PATIENT RESPONSE RECORD (continued) Data Field Element XML Element Attributes Description Valid Values Data Type Size Required Q59-phone None What is your race? You may Black or African Alphanumeric 1 Yes race-african-amer-phone choose one or more of the American 1 character Each element must have a closing tag that following. Are NOT APPLICABLE X you… is the same as the opening tag but with a MISSING/DK M forward slash. This patient response data element should only occur once per patient. Example: Q59-phone None What is your race? You may American Indian or Alphanumeric 1 Yes race-amer-indian-phone choose one or more of the Alaska Native 1 character Each element must have a closing tag that following. Are NOT APPLICABLE X you… is the same as the opening tag but with a MISSING/DK M forward slash. This patient response data element should only occur once per patient. Example: Q59-phone None What is your race? You may Asian 1 Alphanumeric 1 Yes race-asian-phone choose one or more of the NOT APPLICABLE X character Each element must have a closing tag that following. Are MISSING/DK M you… is the same as the opening tag but with a forward slash. This patient response data 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 Q59-phone race-african-amer-phone 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 What is your race? You may choose one or more of the following. Are you… Black or African American 1 NOT APPLICABLE X MISSING/DK M Alphanumeric character 1 Yes Q59-phone race-amer-indian-phone 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 What is your race? You may choose one or more of the following. Are you… American Indian or Alaska Native 1 NOT APPLICABLE X MISSING/DK M Alphanumeric character 1 Yes Q59-phone race-asian-phone 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 What is your race? You may choose one or more of the following. Are you… Asian 1 NOT APPLICABLE X MISSING/DK M Alphanumeric character 1 Yes
ICH_SurveyAdminManual_Ver4_Feb2016.docx