PATIENT RESPONSE RECORD (continued) Data Field Element XML Element Attributes Description Valid Values Data Type Size Required Q40 None In the last 12 months, were Yes 1 Alphanumeric 1 Yes choose-treatment you as involved as much as No 2 character Each element must have a closing tag that you wanted in choosing the NOT APPLICABLE X is the same as the opening tag but with a treatment for kidney disease MISSING/DK M forward slash. This patient response data that is right for you? element should only occur once per patient. Example: Q41 None In the last 12 months, were Yes 1 Alphanumeric 1 Yes unhappy-care you ever unhappy with the No 2 character Each element must have a closing tag that care you received at the NOT APPLICABLE X is the same as the opening tag but with a dialysis center or from your MISSING/DK M forward slash. This patient response data kidney doctors? element should only occur once per patient. Example: unhappy-care1/unhappy-care Q42 None In the last 12 months, did you Yes 1 Alphanumeric 1 Yes talk-withstaff ever talk to someone on the No 2 character Each element must have a closing tag that dialysis center staff about NOT APPLICABLE X is the same as the opening tag but with a this? MISSING/DK M forward slash. This patient response data element should only occur once per patient. Example: talk-withstaff1/talk-withstaff
PATIENT RESPONSE RECORD (continued) XML Element Attributes Description Valid Values Data Type Field Size Data Element Required Q40 choose-treatment Each element must have a closing tag that is the same as the opening tag but with a forward slash. This patient response data element should only occur once per patient. Example: None In the last 12 months, were you as involved as much as you wanted in choosing the treatment for kidney disease that is right for you? Yes 1 No 2 NOT APPLICABLE X MISSING/DK M Alphanumeric character 1 Yes Q41 unhappy-care Each element must have a closing tag that is the same as the opening tag but with a forward slash. This patient response data element should only occur once per patient. Example: unhappy-care1/unhappy-care None In the last 12 months, were you ever unhappy with the care you received at the dialysis center or from your kidney doctors? Yes 1 No 2 NOT APPLICABLE X MISSING/DK M Alphanumeric character 1 Yes Q42 talk-withstaff Each element must have a closing tag that is the same as the opening tag but with a forward slash. This patient response data element should only occur once per patient. Example: talk-withstaff1/talk-withstaff None In the last 12 months, did you ever talk to someone on the dialysis center staff about this? Yes 1 No 2 NOT APPLICABLE X MISSING/DK M Alphanumeric character 1 Yes
ICH_SurveyAdminManual_Ver4_Feb2016.docx