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 Native Hawaiian or Alphanumeric 1 Yes race-nativehawaiian-pacific-phone choose one or more of the Pacific Islander 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 NONE OF ABOVE 1 Alphanumeric 1 Yes race-noneofabove-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: Q59a-phone None Which groups best describes Asian Indian 1 Alphanumeric 1 Yes race-asian-indian-phone you? You may choose one or NOT APPLICABLE X character Each element must have a closing tag that more of the following. Are MISSING/DK M is the same as the opening tag but with a you… 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-nativehawaiian-pacific-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… Native Hawaiian or Pacific Islander 1 NOT APPLICABLE X MISSING/DK M Alphanumeric character 1 Yes Q59-phone race-noneofabove-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… NONE OF ABOVE 1 NOT APPLICABLE X MISSING/DK M Alphanumeric character 1 Yes Q59a-phone race-asian-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 Which groups best describes you? You may choose one or more of the following. Are you… Asian Indian 1 NOT APPLICABLE X MISSING/DK M Alphanumeric character 1 Yes
ICH_SurveyAdminManual_Ver4_Feb2016.docx