PATIENT RESPONSE RECORD (continued) Data Field Element XML Element Attributes Description Valid Values Data Type Size Required Q46 None In general, how would you Excellent 1 Alphanumeric 1 Yes mental-health rate your overall mental or Very good 2 character Each element must have a closing tag that emotional health? Good 3 is the same as the opening tag but with a Fair 4 forward slash. This patient response data Poor 5 element should only occur once per MISSING/DK M patient. Example: mental-health1/mental-health Q47 None Are you being treated for high Yes 1 Alphanumeric 1 Yes high-bloodpressure blood pressure? No 2 character Each element must have a closing tag that MISSING/DK M is the same as the opening tag but with a forward slash. This patient response data element should only occur once per patient. Example: Q48 None Are you being treated for Yes 1 Alphanumeric 1 Yes diabetes diabetes or high blood sugar? No 2 character Each element must have a closing tag that MISSING/DK M is the same as the opening tag but with a forward slash. This patient response data element should only occur once per patient. Example: diabetes1/diabetes
PATIENT RESPONSE RECORD (continued) XML Element Attributes Description Valid Values Data Type Field Size Data Element Required Q46 mental-health 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: mental-health1/mental-health None In general, how would you rate your overall mental or emotional health? Excellent 1 Very good 2 Good 3 Fair 4 Poor 5 MISSING/DK M Alphanumeric character 1 Yes Q47 high-bloodpressure 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 Are you being treated for high blood pressure? Yes 1 No 2 MISSING/DK M Alphanumeric character 1 Yes Q48 diabetes 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: diabetes1/diabetes None Are you being treated for diabetes or high blood sugar? Yes 1 No 2 MISSING/DK M Alphanumeric character 1 Yes
ICH_SurveyAdminManual_Ver4_Feb2016.docx