Data elements found in
Pulmonary Disease Questionnaire
Asthma as a Child (< 18 Yrs Old)
Tuberculous, Non-Tub Requiring Ther. or Hosp
Thor. Surg. or Trauma --Impair Respir.mechanics
Significant Recurrence Lower Respir. Infection
Environment/Occupat. Exposure to Pulmo Toxins
History Interstitial/Fibrotic Lung Disease
History of Chronic Bronchiectasis
Condition Prior 3 Mon. Before Visit
Recurrent Asthma as an Adult
Chronic Bronchitis or Emphysema
Limiting Lower Respi Infection Prior 3 Mons.
Cough, Morning in Bad Weather
Cough Other Times in Bad Weather
Cough Most Days for Three Months of Years
How Many Years Had This Cough
Bring up Phlegm/Mucous From Chest, Morning
Phlegm/Mucous From Chest Other Times
Phlegm/Mucous Chest Most Days, 3 Mons/Year
How Many Years Raised Phlegm/Mucous
Past 3 Yrs, Illness Like Bronchitis, Pneumonia
3 Yrs Unable to do Usual Activities
Ever Had Chest Disorders Like Bron. Emphysema
Doctor Said- Asthma, Bron. or Emphysema
Shortness/Breath Hurrying/Walking up Hill
Shortness/Breath Walking With Same Age Persons
Stop for Breath Walking Own Pace, Level Ground
Short of Breath -- Washing/Dressing Self
How Long Short of Breath
Disabled/Walking Other Than Heart/Lung Disease
Past 3 Yrs -- Breath Wheezy or Whistling
Past 3 Yrs - Short/Breath With Wheezing
Details
for this Data Type
JM -
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