Data elements found in Status

Participant Active
Participant Failure
Participant Withdrawn
Participant Deceased
Recruiter Active
Recruiter Failure
Recruiter Withdrawn
Recruiter Deceased
Who Recruited 0:Volunteer 1:Staff 2:Member
Xray # of Recruiter
Last Contact Code
Month of Last Contact
Day of Last Contact
Year of Last Contact
Month of Input
Year of Input
Active 1:Yes
Failure 1:Yes
Withdrawn 1:Yes
Dead 1:Yes
Hours of Sleep Per 24 Hours
Sleep Soundly
Cups of Coffee Per Day
Cups of Tea Per Day
Ever Fail to Pass Insurance Examination
Ever Fail to Pass Armed Services Examination
History of Scarlet Fever
History of Malaria
History of Typhoid Fever
History of Syphilis
History of Gonorrhea
History of Other Venereal Disease
History of Pneumonia
History of Rheumatic Fever
History of Diphtheria
History of Polio
History of Whooping Cough
History of Tuberculosis
History of Influenza
History of Pleurisy
History of Hay Fever
History of Asthma
History of Hives
History of Drug Reactions or Allergy
History of Stroke
History of Paralysis
History of Arthritis, Rheumatism or Neuritis
History of Diabetes
History of Goiter or Thyroid Disorder
History of Nervous Disorder
History of Loss of Consciousness
History of Ulcer of Stomach or Intestine
History of Liver or Gall Bladder Disorder
History of Kidney, Bladder, or Prostate Disorder
History of Anemia or Blood Disorder
History of Severe Unexplained Rash
History of Severe Unexplained Bruising
History of Sugar in Urine
History of Heart Trouble
History of Taking Medicine for Heart Trouble
Method of Taking Medicine for Heart Trouble
is Medicine Taken Now for Heart Trouble
History of Badly Swollen Ankles
History of High Blood Pressure
Year When Informed of High Blood Pressuere
History of Taking Medicine for High Blood Pressur
Year When Started Taking Medicine for High bp
is Medicine Taken Now for High Blood Pressure
Presence of Shortness of Breath When Excited
Presence of Shortness of Breath When Exercising
Presence of Shortness of Breath When Nervous
Presence of Shortness of Breath When Climbing Ste
History of Being Awakened by Shortness of Breath
History of Discomfort in Chest
Type of Discomfort in Chest
Does the Chest Discomfort Stay in One Place
Does Chest Discomfort Occur at Any Special Time
Does Chest Discomfort Occur After Meals
Does Chest Discomfort Occur Usually at Niht
Does Chest Discomfort Occur When Exercising
Does Chest Discomfort Occur When Walking in Cold
Does Chest Discomfort Occur When Upset or Excited
Does Any Thing Relieve the Chest Discomfort
Does a Posture Ch. Relieve the Chest Discomfort
Does Rest Relieve the Chest Discomfort
Does Physical Act. Relieve the Chest Discomfort
Does Bicarb. of Soda,tums, Etc. Relieve the Pain
Does Med. From Your Doctor Relieve the Chest Pain
Was a Doctor Ever Consulted for This Chest Pain
Pain or Cramps Frequently in Legs at Night
Pain or Cramps in Legs When Walking
if Yes, is Pain Relieved When Walking is Stopped
do You Cough Frequently
do You Cough at Any Special Time of Day
do You Cough up Anything
What is the Color of the Sputum
History of Ever Coughing up Blood
History of Wheezing or Other Breathing Noises
History of Shortness of Breath With the Wheezing
Did the Wheezing Occur at Any Special Time of yr
History of Being Exposed to Excessive Dust
History of Being Exposed to Irritating Gases
History of Being Exposed to Chemical Fumes
History of Being Exposed to Other Irritants
History of Sore or Burning Tongue
History of Difficulty in Swallowing
History of Loss of Appetite
History of Jaundice
History of Nausea or Vomiting
History of Vomiting of Blood Stained Material
History of Passage of Blood in Stool
History of Black or Tar Like Stools
History of Unexplained Abd. Pain or Cramps
History of Definite Change in Bowel Habits
History of Dysentery or Freq. Episodes of Diarrhe
History of Trouble Starting Stream When Urinating
History of Change in Size or Force of the Stream
History of Dribbling of Urine at End of Voiding
History of Urinating Again Shortly After Urinatin
History of Getting up to Urinate During the Night
No. of Times Get up to Urinate During Night
History of Losing Control of Your Bladder
History of Burning or Stinging Pain on Urination
History of Passing Blood in the Urine
History of Having Been Catheterized or Cystoscope
Weight Stable
Gaining Weight
Losing Weight
No. of Pounds Gained or Lost
What Age at Ideal Weight
What Was the Ideal Weight
Presently Drink More Water Than in Past
Presently Drink Less Water Than in Past
Change in Season of Year Preferred
Recent Change in Sex Habits
Sexual Active as Much as When Age Thirty
Anything Else of Bother Which Was Not Covered
History of Changes in Recent Memory
History of Faintness
History of Syncope
History of Convulsions
History of Headache
History of Head Injury of Head Operations
History of Blindness, Hemianopsia or Scotomata
History of Blurring of Vision
History of Diplopia

Details for this Data Type
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Revised 09/18/98 -- Send comments to our Web Master .