PATIENT RESPONSE RECORD (continued) Data Field Element XML Element Attributes Description Valid Values Data Type Size Required Q55 None Because of a physical, mental, Yes 1 Alphanumeric 1 Yes difficulty-errands or emotional condition, do No 2 character Each element must have a closing tag that you have difficulty doing MISSING/DK M is the same as the opening tag but with a errands alone, such as visiting forward slash. This patient response data a or shopping? doctor’s office element should only occur once per patient. Example:
PATIENT RESPONSE RECORD (continued) XML Element Attributes Description Valid Values Data Type Field Size Data Element Required Q55 difficulty-errands 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 Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone, such as visiting a doctor’s office or shopping? Yes 1 No 2 MISSING/DK M Alphanumeric character 1 Yes
ICH_SurveyAdminManual_Ver4_Feb2016.docx