Framingham Heart Study




< Back FRAMINGHAM HEART STUDY - CODING MANUAL EXAM 22 COHORT: ORIGINAL DATA COLLECTION TIME FRAME: EXAM 22 SAS DATASET NAME: EX0_22S.SSD01 #RECORDS: 1166 The value ranges and observation number stated in the manual are based on the original data set In some cases, observation may be deleted due to participant consent form restrictions If observations have been deleted from this data set, the ranges or observation number may differ from those stated in this manual ************************************************************************** Log kept at end of manual of all updates New changes made within manual Version 1: 02-08-2007 F521 should be FO521 Version 2: 09-05-2007 deleted variables FO597-FO606 *********************************************************************** NUMERICAL DATA - PART I ----------------------- VARIABLE INFORMATION -------- ----------- IDTYPE STUDY deleted - use random id ID PATIENT ID NUMBER deleted - use random id FO001 SEX OF PATIENT - CODED BY NURSE 1 MALE 2 FEMALE UNKNOWN (0) deleted - redundant, use most current basic file FO002 AGE OF PATIENT deleted - redundant, use most current basic file FO003 SITE OF EXAM 0 HEART STUDY 1 NURSING HOME 2 RESIDENCE 3 OTHER INSTITUTION UNKNOWN (0) deleted - to preserve confidentiality FO004 NURSING HOME LEVEL OF CARE 0 NONE 1 SKILLED CARE 24 HOURS, MEDICARE 2 SKILLED CARE 24 HOURS, MEDICAID OR PRIVATE 3 SKILLED CARE 8-16 HOURS 4 SELF CARE UNKNOWN (717) deleted - to preserve confidentiality FO005 MARITAL STATUS 1 SINGLE 2 MARRIED 3 WIDOWED 4 DIVORCED 5 SEPARATED UNKNOWN (9) FO006 NURSE EXAMINERS ID NUMBER 19 - 32 UNKNOWN (8) deleted - used for administrative purposes only FO007 WEIGHT (TO NEAREST POUND) 77 - 314 UNKNOWN (227) FO008 HEIGHT (INCHES, TO NEXT LOWER 1/4 INCH) 54.00 - 74.25 UNKNOWN (232) FO009 SKINFOLD TRICEPS - LEFT (MILLIMETERS) 2 - 41 UNKNOWN (235) deleted - data is known to be unreliable FO010 SKINFOLD TRICEPS - RIGHT (MILLIMETERS) 2 - 44 UNKNOWN (235) deleted - data is known to be unreliable FO011 SKINFOLD SUBSCAPULAR - LEFT (MILLIMETERS) 2 - 67 UNKNOWN (236) deleted - data is known to be unreliable FO012 SKINFOLD SUBSCAPULAR - RIGHT (MILLIMETERS) 2 - 52 UNKNOWN (236) deleted - data is known to be unreliable FO013 SKINFOLD ABDOMEN (MILLIMETERS) 1 - 58 UNKNOWN (246) deleted - data is known to be unreliable FO014 BI-DELTOID GIRTH NOT AVAILABLE DROPPED FROM EXAM FO015 RIGHT ARM GIRTH--UPPER THIRD (INCHES TO NEXT LOWER 1/4 INCH) 7.5 - 21.00 UNKNOWN (234) FO016 WAIST GIRTH (INCHES, TO NEXT LOWER 1/4 INCH) 22.00 - 60.00 UNKNOWN (233) FO017 HIP GIRTH (INCHES, TO NEXT LOWER 1/4 INCH) 29.75 - 61.00 UNKNOWN (232) FO018 THIGH GIRTH (INCHES, TO NEXT LOWER 1/4 INCH) 14.5 - 32.25 UNKNOWN (234) FO019 KNEE HEIGHT (CENTIMETERS) 41.5 - 61.6 UNKNOWN (257) FO020 SYSTOLIC NURSE'S BLOOD PRESSURE 82 - 238 UNKNOWN (22) FO021 DIASTOLIC NURSE'S BLOOD PRESSURE 20 - 102 UNKNOWN (27) PROCEDURES SHEET ---------------- NOTE: "PROCEDURES" VARIABLES FO023-FO029: THESE QUESTIONS WERE ADDED DURING THE EXAM CYCLE THEREFORE THE COUNTS ARE LOW FO022 PROCEDURES DONE - ECG 0 NO 1 YES UNKNOWN (0) deleted - data is known to be unreliable FO023 PROCEDURES DONE - BLOOD (SEE NOTE ABOVE REGARDING "PROCEDURES" VARIABLES) 0 NO 1 YES UNKNOWN (360) deleted - data is known to be unreliable FO024 PROCEDURES DONE - BODY COMPOSITION (SEE NOTE ABOVE REGARDING "PROCEDURES" VARIABLES) 0 NO 1 YES UNKNOWN (375) deleted - data is known to be unreliable FO025 ORTHOSTATIC BLOOD PRESSURES (SEE NOTE ABOVE REGARDING "PROCEDURES" VARIABLES) 0 NO 1 YES UNKNOWN (365) deleted - data is known to be unreliable FO026 PROCEDURES DONE - COGNITIVE FUNCTION EXAM (SEE NOTE ABOVE REGARDING "PROCEDURES" VARIABLES) 0 NO 1 YES UNKNOWN (360) deleted - data is known to be unreliable FO027 PROCEDURES DONE - BONE STUDY (SEE NOTE ABOVE REGARDING "PROCEDURES" VARIABLES) 0 NO 1 YES UNKNOWN (378) deleted - data is known to be unreliable FO028 PROCEDURES DONE - ARTHRITIS STUDY (SEE NOTE ABOVE REGARDING "PROCEDURES" VARIABLES) 0 NO 1 YES UNKNOWN (378) deleted - data is known to be unreliable FO029 PROCEDURES DONE - ECHOCARDIOGRAM AND ECHO DOPPLER (SEE NOTE ABOVE REGARDING "PROCEDURES" VARIABLES) 0 NO 1 YES UNKNOWN (376) deleted - data is known to be unreliable COGNITIVE FUNCTION - PART 1 --------------------------- VARIABLE INFORMATION -------- ----------- FO030 MMSE - TODAYS DATE (MONTH,DAY,YEAR) 0 MONTH, DAY AND YEAR INCORRECT 1 1 OF 3 CORRECT 2 2 OF 3 CORRECT 3 3 OF 3 CORRECT 6 NO TRY UNKNOWN (24) deleted - redundant, use most current mmse file FO031 MMSE - SEASON 0 INCORRECT 1 CORRECT 6 NO TRY UNKNOWN (23) deleted - redundant, use most current mmse file FO032 MMSE - DAY OF THE WEEK 0 INCORRECT 1 CORRECT 6 NO TRY UNKNOWN (27) deleted - redundant, use most current mmse file FO033 MMSE - TOWN, COUNTY, & STATE WE ARE IN 0 TOWN, COUNTY AND STATE INCORRECT 1 1 OF 3 CORRECT 2 2 OF 3 CORRECT 3 3 OF 3 CORRECT 6 NO TRY UNKNOWN (24) deleted - redundant, use most current mmse file FO034 MMSE - NAME OF THIS PLACE 0 INCORRECT 1 CORRECT 6 NO TRY UNKNOWN (25) deleted - redundant, use most current mmse file FO035 MMSE - FLOOR OF THE BUILDING WE ARE ON 0 INCORRECT 1 CORRECT 6 NO TRY UNKNOWN (28) deleted - redundant, use most current mmse file FO036 MMSE - REPEAT THE THREE OBJECTS 0 3 OF 3 OBJECTS INCORRECT 1 1 OF 3 CORRECT 2 2 OF 3 CORRECT 3 3 OF 3 CORRECT 6 NO TRY UNKNOWN (26) deleted - redundant, use most current mmse file FO037 MMSE - SPELL 'WORLD' IN REVERSE ORDER XXXXX - CHARACTER VARIABLE UNKNOWN (138) deleted - redundant, use most current mmse file FO038 MMSE - REMEMBER THE THREE OBJECTS 0 3 OF 3 OBJECTS INCORRECT 1 1 OF 3 CORRECT 2 2 OF 3 CORRECT 3 3 OF 3 CORRECT 6 NO TRY UNKNOWN (28) deleted - redundant, use most current mmse file COGNITIVE FUNCTION - PART II ---------------------------- VARIABLE INFORMATION -------- ----------- FO039 MMSE - NAMING WATCH 0 INCORRECT 1 CORRECT 6 NO TRY UNKNOWN (24) deleted - redundant, use most current mmse file FO040 MMSE - NAMING PENCIL 0 INCORRECT 1 CORRECT 6 NO TRY UNKNOWN (24) deleted - redundant, use most current mmse file FO041 MMSE - REPEAT "NO IFS, ANDS, OR BUTS" 0 INCORRECT 1 CORRECT 6 NO TRY UNKNOWN (29) deleted - redundant, use most current mmse file FO042 MMSE - READ THE FOLLOWING & DO WHAT IT SAYS 0 INCORRECT 1 CORRECT 6 NO TRY OR LOW VISION UNKNOWN (29) deleted - redundant, use most current mmse file FO043 MMSE - WRITE A SENTENCE 0 INCORRECT 1 CORRECT 6 NO TRY OR LOW VISION UNKNOWN (30) deleted - redundant, use most current mmse file FO044 MMSE - COPY THIS DRAWING 0 INCORRECT 1 CORRECT 6 NO TRY OR LOW VISION UNKNOWN (34) deleted - redundant, use most current mmse file FO045 MMSE - FOLD PAPER AND PUT IN YOUR LAP (3 STEPS) 0 INCORRECT 1 1 OF 3 CORRECT 2 2 OF 3 CORRECT 3 3 OF 3 CORRECT 6 NO TRY OR LOW VISION UNKNOWN (52) deleted - redundant, use most current mmse file FO046 MMSE - EXAMINER'S ASSESSMENT OF SUBJECT'S MENTAL STATUS 1 NORMAL 2 POSSIBLE DEMENTIA 4 DEMENTIA PRESENT 5 ILLITERATE / LOW EDUCATION 6 NOT FLUENT IN ENGLISH 7 POOR EYESIGHT / BLIND 8 POOR HEARING / DEAF 11 DEPRESSION PRESENT 22 APHASIC 33 COMA 44 PARKINSONIAN FEATURES /TREMORS 55 OTHER UNKNOWN (19) CES-D SCALE ------------ NOTE FOR VARIABLES FO047-FO066: QUESTIONS BASED ON FEELINGS OF SUBJECT DURING THE PAST WEEK (WEEK PRIOR TO THEIR EXAM 22 DATE) VARIABLE INFORMATION -------- ----------- FO047 I WAS BOTHERED BY THINGS THAT USUALLY DON'T BOTHER ME 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (140) FO048 I DID NOT FEEL LIKE EATING; MY APPETITE WAS POOR 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (139) FO049 I FELT THAT I COULD NOT SHAKE OFF THE BLUES, EVEN WITH HELP FROM MY FAMILY AND FRIENDS 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (139) FO050 I FELT THAT I WAS JUST AS GOOD AS OTHER PEOPLE 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (142) FO051 I HAD TROUBLE KEEPING MY MIND ON WHAT I WAS DOING 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (139) FO052 I FELT DEPRESSED 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (139) FO053 I FELT THAT EVERYTHING I DID WAS AN EFFORT 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (139) FO054 I FELT HOPEFUL ABOUT THE FUTURE 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (154) FO055 I THOUGHT MY LIFE HAD BEEN A FAILURE 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (140) FO056 I FELT FEARFUL 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (140) FO057 MY SLEEP WAS RESTLESS 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (139) FO058 I WAS HAPPY 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (141) FO059 I TALKED LESS THAN USUAL 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (139) FO060 I FELT LONELY 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (141) FO061 PEOPLE WERE UNFRIENDLY 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (141) FO062 I ENJOYED LIFE 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (140) FO063 I HAD CRYING SPELLS 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (140) FO064 I FELT SAD 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (141) FO065 I FELT THAT PEOPLE DISLIKED ME 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (140) FO066 I COULD NOT "GET GOING" 0 RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) 1 SOME OR A LITTLE OF THE TIME (1-2 DAYS) 2 OCCASIONALLY OR MODERATE AMOUNT OF TIME (3-4 DAYS) 3 MOST OR ALL OF THE TIME (5-7 DAYS) UNKNOWN (141) ACTIVITIES OF DAILY LIVING -------------------------- NOTE FOR VARIABLES FO067-FO077: ACTIVITIES OF DAILY LIVING - SELF-REPORTED PERFORMANCE "DO YOU GET ASSISTANCE FROM ANOTHER PERSON TO DO THE FOLLOWING ACTIVITIES DURING A NORMAL DAY?" VARIABLE INFORMATION -------- ----------- FO067 GETTING DRESSED AND UNDRESSED 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (10) FO068 BATHING 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (10) FO069 EATING FOOD AND DRINKING LIQUIDS 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (11) FO070 GETTING IN AND OUT OF A CHAIR 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (10) FO071 USING THE TOILET 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (11) FO072 WALKING ON LEVEL SURFACE ABOUT 50 YARDS 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (14) FO073 WALKING UP AND DOWN ONE FLIGHT OF STAIRS (5 STEPS) 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (15) FO074 CARRYING A BUNDLE (CARRY A 10 LB BUNDLE 10 FT.) 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (17) FO075 USING A TELEPHONE 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (12) FO076 CONTINENCE (BOWEL AND BLADDER CONTINENCE) 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT 4 USES COMMERCIAL PRODUCT TO MAINTAIN CONTINENCE, E.G DEPENDS UNKNOWN (13) FO077 TAKES OWN MEDICATIONS 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT 8 TAKES NO MEDICATIONS UNKNOWN (11) FUNCTIONAL PERFORMANCE TEST --------------------------- VARIABLE INFORMATION -------- ----------- FO078 DRESSING 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (31) FO079 TRANSFERRING 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (31) FO080 WALKING (50 FEET IN CORRIDOR) 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (32) FO081 CARRYING A 10 LB BUNDLE 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (34) FO082 POURING LIQUID FROM A PITCHER INTO A GLASS 0 NO HELP NEEDED, INDEPENDENT 1 USES DEVICE, INDEPENDENT 2 HUMAN ASSISTANCE NEEDED, MINIMALLY DEPENDENT 3 DEPENDENT UNKNOWN (39) SCREEN 1: MEDICAL HISTORY - HOSPITALIZATIONS -------------------------------------------- VARIABLE INFORMATION -------- ----------- FO083 SEX OF PATIENT (CODED BY PHYSICIAN) 1 MALE 2 FEMALE UNKNOWN (0) deleted - redundant, use most current basic file FO084 1ST EXAMINER ID NUMBER 42 - 153 UNKNOWN (0) deleted - used for administrative purposes only FO085 HOSPITALIZATION OR E.R VISIT IN INTERIM 0 NO 1 YES, HOSPITAL 2 YES, MORE THAN 1 HOSPITAL 3 YES, EMERGENCY ROOM VISIT UNKNOWN (11) FO086 ILLNESS WITH VISIT TO DOCTOR 0 NO 1 YES, 1 VISIT 2 YES, MORE THAN 1 VISIT UNKNOWN (17) FO087 CHECK UP IN INTERIM BY DOCTOR 0 NO 1 YES UNKNOWN (9) FO088 DATE OF EXAM deleted - redundant, use most current basic file FO089 HEART STUDY EXAMINER TYPE 1 M.D 2 NURSE UNKNOWN (0) deleted - used for administrative purposes only FO090 EXAM NUMBER deleted - redundant, use most current basic file SCREEN 2: MEDICAL HISTORY - CARDIOVASCULAR MEDICATIONS ------------------------------------------------------ VARIABLE INFORMATION -------- ----------- FO091 NUMBER OF ASPIRINS PER TIME INTERVAL 0 - 35 UNKNOWN (14) FO092 TIME INTERVAL FOR ASPIRIN TAKEN 0 NEVER 1 DAY 2 WEEK 3 MONTH 4 YEAR UNKNOWN (18) FO093 CURRENTLY RECEIVING MEDICATION FOR THE TREATMENT OF HYPERTENSION? 0 NO 1 YES UNKNOWN (34) FO094 (TAKING) ANY CARDIOVASCULAR MEDICATIONS BELOW? 0 NO 1 YES UNKNOWN (0) FO095 MEDICATION USE: CARDIAC GLYCOSIDES 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (2) FO096 MEDICATION USE: NITROGLYCERINE 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (1) FO097 MEDICATION USE: LONGER ACTING NITRATES (ISORDIL, CARDILATE, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (1) FO098 MEDICATION USE: CALCIUM CHANNEL BLOCKERS (NIFIDIPINE, VERAPAMIL, DILTIAZEM) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (4) FO099 MEDICATION USE: BETA BLOCKERS 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (3) FO100 MEDICATION USE: BETA BLOCKERS GROUP 0 NOT TAKING BETA BLOCKERS 1 PROPRANOLOL 2 TIMOLOL 3 NADOLOL 4 ATENOLOL 5 METOPROLOL 6 PINDOLOL 7 ACEBUTOLOL 8 LABETALOL 9 OTHER UNKNOWN (4) FO101 MEDICATION USE: BETA BLOCKERS DOSE (MG/DAY) 0 NOT TAKING BETA BLOCKERS 4 - 400 UNKNOWN (31) FO102 MEDICATION USE: LOOP DIURETICS (LASIX, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (3) FO103 MEDICATION USE: THIAZIDE/K-SPARING DIURETICS (DYAZIDE, MAXIDE, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (4) FO104 MEDICATION USE: THIAZIDE DIURETICS 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (3) FO105 MEDICATION USE: K-SPARING DIURETICS (ALDACTONE, TRIAMTERENE, AMILORIDE) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (4) FO106 MEDICATION USE: POTASSIUM SUPPLEMENTS 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (1) FO107 MEDICATION USE: RESERPINE DERIVATIVES 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (3) FO108 MEDICATION USE: METHYLDOPA (ALDOMET) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (3) FO109 MEDICATION USE: ALPHA-1 AGONIST (CLONIDINE, WYTENSIN, GUANABENZ) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (3) FO110 MEDICATION USE: ALPHA-2 BLOCKERS (PRAZOSIN, TERAZOSIN) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (3) FO111 MEDICATION USE: RENIN-ANGIOTENSIN BLOCKING DRUGS (CAPTOPRIL, ENALAPRIL, LISINOPRIL) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (3) FO112 MEDICATION USE: PERIPHERAL VASODILATORS (HYDRALAZINE, MINOXIDIL, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (3) FO113 MEDICATION USE: OTHER ANTI-HYPERTENSIVES 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (2) FO114 MEDICATION USE: ANTIARRHYTHMICS (QUINIDINE, PROCAINAMIDE, NORPACE, DISOPYRAMIDE, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (1) FO115 MEDICATION USE: ANTIPLATELET (ANTURANE, PERSANTINE, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (1) FO116 MEDICATION USE: ANTICOAGULANTS (COUMADIN, WARFARIN, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (1) FO117 MEDICATION USE: OTHER CARDIAC MEDICATION 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (1) SCREEN 3: MEDICAL HISTORY - OTHER MEDICATIONS --------------------------------------------- VARIABLE INFORMATION -------- ----------- FO118 (TAKING) ANY OF THE "NON-CARDIOVASCULAR MEDICATIONS" BELOW? O NO 1 YES UNKNOWN (0) FO119 MEDICATION USE: ANTI CHOLESTEROL DRUGS (RESINS -- E.G QUESTRAN, COLESTID) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO120 MEDICATION USE: ANTI CHOLESTEROL DRUGS (NIACIN OR NICOTINIC ACID) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (5) FO121 MEDICATION USE: ANTI CHOLESTEROL DRUGS (FIBRATES -- E.G GEMFIBROZIL) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO122 MEDICATION USE: ANTI CHOLESTEROL DRUGS (STATINS -- E.G LOVASTATIN, PRAVASTATIN) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO123 MEDICATION USE: ANTI CHOLESTEROL DRUGS (OTHER) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (3) FO124 MEDICATION USE: ANTIGOUT--URIC ACID LOWERING (ALLOPURINOL, PROBENECID, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (1) FO125 MEDICATION USE: ANTIGOUT (COLCHICINE) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO126 MEDICATION USE: THYROID EXTRACT (DESSICATED THYROID) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO127 MEDICATION USE: THYROXINE (SYNTHROID, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (9) FO128 MEDICATION USE: INSULIN 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO129 MEDICATION USE: TOTAL UNITS OF INSULIN PER DAY 0 NONE 6 - 90 UNKNOWN (0) FO130 MEDICATION USE: ORAL HYPOGLYCEMICS 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO131 MEDICATION USE: ORAL/PATCH ESTROGEN (FOR WOMEN USERS ALSO SEE ESTROGEN SECTION) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (2) FO132 MEDICATION USE: ORAL GLUCOCORTICOIDS (PREDNISONE, CORTISONE, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO133 MEDICATION USE: NON-STEROIDAL ANTI-INFLAMMATORY AGENTS (MOTRIN, IBUPROFEN, NAPROSYN, INDOCIN, CLINORIL) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO134 MEDICATION USE: IF TAKING NON-STEROIDAL ANTI-INFLAMMATORY AGENTS, DO YOU TAKE THEM EVERY DAY? 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (32) FO135 MEDICATION USE: ANALGESIC-NARCOTICS (DEMEROL, CODEINE, DILAUDID, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (1) FO136 MEDICATION USE: ANALGESIC-NON-NARCOTICS (ACETAMINOPHEN, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (1) FO137 MEDICATION USE: BRONCHODILATORS, AEROSOLS, ETC 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO138 MEDICATION USE: ANTIHISTAMINES 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO139 MEDICATION USE: ANTIULCER (TAGAMET, RANITIDINE, PROBANTHINE, H ION INHIBITORS) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO140 MEDICATION USE: ANTI-ANXIETY,SEDATIVE/HYPNOTICS ETC (LIBRIUM, VALIUM, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO141 MEDICATION USE: SLEEPING PILLS 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO142 MEDICATION USE: ANTI-DEPRESSANTS 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO143 MEDICATION USE: EYEDROPS 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO144 MEDICATION USE: ANTIBIOTICS 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO145 MEDICATION USE: ANTI-PARKINSON DRUGS (SINEMET, L-DOPA, SYMMETREL, COGENTIN, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO146 MEDICATION USE: ANTICONVULSANTS (DILANTIN, PHENOBARB, TEGRETOL, MYSOLINE, ETC.) 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (0) FO147 MEDICATION USE: NON-CARDIOVASCULAR MEDICATION - OTHER 0 NO 1 YES, NOW 2 YES, NOT NOW 3 MAYBE UNKNOWN (3) SCREEN 4: MEDICAL HISTORY - MALE/FEMALE GENITOURINARY DISEASE ------------------------------------------------------------- VARIABLE INFORMATION -------- ----------- FO148 AGE AT HYSTERECTOMY (YEARS) - FEMALE 0 NO HYSTERECTOMY 20 - 87 88 MALE UNKNOWN (19) FO149 OVARY OR OVARIES REMOVED - FEMALE 0 NO 1 YES, ONE 2 YES, TWO 8 MALE UNKNOWN (30) NOTE: as of 8/28/06, this variable is currently being reviewed or adjuducated An improved data set is planned for future release FO150 NUMBER OF LIVE BIRTHS - FEMALE 0 - 9 88 MALE UNKNOWN (40) modified - to preserve confidentiality, 5=5 or more live births FO151 CONJUGATED ESTROGEN USE IN INTERIM (E.G PREMARIN) 0 NO 1 YES, NOW 2 YES, NOT NOW 8 MALE UNKNOWN (2) NOTE: as of 8/28/06, this variable is currently being reviewed or adjuducated An improved data set is planned for future release FO152 ORAL DOSE/DAY OF PREMARIN OR CONJ ESTROGEN - FEMALE 0 NO 1 0.325 MG 2 0.625 MG 3 1.25 MG 4 2.5 MG 8 MALE UNKNOWN (4) NOTE: as of 8/28/06, this variable is currently being reviewed or adjuducated An improved data set is planned for future release FO153 PATCH DOSE/DAY OF ESTROGEN - FEMALE 0 NO 1 0.5 MG 8 MALE UNKNOWN (3) NOTE: as of 8/28/06, this variable is currently being reviewed or adjuducated An improved data set is planned for future release FO154 NUMBER OF DAYS/MONTH TAKING ESTROGENS - FEMALE 0 NO 4 - 30 88 MALE UNKNOWN (8) NOTE: as of 8/28/06, this variable is currently being reviewed or adjuducated An improved data set is planned for future release FO155 ESTROGEN CREAM USE IN INTERIM - FEMALE 0 NO 1 YES, NOW--(NOTE: THERE IS ONE MALE IN THIS GROUP) 2 YES, NOT NOW 8 MALE UNKNOWN (2) NOTE: as of 8/28/06, this variable is currently being reviewed or adjuducated An improved data set is planned for future release FO156 PROGESTERONE USE IN INTERIM - FEMALE 0 NO 1 YES, NOW 2 YES, NOT NOW 8 MALE UNKNOWN (1) NOTE: as of 8/28/06, this variable is currently being reviewed or adjuducated An improved data set is planned for future release FO157 URINARY DISEASE IN INTERIM - MALE AND FEMALE 0 NO 1 YES 2 MAYBE UNKNOWN (35) FO158 KIDNEY DISEASE IN INTERIM - MALE AND FEMALE 0 NO 1 YES 2 MAYBE UNKNOWN (7) FO159 KIDNEY STONES IN INTERIM - MALE AND FEMALE 0 NO 1 YES 2 MAYBE UNKNOWN (8) FO160 PROSTATE TROUBLE IN INTERIM - MALE 0 NO 1 YES 2 MAYBE 8 FEMALE UNKNOWN (4) FO161 PROSTATE SURGERY IN INTERIM - MALE 0 NO 1 YES 2 MAYBE 8 FEMALE UNKNOWN (2) SCREEN 5: MEDICAL HISTORY - BEVERAGES AND THYROID ------------------------------------------------- NOTE FOR VARIABLES FO163-FO179: DAILY INTAKE OF BEVERAGES OVER PAST YEAR VARIABLE INFORMATION -------- ----------- FO162 DIAGNOSED WITH THYROID CONDITION IN INTERIM 0 NO 1 YES UNKNOWN (3) FO163 COFFEE/CAFFEINATED - # CUPS PER DAY 0 - 20 UNKNOWN (1) FO164 COFFEE/CAFFEINATED - PREDOMINANT METHOD 0 NON DRINKER 1 FILTER 2 PERC 3 BOIL 4 INSTANT 8 OTHER UNKNOWN (16) FO165 COFFEE/DECAFFEINATED - # CUPS PER DAY 0 - 30 UNKNOWN (6) FO166 COFFEE/DECAFFEINATED - PREDOMINANT METHOD 0 NON DRINKER 1 FILTER 2 PERC 3 BOIL 4 INSTANT 8 OTHER UNKNOWN (11) FO167 TEA/CAFFEINATED - # CUPS PER DAY 0 - 7 UNKNOWN (4) FO168 TEA/DECAFFEINATED - # CUPS PER DAY 0 - 10 UNKNOWN (6) FO169 COLA/CAFFEINATED - # 12 OZ CUPS PER DAY 0 - 5 UNKNOWN (8) FO170 COLA/DECAFFEINATED - # 12 OZ CUPS PER DAY 0 - 6 UNKNOWN (10) FO171 BEER-# PER WEEK - BOTTLE, CAN, GLASS (12 OZ.) 0 - 56 0 NEVER 1 ONE OR LESS UNKNOWN (2) FO172 BEER-# DAYS DRINK PER WEEK 0 - 7 UNKNOWN (13) FO173 BEER-LIMIT AT ONE PERIOD OF TIME 0 - 12 UNKNOWN (14) FO174 WINE-# PER WEEK - GLASS (4 OZ.) 0 - 28 0 NEVER 1 ONE OR LESS UNKNOWN (1) FO175 WINE-# DAYS DRINK PER WEEK 0 - 7 UNKNOWN (10) FO176 WINE-LIMIT AT ONE PERIOD OF TIME 0 - 4 UNKNOWN (13) FO177 LIQUOR/COCKTAILS-# PER WEEK 0 - 42 0 NEVER 1 ONE OR LESS UNKNOWN (1) FO178 LIQUOR/COCKTAILS-# DAYS DRINK PER WEEK 0 - 7 UNKNOWN (12) FO179 LIQUOR/COCKTAILS-LIMIT AT ONE PERIOD OF TIME 0 - 6 UNKNOWN (14) SCREEN 6: MEDICAL HISTORY - SMOKING ----------------------------------- VARIABLE INFORMATION -------- ----------- FO180 SMOKED CIGARETTES REGULARLY IN LAST YEAR? 0 NO 1 YES UNKNOWN (2) FO181 CIGARETTES - HOW MANY CIGARETTES DO/DID YOU SMOKE PER DAY? 0 - 50 0 NONSMOKER (FO180=0) 1 ONE OR LESS UNKNOWN (2) FO182 CIGARETTES - DO YOU INHALE? 0 NONSMOKER (FO180=0) 1 YES UNKNOWN (4) FO183 CIGARETTE BRAND XXXXXXXX FIRST EIGHT LETTERS OF CIGARETTE BRAND CHARACTER VARIABLE 00000000 NONSMOKER (FO180=0) UNKNOWN (6) FO184 CIGARETTE-STRENGTH 0 NONSMOKER (FO180=0) 1 NORMAL 2 LITE 3 ULTRALITE UNKNOWN (9) FO185 CIGARETTE-TYPE 0 NONSMOKER (FO180=0) 1 REGULAR 2 MENTHOL UNKNOWN (3) FO186 CIGARETTE-FILTER 0 NONSMOKER (FO180=0) 1 NONFILTER 2 FILTER UNKNOWN (3) FO187 CIGARETTE-LENGTH 0 NONSMOKER (FO180=0) 1 REGULAR 2 KING 3 100MM 4 120MM UNKNOWN (3) FO188 HOURS SINCE LAST CIGARETTE 1 - 24 1 ONE HOUR OR LESS 24 24 HOURS OR MORE 88 CURRENTLY NON-SMOKER UNKNOWN (2) FO189 DO YOU NOW SMOKE CIGARS 0 NO 1 YES, INHALE 2 YES, NO INHALE UNKNOWN (23) FO190 DO YOU NOW SMOKE PIPES 0 NO 1 YES, INHALE 2 YES, NO INHALE UNKNOWN (23) SCREEN 7: MEDICAL HISTORY - RESPIRATORY --------------------------------------- VARIABLE INFORMATION -------- ----------- FO191 CHRONIC COUGH IN INTERIM (AT LEAST 3 MONTHS/YEAR) 0 NO 1 YES, PRODUCTIVE 2 YES, NON-PRODUCTIVE UNKNOWN (1) FO192 WHEEZING OR ASTHMA 0 NO 1 YES UNKNOWN (3) FO193 WHEEZING OR ASTHMA - TYPE 0 NONE 1 NEW IN INTERIM 2 OLD UNKNOWN (12) FO194 DYSPNEA ON EXERTION 0 NO 1 CLIMBING STAIRS OR VIGOROUS EXERTION 2 RAPID WALKING OR MODERATE EXERTION 3 ANY SLIGHT EXERTION UNKNOWN (30) FO195 DYSPNEA HAS INCREASED OVER THE PAST TWO YEARS 0 NO 1 YES UNKNOWN (25) FO196 ORTHOPNEA 0 NO 1 YES, NEW IN INTERIM 2 YES, OLD COMPLAINT UNKNOWN (8) FO197 PAROXYSMAL NOCTURNAL DYSPNEA 0 NO 1 YES, NEW IN INTERIM 2 YES, OLD COMPLAINT UNKNOWN (7) FO198 ANKLE EDEMA BILATERALLY 0 NO 1 YES, NEW IN INTERIM 2 YES, OLD COMPLAINT UNKNOWN (10) FO199 1ST EXAMINER BELIEVES CHF 0 NO 1 YES 2 MAYBE UNKNOWN (0) deleted - redundant, use most current soe file FO200 1ST EXAMINER BELIEVES CHRONIC BRONCHITIS (COUGH THAT PRODUCES SPUTUM AT LEAST 3 MONTHS IN THE PAST 12 MONTHS) 0 NO 1 YES 2 MAYBE UNKNOWN (0) SCREEN 8: MEDICAL HISTORY - HEART PART I ---------------------------------------- VARIABLE INFORMATION -------- ----------- FO201 ANY CHEST DISCOMFORT SINCE LAST EXAM? 0 NO 1 YES 2 MAYBE UNKNOWN (12) FO202 CHEST DISCOMFORT WITH EXERTION OR EXCITEMENT 0 NO OR NO CHEST DISCOMFORT SINCE LAST EXAM 1 YES 2 MAYBE UNKNOWN (16) FO203 CHEST DISCOMFORT WHEN QUIET OR RESTING 0 NO OR NO CHEST DISCOMFORT SINCE LAST EXAM 1 YES 2 MAYBE UNKNOWN (13) FO204 DATE OF ONSET (MONTH) OF CHEST DISCOMFORT 0 - 12 0 NO CHEST DISCOMFORT SINCE LAST EXAM UNKNOWN (139) deleted - to preserve confidentiality FO205 DATE OF ONSET (YEAR) OF CHEST DISCOMFORT 0 - 94 0 NO CHEST DISCOMFORT SINCE LAST EXAM UNKNOWN (61) deleted - to preserve confidentiality FO206 USUAL DURATION OF CHEST DISCOMFORT - MINUTES 0 - 900 0 NO CHEST DISCOMFORT SINCE LAST EXAM 900 15 HOURS OR MORE UNKNOWN (37) FO207 LONGEST DURATION OF CHEST DISCOMFORT - MINUTES 0 - 900 0 NO CHEST DISCOMFORT SINCE LAST EXAM 1 1 MINUTE OR LESS 900 15 HOURS OR MORE UNKNOWN (35) FO208 LOCATION OF CHEST DISCOMFORT 0 NO CHEST DISCOMFORT SINCE LAST EXAM 1 CENTRAL STERNUM AND UPPER CHEST 2 LEFT UPPER QUADRANT 3 LEFT LOWER RIBCAGE 4 RIGHT CHEST 5 EPIGASTRIC 6 LOWER STERNUM 7 LEFT ANTERIOR CHEST 8 OTHER UNKNOWN (13) FO209 RADIATION OF CHEST DISCOMFORT 0 NO RADIATION OR NO CHEST DISCOMFORT SINCE LAST EXAM 1 LEFT SHOULDER OR LEFT ARM 2 NECK 3 RIGHT SHOULDER OR ARM 4 BACK 5 ABDOMEN 6 OTHER 7 COMBINATION UNKNOWN (18) FO210 FREQUENCY OF CHEST DISCOMFORT (# IN PAST MONTH) 0 - 40 0 NONE OR NO CHEST DISCOMFORT SINCE LAST EXAM UNKNOWN (18) FO211 FREQUENCY OF CHEST DISCOMFORT (# IN PAST YEAR) 0 - 366 0 NONE OR NO CHEST DISCOMFORT SINCE LAST EXAM UNKNOWN (39) FO212 TYPE OF CHEST DISCOMFORT 0 NO CHEST DISCOMFORT SINCE LAST EXAM 1 PRESSURE, HEAVY, VISE 2 SHARP 3 DULL 4 OTHER UNKNOWN (19) FO213 CHEST DISCOMFORT RELIEF WITH NITRO IN < 15 MIN 0 NO OR NO CHEST DISCOMFORT SINCE LAST EXAM 1 YES 8 NOT TRIED UNKNOWN (35) FO214 CHEST DISCOMFORT RELIEF WITH REST IN < 15 MIN 0 NO OR NO CHEST DISCOMFORT SINCE LAST EXAM 1 YES 8 NOT TRIED UNKNOWN (26) FO215 CHEST DISCOMFORT RELIEF SPONTANEOUSLY IN < 15 MIN 0 NO OR NO CHEST DISCOMFORT SINCE LAST EXAM 1 YES 8 NOT TRIED UNKNOWN (23) FO216 CHEST DISCOMFORT RELIEF BY OTHER CAUSE IN < 15 MIN 0 NO OR NO CHEST DISCOMFORT SINCE LAST EXAM 1 YES 8 NOT TRIED UNKNOWN (24) FO217 1ST EXAMINER BELIEVES ANGINA PECTORIS IN INTERIM 0 NO 1 YES 2 MAYBE UNKNOWN (9) deleted - redundant, use most current soe file FO218 1ST EXAMINER BELIEVES CORONARY INSUFF IN INTERIM 0 NO 1 YES 2 MAYBE UNKNOWN (9) deleted - redundant, use most current soe file FO219 1ST EXAMINER BELIEVES MYOCARDIAL INFARCT IN INTERIM 0 NO 1 YES 2 MAYBE UNKNOWN (9) deleted - redundant, use most current soe file SCREEN 9: MEDICAL HISTORY - HEART PART II ------------------------------------------ VARIABLE INFORMATION -------- ----------- FO220 HEART SURGERY PROCEDURE-AORTIC 0 NO 1 MECHANICAL (BJORK, STARR EDWARDS) 2 BIOPROSTHESIS (PIG, HOMOGRAFT) 3 COMMISSUROTOMY, BALLOON VALVULOPLASTY 4 REPAIR (NOT A COMMISSUROTOMY) 5 OTHER UNKNOWN (4) FO221 HEART SURGERY PROCEDURE-MITRAL 0 NO 1 MECHANICAL (BJORK, STARR EDWARDS) 2 BIOPROSTHESIS (PIG, HOMOGRAFT) 3 COMMISSUROTOMY, BALLOON VALVULOPLASTY 4 REPAIR (NOT A COMMISSUROTOMY) 5 OTHER UNKNOWN (4) FO222 HEART SURGERY PROCEDURE-TRICUSPID 0 NO 1 MECHANICAL (BJORK, STARR EDWARDS) 2 BIOPROSTHESIS (PIG, HOMOGRAFT) 3 COMMISSUROTOMY, BALLOON VALVULOPLASTY 4 REPAIR (NOT A COMMISSUROTOMY) 5 OTHER UNKNOWN (4) FO223 HEART SURGERY PROCEDURE-PULMONIC 0 NO (THERE WERE NO POSITIVE RESPONSES TO THIS QUESTION) 1 MECHANICAL (BJORK, STARR EDWARDS) 2 BIOPROSTHESIS (PIG, HOMOGRAFT) 3 COMMISSUROTOMY, BALLOON VALVULOPLASTY 4 REPAIR (NOT A COMMISSUROTOMY) 5 OTHER UNKNOWN (5) FO224 HEART SURGERY-AORTIC PROCEDURE-YEAR DONE 0 - 91 0 NOT DONE UNKNOWN (4) deleted - to preserve confidentiality FO225 HEART SURGERY-MITRAL PROCEDURE-YEAR DONE 0 - 91 0 NOT DONE UNKNOWN (4) deleted - to preserve confidentiality FO226 HEART SURGERY-TRICUSPID PROCEDURE-YEAR DONE 0 NOT DONE (THERE WERE NO POSITIVE RESPONSES TO THIS QUESTION) UNKNOWN (5) deleted - to preserve confidentiality FO227 HEART SURGERY-PULMONIC PROCEDURE-YEAR DONE 0 NOT DONE (THERE WERE NO POSITIVE RESPONSES TO THIS QUESTION) UNKNOWN (5) deleted - to preserve confidentiality SCREEN 10: MEDICAL HISTORY - CHD AND COMPLICATIONS - HEART PART III ------------------------------------------------------------------- VARIABLE INFORMATION -------- ----------- FO228 HISTORY OF CORONARY ARTERIOGRAM 0 NO 1 YES 2 MAYBE UNKNOWN (9) FO229 CORONARY ARTERIOGRAM - YEAR FIRST DONE 0 - 93 0 NOT DONE UNKNOWN (18) deleted - to preserve confidentiality FO230 HISTORY OF CORONARY ARTERY ANGIOPLASTY 0 NO 1 YES 2 MAYBE UNKNOWN (7) FO231 CORONARY ARTERY ANGIOPLASTY-YEAR FIRST DONE 0 - 93 0 NOT DONE UNKNOWN (8) deleted - to preserve confidentiality FO232 CORONARY ARTERY ANGIOPLASTY-TYPE OF PROCEDURE 0 NONE/NOT DONE 1 BALLOON 2 OTHER UNKNOWN (9) FO233 HISTORY OF CORONARY BYPASS SURGERY 0 NO 1 YES 2 MAYBE UNKNOWN (7) FO234 CORONARY BYPASS SURGERY-YEAR FIRST DONE 0 - 93 0 NOT DONE UNKNOWN (8) deleted - to preserve confidentiality FO235 HISTORY OF CAROTID ARTERY SURGERY 0 NO 1 YES 2 MAYBE UNKNOWN (17) FO236 CAROTID ARTERY SURGERY-YEAR FIRST DONE 0 - 92 0 NOT DONE UNKNOWN (19) deleted - to preserve confidentiality FO237 HISTORY OF ABDOMINAL AORTA SURGERY 0 NO 1 YES 2 MAYBE UNKNOWN (6) FO238 ABDOMINAL AORTA SURGERY-YEAR FIRST DONE 0 - 93 0 NOT DONE UNKNOWN (7) deleted - to preserve confidentiality FO239 HISTORY OF FEMORAL OR LOWER EXTREMITY SURGERY 0 NO 1 YES 2 MAYBE UNKNOWN (6) FO240 FEMORAL OR LOWER EXTREMITY SURGERY-YEAR FIRST DONE 0 - 93 0 NOT DONE UNKNOWN (8) deleted - to preserve confidentiality FO241 HISTORY OF PERMANENT PACEMAKER INSERTION 0 NO 1 YES 2 MAYBE UNKNOWN (7) FO242 PERMANENT PACEMAKER INSERTION-YEAR FIRST DONE 0 - 93 0 NOT DONE UNKNOWN (8) deleted - to preserve confidentiality SCREEN 11: MEDICAL HISTORY - SYNCOPE - HEART PART IV ----------------------------------------------------- VARIABLE INFORMATION -------- ----------- FO243 IF YOU SIT/STAND UP QUICKLY DO YOU GET DIZZY/VERTIGO 0 NO 1 YES 2 MAYBE UNKNOWN (19) NOTE: THERE ARE 59 CASES WHERE FO243 AND FO244 ARE BOTH POSITIVE, IT NEEDS TO BE DETERMINED TO WHICH VARIABLE FO245 AND FO246 APPLY FO244 IF YOU SIT/STAND UP QUICKLY DO YOU GET LIGHTHEADED/UNSTABLE 0 NO 1 YES 2 MAYBE UNKNOWN (23) NOTE: THERE ARE 59 CASES FO243 AND FO244 ARE BOTH POSITIVE, IT NEEDS TO BE DETERMINED TO WHICH VARIABLE FO245 AND FO246 APPLY FO245 # OF EPISODES OF DIZZY/VERTIGO OR LIGHTHEADEDNESS/UNSTABLE PER YEAR 0 - 998 998 998 EPISODES OR MORE PER YEAR (SPACE ON FORM ONLY ALLOWED 3 DIGIT RESPONSE) UNKNOWN (67) FO246 USUAL DURATION OF DIZZINESS/VERTIGO OR LIGHTHEADEDNESS/UNSTABLE FROM ONSET TO RECOVERY 0 - 998 1 ONE MINUTE OR LESS 998 998 MINUTES (OR MORE) FOR USUAL DURATION FROM ONSET TO RECOVERY (SPACE ON FORM ONLY ALLOWED 3 DIGIT RESPONSE) UNKNOWN (37) FO247 FAINTED OR LOST CONSCIOUSNESS IN INTERIM (IF EVENT IMMEDIATELY PRECEDED BY HEAD INJURY OR ACCIDENT CODE TO 0=NO) 0 NO 1 YES 2 MAYBE UNKNOWN (14) FO248 # EPISODES OF FAINTING OR LOST CONSCIOUSNESS IN PAST 2 YEARS 0 - 10 UNKNOWN (24) FO249 MONTH OF 1ST EPISODE OF FAINTING OR LOST CONSCIOUSNESS 0 -12 0 NO FAINTING OR LOSS OF CONSCIOUSNESS IN INTERIM UNKNOWN (29) deleted - to preserve confidentiality FO250 YEAR OF 1ST EPISODE OF FAINTING OR LOST CONSCIOUSNESS 0 - 93 0 NO FAINTING OR LOSS OF CONSCIOUSNESS IN INTERIM UNKNOWN (22) deleted - to preserve confidentiality FO251 USUAL DURATION OF FAINTING OR LOSS 0F CONSCIOUSNESS - MINUTES 0 - 20 0 NO FAINTING OR LOSS OF CONCIOUSNESS IN INTERIM UNKNOWN (47) FO252 (USUAL) ACTIVITY PRECEDING FAINTING OR LOSS OF CONSCIOUSNESS 0 NONE 1 EXERTION 2 REST 3 DEFECATION/MICTURITION/COUGH 4 EMOTIONAL UPSET 5 ALCOHOL CONSUMPTION 6 TURNING NECK (E.G SHAVING) 7 POSTURAL CHANGE (E.G LAYING TO STANDING) 8 RECENT MEDICATION CHANGE OR INGESTION 9 OTHER, OR COMBINATION UNKNOWN (25) FO253 SYMPTOMS BEFORE FAINTING OR L.O.C-NAUSEA/VOMITING 0 NO 1 YES 2 MAYBE UNKNOWN (17) FO254 SYMPTOMS BEFORE FAINTING OR L.O.C-WARNING SIGNS (E.G AURA) 0 NO 1 YES 2 MAYBE UNKNOWN (17) FO255 SYMPTOMS BEFORE FAINTING OR L.O.C-CHEST DISCOMFORT 0 NO 1 YES 2 MAYBE UNKNOWN (17) FO256 SYMPTOM BEFORE FAINTING OR L.O.C-SHORTNESS OF BREATH 0 NO 1 YES 2 MAYBE UNKNOWN (17) FO257 SYMPTOMS BEFORE FAINTING OR L.O.C-PALPITATIONS 0 NO 1 YES 2 MAYBE UNKNOWN (18) FO258 SYMPTOMS NOTED AFTER FAINTING OR L.O.C- URINARY/FECAL INCONTINENCE 0 NO 1 YES 2 MAYBE UNKNOWN (20) FO259 SYMPTOMS NOTED AFTER FAINTING OR L.O.C-CONFUSION 0 NO 1 YES 2 MAYBE UNKNOWN (17) FO260 SYMPTOMS NOTED AFTER FAINTING OR L.O.C-FOCAL WEAKNESS (E.G - ARM, LEG) 0 NO 1 YES 2 MAYBE UNKNOWN (17) FO261 SYMPTOMS NOTED AFTER FAINTING OR L.O.C-OTHER 0 NO 1 YES 2 MAYBE UNKNOWN (22) FO262 DID YOU HAVE ANY INJURY CAUSED BY THE EVENT? 0 NO 1 YES 2 MAYBE UNKNOWN (14) FO263 WAS SEIZURE ACTIVITY OBSERVED (WITH FAINTING OR LOSS OF CONSCIOUSNESS) 0 NO 1 YES 2 MAYBE UNKNOWN (13) FO264 ER/HOSPITALIZED OR SAW M.D (FOR FAINTING OR LOSS OF CONSCIOUSNESS) 0 NO 1 HOSP 2 SAW M.D UNKNOWN (14) SCREEN 12 - MEDICAL HISTORY - SYNCOPE - HEART PART V ---------------------------------------- VARIABLE INFORMATION -------- ----------- FO265 1ST EXAMINER OPINIONS-CARDIAC SYNCOPE 0 NO 1 YES 2 MAYBE 3 PRESYNCOPE UNKNOWN (6) FO266 1ST EXAMINER OPINIONS-SEIZURE DISORDER 0 NO 1 YES 2 MAYBE UNKNOWN (7) FO267 1ST EXAMINER OPINIONS-VASOVAGAL EPISODE 0 NO 1 YES 2 MAYBE UNKNOWN (7) FO268 1ST EXAMINER OPINION-OTHER (SYNCOPE PAGE) 0 NO 1 YES 2 MAYBE UNKNOWN (12) SCREEN 13: MEDICAL HISTORY - CEREBROVASCULAR IN INTERIM - PART I ---------------------------------------------------------------- VARIABLE INFORMATION -------- ----------- FO269 SUDDEN MUSCULAR WEAKNESS 0 NO 1 YES 2 MAYBE UNKNOWN (4) FO270 SUDDEN SPEECH DIFFICULTY 0 NO 1 YES 2 MAYBE UNKNOWN (4) FO271 SUDDEN VISUAL DEFECT 0 NO 1 YES 2 MAYBE UNKNOWN (6) FO272 UNCONSCIOUSNESS 0 NO 1 YES 2 MAYBE UNKNOWN (5) FO273 DOUBLE VISION 0 NO 1 YES 2 MAYBE UNKNOWN (6) FO274 LOSS OF VISION IN ONE EYE 0 NO 1 YES 2 MAYBE UNKNOWN (7) FO275 NUMBNESS, TINGLING 0 NO 1 YES 2 MAYBE UNKNOWN (5) FO276 NUMBNESS AND TINGLING IS POSITIONAL 0 NO 1 YES 2 MAYBE UNKNOWN (11) FO277 CT SCAN (HEAD) SINCE LAST EXAM 0 NO 1 YES 2 MAYBE UNKNOWN (27) FO278 SEEN BY NEUROLOGIST SINCE LAST EXAM 0 NO 1 YES 2 MAYBE UNKNOWN (26) FO279 DATE (MONTH) OF CEREBROVASCULAR SYMPTOM 0 - 12 0 NO CEREBROVASCULAR EPISODES SINCE LAST EXAM UNKNOWN (182) deleted - to preserve confidentiality FO280 DATE (YEAR) OF CEREBROVASCULAR SYMPTOM 0 - 93 0 NO CEREBROVASCULAR EPISODES SINCE LAST EXAM UNKNOWN (179) deleted - to preserve confidentiality FO281 ONSET TIME OF CEREBROVASCULAR SYMPTOM 0 NO SYMPTOM 1 ACTIVE 2 DURING SLEEP 3 WHILE ARISING UNKNOWN (177) FO282 DURATION OF CEREBROVASCULAR SYMPTOM (DAYS) 0 - 10 0 NO SYMPTOM UNKNOWN (208) NOTE: FO282+FO283+FO204 = TOTAL DURATION OF CEREBROVASCULAR SYMPTOM FO283 DURATION OF CEREBROVASCULAR SYMPTOM (HOURS) 0 - 24 0 NO SYMPTOM NOTE: FO282+FO283+FO204 = TOTAL DURATION OF CEREBROVASCULAR SYMPTOM UNKNOWN (208) FO284 DURATION OF CEREBROVASCULAR SYMPTOM (MINUTES) 0 - 40 0 NO SYMPTOM NOTE: FO282+FO283+FO204 = TOTAL DURATION OF CEREBROVASCULAR SYMPTOM UNKNOWN (208) FO285 HOSPITALIZED OR SAW M.D FOR CEREBROVASCULAR SYMPTOM 0 NO SYMPTOM 1 HOSPITALIZED 2 SAW M.D UNKNOWN (173) FO286 # DAYS STAYED (AT INSTITUTION) FOR CEREBROVASCULAR SYMPTOM 0 - 40 0 NO SYMPTOM UNKNOWN (180) FO287 1ST EXAMINER OPINIONS-CEREBROVASCULAR DISEASE 0 NO 1 YES 2 MAYBE UNKNOWN (5) deleted - redundant, use most current soe file FO288 1ST EXAMINER OPINIONS-STROKE IN INTERIM 0 NO 1 YES 2 MAYBE UNKNOWN (5) deleted - redundant, use most current soe file FO289 1ST EXAMINER OPINION-TRANSIENT ISCHEMIC ATTACK IN INTERIM (TIA) 0 NO 1 YES 2 MAYBE UNKNOWN (6) deleted - redundant, use most current soe file SCREEN 14: MEDICAL HISTORY - PERIPHERAL ARTERIAL AND VENOUS ----------------------------------------------------------- VARIABLE INFORMATION -------- ----------- FO290 DO YOU HAVE LOWER LIMB DISCOMFORT WHILE WALKING 0 NO 1 YES UNKNOWN (55) FO291 LOWER LIMB DISCOMFORT IN LEFT CALF WHILE WALKING 0 NO 1 YES UNKNOWN (57) FO292 LOWER LIMB DISCOMFORT IN RIGHT CALF WHILE WALKING 0 NO 1 YES UNKNOWN (57) FO293 LOWER LIMB DISCOMFORT-LEFT LOWER EXTREMITY/NOT CALF 0 NO OR NO LOWER LIMB DISCOMFORT WHILE WALKING 1 YES UNKNOWN (56) FO294 LOWER LIMB DISCOMFORT-RIGHT LOWER EXTREMITY/NOT CALF 0 NO OR NO LOWER LIMB DISCOMFORT WHILE WALKING 1 YES UNKNOWN (56) FO295 LOWER LIMB DISCOMFORT OCCURS WITH FIRST STEPS 0 NO OR NO LOWER LIMB DISCOMFORT WHILE WALKING 1 YES UNKNOWN (61) FO296 LOWER LIMB DISCOMFORT AFTER WALKING A WHILE 0 NO OR NO LOWER LIMB DISCOMFORT WHILE WALKING 1 YES UNKNOWN (57) FO297 LOWER LIMB DISCOMFORT RELATED TO RAPIDITY OF WALKING OR STEEPNESS 0 NO OR NO LOWER LIMB DISCOMFORT WHILE WALKING 1 YES UNKNOWN (68) FO298 LOWER LIMB DISCOMFORT-FORCED TO STOP WALKING 0 NO OR NO LOWER LIMB DISCOMFORT WHILE WALKING 1 YES UNKNOWN (58) FO299 LOWER LIMB DISCOMFORT-TIME FOR DISCOMFORT TO BE RELIEVED BY STOPPING (MINUTES) 0 - 60 0 NO RELIEF BY STOPPING OR NO LOWER LIMB DISCOMFORT WHILE WALKING UNKNOWN (69) FO300 # DAYS/MONTH OF LOWER LIMB DISCOMFORT 0 - 30 0 NO LOWER LIMB DISCOMFORT WHILE WALKING UNKNOWN (83) FO301 IS ONE FOOT COLDER THAN THE OTHER? 0 NO 1 YES UNKNOWN (79) FO302 LEFT PHLEBITIS 0 NO 1 YES UNKNOWN (125) FO303 RIGHT PHLEBITIS 0 NO 1 YES UNKNOWN (128) FO304 LEFT LEG ULCERS 0 NO 1 YES UNKNOWN (125) FO305 RIGHT LEG ULCERS 0 NO 1 YES UNKNOWN (128) FO306 TREATMENT FOR VARICOSE VEINS - LEFT 0 NO 1 YES UNKNOWN (126) FO307 TREATMENT FOR VARICOSE VEINS - RIGHT 0 NO 1 YES UNKNOWN (127) FO308 1ST EXAMINER OPINIONS - INTERMITTENT CLAUDICATION 0 NO 1 YES 2 MAYBE UNKNOWN (14) deleted - redundant, use most current soe file FO309 1ST EXAMINER OPINIONS - VENOUS INSUFFICIENCY 0 NO 1 YES 2 MAYBE UNKNOWN (10) SCREEN 15: CANCER SITE OR TYPE ------------------------------ VARIABLE INFORMATION -------- ----------- FO310 HAVE YOU EVER HAD CANCER OR TUMOR? 0 NO 1 YES 2 MAYBE UNKNOWN (19) deleted - redundant, use most current cancer file FO311 CANCER-ESOPHAGUS 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (26) deleted - redundant, use most current cancer file FO312 CANCER-STOMACH 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (24) deleted - redundant, use most current cancer file FO313 CANCER-COLON 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (25) deleted - redundant, use most current cancer file FO314 CANCER-RECTUM 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (26) deleted - redundant, use most current cancer file FO315 CANCER-PANCREAS 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (25) deleted - redundant, use most current cancer file FO316 CANCER-LARYNX 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (26) deleted - redundant, use most current cancer file FO317 CANCER-TRACHEA/BRONCHUS/LUNG 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (25) deleted - redundant, use most current cancer file FO318 CANCER-LEUKEMIA 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (25) deleted - redundant, use most current cancer file FO319 CANCER-SKIN 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (24) deleted - redundant, use most current cancer file FO320 CANCER-BREAST 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (24) deleted - redundant, use most current cancer file FO321 CANCER-CERVIX/UTERUS 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (26) deleted - redundant, use most current cancer file FO322 CANCER-OVARY 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (27) deleted - redundant, use most current cancer file FO323 CANCER-PROSTATE 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (25) deleted - redundant, use most current cancer file FO324 CANCER-BLADDER 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (26) deleted - redundant, use most current cancer file FO325 CANCER-KIDNEY 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (27) deleted - redundant, use most current cancer file FO326 CANCER-BRAIN 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (27) deleted - redundant, use most current cancer file FO327 CANCER-LYMPHOMA 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (26) deleted - redundant, use most current cancer file FO328 CANCER-OTHER/UNKNOWN 0 NO 1 YES, CANCEROUS 2 MAYBE, POSSIBLE CANCER 3 BENIGN UNKNOWN (27) deleted - redundant, use most current cancer file SCREEN 16: PHYSICAL EXAM - HEAD, NECK AND RESPIRATORY ----------------------------------------------------- VARIABLE INFORMATION -------- ----------- FO329 BLOOD PRESSURE: SYSTOLIC - 1ST MD READING 96 - 224 UNKNOWN (0) FO330 BLOOD PRESSURE: DIASTOLIC - 1ST MD READING 36 - 120 UNKNOWN (3) FO331 CORNEAL ARCUS 0 NO 1 SLIGHT 2 MODERATE 3 MARKED UNKNOWN (3) FO332 XANTHELASMA 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO333 XANTHOMATA 0 NO 1 YES 2 MAYBE UNKNOWN (5) FO334 ACHILLES TENDON XANTHOMATA 0 NO 1 YES UNKNOWN (4) FO335 PALMAR XANTHOMATA 0 NO 1 YES UNKNOWN (3) FO336 TUBEROUS XANTHOMATA 0 NO 1 YES UNKNOWN (3) FO337 THYROID ABNORMALITY 0 NO 1 YES 2 MAYBE UNKNOWN (3) FO338 THYROID ABNORMALITY - SCAR 0 NO 1 YES 2 MAYBE UNKNOWN (7) FO339 THYROID ABNORMALITY - SINGLE NODULE 0 NO 1 YES 2 MAYBE UNKNOWN (7) FO340 THYROID ABNORMALITY - OTHER 0 NO 1 YES 2 MAYBE UNKNOWN (12) FO341 THYROID ABNORMALITY-DIFFUSE ENLARGEMENT 0 NO 1 YES 2 MAYBE UNKNOWN (7) FO342 THYROID ABNORMALITY - MULTIPLE NODULES 0 NO 1 YES 2 MAYBE UNKNOWN (8) FO343 RESPIRATORY - INCREASED A-P DIAMETER 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO344 RESPIRATORY - FIXED THORAX 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO345 RESPIRATORY - WHEEZING ON AUSCULTATION 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO346 RESPIRATORY - RALES 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO347 RESPIRATORY - OTHER ABNORMAL BREATH SOUNDS 0 NO 1 YES 2 MAYBE UNKNOWN (2) SCREEN 17: PHYSICAL EXAM - HEART ------------------------------- VARIABLE INFORMATION -------- ----------- FO348 HEART - ENLARGEMENT 0 NO 1 LEFT ONLY 2 RIGHT ONLY 3 BOTH UNKNOWN (115) FO349 HEART - GALLOP 0 NO 1 S3, ONLY 2 S4, ONLY 3 BOTH UNKNOWN (4) FO350 HEART-ABNORMAL SOUNDS-CLICK 0 NO 1 YES UNKNOWN (4) FO351 HEART-ABNORMAL SOUNDS-ABNORMALLY SPLIT S2 0 NO 1 YES UNKNOWN (5) FO352 HEART-ABNORMAL SOUNDS-DIMINISHED A2 0 NO 1 YES UNKNOWN (6) FO353 HEART-ABNORMAL SOUNDS-OTHER 0 NO 1 YES UNKNOWN (4) FO354 HEART-ABNORMAL SOUNDS-SYSTOLIC MURMUR(S) 0 NO 1 YES 2 MAYBE UNKNOWN (2) FO355 SYSTOLIC MURMUR - APEX - GRADE 0 NO SOUND HEARD 1 TO 6 FOR GRADE OF SOUND HEARD UNKNOWN (7) FO356 SYSTOLIC MURMUR - APEX - TYPE 0 NONE 1 EJECTION 2 REGURGITANT 3 OTHER UNKNOWN (16) FO357 SYSTOLIC MURMUR - APEX - RADIATION 0 NONE 1 AXILLA 2 NECK 3 BACK 4 RIGHT CHEST UNKNOWN (17) FO358 SYSTOLIC MURMUR - APEX - VALSALVA 0 NO CHANGE OR NO SOUND HEARD 1 INCREASE 2 DECREASE UNKNOWN (117) FO359 SYSTOLIC MURMUR - APEX - ORIGIN 0 NONE, INDET 1 MITRAL 2 AORTIC 3 TRICUSPID 4 PULM UNKNOWN (24) FO360 SYSTOLIC MURMUR - LEFT STERNUM - GRADE 0 NO SOUND HEARD 1 TO 6 FOR GRADE OF SOUND HEARD UNKNOWN (9) FO361 SYSTOLIC MURMUR - LEFT STERNUM - TYPE 0 NONE 1 EJECTION 2 REGURGITANT 3 OTHER UNKNOWN (10) FO362 SYSTOLIC MURMUR-LEFT STERNUM-RADIATION 0 NONE 1 AXILLA 2 NECK 3 BACK 4 RIGHT CHEST UNKNOWN (11) FO363 SYSTOLIC MURMUR-LEFT STERNUM-VALSALVA 0 NO CHANGE OR NO SOUND HEARD 1 INCREASE 2 DECREASE UNKNOWN (82) FO364 SYSTOLIC MURMUR - LEFT STERNUM - ORIGIN 0 NONE, INDET 1 MITRAL 2 AORTIC 3 TRICUSPID 4 PULM UNKNOWN (16) FO365 SYSTOLIC MURMUR - BASE - GRADE 0 NO SOUND HEARD 1 TO 6 FOR GRADE OF SOUND HEARD UNKNOWN (9) FO366 SYSTOLIC MURMUR - BASE - TYPE 0 NONE 1 EJECTION 2 REGURGITANT 3 OTHER UNKNOWN (14) FO367 SYSTOLIC MURMUR - BASE - RADIATION 0 NONE 1 AXILLA 2 NECK 3 BACK 4 RIGHT CHEST UNKNOWN (18) FO368 SYSTOLIC MURMUR - BASE - VALSALVA 0 NO CHANGE OR NO SOUND HEARD 1 INCREASE 2 DECREASE UNKNOWN (121) FO369 SYSTOLIC MURMUR - BASE - ORIGIN 0 NONE, INDET 1 MITRAL 2 AORTIC 3 TRICUSPID 4 PULM UNKNOWN (21) FO370 HEART-ABNORMAL SOUNDS-DIASTOLIC MURMUR(S) 0 NO 1 YES 2 MAYBE UNKNOWN (2) FO371 VALVE OF ORIGIN FOR DIASTOLIC MURMUR(S) 0 NONE 1 MITRAL 2 AORTIC 3 BOTH 4 OTHER UNKNOWN (6) FO372 NECK VEIN DISTENTION AT 45 DEGREES 0 NO 1 YES 2 MAYBE UNKNOWN (269) SCREEN 18: PHYSICAL EXAM - BREASTS AND ABDOMEN ---------------------------------------------- VARIABLE INFORMATION -------- ----------- FO373 BREAST ABNORMALITY 0 NO 1 YES 2 MAYBE UNKNOWN (41) FO374 BREAST ABNORMALITY - LOCALIZED MASS 0 NO 1 YES 2 MAYBE UNKNOWN (43) FO375 BREAST ABNORMALITY - AXILLARY NODES 0 NO 1 YES 2 MAYBE UNKNOWN (43) FO376 BREAST SURGERY 0 NO 1 YES UNKNOWN (41) FO377 BREAST SURGERY - PROCEDURE - LEFT BREAST USE LOWEST CODE 0 NO 1 RADICAL MASTECTOMY 2 SIMPLE MASTECTOMY 3 BIOPSY 4 LUMP REMOVAL 5 COSMETIC ONLY UNKNOWN (42) FO378 BREAST SURGERY -PROCEDURE - RIGHT BREAST USE LOWEST CODE 0 NO 1 RADICAL MASTECTOMY 2 SIMPLE MASTECTOMY 3 BIOPSY 4 LUMP REMOVAL 5 COSMETIC ONLY UNKNOWN (41) FO379 ABDOMINAL ABNORMALITY - LIVER ENLARGED 0 NO 1 YES 2 MAYBE UNKNOWN (5) FO380 ABDOMINAL ABNORMALITY - SURGICAL SCAR 0 NO 1 YES 2 MAYBE UNKNOWN (7) FO381 ABDOMINAL ABNORMALITY-ABDOMINAL ANEURYSM 0 NO 1 YES 2 MAYBE UNKNOWN (6) FO382 ABDOMINAL ABNORMALITY - BRUIT 0 NO 1 YES 2 MAYBE UNKNOWN (4) FO383 ABDOMINAL ABNORMALITY-SURGICAL GALLBLADDER SCAR 0 NO 1 YES 2 MAYBE UNKNOWN (6) FO384 ABDOMINAL ABNORMALITY - OTHER 0 NO 1 YES 2 MAYBE UNKNOWN (10) SCREEN 19: PHYSICAL EXAM - PERIPHERAL VESSELS - PART I ------------------------------------------------------ VARIABLE INFORMATION -------- ----------- FO385 STEM VARICOSITIES - LEFT 0 NO ABNORMALITY 1 UNCOMPLICATED 2 WITH SKIN CHANGES 3 WITH ULCER UNKNOWN (9) FO386 STEM VARICOSITIES - RIGHT 0 NO ABNORMALITY 1 UNCOMPLICATED 2 WITH SKIN CHANGES 3 WITH ULCER UNKNOWN (9) FO387 RETICULAR VARICOSITIES - LEFT 0 NO ABNORMALITY 1 UNCOMPLICATED 2 WITH SKIN CHANGES 3 WITH ULCER UNKNOWN (9) FO388 RETICULAR VARICOSITIES - RIGHT 0 NO ABNORMALITY 1 UNCOMPLICATED 2 WITH SKIN CHANGES 3 WITH ULCER UNKNOWN (9) FO389 SPIDER VARICOSITIES - LEFT 0 NO ABNORMALITY 1 UNCOMPLICATED 2 WITH SKIN CHANGES 3 WITH ULCER UNKNOWN (10) FO390 SPIDER VARICOSITIES - RIGHT 0 NO ABNORMALITY 1 UNCOMPLICATED 2 WITH SKIN CHANGES 3 WITH ULCER UNKNOWN (10) FO391 ANKLE EDEMA - LEFT 0 NO 1 - 4 GRADE UNKNOWN (4) FO392 ANKLE EDEMA - RIGHT 0 NO 1 - 4 GRADE UNKNOWN (2) FO393 FOOT IS COLD - LEFT 0 NO 1 YES 2 MAYBE UNKNOWN (4) FO394 FOOT IS COLD - RIGHT 0 NO 1 YES 2 MAYBE UNKNOWN (4) FO395 AMPUTATION - LEFT LOWER EXTREMITY 0 NO 1 YES UNKNOWN (0) deleted - to preserve confidentiality FO396 AMPUTATION - RIGHT LOWER EXTREMITY 0 NO 1 YES UNKNOWN (0) deleted - to preserve confidentiality FO397 AMPUTATION LEVEL - LEFT LOWER EXTREMITY 0 NO 1 TOES ONLY 2 ANKLE 3 KNEE 4 HIP UNKNOWN (0) deleted - to preserve confidentiality FO398 AMPUTATION LEVEL - RIGHT LOWER EXTREMITY 0 NO 1 TOES ONLY 2 ANKLE 3 KNEE 4 HIP UNKNOWN (0) deleted - to preserve confidentiality SCREEN 20: PHYSICAL EXAM - PERIPHERAL VESSELS - PART II ------------------------------------------------------- VARIABLE INFORMATION -------- ----------- FO399 CAROTID BRUIT - LEFT 0 NO 1 YES UNKNOWN (16) FO400 CAROTID BRUIT - RIGHT 0 NO 1 YES UNKNOWN (16) FO401 RADIAL PULSE - LEFT 0 NORMAL 1 ABSENT 2 ABNORMAL BUT PRESENT UNKNOWN (136) FO402 RADIAL PULSE - RIGHT 0 NORMAL 1 ABSENT 2 ABNORMAL BUT PRESENT UNKNOWN (140) FO403 FEMORAL PULSE - LEFT 0 NORMAL 1 ABSENT 2 ABNORMAL BUT PRESENT UNKNOWN (14) FO404 FEMORAL PULSE - RIGHT 0 NORMAL 1 ABSENT 2 ABNORMAL BUT PRESENT UNKNOWN (17) FO405 FEMORAL BRUIT - LEFT 0 NO 1 YES UNKNOWN (24) FO406 FEMORAL BRUIT - RIGHT 0 NO 1 YES UNKNOWN (26) FO407 MID-THIGH BRUIT - LEFT 0 NO 1 YES UNKNOWN (19) FO408 MID-THIGH BRUIT - RIGHT 0 NO 1 YES UNKNOWN (17) FO409 POPLITEAL BRUIT - LEFT 0 NO 1 YES UNKNOWN (23) FO410 POPLITEAL BRUIT - RIGHT 0 NO 1 YES UNKNOWN (20) FO411 POST TIBIAL PULSE - LEFT 0 NORMAL 1 ABSENT 2 ABNORMAL BUT PRESENT UNKNOWN (22) FO412 POST TIBIAL PULSE - RIGHT 0 NORMAL 1 ABSENT 2 ABNORMAL BUT PRESENT UNKNOWN (22) FO413 DORSALIS PEDIS PULSE - LEFT 0 NORMAL 1 ABSENT 2 ABNORMAL BUT PRESENT UNKNOWN (14) FO414 DORSALIS PEDIS PULSE - RIGHT 0 NORMAL 1 ABSENT 2 ABNORMAL BUT PRESENT UNKNOWN (14) SCREEN 21: PHYSICAL EXAM - NEUROLOGICAL AND FINAL BLOOD PRESSURE ---------------------------------------------------------------- VARIABLE INFORMATION -------- ----------- FO415 SPEECH DISTURBANCE 0 NO 1 YES 2 MAYBE UNKNOWN (2) FO416 GAIT DISTURBANCE 0 NO 1 YES 2 MAYBE UNKNOWN (11) FO417 LOCALIZED MUSCLE WEAKNESS 0 NO 1 YES 2 MAYBE UNKNOWN (9) FO418 VISUAL FIELD DEFECT 0 NO 1 YES 2 MAYBE UNKNOWN (236) FO419 ABNORMAL REFLEXES 0 NO 1 YES 2 MAYBE UNKNOWN (17) FO420 CRANIAL NERVE ABNORMALITY 0 NO 1 YES 2 MAYBE UNKNOWN (23) FO421 CEREBELLAR SIGNS 0 NO 1 YES 2 MAYBE UNKNOWN (137) FO422 SENSORY IMPAIRMENT 0 NO 1 YES 2 MAYBE UNKNOWN (159) FO423 1ST EXAMINER BELIEVES RESIDUAL OF STROKE 0 NO 1 YES 2 MAYBE UNKNOWN (7) deleted - redundant, use most current soe file FO424 BLOOD PRESSURE: SYSTOLIC - 2ND MD READING 90 - 220 UNKNOWN (0) FO425 BLOOD PRESSURE: DIASTOLIC - 2ND MD READING 40 - 104 UNKNOWN (3) SCREEN 22: ELECTROCARDIOGRAPH - PART I -------------------------------------- VARIABLE INFORMATION -------- ----------- FO426 ECG DONE 0 NO 1 YES UNKNOWN (0) NOTE: THERE WERE NO NEGATIVE RESPONSES TO THIS QUESTION FO427 ECG: VENTRICULAR RATE PER MINUTE 38 - 150 UNKNOWN (0) FO428 ECG: P-R INTERVAL (HUNDREDTHS OF SECOND) 8 - 60 FULLY PACED, ATRIAL FIB OR UNKNOWN (88) FO429 ECG: QRS INTERVAL (HUNDREDTHS OF SECOND) 6 - 18 FULLY PACED OR UNKNOWN (19) FO430 ECG: Q-T INTERVAL (HUNDREDTHS OF SECOND) 28 - 54 FULLY PACED OR UNKNOWN (20) FO431 ECG: QRS ANGLE -85 - +160 FULLY PACED OR UNKNOWN (20) FO432 ECG: RHYTHM 0 OR 1 NORMAL SINUS 2 SINUS RHYTHM WITH 1ST DEGREE AV BLOCK (PR INTVERVAL > = .20 SEC) 3 2ND DEGREE AV BLOCK, MOBITZ I (WENCKEBACH) 4 2ND DEGREE AV BLOCK, MOBITZ II 5 3RD DEGREE AV BLOCK/AV DISSOCIATION 6 ATRIAL FIBRILLATION/ATRIAL FLUTTER 7 NODAL 8 PACED 9 OTHER OR COMBINATION OF ABOVE (LIST) UNKNOWN (0) FO433 ECG: IV BLOCK 0 NO 1 YES FULLY PACED OR UNKNOWN (19) FO434 ECG: IV BLOCK-PATTERN 0 NO IV BLOCK 1 LEFT 2 RIGHT 3 INDETERMINATE FULLY PACED OR UNKNOWN (19) FO435 ECG: IV BLOCK-COMPLETE 0 NO OR NO IV BLOCK 1 YES FULLY PACED OR UNKNOWN (19) FO436 ECG: IV BLOCK-INCOMPLETE 0 NO OR NO IV BLOCK 1 YES FULLY PACED OR UNKNOWN (19) FO437 ECG: HEMIBLOCK 0 NO 1 LEFT ANTERIOR 2 LEFT POSTERIOR FULLY PACED OR UNKNOWN (19) FO438 ECG: WPW SYNDROME 0 NO 1 YES 2 MAYBE FULLY PACED OR UNKNOWN (19) FO439 ECG: ATRIAL PREMATURE BEATS 0 NO 1 ATRIAL 2 ATRIAL ABERRANT UNKNOWN (12) FO440 ECG: VENTRICULAR PREMATURE BEATS 0 NO 1 SIMPLE 2 MULTIFOCAL 3 PAIRS 4 RUN 5 R ON T UNKNOWN (3) FO441 ECG: # OF VENTRICULAR PREMATURE BEATS IN 10 SECONDS 0 - 4 UNKNOWN (4) SCREEN 23: ELECTROCARDIOGRAPH - PART II --------------------------------------- VARIABLE INFORMATION -------- ----------- FO442 ECG: MYOCARDIAL INFARCT-ANTERIOR 0 NO 1 YES 2 MAYBE FULLY PACED OR UNKNOWN (52) FO443 ECG: MYOCARDIAL INFARCT-INFERIOR 0 NO 1 YES 2 MAYBE FULLY PACED OR UNKNOWN (46) FO444 ECG: MYOCARDIAL INFARCT-TRUE POSTERIOR 0 NO 1 YES 2 MAYBE FULLY PACED OR UNKNOWN (47) FO445 ECG: LEFT VENTRICULAR HYPERTROPHY CRITERIA R>20 MM IN ANY LIMB LEAD 0 NO 1 YES FULLY PACED, COMPLETE BBB OR UNKNOWN (22) FO446 ECG: LEFT VENTRICULAR HYPERTROPHY CRITERIA R>11 MM IN AVL 0 NO 1 YES FULLY PACED, COMPLETE BBB OR UNKNOWN (20) FO447 ECG: LEFT VENTRICULAR HYPERTROPHY CRITERIA R IN LEAD I PLUS S IN LEAD III >= 25MM 0 NO 1 YES FULLY PACED, COMPLETE BBB OR UNKNOWN (22) FO448 ECG: LEFT VENTRICULAR HYPERTROPHY CRITERIA R AVL IN MM (AT 1 MV = 10 MM STANDARD) 0 - 28 FULLY PACED, COMPLETE BBB OR UNKNOWN (18) FO449 ECG: LEFT VENTRICULAR HYPERTROPHY CRITERIA S V3 IN MM (AT 1 MV = 10 MM STANDARD) 0 - 54 FULLY PACED, COMPLETE BBB OR UNKNOWN (18) FO450 ECG: LEFT VENTRICULAR HYPERTROPHY CRITERIA R>=25MM, (R IN V5 OR V6) OR (S IN V1 OR V2) 0 NO 1 YES FULLY PACED, COMPLETE BBB OR UNKNOWN (20) FO451 ECG: LEFT VENTRICULAR HYPERTROPHY CRITERIA S>=25MM, (R IN V5 OR V6) OR (S IN V1 OR V2) 0 NO 1 YES FULLY PACED, COMPLETE BBB OR UNKNOWN (21) FO452 ECG: LEFT VENTRICULAR HYPERTROPHY CRITERIA R OR S>=30MM, (R IN V5 OR V6) OR (S IN V1 OR V2) 0 NO 1 YES FULLY PACED, COMPLETE BBB OR UNKNOWN (20) FO453 ECG: LEFT VENTRICULAR HYPERTROPHY CRITERIA R+S >= 35MM, (R IN V5 OR V6) OR (S IN V1 OR V2) 0 NO 1 YES FULLY PACED, COMPLETE BBB OR UNKNOWN (20) FO454 ECG: LEFT VENTRICULAR HYPERTROPHY CRITERIA INTRINSICOID DEFLECTION >= .05 SEC 0 NO 1 YES FULLY PACED, COMPLETE BBB OR UNKNOWN (22) FO455 ECG: LEFT VENTRICULAR HYPERTROPHY CRITERIA ST DEPRESSION (STRAIN PATTERN, WITH DOWN SLOPING ST) 0 NO 1 YES FULLY PACED, COMPLETE BBB OR UNKNOWN (26) FO456 ECG: NONSPECIFIC S-T SEGMENT ABNORMALITY 0 NO 1 YES 2 MAYBE FULLY PACED OR UNKNOWN (20) FO457 ECG: NONSPECIFIC T-WAVE ABNORMALITY 0 NO 1 YES 2 MAYBE FULLY PACED OR UNKNOWN (20) FO458 ECG: U-WAVE PRESENT 0 NO 1 YES 2 MAYBE FULLY PACED OR UNKNOWN (22) FO459 ECG: ATRIAL ENLARGEMENT 0 NONE 1 LEFT 2 RIGHT 3 BOTH ATRIAL FIBRILLATION OR UNKNOWN (86) FO460 ECG: RIGHT VENTRICULAR HYPERTROPHY 0 NO 1 YES 2 MAYBE FULLY PACED, COMPLETE BBB, OR UNKNOWN (136) FO461 ECG: LEFT VENTRICULAR HYPERTROPHY 0 NO 1 LVH WITH STRAIN 2 LVH WITH MILD S-T SEGMENT ABNORMALITY 3 LVH BY VOLTAGE ONLY FULLY PACED, COMPLETE BBB OR UNKNOWN (65) SCREEN 24: CLINICAL DIAGNOSTIC IMPRESSION - PART I -------------------------------------------------- VARIABLE INFORMATION -------- ----------- FO462 CLINICAL DIAGNOSTIC IMPRESSION: ANGINA PECTORIS 0 NO 1 YES, NEW 2 YES, OLD 3 YES, RECURRENT 4 MAYBE UNKNOWN (7) deleted - redundant, use most current soe file FO463 CLINICAL DIAGNOSTIC IMPRESSION: CORONARY INSUFFICIENCY 0 NO 1 YES, NEW 2 YES, OLD 3 YES, RECURRENT 4 MAYBE UNKNOWN (4) deleted - redundant, use most current soe file FO464 CLINICAL DIAGNOSTIC IMPRESSION: MYOCARDIAL INFARCT 0 NO 1 YES, NEW 2 YES, OLD 3 YES, RECURRENT 4 MAYBE UNKNOWN (5) deleted - redundant, use most current soe file FO465 CLINICAL DIAGNOSTIC IMPRESSION: RHEUMATIC HEART DISEASE 0 NO 1 YES 2 MAYBE UNKNOWN (2) FO466 CLINICAL DIAGNOSTIC IMPRESSION: AORTIC VALVE DISEASE 0 NO 1 YES 2 MAYBE UNKNOWN (3) FO467 CLINICAL DIAGNOSTIC IMPRESSION: MITRAL VALVE DISEASE 0 NO 1 YES 2 MAYBE UNKNOWN (4) DIAGNOSTIC IMPRESSIONS - NOT HARD DATA - USE WITH CAUTION FO468 CLINICAL DIAGNOSTIC IMPRESSION: OTHER HEART DISEASE (INCLUDES CONGENITAL) 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO469 CLINICAL DIAGNOSTIC IMPRESSION: CONGESTIVE HEART FAILURE 0 NO 1 YES 2 MAYBE UNKNOWN (7) deleted - redundant, use most current soe file FO470 CLINICAL DIAGNOSTIC IMPRESSION: FUNCTIONAL CLASS (NYHA CLASSIFICATION) 0 NONE 1 CLASS 1 - ORDINARY PHYSICAL ACTIVITY DOES NOT CAUSE SYMPTOMS 2 CLASS 2 - ORDINARY PHYSICAL ACTIVITY RESULTS IN SYMPTOMS 3 CLASS 3 - LESS THAN ORDINARY PHYSICAL ACTIVITY RESULTS IN SYMPTOMS 4 CLASS 4 - ANY PHYSICAL ACTIVITY RESULTS IN SYMPTOMS UNKNOWN (5) DIAGNOSTIC IMPRESSIONS - NOT HARD DATA - USE WITH CAUTION SCREEN 25: CLINICAL DIAGNOSTIC IMPRESSION - PART II --------------------------------------------------- VARIABLE INFORMATION -------- ----------- FO471 CLINICAL DIAGNOSTIC IMPRESSION: INTERMITTENT CLAUDICATION 0 NO 1 YES 2 MAYBE UNKNOWN (8) deleted - redundant, use most current soe file FO472 CLINICAL DIAGNOSTIC IMPRESSION: ABDOMINAL AORTIC ANEURYSM 0 NO 1 YES 2 MAYBE UNKNOWN (3) FO473 CLINICAL DIAGNOSTIC IMPRESSION: STEM VARICOSE VEINS 0 NO 1 YES 2 MAYBE UNKNOWN (2) FO474 CLINICAL DIAGNOSTIC IMPRESSION: PHLEBITIS 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO475 CLINICAL DIAGNOSTIC IMPRESSION: OTHER VASCULAR DIAGNOSIS 0 NO 1 YES 2 MAYBE UNKNOWN (5) FO476 CLINICAL DIAGNOSTIC IMPRESSION: STROKE 0 NO 1 YES, NEW 2 YES, OLD 3 YES, RECURRENT 4 MAYBE UNKNOWN (1) deleted - redundant, use most current soe file DIAGNOSTIC IMPRESSIONS - NOT HARD DATA - USE WITH CAUTION FO477 CLINICAL DIAGNOSTIC IMPRESSION: TRANSIENT ISCHEMIC ATTACK (TIA) 0 NO 1 YES, NEW 2 YES, OLD 3 YES, RECURRENT 4 MAYBE UNKNOWN (2) deleted - redundant, use most current soe file FO478 CLINICAL DIAGNOSTIC IMPRESSION: DEMENTIA 0 NO 1 YES, NEW 2 YES, OLD 3 YES, RECURRENT 4 MAYBE UNKNOWN (0) FO479 CLINICAL DIAGNOSTIC IMPRESSION: PARKINSON'S DISEASE 0 NO 1 YES, NEW 2 YES, OLD 3 YES, RECURRENT 4 MAYBE UNKNOWN (0) FO480 CLINICAL DIAGNOSTIC IMPRESSION: OTHER NEUROLOGICAL DISEASE 0 NO 1 YES, NEW 2 YES, OLD 3 YES, RECURRENT 4 MAYBE UNKNOWN (0) FO481 CLINICAL DIAGNOSTIC IMPRESSION: DEPRESSION 0 NO 1 YES, NEW 2 YES, OLD 3 YES, RECURRENT 4 MAYBE UNKNOWN (29) DIAGNOSTIC IMPRESSIONS - NOT HARD DATA - USE WITH CAUTION SCREEN 26: CLINICAL DIAGNOSTIC IMPRESSION - PART III ---------------------------------------------------- VARIABLE INFORMATION -------- ----------- FO482 CLINICAL DIAGNOSTIC IMPRESSION: DIABETES MELLITUS 0 NO 1 YES 2 MAYBE UNKNOWN (1) deleted - redundant, use most current diabetes file FO483 CLINICAL DIAGNOSTIC IMPRESSION: URINARY TRACT DISEASE 0 NO 1 YES 2 MAYBE UNKNOWN (2) FO484 CLINICAL DIAGNOSTIC IMPRESSION: PROSTATE DISEASE 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO485 CLINICAL DIAGNOSTIC IMPRESSION: RENAL DISEASE 0 NO 1 YES 2 MAYBE UNKNOWN (2) FO486 CLINICAL DIAGNOSTIC IMPRESSION: EMPHYSEMA 0 NO 1 YES 2 MAYBE UNKNOWN (2) FO487 CLINICAL DIAGNOSTIC IMPRESSION: CHRONIC BRONCHITIS 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO488 CLINICAL DIAGNOSTIC IMPRESSION: PNEUMONIA 0 NO 1 YES 2 MAYBE UNKNOWN (1) DIAGNOSTIC IMPRESSIONS - NOT HARD DATA - USE WITH CAUTION FO489 CLINICAL DIAGNOSTIC IMPRESSION: ASTHMA 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO490 CLINICAL DIAGNOSTIC IMPRESSION: OTHER PULMONARY DISEASE 0 NO 1 YES 2 MAYBE UNKNOWN (2) FO491 CLINICAL DIAGNOSTIC IMPRESSION: GOUT 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO492 CLINICAL DIAGNOSTIC IMPRESSION: DEGENERATIVE JOINT DISEASE 0 NO 1 YES 2 MAYBE UNKNOWN (1) FO493 CLINICAL DIAGNOSTIC IMPRESSION: RHEUMATOID ARTHRITIS 0 NO 1 YES 2 MAYBE UNKNOWN (2) FO494 CLINICAL DIAGNOSTIC IMPRESSION: GALLBLADDER DISEASE 0 NO 1 YES 2 MAYBE UNKNOWN (3) FO495 CLINICAL DIAGNOSTIC IMPRESSION: OTHER NON C-V DIAGNOSIS 0 NO 1 YES 2 MAYBE UNKNOWN (3) DIAGNOSTIC IMPRESSIONS - NOT HARD DATA - USE WITH CAUTION SCREEN 27: SECOND EXAMINER OPINIONS IN INTERIM ---------------------------------------------- VARIABLE INFORMATION -------- ----------- FO496 2ND EXAMINER ID 42 - 153 UNKNOWN (977) deleted - used for administrative purposes only FO497 2ND EXAMINER-CONGESTIVE HEART FAILURE 0 NO 1 YES 2 MAYBE UNKNOWN (1096) deleted - redundant, use most current soe file FO498 2ND EXAMINER-CORONARY INSUFFICIENCY 0 NO 1 YES 2 MAYBE UNKNOWN (1092) deleted - redundant, use most current soe file FO499 2ND EXAMINER-ANGINA PECTORIS 0 NO 1 YES 2 MAYBE UNKNOWN (1061) deleted - redundant, use most current soe file FO500 2ND EXAMINER-MYOCARDIAL INFARCTION 0 NO 1 YES 2 MAYBE UNKNOWN (1094) deleted - redundant, use most current soe file FO501 2ND EXAMINER-SYNCOPE 0 NO 1 YES 2 MAYBE UNKNOWN (1113) FO502 2ND EXAMINER-INTERMITTENT CLAUDICATION 0 NO 1 YES 2 MAYBE UNKNOWN (1095) deleted - redundant, use most current soe file FO503 2ND EXAMINER-STROKE 0 NO 1 YES 2 MAYBE UNKNOWN (1130) deleted - redundant, use most current soe file DIAGNOSTIC IMPRESSIONS - NOT HARD DATA - USE WITH CAUTION FO504 2ND EXAMINER-TIA 0 NO 1 YES 2 MAYBE UNKNOWN (1128) deleted - redundant, use most current soe file DIAGNOSTIC IMPRESSIONS - NOT HARD DATA - USE WITH CAUTION ACTIVITIES QUESTIONS - PART A ----------------------------- VARIABLE INFORMATION -------- ----------- FO505 ACTIVITIES A - WHERE DO YOU LIVE? 0 RESIDENCE 1 NURSING HOME 2 OTHER INSTITUTION 3 RETIREMENT HOME / CONGREGATE HOUSING UNKNOWN (12) deleted - to preserve confidentiality FO506 ACTIVITIES A - DOES ANYONE LIVE WITH YOU? 0 NO OR NURSING HOME RESIDENT 1 YES UNKNOWN (12) FO507 ACTIVITIES A - LIVING WITH YOU-SPOUSE 0 NO OR NURSING HOME RESIDENT 1 YES UNKNOWN (20) FO508 ACTIVITIES A - LIVING WITH YOU-CHILDREN 0 NO OR NURSING HOME RESIDENT 1 YES UNKNOWN (29) FO509 ACTIVITIES A - LIVING WITH YOU-FRIENDS 0 NO OR NURSING HOME RESIDENT 1 YES UNKNOWN (36) FO510 ACTIVITIES A - LIVING WITH YOU-RELATIVES 0 NO OR NURSING HOME RESIDENT 1 YES UNKNOWN (36) FO511 ACTIVITIES A - IN GENERAL, HOW IS YOUR HEALTH NOW? 1 EXCELLENT 2 GOOD 3 FAIR 4 POOR UNKNOWN (83) FO512 ACTIVITIES A - COMPARE YOUR HEALTH TO MOST PEOPLE YOUR OWN AGE 1 BETTER 2 ABOUT THE SAME 3 WORSE THAN MOST PEOPLE YOUR OWN AGE UNKNOWN (91) FO513 ACTIVITIES A - IN WHAT CITY OR TOWN DO YOU CURRENTLY LIVE? NOTE: VARIABLES FO513-FO518 ARE RELATED 1 FRAMINGHAM AREA 2 METRO BOSTON 3 CAPE COD 4 OTHER MA AREAS 5 FLORIDA 6 ARIZONA 7 CALIFORNIA 8 OTHER UNKNOWN (76) deleted - to preserve confidentiality FO514 ACTIVITIES A - HOW MANY MONTHS OF THE YEAR DO YOU LIVE THERE? (IF LESS THAT 12 MONTHS, CONTINUE BELOW) NOTE: VARIABLES FO513-FO518 ARE RELATED 2 - 12 UNKNOWN (79) deleted - to preserve confidentiality FO515 ACTIVITIES A - IN WHAT OTHER AREA DO YOU LIVE? NOTE: VARIABLES FO513-FO518 ARE RELATED 0 NOT APPLICABLE 1 FRAMINGHAM AREA 2 METRO BOSTON 3 CAPE COD 4 OTHER MA AREAS 5 FLORIDA 6 ARIZONA 7 CALIFORNIA 8 OTHER UNKNOWN (79) deleted - to preserve confidentiality FO516 ACTIVITIES A - HOW MANY MONTHS OF THE YEAR DO YOU LIVE THERE? (IF LESS THAN 12 MONTH TOTAL, CONTINUE BELOW) NOTE: VARIABLES FO513-FO518 ARE RELATED O NONE OR NOT APPLICABLE 1 - 8 UNKNOWN (80) deleted - to preserve confidentiality FO517 ACTIVITIES A - IN WHAT OTHER AREA DO YOU LIVE? NOTE: VARIABLES FO513-FO518 ARE RELATED 0 NOT APPLICABLE 1 FRAMINGHAM AREA 2 METRO BOSTON 3 CAPE COD 4 OTHER MA AREAS 5 FLORIDA 6 ARIZONA 7 CALIFORNIA 8 OTHER UNKNOWN (79) deleted - to preserve confidentiality FO518 ACTIVITIES A - HOW MANY MONTHS OF THE YEAR DO YOU LIVE THERE? NOTE: VARIABLES FO513-FO518 ARE RELATED 0 NONE OR NOT APPLICABLE 1 - 5 UNKNOWN (80) deleted - to preserve confidentiality FO519 ACTIVITIES A - IN THE SUMMER, ON AVERAGE, ABOUT HOW MANY HOURS PER DAY DO YOU SPEND OUTSIDE? 0 NONE 0.2 - 16.0 UNKNOWN (120) FO520 ACTIVITIES A - IN THE SUMMER WHEN YOU WERE OUTSIDE, HOW MUCH OF YOUR SKIN WAS USUALLY EXPOSED TO THE SUN? 1 FACE ONLY 2 FACE AND HANDS 3 FACE, HANDS AND ARMS 4 FACE, HANDS, ARMS, LEGS UNKNOWN (169) ACTIVITIES QUESTIONS - PART B ----------------------------- VARIABLE INFORMATION -------- ----------- FO521 ACTIVITIES B - ARE YOU IN BED OR IN A CHAIR FOR MOST OR ALL OF THE DAY (ON THE AVERAGE)?: (NOTE: THIS IS A LIFESTYLE QUESTION, NOT DUE TO HEALTH) 0 NO 1 YES UNKNOWN OR NOT SURE (86) * Version 1: 02-08-2007 F521 was changed to FO521 FO522 ACTIVITIES B - DO YOU NEED A SPECIAL AID (WHEELCHAIR, CANE, WALKER) TO GET AROUND? 0 NO 1 YES 2 SOMETIMES UNKNOWN (79) FO523 ACTIVITIES B - DO YOU USE A CANE OR WALKING STICK? 0 NO OR DO NOT NEED A SPECIAL AID TO GET AROUND 1 YES 2 SOMETIMES UNKNOWN (89) FO524 ACTIVITIES B - DO YOU USE A WHEELCHAIR? 0 NO OR DO NOT NEED A SPECIAL AID TO GET AROUND 1 YES 2 SOMETIMES UNKNOWN (86) FO525 ACTIVITIES B - DO YOU USE A WALKER? 0 NO OR DO NOT NEED A SPECIAL AID TO GET AROUND 1 YES 2 SOMETIMES UNKNOWN (88) FO526 ACTIVITIES B - DO YOU USE SOME OTHER SPECIAL AID TO GET AROUND? (WRITE IN) 0 NO OR DO NOT NEED A SPECIAL AID TO GET AROUND 1 YES 2 SOMETIMES UNKNOWN (92) FO527 ACTIVITIES B - ARE YOU WORKING NOW ? 0 NO 1 YES, FULL TIME 2 YES, PART TIME UNKNOWN (63) FO528 ACTIVITIES B - # OF DAYS IN PAST 6 MONTHS TOO SICK TO CARRY OUT USUAL ACTIVITIES 0 NONE 1 - 180 UNKNOWN (110) FO529 ACTIVITIES B - ARE YOU ABLE TO DO HEAVY WORK AROUND HOUSE LIKE SHOVEL SNOW OR WASH WINDOWS, WALLS OR FLOORS WITHOUT HELP? 0 NO, UNABLE TO DO 1 YES, INDEPENDENT 2 YES, WITH HUMAN ASSISTANCE UNKNOWN (63) FO530 ACTIVITIES B - ARE YOU ABLE TO WALK UP AND DOWN STAIRS TO THE SECOND FLOOR WITHOUT ANY HELP? 0 NO, UNABLE TO DO 1 YES, INDEPENDENT 2 YES, WITH HUMAN ASSISTANCE UNKNOWN (63) FO531 ACTIVITIES B - ARE YOU ABLE TO WALK A MILE WITHOUT HELP? (ABOUT 8 BLOCKS) 0 NO, UNABLE TO DO 1 YES, INDEPENDENT 2 YES, WITH HUMAN ASSISTANCE UNKNOWN (101) FO532 ACTIVITIES B - IF YOU HAD TO, COULD YOU DO ALL THE HOUSEKEEPING YOURSELF (LIKE WASHING CLOTHES AND CLEANING)? 0 NO, UNABLE TO DO 1 YES, INDEPENDENT 2 YES, WITH HUMAN ASSISTANCE UNKNOWN (88) FO533 ACTIVITIES B - IF YOU HAD TO, COULD YOU DO ALL THE COOKING YOURSELF? 0 NO, UNABLE TO DO 1 YES, INDEPENDENT 2 YES, WITH HUMAN ASSISTANCE UNKNOWN (88) FO534 ACTIVITIES B - IF YOU HAD TO, COULD YOU DO ALL THE GROCERY SHOPPING YOURSELF? 0 NO, UNABLE TO DO 1 YES, INDEPENDENT 2 YES, WITH HUMAN ASSISTANCE UNKNOWN (89) FO535 ACTIVITIES-DO YOU DRIVE? 0 NO 1 YES, CURRENTLY 2 YES, NOT NOW UNKNOWN (64) FO536 ACTIVITIES-REASON FOR NOT DRIVING NOW 1 HEALTH 2 OTHER NON-HEALTH REASON 3 NEVER LICENSED 8 N/A, CURRENT DRIVER UNKNOWN (91) ACTIVITIES QUESTIONS - PART C ----------------------------- NOTE FOR VARIABLES FO537 - FO580: FOR EACH ACTIVITY VARIABLE THAT SUBJECT REPLIED HAVING DIFFICULTY ("3=A LOT OF DIFFICULTY","4=UNABLE TO DO") THE CORRESPONDING SYMPTOM VARIABLES ARE CODED WITH APPROPRIATE HEALTH PROBLEM OR SYMPTOM FOR EACH ACTIVITY VARIABLE WHICH SUBJECT ANSWERED LITTLE DIFFICULTY OR DON'T DO ON MD ORDERS ("0=NO DIFFICULTY", "1=A LITTLE DIFFICULTY", "2=SOME DIFFICULTY","5=DON'T DO ON MDS ORDERS") THE CORRESPONDING SYMPTOM VARIABLES ARE CODED AS "88=N/A" VARIABLE INFORMATION -------- ----------- FO537 ACTIVITIES C - SEE NOTE ABOVE PULLING/PUSHING LARGE OBJECTS LIKE A LIVING ROOM CHAIR 0 NO DIFFICULTY 1 A LITTLE DIFFICULTY 2 SOME DIFFICULTY 3 A LOT OF DIFFICULTY 4 UNABLE TO DO 5 DON'T DO ON MD ORDERS UNKNOWN (56) FO538 ACTIVITIES C - SEE NOTE ABOVE PULLING/PUSHING LARGE OBJECTS LIKE A LIVING ROOM CHAIR SYMPTOM 1 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (86) FO539 ACTIVITIES C - SEE NOTE ABOVE PULLING/PUSHING LARGE OBJECTS LIKE A LIVING ROOM CHAIR SYMPTOM 2 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (104) FO540 ACTIVITIES C - SEE NOTE ABOVE PULLING/PUSHING LARGE OBJECTS LIKE A LIVING ROOM CHAIR SYMPTOM 3 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (111) FO541 ACTIVITIES C - SEE NOTE ABOVE STOOPING/CROUCHING/KNEELING 0 NO DIFFICULTY 1 A LITTLE DIFFICULTY 2 SOME DIFFICULTY 3 A LOT OF DIFFICULTY 4 UNABLE TO DO 5 DON'T DO ON MD ORDERS UNKNOWN (57) FO542 ACTIVITIES C - SEE NOTE ABOVE STOOPING/CROUCHING/KNEELING SYMPTOM 1 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (94) FO543 ACTIVITIES C - SEE NOTE ABOVE STOOPING/CROUCHING/KNEELING SYMPTOM 2 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (115) FO544 ACTIVITIES C - SEE NOTE ABOVE STOOPING/CROUCHING/KNEELING SYMPTOM 3 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (123) FO545 ACTIVITIES C - SEE NOTE ABOVE REACHING OR EXTENDING ARMS BELOW SHOULDER LEVEL (NOTE: THIS QUESTION WAS MISSING ON SOME FORMS) 0 NO DIFFICULTY 1 A LITTLE DIFFICULTY 2 SOME DIFFICULTY 3 A LOT OF DIFFICULTY 4 UNABLE TO DO 5 DON'T DO ON MD ORDERS UNKNOWN (315) FO546 ACTIVITIES C - SEE NOTE ABOVE REACHING OR EXTENDING ARMS BELOW SHOULDER LEVEL SYMPTOM 1 (NOTE: THIS QUESTION WAS MISSING ON SOME FORMS) 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (317) FO547 ACTIVITIES C - SEE NOTE ABOVE REACHING OR EXTENDING ARMS BELOW SHOULDER LEVEL SYMPTOM 2 (NOTE: THIS QUESTION WAS MISSING ON SOME FORMS) 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (321) FO548 ACTIVITIES C - SEE NOTE ABOVE REACHING OR EXTENDING ARMS BELOW SHOULDER LEVEL SYMPTOM 3 (NOTE: THIS QUESTION WAS MISSING ON SOME FORMS) 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (320) FO549 ACTIVITIES C - SEE NOTE ABOVE REACHING OR EXTENDING ARMS ABOVE SHOULDER LEVEL 0 NO DIFFICULTY 1 A LITTLE DIFFICULTY 2 SOME DIFFICULTY 3 A LOT OF DIFFICULTY 4 UNABLE TO DO 5 DON'T DO ON MD ORDERS UNKNOWN (54) FO550 ACTIVITIES C - SEE NOTE ABOVE REACHING OR EXTENDING ARMS ABOVE SHOULDER LEVEL SYMPTOM 1 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (62) FO551 ACTIVITIES C - SEE NOTE ABOVE REACHING OR EXTENDING ARMS ABOVE SHOULDER LEVEL SYMPTOM 2 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (70) FO552 ACTIVITIES C - SEE NOTE ABOVE REACHING OR EXTENDING ARMS ABOVE SHOULDER LEVEL SYMPTOM 3 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (73) FO553 ACTIVITIES C - SEE NOTE ABOVE WRITING, HANDLING OR FINGERING SMALL OBJECTS 0 NO DIFFICULTY 1 A LITTLE DIFFICULTY 2 SOME DIFFICULTY 3 A LOT OF DIFFICULTY 4 UNABLE TO DO 5 DON'T DO ON MD ORDERS UNKNOWN (54) FO554 ACTIVITIES C - SEE NOTE ABOVE WRITING, HANDLING OR FINGERING SMALL OBJECTS SYMPTOM 1 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (62) FO555 ACTIVITIES C - SEE NOTE ABOVE WRITING, HANDLING OR FINGERING SMALL OBJECTS SYMPTOM 2 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (71) FO556 ACTIVITIES C - SEE NOTE ABOVE WRITING, HANDLING OR FINGERING SMALL OBJECTS SYMPTOM 3 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (74) FO557 ACTIVITIES C - SEE NOTE ABOVE STANDING IN ONE PLACE FOR LONG PERIODS, SAY FOR 15 MIN 0 NO DIFFICULTY 1 A LITTLE DIFFICULTY 2 SOME DIFFICULTY 3 A LOT OF DIFFICULTY 4 UNABLE TO DO 5 DON'T DO ON MD ORDERS UNKNOWN (55) FO558 ACTIVITIES C - SEE NOTE ABOVE STANDING IN ONE PLACE FOR LONG PERIODS, SAY FOR 15 MIN SYMPTOM 1 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (89) FO559 ACTIVITIES C - SEE NOTE ABOVE STANDING IN ONE PLACE FOR LONG PERIODS, SAY FOR 15 MIN SYMPTOM 2 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (99) FO560 ACTIVITIES C - SEE NOTE ABOVE STANDING IN ONE PLACE FOR LONG PERIODS, SAY FOR 15 MIN SYMPTOM 3 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (109) FO561 ACTIVITIES C - SEE NOTE ABOVE SITTING FOR LONG PERIODS, SAY 1 HOUR (NOTE: THIS QUESTION WAS MISSING ON SOME FORMS) 0 NO DIFFICULTY 1 A LITTLE DIFFICULTY 2 SOME DIFFICULTY 3 A LOT OF DIFFICULTY 4 UNABLE TO DO 5 DON'T DO ON MD ORDERS UNKNOWN (314) FO562 ACTIVITIES C - SEE NOTE ABOVE SITTING FOR LONG PERIODS, SAY 1 HOUR (NOTE: THIS QUESTION WAS MISSING ON SOME FORMS) SYMPTOM 1 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (317) FO563 ACTIVITIES C - SEE NOTE ABOVE SITTING FOR LONG PERIODS, SAY 1 HOUR (NOTE: THIS QUESTION WAS MISSING ON SOME FORMS) SYMPTOM 2 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (317) FO564 ACTIVITIES C - SEE NOTE ABOVE SITTING FOR LONG PERIODS, SAY 1 HOUR (NOTE: THIS QUESTION WAS MISSING ON SOME FORMS) SYMPTOM 3 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (317) FO565 ACTIVITIES C - SEE NOTE ABOVE GETTING IN AND OUT OF A CAR 0 NO DIFFICULTY 1 A LITTLE DIFFICULTY 2 SOME DIFFICULTY 3 A LOT OF DIFFICULTY 4 UNABLE TO DO 5 DON'T DO ON MD ORDERS UNKNOWN (84) FO566 ACTIVITIES C - SEE NOTE ABOVE GETTING IN AND OUT OF A CAR SYMPTOM 1 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (95) FO567 ACTIVITIES C - SEE NOTE ABOVE GETTING IN AND OUT OF A CAR SYMPTOM 2 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (103) FO568 ACTIVITIES C - SEE NOTE ABOVE GETTING IN AND OUT OF A CAR SYMPTOM 3 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (108) FO569 ACTIVITIES C - SEE NOTE ABOVE LIFTING A 10 LB OBJECT OFF THE FLOOR (SACK OF POTATOES) 0 NO DIFFICULTY 1 A LITTLE DIFFICULTY 2 SOME DIFFICULTY 3 A LOT OF DIFFICULTY 4 UNABLE TO DO 5 DON'T DO ON MD ORDERS UNKNOWN (87) FO570 ACTIVITIES C - SEE NOTE ABOVE LIFTING A 10 LB OBJECT OFF THE FLOOR (SACK OF POTATOES) SYMPTOM 1 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (116) FO571 ACTIVITIES C - SEE NOTE ABOVE LIFTING A 10 LB OBJECT OFF THE FLOOR (SACK OF POTATOES) SYMPTOM 2 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (125) FO572 ACTIVITIES C - SEE NOTE ABOVE LIFTING A 10 LB OBJECT OFF THE FLOOR (SACK OF POTATOES) SYMPTOM 3 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (129) FO573 ACTIVITIES C - SEE NOTE ABOVE PUTTING SOCKS OR STOCKINGS ON 0 NO DIFFICULTY 1 A LITTLE DIFFICULTY 2 SOME DIFFICULTY 3 A LOT OF DIFFICULTY 4 UNABLE TO DO 5 DON'T DO ON MD ORDERS UNKNOWN (80) FO574 ACTIVITIES C - SEE NOTE ABOVE PUTTING SOCKS OR STOCKINGS ON SYMPTOM 1 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (92) FO575 ACTIVITIES C - SEE NOTE ABOVE PUTTING SOCKS OR STOCKINGS ON SYMPTOM 2 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (101) FO576 ACTIVITIES C - SEE NOTE ABOVE PUTTING SOCKS OR STOCKINGS ON SYMPTOM 3 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (107) FO577 ACTIVITIES C - SEE NOTE ABOVE WALKING ONE HALF MILE (4-6 BLOCKS) 0 NO DIFFICULTY 1 A LITTLE DIFFICULTY 2 SOME DIFFICULTY 3 A LOT OF DIFFICULTY 4 UNABLE TO DO 5 DON'T DO ON MD ORDERS UNKNOWN (73) FO578 ACTIVITIES C - SEE NOTE ABOVE WALKING ONE HALF MILE (4-6 BLOCKS) SYMPTOM 1 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (101) FO579 ACTIVITIES C - SEE NOTE ABOVE WALKING ONE HALF MILE (4-6 BLOCKS) SYMPTOM 2 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (115) FO580 ACTIVITIES C - SEE NOTE ABOVE WALKING ONE HALF MILE (4-6 BLOCKS) SYMPTOM 3 1 CHEST PAIN 2 ARTHRITIS / JOINT 3 BACK PAIN / STIFFNESS 4 PRIOR STROKE 5 HIP FRACTURE 6 FEELING SAD OR TENSE 7 SHORTNESS OF BREATH 8 DIABETES SYMPTOMS 9 PARKINSON'S DISEASE 10 OTHER PROBLEM (WRITE IN) 88 N/A UNKNOWN (122) ACTIVITIES QUESTIONS - PART D ----------------------------- VARIABLE INFORMATION -------- ----------- FO581 ACTIVITIES D - IN PAST YEAR HAVE YOU ACCIDENTALLY FALLEN AND HIT THE FLOOR OR GROUND? (CODE AS NO IF DURING SPORTS ACTIVITY) 0 NO 1 YES 2 MAYBE UNKNOWN (70) FO582 ACTIVITIES D - IF YES (TO FO581), HOW MANY TIMES DID YOU FALL IN THE PAST YEAR? 1 - 21 88 DID NOT FALL OR NOT APPLICABLE UNKNOWN (83) FO583 ACTIVITIES D - IF YES (TO FO581), THINKING OF THE FALLS YOU HAD IN THE PAST YEAR, IN WHAT DIRECTION DID YOU TEND TO FALL? 0 FORWARD 1 BACKWARD 3 TO THE SIDE 4 VARIES 5 CAN'T RECALL 8 DID NOT FALL OR NOT APPLICABLE UNKNOWN (97) FO584 ACTIVITIES D - IF YES (TO FO581), DID ANY OF YOUR FALLS IN THE PAST YEAR RESULT IN A FRACTURE? 0 NO OR DID NOT FALL 1 YES 2 MAYBE UNKNOWN (84) FO585 ACTIVITIES D - IF YES (TO FO581), DID ANY OF YOUR FALLS IN THE PAST YEAR RESULT IN A HEAD INJURY REQUIRING MEDICAL ATTENTION? 0 NO OR DID NOT FALL 1 YES 2 MAYBE UNKNOWN (86) FO586 ACTIVITIES D - IF YES (TO FO581), DID ANY OF YOUR FALLS IN THE PAST YEAR RESULT IN A DISLOCATION? 0 NO OR DID NOT FALL 1 YES 2 MAYBE UNKNOWN (88) FO587 ACTIVITIES D - IF YES (TO FO581), DID ANY OF YOUR FALLS IN THE PAST YEAR RESULT IN A BRUISE, SPRAIN OR CUT? 0 NO OR DID NOT FALL 1 YES 2 MAYBE UNKNOWN (85) FO588 ACTIVITIES D - IF YES (TO FO581), DID ANY OF YOUR FALLS IN THE PAST YEAR RESULT IN OTHER THAN LISTED ABOVE? 0 NO OR DID NOT FALL 1 YES 2 MAYBE UNKNOWN (147) FO589 ACTIVITIES D - IF YES (TO FO581), DID YOU LOSE CONCIOUSNESS OR BLACK OUT BEFORE ANY FALLS IN THE PAST YEAR? 0 NO OR DID NOT FALL 1 YES 2 MAYBE UNKNOWN (89) FO590 ACTIVITIES D - ARE YOU AFRAID YOU MAY FALL? 0 NO 1 YES UNKNOWN (118) FO591 ACTIVIES D - IF YES (TO FO590), HOW MUCH DOES YOUR FEAR OF FALLING INTERFERE WITH BATHING? 0 NONE OR NOT AFRAID OF FALLING 1 SOME 2 A LOT UNKNOWN (123) FO592 ACTIVIES D - IF YES (TO FO590), HOW MUCH DOES YOUR FEAR OF FALLING INTERFERE WITH REACHING INTO CABINETS OR CLOSETS? 0 NONE OR NOT AFRAID OF FALLING 1 SOME 2 A LOT UNKNOWN (127) FO593 ACTIVIES D - IF YES (TO FO590), HOW MUCH DOES YOUR FEAR OF FALLING INTERFERE WITH WALKING OUTSIDE YOUR HOME (E.G AT A GROCERY STORE OR MALL)? 0 NONE OR NOT AFRAID OF FALLING 1 SOME 2 A LOT UNKNOWN (132) FO594 ACTIVIES D - IF YES (TO FO590), HOW MUCH DOES YOUR FEAR OF FALLING INTERFERE WITH WALKING INSIDE YOUR HOME? 0 NONE OR NOT AFRAID OF FALLING 1 SOME 2 A LOT UNKNOWN (129) FO595 ACTIVIES D - IF YES (TO FO590), HOW MUCH DOES YOUR FEAR OF FALLING INTERFERE WITH CLIMBING STAIRS (UP AND DOWN)? 0 NONE OR NOT AFRAID OF FALLING 1 SOME 2 A LOT UNKNOWN (132) FO596 ACTIVIES D - IF YES (TO FO590), HOW MUCH DOES YOUR FEAR OF FALLING INTERFERE WITH OTHER ACTIVITY NOT LISTED ABOVE? 0 NONE OR NOT AFRAID OF FALLING 1 SOME 2 A LOT UNKNOWN (190) ACTIVIES QUESTIONS -- PART E ---------------------------- VARIABLE INFORMATION -------- ----------- FO597 ACTIVITIES E - BROKEN ANY BONES SINCE LAST VISIT? 0 NO OR UNDER AGE 30 1 YES 2 MAYBE UNKNOWN (68) * Version 2 09-05-2007 deleted - to preserve confidentiality FO598 ACTIVITIES E - (SINCE LAST VISIT) YEAR BROKE LEFT UPPER ARM (HUMERUS) / ELBOW 0 NOT BROKEN OR UNDER AGE 30 90 - 92 UNKNOWN (106) * Version 2 09-05-2007 deleted - to preserve confidentiality FO599 ACTIVITIES E - (SINCE LAST VISIT) YEAR BROKE RIGHT UPPER ARM (HUMERUS) / ELBOW 0 NOT BROKEN OR UNDER AGE 30 81 - 92 UNKNOWN (101) * Version 2 09-05-2007 deleted - to preserve confidentiality FO600 ACTIVITIES E - (SINCE LAST VISIT) YEAR BROKE LEFT FOREARM OR WRIST 0 NOT BROKEN OR UNDER AGE 30 91 - 93 UNKNOWN (102) * Version 2 09-05-2007 deleted - to preserve confidentiality FO601 ACTIVITIES E - (SINCE LAST VISIT) YEAR BROKE RIGHT FOREARM OR WRIST 0 NOT BROKEN OR UNDER AGE 30 89 - 92 UNKNOWN (104) * Version 2 09-05-2007 deleted - to preserve confidentiality FO602 ACTIVITIES E - (SINCE LAST VISIT) YEAR BROKE BACK 0 NOT BROKEN OR UNDER AGE 30 89 - 93 UNKNOWN (103) * Version 2 09-05-2007 deleted - to preserve confidentiality FO603 ACTIVITIES E - (SINCE LAST VISIT) YEAR BROKE PELVIS 0 NOT BROKEN OR UNDER AGE 30 90 - 93 UNKNOWN (103) * Version 2 09-05-2007 deleted - to preserve confidentiality FO604 ACTIVITIES E - (SINCE LAST VISIT) YEAR BROKE LEFT HIP 0 NOT BROKEN OR UNDER AGE 30 54 - 93 UNKNOWN (102) * Version 2 09-05-2007 deleted - to preserve confidentiality FO605 ACTIVITIES E - (SINCE LAST VISIT) YEAR BROKE RIGHT HIP 0 NOT BROKEN OR UNDER AGE 30 70 - 93 UNKNOWN (104) * Version 2 09-05-2007 deleted - to preserve confidentiality FO606 ACTIVITIES E - (SINCE LAST VISIT) YEAR BROKE OTHER BONE 0 NOT BROKEN OR UNDER AGE 30 80 - 93 UNKNOWN (90) * Version 2 09-05-2007 deleted - to preserve confidentiality FO607 ACTIVITIES E - KNEE OSTEOARTHRITIS PHYSICAL EXAM LEFT KNEE GRIND 0 ABSENT OR NEGATIVE TEST 1 PRESENT OR POSITIVE TEST UNKNOWN OR DID NOT TEST (266) FO608 ACTIVITIES E - KNEE OSTEOARTHRITIS PHYSICAL EXAM LEFT KNEE TENDER 0 ABSENT OR NEGATIVE TEST 1 PRESENT OR POSITIVE TEST UNKNOWN OR DID NOT TEST (262) FO609 ACTIVITES E - KNEE OSTEOARTHRITIS PHYSICAL EXAM LEFT KNEE ENLARGEMENT 0 ABSENT OR NEGATIVE TEST 1 PRESENT OR POSITIVE TEST UNKNOWN OR DID NOT TEST (265) FO610 ACTIVITIES E - KNEE OSTEOARTHRITIS PHYSICAL EXAM RIGHT KNEE GRIND 0 ABSENT OR NEGATIVE TEST 1 PRESENT OR POSITIVE TEST UNKNOWN OR DID NOT TEST (259) FO611 ACTIVITIES E - KNEE OSTEOARTHRITIS PHYSICAL EXAM RIGHT KNEE TENDER 0 ABSENT OR NEGATIVE TEST 1 PRESENT OR POSITIVE TEST UNKNOWN OR DID NOT TEST (259) FO612 ACTIVITIES E - KNEE OSTEOARTHRITIS PHYSICAL EXAM RIGHT KNEE ENLARGEMENT 0 ABSENT OR NEGATIVE TEST 1 PRESENT OR POSITIVE TEST UNKNOWN OR DID NOT TEST (260) ARTHRITIS HISTORY -- PART A --------------------------- VARIABLE INFORMATION -------- ----------- FO613 ARTHRITIS A - KNEE - HAVE YOU EVER HAD PAIN LASTING AT LEAST A MONTH IN OR AROUND THE KNEE INCLUDING THE BACK OF THE KNEE? 0 NO 1 YES, LEFT 2 YES, RIGHT 3 YES, BOTH UNKNOWN (104) FO614 ARTHRITIS A - KNEE - IF YES (TO FO613), WHAT YEAR DID THE PAIN START IN LEFT KNEE? (TWO DIGIT FORMAT FOR YEAR: 19??) 0 NO OR NOT APPLICABLE 26 - 93 UNKNOWN (120) deleted - to preserve confidentiality FO615 ARTHRITIS A - KNEE - IF YES (TO FO613), WHAT YEAR DID THE PAIN START IN RIGHT KNEE? (TWO DIGIT FORMAT FOR YEAR: 19??) 0 NO OR NOT APPLICABLE 10 - 93 UNKNOWN (117) deleted - to preserve confidentiality FO616 ARTHRITIS A - KNEE - IF YES (TO FO613), WHEN WAS THE LAST TIME YOU HAD LEFT KNEE PAIN? (TWO DIGIT FORMAT FOR YEAR: 19??) 0 NO OR NOT APPLICABLE 27 - 94 UNKNOWN (110) deleted - to preserve confidentiality FO617 ARTHRITIS A - KNEE - IF YES (TO FO613), WHEN WAS THE LAST TIME YOU HAD RIGHT KNEE PAIN? (TWO DIGIT FORMAT FOR YEAR: 19??) 0 NO OR NOT APPLICABLE 12 - 94 UNKNOWN (109) deleted - to preserve confidentiality FO618 ARTHRITIS A - KNEE - IF YES (TO FO613), HOW SEVERE IS/WAS THE PAIN IN LEFT KNEE USUALLY? 1 MILD 2 MODERATE 3 SEVERE 8 NOT APPLICABLE UNKNOWN (111) FO619 ARTHRITIS A - KNEE - IF YES (TO FO613), HOW SEVERE IS/WAS THE PAIN IN RIGHT KNEE USUALLY? 1 MILD 2 MODERATE 3 SEVERE 8 NOT APPLICABLE UNKNOWN (108) FO620 ARTHRITIS A - KNEE - HAVE YOU EVERY HAD A FRACTURE OR INJURY TO A KNEE REQUIRING THE USE OF CRUTCHES OR A CANE? 0 NO 1 YES, LEFT 2 YES, RIGHT 3 YES, BOTH UNKNOWN (108) FO621 ARTHRITIS A - KNEE - ON MOST DAYS DO YOU HAVE PAIN, ACHING OR STIFFNESS IN EITHER OF YOUR KNEES? 0 NO 1 YES, LEFT 2 YES, RIGHT 3 YES, BOTH UNKNOWN (110) FO622 ARTHRITIS A - KNEE - IF YES (TO FO621), IS THE PAIN, ACHING OR STIFFNESS MILD, MODERATE OR SEVERE IN LEFT KNEE? 0 NO OR NOT APPLICABLE 1 MILD 2 MODERATE 3 SEVERE UNKNOWN (117) FO623 ARTHRITIS A - KNEE - IF YES (TO FO621), IS THE PAIN, ACHING OR STIFFNESS MILD, MODERATE OR SEVERE IN RIGHT KNEE? 0 NO OR NOT APPLICABLE 1 MILD 2 MODERATE 3 SEVERE UNKNOWN (118) FO624 ARTHRITIS A - KNEE - IN THE PAST MONTH HAVE YOU HAD ANY PAIN, ACHING OR STIFFNESS IN EITHER OF YOUR KNEES? 0 NO 1 YES, LEFT 2 YES, RIGHT 3 YES, BOTH UNKNOWN (112) FO625 ARTHRITIS A - HANDS - ON MOST DAYS DO YOU HAVE PAIN, ACHING OR STIFFNESS IN THE JOINTS OF YOUR HANDS OR WRISTS? 0 NO 1 YES, LEFT 2 YES, RIGHT 3 YES, BOTH UNKNOWN (106) FO626 ARTHRITIS A - HANDS - IF YES (TO FO625), IS THE PAIN, ACHING OR STIFFNESS MILD, MODERATE OR SEVERE IN LEFT HAND? 0 NONE OR NO PAIN ACHING OR STIFFNESS IN HANDS 1 MILD 2 MODERATE 3 SEVERE 8 NOT APPLICABLE UNKNOWN (107) FO627 ARTHRITIS A - HANDS - IF YES (TO FO625), IS THE PAIN, ACHING OR STIFFNESS MILD, MODERATE OR SEVERE IN RIGHT HAND? 0 NONE OR NO PAIN ACHING OR STIFFNESS IN HANDS 1 MILD 2 MODERATE 3 SEVERE 8 NOT APPLICABLE UNKNOWN (109) FO628 ARTHRITIS A - HANDS - IN THE PAST MONTH HAVE YOU HAD ANY PAIN, ACHING OR STIFFNESS IN THE JOINTS OF YOUR HANDS OR WRISTS? 0 NO 1 YES, LEFT 2 YES, RIGHT 3 YES, BOTH UNKNOWN (108) ARTHRITIS HISTORY -- PART B --------------------------- VARIABLE INFORMATION -------- ----------- FO629 ARTHRITIS B - BACK - HAVE YOU EVER HAD ANY BACK PAINS OR ACHES THAT WERE PERSISTENT OR TROUBLESOME TO YOU ANYTIME IN YOUR LIFE? 0 NO 1 YES 2 DON'T REMEMBER UNKNOWN (108) FO630 ARTHRITIS B - BACK - IF YES (TO FO629), WAS YOUR PAIN TROUBLESOME DURING CHILDHOOD? 0 NO OR NOT APPLICABLE 1 YES 2 DON'T REMEMBER UNKNOWN (124) FO631 ARTHRITIS B - BACK - IF YES (TO FO629), WAS YOUR PAIN TROUBLESOME DURING TEENAGE YEARS? 0 NO OR NOT APPLICABLE 1 YES 2 DON'T REMEMBER UNKNOWN (124) FO632 ARTHRITIS B - BACK - IF YES (TO FO629), WAS YOUR PAIN TROUBLESOME DURING AGES 20 TO < 40? 0 NO OR NOT APPLICABLE 1 YES 2 DON'T REMEMBER UNKNOWN (123) FO633 ARTHRITIS B - BACK - IF YES (TO FO629), WAS YOUR PAIN TROUBLESOME DURING AGES 40-65? 0 NO OR NOT APPLICABLE 1 YES 2 DON'T REMEMBER UNKNOWN (116) FO634 ARTHRITIS B - BACK - IF YES (TO FO629), WAS YOUR PAIN TROUBLESOME DURING AGES > 65? 0 NO OR NOT APPLICABLE 1 YES 2 DON'T REMEMBER UNKNOWN (115) FO635 ARTHRITIS B - ON MOST DAYS DO YOU HAVE PAIN, ACHING OR STIFFNESS IN YOUR BACK (EXCLUDING YOUR NECK)? 0 NO 1 YES, MILD 2 YES, MODERATE 3 YES, SEVERE UNKNOWN (113) FO636 ARTHRITIS B - DURING THE PAST YEAR HAVE YOU HAD AN EPISODE OF PAIN, ACHING OR STIFFNESS IN YOUR BACK (EXCLUDING YOUR NECK)? HOW LONG HAS IT LASTED? 0 NO 1 YES, LESS THAN 1 WEEK 2 YES, 1-4 WEEKS 3 YES, MORE THAN 4 WEEKS UNKNOWN (114) FO637 ARTHRITIS B - HAS A DOCTOR EVER TOLD YOU THAT YOU HAD ANY OF THE FOLLOWING LISTED BELOW? 0 NO 1 YES UNKNOWN (102) FO638 ARTHRITIS B - HAS A DOCTOR EVER TOLD YOU THAT YOU HAVE HAD OSTEOARTHRITIS (ALSO CALLED DEGENERATIVE ARTHRITIS)? 0 NO OR NOT APPLICABLE 1 YES UNKNOWN (115) FO639 ARTHRITIS B - HAS A DOCTOR EVER TOLD YOU THAT YOU HAVE HAD RHEUMATOID ARTHRITIS? 0 NO OR NOT APPLICABLE 1 YES UNKNOWN (124) FO640 ARTHRITIS B - HAS A DOCTOR EVER TOLD YOU THAT YOU HAVE HAD ARTHRITIS (NOT SURE WHAT TYPE)? 0 NO OR NOT APPLICABLE 1 YES UNKNOWN (122) FO641 ARTHRITIS B - HAS A DOCTOR EVER TOLD YOU THAT YOU HAVE HAD GOUT 0 NO OR NOT APPLICABLE 1 YES UNKNOWN (124) FO642 ARTHRITIS B - HAS A DOCTOR EVER TOLD YOU THAT YOU HAVE HAD OTHER THAN LISTED ABOVE? 0 NO OR NOT APPLICABLE 1 YES UNKNOWN (137) FO643 ARTHRITIS B - DO YOU TAKE MEDICATION DAILY FOR YOUR JOINT PAIN, ACHING OR STIFFNESS? 0 NO 1 YES UNKNOWN (98) FO644 ARTHRITIS B - IF YES (TO FO643), WHAT IS THE NAME OF THE MEDICATION? 1 DRUG NAMED 2 DRUG NAME NOT KNOWN 8 NOT APPLICABLE UNKNOWN (105) ARTHRITIS HISTORY -- PART C --------------------------- VARIABLE INFORMATION -------- ----------- FO645 ARTHRITIS C - ON MOST DAYS, DO YOU HAVE PAIN, ACHING OR STIFFNESS IN ANY OF YOUR JOINTS? 0 NO 1 YES UNKNOWN (108) FO646 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT SHOULDER 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (112) FO647 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT SHOULDER 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (113) FO648 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): NECK 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (116) FO649 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT ELBOW 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (112) FO650 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT ELBOW 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (115) FO651 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): UPPER BACK 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (118) FO652 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HIP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (112) FO653 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HIP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (113) FO654 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): MID BACK 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (121) FO655 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT WRIST 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (112) FO656 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT WRIST 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (113) FO657 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LOWER BACK 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (118) FO658 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT KNEE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (111) FO659 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT KNEE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (112) FO660 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT ANKLE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (112) FO661 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT ANKLE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (114) FO662 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND PINKIE TOP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (114) FO663 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND PINKIE MID 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (115) FO664 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND PINKIE KNUCKLE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (118) FO665 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND PINKIE TOP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (116) FO666 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND PINKIE MID 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (117) FO667 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND PINKIE KNUCKLE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (120) FO668 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND RING TOP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (115) FO669 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND RING MID 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (114) FO670 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND RING KNUCKLE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (117) FO671 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND RING TOP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (116) FO672 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND RING MID 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (118) FO673 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND RING KNUCKLE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (120) FO674 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND MIDDLE TOP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (113) FO675 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND MIDDLE MID 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (114) FO676 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND MIDDLE KNUCKLE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (116) FO677 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND MIDDLE TOP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (116) FO678 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND MIDDLE MID 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (117) FO679 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND MIDDLE KNUCKLE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (119) FO680 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND INDEX TOP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (114) FO681 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND INDEX MID 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (116) FO682 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND INDEX KNUCKLE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (116) FO683 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND INDEX TOP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (115) FO684 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND INDEX MID 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (117) FO685 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND INDEX KNUCKLE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (121) FO686 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND THUMB TOP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (113) FO687 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND THUMB MID 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (115) FO688 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): LEFT HAND THUMB KNUCKLE 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (118) FO689 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RIGHT HAND THUMB TOP 0 NO OR NO PAIN/ACHING/STIFFNESS IN ANY JOINTS 1 YES 8 NOT APPLICABLE UNKNOWN (117) FO690 ARTHRITIS C - IF YES (TO FO645), PLEASE POINT TO THE CIRCLE WHERE YOU HAVE PAIN, ACHING OR STIFFNESS ON MOST DAYS (SHOW PICTURE): RI