30
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
SPECIFY OTHER _______________________
TYPE OF CANCER.
{LOOP_02}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
{LOOP_02}
{LOOP_02}
PROGRAMMER NOTES:
ALLOW UP TO 23 CHARACTERS FOR THIS FIELD.
ADD 'CANCER-{OTHER SPECIFY}' TO PERSON'S -MEDICAL-CONDITIONSROSTER AND FLAG CONDITION AS CREATED IN THE PE SECTION
LOOP_02
FOR EACH ELEMENT IN PERSON’S-MEDICAL-CONDITIONS ROSTER, ASK PE23-END_LP02
LOOP DEFINITION: LOOP_02 CYCLES ON EACH TYPE OF CANCER ENUMERATED AT PE22
FOR PERSON. LOOP_02 COLLECTS THE AGE THE CANCER WAS DIAGNOSED, WHETHER IT
IS MALIGNANT OR BENIGN AND WHETHER IT IS IN REMISSION. THIS LOOP CYCLES ON
EACH CONDITION IN PERSON’S-MEDICAL-CONDITIONS-ROSTER THAT MEETS THE
FOLLOWING CONDITION:
- CONDITION WAS CREATED AT PE22 IN THE CURRENT ROUND
29
Priority Conditions Enumeration (PE) Section
Beta
PE23
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON'S FIRST MIDDLE AND LAST NAME} {PERSON'S MEDICAL
CONDITION.}
How old (were/was) (PERSON) when the (CONDITION) was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{PE24}
----------------------------------------------------------------------------------------------------------------------------------
Refused
RF
{PE24}
Don't Know
DK
{PE24}
DISPLAY INSTRUCTIONS:
{PERSON'S MEDICAL CONDITION} : IN THE HEADER, DISPLAY THE TYPE
OF CANCER ENUMERATED AT PE22 THAT IS CURRENTLY BEING CYCLED ON
IN LOOP_02.
HARD CHECK:
RANGE CHECK:
0 TO PERSON’S CURRENT AGE
30
Priority Conditions Enumeration (PE) Section
Beta
PE24
Help Enabled (PE24Help)
Variable Name
COND.MALBEN
Comment Enabled
Jump Back Enabled
Label
Size
MALIGNANT OR BENIGN
{PERSON'S FIRST MIDDLE AND LAST NAME} {PERSON'S MEDICAL
CONDITION.}
Is (PERSON)’s (CONDITION) malignant or benign?
MALIGNANT
1
{PE25}
BENIGN
2
{PE25}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
{PE25}
{PE25}
HELP AVAILABLE FOR DEFINITION OF MALIGNANT AND BENIGN.
DISPLAY INSTRUCTIONS:
{PERSON'S MEDICAL CONDITION} : IN THE HEADER, DISPLAY THE TYPE
OF CANCER ENUMERATED AT PE22 THAT IS CURRENTLY BEING CYCLED ON
IN LOOP_02.
31
Priority Conditions Enumeration (PE) Section
Beta
PE25
Help Enabled (PE25Help)
Variable Name
COND.REMISSN
Comment Enabled
Jump Back Enabled
Label
Size
REMISSION
{PERSON'S FIRST MIDDLE AND LAST NAME} {PERSON'S MEDICAL
CONDITION.}
Is (PERSON)’s (CONDITION) in remission, that is, the (CONDITION) is under
control?
YES
NO
1
2
{END_LP02}
{END_LP02}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
{END_LP02}
{END_LP02}
HELP AVAILABLE FOR DEFINITION OF REMISSION.
DISPLAY INSTRUCTIONS:
{PERSON'S MEDICAL CONDITION} : IN THE HEADER, DISPLAY THE TYPE
OF CANCER ENUMERATED AT PE22 THAT IS CURRENTLY BEING CYCLED ON
IN LOOP_02.
END_LP02
CYCLE ON NEXT CONDITION IN PERSON'S-MEDICAL-CONDITIONS-ROSTER THAT MEETS
THE CONDITIONS STATED IN THE LOOP DEFINITION
IF NO OTHER CONDITIONS MEET THE STATED CONDITIONS, END LOOP_02 AND
CONTINUE WITH BOX_12
32
Priority Conditions Enumeration (PE) Section
Beta
BOX_12
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
OR
- ROUND 3 OR 5 AND 'DIABETES' (FLAGGED AS COLLECTED IN PE SECTION) NOT ON
PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS ROUND (THAT IS,
DIABETES HAS NOT BEEN REPORTED FOR PERSON AT PE26 IN ANY PREVIOUS ROUND),
CONTINUE WITH PE26
OTHERWISE, GO TO BOX_13
33
Priority Conditions Enumeration (PE) Section
Beta
PE26
Help Enabled (PE26Help)
Comment Enabled
Jump Back Enabled
Variable Name
PRND.PCDIABET
PERSON HAS DIABETES
Label
Size
2
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Other than during pregnancy, (have/has)/(Have/Has)} (PERSON) ever been
told by a doctor or other health professional that (PERSON) had diabetes or
sugar diabetes?
YES
1
{PE27}
NO
2
{BOX_13}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
{BOX_13}
{BOX_13}
HELP AVAILABLE FOR DEFINITION OF DIABETES.
DISPLAY INSTRUCTIONS:
DISPLAY ‘Other than during pregnancy, (have/has)’ IF PERSON
BEING ASKED ABOUT IS FEMALE. DISPLAY ‘(Have/Has)’ IF PERSON
BEING ASKED ABOUT IS MALE
PROGRAMMER NOTES:
IF CODED ‘1’ (YES), ADD ‘DIABETES’ TO PERSON’S-MEDICALCONDITIONS-ROSTER. FLAG CONDITION AS COLLECTED IN PE SECTION.
34
Priority Conditions Enumeration (PE) Section
Beta
PE27
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the diabetes or sugar diabetes was first
diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{BOX_13}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
HARD CHECK:
RANGE CHECK:
RF
DK
{BOX_13}
{BOX_13}
0 TO PERSON’S CURRENT AGE
BOX_13
IF:
- ROUND 1, 3 OR 5
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
CONTINUE WITH PE28
OTHERWISE, GO TO BOX_14
35
Priority Conditions Enumeration (PE) Section
Beta
PE28
Help Enabled
Variable Name
PRND.ACHEJNT
Comment Enabled
Jump Back Enabled
Label
Size
2
PAIN ACHING AROUND A JOINT
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) had pain, aching, stiffness or swelling around a joint in
the past 12 months?
YES
1
NO
2
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
PROGRAMMER NOTES:
ADD
ROUTING INSTRUCTION:
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING
THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND ‘RHEUMATHOID ARTHRITIS’, ‘OSTEOARTHRITIS’ OR
‘ARTHRITIS (NOT SPECIFIED)’ (FLAGGED AS COLLECTED IN PE
SECTION)
NOT ON PERSON’S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS
ROUND
(THAT IS, ARTHRITIS OF ANY KIND HAS NOT BEEN REPORTED FOR
PERSON AT PE29 IN ANY
PREVIOUS ROUND),
CONTINUE WITH PE29
OTHERWISE, GO TO BOX_14
36
Priority Conditions Enumeration (PE) Section
Beta
PE29
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PRND.ARTHRIT
ARTHRITIS
Label
Size
2
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) ever been told by a doctor or other health professional
that (PERSON) had arthritis?
YES
NO
1
2
{PE30}
{BOX_14}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
{BOX_14}
{BOX_14}
PROGRAMMER NOTES:
IF PE28 IS CODED ‘1’ (YES) AND PE29 IS CODED ‘2’ (NO), ‘RF’
(REFUSED), OR ‘DK’ (DON’T KNOW), ADD ‘JOINT PAIN’ TO PERSON’SMEDICAL-CONDITIONS-ROSTER. FLAG CONDITION AS COLLECTED IN PE
SECTION. (NOTE THAT CONDITION
RECORD FOR ARTHRITIS IS NOT CREATED HERE BUT AT PE30.)
37
Priority Conditions Enumeration (PE) Section
Beta
PE30
Help Enabled (PE30Help)
Comment Enabled
Jump Back Enabled
Variable Name
COND.PRIOLIST
Label
IS THE CONDITION ON JOB AIDE LIST?
Size
2
CRND.CRNDRURN
CRND.CRNDID
ROUND STAMP: RU LETTER + ROUND NUMBER
CRND ID KEY: CONDID + ROUND NUMBER
2
13
CRND.CREATEQ
COND.CREATEQ
CREATION STAMP
QUESTION THAT CREATED COND SEGMENT
2
4
COND.CONDRURN
ROUND STAMP: RU LETTER + ROUND NUMBER
2
COND.CONDNAM
COND.CONDID
NAME OF CONDITION
COND ID KEY: PERSID + COUNTER(3) + CD
30
12
PRND.ARTHTYPE
TYPE OF ARTHRITIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
What type of arthritis was that?
PROBE: (Were/Was) (PERSON) diagnosed with rheumatoid arthritis or
osteoarthritis?
CODE ‘NOT SPECIFIED’ IF RESPONDENT DOES NOT KNOW THE TYPE
OF ARTHRITIS.
RHEUMATOID ARTHRITIS
OSTEOARTHRITIS
1
2
{PE31}
{PE31}
NOT SPECIFIED
3
{PE31}
----------------------------------------------------------------------------------------------------------------------------------
Refused
RF
{PE31}
HELP AVAILABLE FOR DEFINITION OF RHEUMATOID ARTHRITIS AND
OSTEOARTHRITIS.
38
Priority Conditions Enumeration (PE) Section
Beta
PROGRAMMER NOTES:
IF CODED ‘1’ (RHEUMATOID ARTHRITIS), ADD ‘RHEUMATOID
ARTHRITIS’ TO PERSON’S-MEDICAL-CONDITIONS-ROSTER. FLAG
CONDITION AS COLLECTED IN PE SECTION.
IF CODED ‘2’ (OSTEOARTHRITIS), ADD ‘OSTEOARTHRITIS’ TO
PERSON’S-MEDICAL-CONDITIONS-ROSTER. FLAG CONDITION AS
COLLECTED IN PE SECTION.
IF CODED ‘3’ (NOT SPECIFIED) OR ‘RF’ (REFUSED), ADD ‘ARTHRITIS
(NOT SPECIFIED)’ TO PERSON’S-MEDICAL-CONDITIONS-ROSTER. FLAG
CONDITION AS COLLECTED IN PE SECTION.
CODE ‘DK’ (DON’T KNOW) DISALLOWED.
39
Priority Conditions Enumeration (PE) Section
Beta
PE31
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the {rheumatoid arthritis/
osteoarthritis/arthritis} was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{BOX_14}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
{BOX_14}
{BOX_14}
DISPLAY INSTRUCTIONS:
DISPLAY ‘rheumatoid arthritis’ IF PE30 IS CODED ‘1’
(RHEUMATOID ARTHRITIS). DISPLAY ‘osteoarthritis’ IF PE30 IS
CODED ‘2’ (OSTEOARTHRITIS). DISPLAY ‘arthritis’ IF PE30 IS
CODED ‘3’ (NOT SPECIFIED) OR ‘RF’ (REFUSED).
HARD CHECK:
RANGE CHECK:
0 TO PERSON’S CURRENT AGE
BOX_14
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
OR
- ROUND 3 OR 5 AND 'ASTHMA' (FLAGGED AS COLLECTED IN PE SECTION) NOT ON
PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS ROUND
CONTINUE WITH PE32
OTHERWISE, GO TO BOX_15
40
Priority Conditions Enumeration (PE) Section
Beta
PE32
Help Enabled (PE32Help)
Comment Enabled
Jump Back Enabled
Variable Name
PRND.PCASTHMA
PERSON HAS ASTHMA
Label
Size
2
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) ever been told by a doctor or other health professional
that (PERSON) (have/has) asthma?
YES
NO
1
2
{PE33}
{BOX_15}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
{BOX_15}
{BOX_15}
HELP AVAILABLE FOR DEFINITION OF ASTHMA.
PROGRAMMER NOTES:
IF CODED ‘1’ (YES), ADD ‘ASTHMA’ TO PERSON’S-MEDICALCONDITIONS-ROSTER. FLAG CONDITION AS COLLECTED IN PE SECTION.
41
Priority Conditions Enumeration (PE) Section
Beta
PE33
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the asthma was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{BOX_15}
----------------------------------------------------------------------------------------------------------------------------------
HARD CHECK:
RANGE CHECK:
Refused
RF
{BOX_15}
Don't Know
DK
{BOX_15}
0 TO PERSON’S CURRENT AGE
BOX_15
IF:
- ROUND 1, 3 OR 5
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
ROUND
CONTINUE WITH BOX_16
OTHERWISE, GO TO BOX_17
BOX_16
IF 'ASTHMA' (FLAGGED AS COLLECTED IN PE SECTION) ON PERSON'S-MEDICALCONDITIONS-ROSTER, CONTINUE WITH PE34
OTHERWISE, GO TO BOX_17
42
Priority Conditions Enumeration (PE) Section
Beta
PE34
Help Enabled (PE34Help)
Variable Name
PRND.ASTHMATK
Comment Enabled
Jump Back Enabled
Label
Size
2
HAD ASTHMA ATTACK PAST YEAR
{PERSON’S FIRST MIDDLE AND LAST NAME}
During the past 12 months, (have/has) (PERSON) had an episode of
asthma or an asthma attack?
YES
NO
1
2
{BOX_17}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
{BOX_17}
{BOX_17}
HELP AVAILABLE FOR DEFINITION OF ASTHMA ATTACK.
ROUTING INSTRUCTION:
IF:
- PE34 IS CODED ‘2’ (NO)
AND
- ROUND 1 OR NOT ROUND 1 AND PE35 NOT ASKED IN A PREVIOUS ROUND
CONTINUE WITH PE35
OTHERWISE, GO TO BOX_17
43
Priority Conditions Enumeration (PE) Section
Beta
PE35
Help Enabled
Comment Enabled
Variable Name
PRND.ASTHEPIS
Jump Back Enabled
Label
Size
{PERSON’S FIRST MIDDLE AND LAST NAME}
When did (PERSON) last have an episode of asthma or an asthma attack?
WITHIN PAST 2 YEARS
1
{BOX_17}
WITHIN PAST 3 YEARS
WITHIN PAST 5 YEARS
2
3
{BOX_17}
{BOX_17}
MORE THAN 5 YEARS
NEVER
4
5
{BOX_17}
{BOX_17}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
{BOX_17}
{BOX_17}
BOX_17
IF PERSON IS 5 - 17 YEARS OF AGE INCLUSIVE OR IN AGE CATEGORIES 3 OR 4,
CONTINUE WITH BOX_18
OTHERWISE, GO TO END_LP01
44
Priority Conditions Enumeration (PE) Section
Beta
BOX_18
IF:
- ROUND
OR
- ROUND
ROUND
OR
- ROUND
IN PE
ROUND
1
2 OR 4 AND PERSON ADDED TO DU-MEMBERS-ROSTER DURING THE CURRENT
3 OR 5 AND 'ATTENTION DEFICIT/HYPERACTIVITY' (FLAGGED AS COLLECTED
SECTION) NOT ON PERSON'S-MEDICAL-CONDITIONS-ROSTER FROM A PREVIOUS
CONTINUE WITH PE36
OTHERWISE, GO TO END_LP01
45
Priority Conditions Enumeration (PE) Section
Beta
PE36
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PRND.ADHDADD
Label
ATTENTION DEFICIT HYPERACTIVITY DISORDER
Size
COND.PRIOLIST
CRND.CRNDRURN
IS THE CONDITION ON JOB AIDE LIST?
ROUND STAMP: RU LETTER + ROUND NUMBER
2
2
CRND.CRNDID
CRND.CREATEQ
CRND ID KEY: CONDID + ROUND NUMBER
CREATION STAMP
13
2
COND.CREATEQ
QUESTION THAT CREATED COND SEGMENT
4
COND.CONDRURN
COND.CONDNAM
ROUND STAMP: RU LETTER + ROUND NUMBER
NAME OF CONDITION
2
30
COND.CONDID
COND ID KEY: PERSID + COUNTER(3) + CD
12
{PERSON’S FIRST MIDDLE AND LAST NAME}
Have you or (PERSON) ever been told by a doctor or other health
professional that (PERSON) had Attention Deficit Hyperactivity Disorder
(ADHD) or Attention Deficit Disorder (ADD)?
YES
1
{PE37}
NO
2
{END_LP01}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
{END_LP01}
{END_LP01}
PROGRAMMER NOTES:
IF CODED ‘1’ (YES), ADD ‘ATTENTION DEFICIT/HYPERACTIVITY’ TO
PERSON’S-MEDICAL-CONDITIONS-ROSTER. FLAG CONDITION AS
COLLECTED IN PE SECTION.
46
Priority Conditions Enumeration (PE) Section
Beta
PE37
Help Enabled
Variable Name
COND.AGEDIAG
Comment Enabled
Jump Back Enabled
Label
Size
AGE AT DIAGNOSIS
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old (were/was) (PERSON) when the Attention Deficit Hyperactivity
Disorder (ADHD) or Attention Deficit Disorder (ADD) was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR AGE.
AGE: _______
{END_LP01}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
HARD CHECK:
RANGE CHECK:
RF
DK
{END_LP01}
{END_LP01}
0 TO PERSON’S CURRENT AGE
END_LP01
CYCLE ON NEXT PERSON IN RU-MEMBERS-ROSTER WHO MEETS THE CONDITIONS STATED
IN THE LOOP DEFINITION
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_01 AND CONTINUE
WITH BOX_19
BOX_19
GO TO NEXT QUESTIONNAIRE SECTION
47
| File Type | application/pdf |
| File Title | \\rk29\vol2905\MEPSWVS\SpecWriter\BETA\PE (BETA).snp |
| Author | miller_n |
| File Modified | 2006-02-06 |
| File Created | 2006-02-06 |