Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | ALCMonth | 394 | Days per month: | 1999-10-01 - Variable Added |
Form 2 | ALC5DrinksFSO | 3578 | Alcohol (SO) - Considering all types of alcoholic beverages, how many times during the past month did XXX have five or more drinks on an occasion | 1999-10-01 - Variable Added |
Form 2 | ALCMonthF | 575 | Days per month: | 1999-10-01 - Variable Added |
Form 2 | ALCAnyDrinkFSO | 3579 | Alcohol (SO) - During the past month , has XXX had at least one drink of any alcoholic beverage such as beer,wine, wine coolers, or liquor? | 1999-10-01 - Variable Added |
Form 2 | ALCDrinksFSO | 3580 | Alcohol (SO) - A drink is 1 can or bottle of beer, 1 glass of wine, 1 can or bottle of wine cooler, 1 cocktail, or 1 shot of liquor. On the days when XXX drank, about how many drinks did XXX drink on average? | 1999-10-01 - Variable Added |
Form 2 | ALCMonthFSO | 3581 | Alcohol Use Per Month (SO) - During the past month, how many days per week or per month did XXX drink any alcoholic beverages, on the average? | 1999-10-01 - Variable Added |
Form 2 | ALCWeekFSO | 3582 | Alcohol Use Per Week (SO) - During the past month, how many days per week or per month did XXX drink any alcoholic beverages, on the average? | 1999-10-01 - Variable Added |
SUBSTANCE USE - ARCHIVE
ALCOHOL - ARCHIVE
Definition
Significant Other report of alcohol use of participant.
- During the past month, has __ had at least one drink of any alcoholic beverage such as beer, wine, wine coolers, or liquor?
- During the past month, how many days per week or per month did __ drink any alcoholic beverages, on the average?
- A drink is 1 can or bottle of beer, 1 glass of wine, 1 can or bottle of wine cooler, 1 cocktail, or 1 shot of liquor. On the days when __ drank, about how many drinks did __ drink on the average?
- Considering all types of alcoholic beverages, how many times during the past month did __ have five or more drinks on an occasion?
ALCMonthF - Days alcohol per month.
Form
[ ] Form 1
[X] Form 2
ALCWeek - Enter number of days per week OR per month. Code item not answered as “66. Not Applicable.”
Variables
Codes and Values
ID 394
For Form: [Form 1]
For Variables: [ALCMonth]
Code | Description |
|---|---|
666 | Variable Did Not Exist |
777 | Refused |
888 | Not Applicable |
999 | Unknown |
ID 3578
For Form: [Form 2]
For Variables: [ALC5DrinksFSO]
Code | Description |
|---|---|
00 | None |
55 | Not Applicable: Variable not due this year |
60 | No Significant Other |
66 | Not Applicable |
77 | Don't Know/Not Sure |
88 | Variable Did Not Exist |
99 | Refused |
ID 3579
For Form: [Form 2]
For Variables: [ALCAnyDrinkFSO]
Code | Description |
|---|---|
1 | No |
2 | Yes |
5 | Not Applicable: Variable not due this year |
6 | No Significant Other |
7 | Don’t Know/Not Sure |
8 | Variable Did Not Exist |
9 | Refused |
ID 3580
For Form: [Form 2]
For Variables: [ALCDrinksFSO]
Code | Description |
|---|---|
55 | Not Applicable: Variable not due this year |
60 | No Significant Other |
66 | Not Applicable |
77 | Don't Know/Not Sure |
88 | Variable Did Not Exist |
99 | Refused |
ID 3581
For Form: [Form 2]
For Variables: [ALCMonthFSO]
Code | Description |
|---|---|
55 | Not Applicable: Variable not due this year |
60 | No Significant Other |
66 | Not Applicable |
77 | Don't Know/Not Sure |
88 | Variable Did Not Exist |
99 | Refused |
ID 3582
For Form: [Form 2]
For Variables: [ALCWeekFSO]
Code | Description |
|---|---|
55 | Not Applicable: Variable not due this year |
60 | No Significant Other |
66 | Not Applicable |
77 | Don't Know/Not Sure |
88 | Variable Did Not Exist |
99 | Refused |
ID 575
For Form: [Form 2]
For Variables: [ALCMonthF]
Code | Description |
|---|---|
666 | Variable Did Not Exist |
777 | Refused |
881 | Not Applicable |
882 | Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years ) |
999 | Unknown |
History
Date | Description |
|---|---|
1994-08-12 | Added NOTE : for coding someone who does not drink at all. |
1994-08-12 | Added full reference for Cahalan/Cisin article. |
1996-04-01 | Added CODE : for additional CIQ questions not due this year. |
1997-01-01 | Moved drug question to separate variable. |
CAGE - ARCHIVE
Definition
Indices of alcohol abuse collected by participant and family member/significant other.
CAGE During the last 6 to 12 months…
1) Did you feel you ought to cut down on drinking?
2) Did people annoy you by criticizing your drinking?
3) Did you feel bad or guilty about drinking?
4) Did you have a drink first thing in the morning to steady nerves or get rid of a hangover (eye opener)?
CAGEFAM 1) Has ____ felt he/she ought to cut down on drinking?
2) Have people annoyed _____ by criticizing his/her drinking?
3) Has _____ felt bad or guilty about drinking?
4) Has _____ Had a drink first thing in the morning to steady nerves or get rid of a hangover (eye opener)?
Form
[X] Form 1
[X] Form 2
Source
- Form 1 - Pre-Injury History (participant or proxy)
- Form 2 - Interview, Mail-out (participant or proxy)
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | DrinkAnnoy | 3403 | CAGE 2. Did people annoy you by criticizing your drinking? | 1989-10-01 - Variable Added |
Form 1 | DrinkCut | 3404 | CAGE 1. Did you feel you ought to cut down drinking? | 1989-10-01 - Variable Added |
Form 1 | DrinkGuilty | 3405 | CAGE 3. Did you feel bad or guilty about drinking? | 1989-10-01 - Variable Added |
Form 1 | DrinkMorning | 3406 | CAGE 4. Did you have a drink first thing in the morning to steady nerves or get rid of a hangover (eye opener)? | 1989-10-01 - Variable Added |
Form 2 | DrinkAnnoyF | 3656 | CAGE 2. Did people annoy you by criticizing your drinking? (TBI) | 1989-10-01 - Variable Added |
Form 2 | DrinkAnnoyFSO | 3657 | CAGE 2. Have people annoyed ___ by criticizing his/her drinking? | 1989-10-01 - Variable Added |
Form 2 | DrinkCutF | 3658 | CAGE 1. Did you feel you ought to cut down drinking? (TBI) | 1989-10-01 - Variable Added |
Form 2 | DrinkCutFSO | 3659 | CAGE 1. Has ___ felt he/she ought to cut down drinking? | 1989-10-01 - Variable Added |
Form 2 | DrinkGuiltyF | 3660 | CAGE 3. Did you feel bad or guilty about drinking? (TBI) | 1989-10-01 - Variable Added |
Form 2 | DrinkGuiltyFSO | 3661 | CAGE 3. Has ___ felt bad or guilty about drinking? | 1989-10-01 - Variable Added |
Form 2 | DrinkMorningF | 3662 | CAGE 4. Did you have a drink first thing in the morning to steady nerves or get rid of a hangover (eye opener)? (TBI) | 1989-10-01 - Variable Added |
Form 2 | DrinkMorningFSO | 3663 | CAGE 4. Has ___ had a drink first thing in the morning to steady nerves or get rid of a hangover? | 1989-10-01 - Variable Added |
Codes and Values
ID 3403
For Form: [Form 1]
For Variables: [DrinkAnnoy]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
9 | Unknown |
ID 3404
For Form: [Form 1]
For Variables: [DrinkCut]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
9 | Unknown |
ID 3405
For Form: [Form 1]
For Variables: [DrinkGuilty]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
9 | Unknown |
ID 3406
For Form: [Form 1]
For Variables: [DrinkMorning]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
9 | Unknown |
ID 3656
For Form: [Form 2]
For Variables: [DrinkAnnoyF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
7 | Variable Did not Exist |
9 | Unknown |
ID 3657
For Form: [Form 2]
For Variables: [DrinkAnnoyFSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
7 | Variable Did not Exist |
9 | Unknown |
ID 3658
For Form: [Form 2]
For Variables: [DrinkCutF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
7 | Variable Did not Exist |
9 | Unknown |
ID 3659
For Form: [Form 2]
For Variables: [DrinkCutFSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
7 | Variable Did not Exist |
9 | Unknown |
ID 3660
For Form: [Form 2]
For Variables: [DrinkGuiltyF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
7 | Variable Did not Exist |
9 | Unknown |
ID 3661
For Form: [Form 2]
For Variables: [DrinkGuiltyFSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
7 | Variable Did not Exist |
9 | Unknown |
ID 3662
For Form: [Form 2]
For Variables: [DrinkMorningF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
7 | Variable Did not Exist |
9 | Unknown |
ID 3663
For Form: [Form 2]
For Variables: [DrinkMorningFSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No |
2 | Yes |
7 | Variable Did not Exist |
9 | Unknown |
History
No history found for the Domain.
CHEWING TOBACCO - ARCHIVE
Definition
Form 2 - Do you currently use chewing tobacco, snuff, or snus every day, some days, or not at all?
Form
[X] Form 1 [X] Form 2
Source
- Form 1 - Pre-Injury History (participant or proxy)
- Form 2 - Interview, Mail-out (participant or proxy)
Details
If cannot get patient’s response, get family, if not family then medical chart.
Snus ([snu:s]) is a type of tobacco snuff consumed in the form of a moist powder which is placed under the upper lip, without chewing, for extended periods of time.
Base the data recorded for these questions on self-response.
Reference
Other Tobacco Use
BRFSS 7.5 - national and state norms
Characteristics
On 4/1/2013 codes were changed, and existing cases were re-coded in the database.
Codes at implementation:
1 - Everyday
2 - Some Days
3 - Not At All
Codes on/after 4/1/2013:
1 - Not At All
2 - Some Days
3 - Everyday
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | ChwTob | 555 | At the time of your injury, or just prior to your injury, did you use chewing tobacco, snuff, or snus every day, some days, or not at all? | 2012-10-01 - Variable Added |
Form 2 | ChwTobF | 769 | Do you currently use chewing tobacco, snuff, or snus every day, some days, or not at all? | 2012-10-01 - Variable Added |
Codes and Values
ID 555
For Form: [Form 1]
For Variables: [ChwTob]
Code | Description |
|---|---|
1 | Not At All |
2 | Some Days |
3 | Everyday |
66 | Variable Did Not Exist |
77 | Refused |
99 | Unknown |
ID 769
For Form: [Form 2]
For Variables: [ChwTobF]
Code | Description |
|---|---|
1 | Not At All |
2 | Some Days |
3 | Everyday |
66 | Variable Did Not Exist |
77 | Refused |
99 | Unknown |
History
No history found for the Domain.
DRUG TYPES - ARCHIVE
Definition
The intent of the question is to capture problematic use of drugs other than alcohol. Illegal or harmful use of substances is considered problematic use. The use of street drugs and drugs prescribed to someone else constitutes illegal use. “Huffing” or the inhalation of a toxic chemical is considered problematic due to the harmful effects (it is also illegal in 46 states). In addition, the overuse of drugs prescribed to the participant is considered problematic use.
‘’During the last 12 months, did you use any illicit or non-prescription drugs?’’ “If yes, please indicate the drugs used: 1 No drug use 2 Crack/cocaine 3 Pot/Marijuana 4 LSD/Hallucinogens 5 Heroin/Opiates/Oxycodone 6 Speed/Stimulants 8 N/ A, no other drug use 0 Variable not in existence when data collected for this case 9 Unknown
DRUGFAM - Indices of drug use asked at annual evaluation of the family member/significant other of the individual who experienced brain injury.
- During the last 12 months (or during the time since _____’s injury – if year 1 follow-up) has _____used illicit or non-prescription drugs?
1a-f) If yes for #1, please indicate the drugs used.
Form
[X] Form 1
[ ] Form 2
Source
- Form 1 - Pre-Injury History (participant or proxy)
Details
*Use patient’s response, even if response contradicts other information. This is a self-report variable.
The question should be presented as follows: ‘’During the last 12 months, did you use any illicit or non-prescription drugs?’’
Characteristics
Prior to 10/1/2011 the variable was defined as follows:
Index of drug use; asked of best source at every follow-up evaluation. “During the last 12 months (or during the time since your injury – if year 1 follow-up) did you use any illicit or non-prescription drugs?” “Non-prescription drugs” refers to prescription drugs obtained without a prescription and street drugs.
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | DrugType1 | 3408 | Type of Drug Used 1 | 1997-01-01 - Variable Added |
Form 1 | DrugType2 | 3409 | Type of Drug Used 2 | 1997-01-01 - Variable Added |
Form 1 | DrugType3 | 3410 | Type of Drug Used 3 | 1997-01-01 - Variable Added |
Form 1 | DrugType4 | 3411 | Type of Drug Used 4 | 1997-01-01 - Variable Added |
Form 1 | DrugType5 | 3412 | Type of Drug Used 5 | 1997-01-01 - Variable Added |
Form 1 | DrugTypeOth | 3413 | Type of Drug Used Other | 1997-01-01 - Variable Added |
Form 2 | DrugType1F | 3681 | Drug Used 1 | 1997-01-01 - Variable Added |
Form 2 | DrugType1FSO | 3682 | Drug Used 1 (SO) | 1997-01-01 - Variable Added |
Form 2 | DrugType2F | 3683 | Drug Used 2 | 1997-01-01 - Variable Added |
Form 2 | DrugType2FSO | 3684 | Drug Used 2 (SO) | 1997-01-01 - Variable Added |
Form 2 | DrugType3F | 3685 | Drug Used 3 | 1997-01-01 - Variable Added |
Form 2 | DrugType3FSO | 3686 | Drug Used 3 (SO) | 1997-01-01 - Variable Added |
Form 2 | DrugType4F | 3687 | Drug Used 4 | 1997-01-01 - Variable Added |
Form 2 | DrugType4FSO | 3688 | Drug Used 4 (SO) | 1997-01-01 - Variable Added |
Form 2 | DrugType5F | 3689 | Drug Used 5 | 1997-01-01 - Variable Added |
Form 2 | DrugType5FSO | 3690 | Drug Used 5 (SO) | 1997-01-01 - Variable Added |
Form 2 | DrugTypeOthF | 3691 | Other Drug Used | 1997-01-01 - Variable Added |
Form 2 | DrugTypeOthFSO | 3692 | Other Drug Used (SO) | 1997-01-01 - Variable Added |
Form 2 | DrugsSO | 3680 | Drug Use (SO) - During the last 12 months did XXX use any illicit or non-prescription drugs? | 1997-01-01 - Variable Added |
Codes and Values
ID 3408
For Form: [Form 1]
For Variables: [DrugType1]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did Not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3409
For Form: [Form 1]
For Variables: [DrugType2]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did Not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3410
For Form: [Form 1]
For Variables: [DrugType3]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did Not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3411
For Form: [Form 1]
For Variables: [DrugType4]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did Not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3412
For Form: [Form 1]
For Variables: [DrugType5]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did Not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3413: No codes found.
ID 3680
For Form: [Form 2]
For Variables: [DrugsSO]
Code | Description |
|---|---|
1 | No |
2 | Yes |
7 | Not Applicable: Variable not due this year |
8 | No Significant Other or Family Member |
9 | Unknown |
ID 3681
For Form: [Form 2]
For Variables: [DrugType1F]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3682
For Form: [Form 2]
For Variables: [DrugType1FSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3683
For Form: [Form 2]
For Variables: [DrugType2F]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3684
For Form: [Form 2]
For Variables: [DrugType2FSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3685
For Form: [Form 2]
For Variables: [DrugType3F]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3686
For Form: [Form 2]
For Variables: [DrugType3FSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3687
For Form: [Form 2]
For Variables: [DrugType4F]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3688
For Form: [Form 2]
For Variables: [DrugType4FSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3689
For Form: [Form 2]
For Variables: [DrugType5F]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3690
For Form: [Form 2]
For Variables: [DrugType5FSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | No Drug Use |
2 | Crack/Cocaine |
3 | Pot/Marijuana |
4 | LSD/Hallucinogens |
5 | Heroin/Opiates |
6 | Speed/Stimulants |
7 | Variable Did not Exist |
8 | Not Applicable: No other drug use |
9 | Unknown |
ID 3691: No codes found.
ID 3692: No codes found.
History
Date | Description |
|---|---|
1998-09-01 | Added NOTE : regarding contradictory information from patient. |
ETOH - ARCHIVE
Definition
Actual Serum Ethanol Level in milligrams per deciliter on admission to emergency room.
Form
[X] Form 1
[ ] Form 2
Source
- Form 1 - Abstraction (acute record)
Details
Milligram/deciliter is equivalent to milligrams/100 milliliters times 1000 or milligrams% times 1000. Variable is coded in this manner so as to avoid data problems in coding of decimal point.
Use BAL data from first available ED which may or may not be the Model System ED.
000 Test completed, no ethanol found
777 Positive, unknown level
888 Not tested
999 Unknown
Archived Variable Group
Links
Reference
UAB
Characteristics
Some of our acute hospitals do not collect (or record) this information. Some report only positive or negative. In 2003, the overall TBIMS missing data rate was 25% and 10 Model Systems had difficulty obtaining this information (10% or more missing data). In 2004 the missing data rate was 28% and 11 MS’s had 10% or more missing data.
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | ETOH | 3423 | ETOH Blood Level | 1989-10-01 - Variable Added |
Codes and Values
ID 3423
For Form: [Form 1]
For Variables: [ETOH]
Code | Description |
|---|---|
000 | Test completed: No ethanol found |
777 | Positive, But Unknown Level of Ethanol |
888 | Not Tested |
999 | Unknown |
History
Date | Description |
|---|---|
1998-09-01 | Added NOTE : clarified measurement as “milligrams” not “micrograms”. |
1999-04-01 | Added NOTE : regarding use of first available ED BAL data. |
2007-04-01 | Added CODE : 777 positive, but unknown level. |
2008-04-01 | Added NOTE : code 777 should only be used when know that a blood alcohol level lab was done and somewhere documented as positive, but the actual lab report with the specific level is not available |
QFVI - ARCHIVE
Definition
During the past 3 to 6 months…
1) How often did you have one or more drinks containing alcohol?
2) When you drank alcohol, how often did you have 6 or more drinks?
3) When you drank alcohol, how often did you have just 4 or 5 drinks?
4) When you drank alcohol, how often did you have just 1 to 3 drinks?
Form
[X] Form 1 [X] Form 2
Source
- Form 1 - Pre-Injury History (participant or proxy)
- Form 2 - Interview, Mail-out (participant or proxy)
Characteristics
The QFVI was added to the Form II database 3/21/91. Centers began piloting the Form I database in 9/88 and data collection was totally implemented in 11/89 so you’ll see cases in the database that were actually part of the pilot. Follow-up data collection also began in 1989. The QFVI was also added to the Form I database as one of the premorbid history questions on 1/1/97. The QFVI was dropped from both Form I and Form II on 10/1/99.
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 1 | QFVI1to3 | 3509 | QFVI 4. When you drank alcohol, how often did you have just 1 to 3 drinks? | 1989-10-01 - Variable Added |
Form 1 | QFVI4or5 | 3510 | QFVI 3. When you drank alcohol, how often did you have just 4 or 5 drinks? | 1989-10-01 - Variable Added |
Form 1 | QFVI6Plus | 3511 | QFVI 2. When you drank alcohol, how often did you have 6 or more drinks? | 1989-10-01 - Variable Added |
Form 1 | QFVIAny | 3512 | QFVI 1. How often did you have one or more drinks containing alcohol? | 1989-10-01 - Variable Added |
Form 2 | QFVI1to3F | 3929 | QFVI 4. When you drank alcohol, how often did you have just 1 to 3 drinks? (TBI) | 1989-10-01 - Variable Added |
Form 2 | QFVI1to3FSO | 3930 | QFVI 4. When you drank alcohol, how often did you have just 1 to 3 drinks? (SO) | 1989-10-01 - Variable Added |
Form 2 | QFVI4or5F | 3931 | QFVI 3. When you drank alcohol, how often did you have just 4 or 5 drinks? (TBI) | 1989-10-01 - Variable Added |
Form 2 | QFVI4or5FSO | 3932 | QFVI 3. When you drank alcohol, how often did you have just 4 or 5 drinks? (SO) | 1989-10-01 - Variable Added |
Form 2 | QFVI6PlusF | 3933 | QFVI 2. When you drank alcohol, how often did you have 6 or more drinks? (TBI) | 1989-10-01 - Variable Added |
Form 2 | QFVI6PlusFSO | 3934 | QFVI 2. When you drank alcohol, how often did you have 6 or more drinks? (SO) | 1989-10-01 - Variable Added |
Form 2 | QFVIAnyF | 3935 | QFVI 1. How often did you have one or more drinks containing alcohol? (TBI) | 1989-10-01 - Variable Added |
Form 2 | QFVIAnyFSO | 3936 | QFVI 1. How often did you have one or more drinks containing alcohol? (SO) | 1989-10-01 - Variable Added |
Codes and Values
ID 3509
For Form: [Form 1]
For Variables: [QFVI1to3]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Nearly Every Time |
2 | More Than Half the Time |
3 | Less Than Half the Time |
4 | Once in a While |
5 | Never |
9 | Unknown |
ID 3510
For Form: [Form 1]
For Variables: [QFVI4or5]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Nearly Every Time |
2 | More Than Half the Time |
3 | Less Than Half the Time |
4 | Once in a While |
5 | Never |
9 | Unknown |
ID 3511
For Form: [Form 1]
For Variables: [QFVI6Plus]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Nearly every time |
2 | More Than Half the Time |
3 | Less Than Half the Time |
4 | Once in a While |
5 | Never |
9 | Unknown |
ID 3512
For Form: [Form 1]
For Variables: [QFVIAny]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Three or More Times a Day |
2 | Two Times a Day |
3 | Once a Day |
4 | Nearly Every Day |
5 | Three or Four Times a Week |
6 | Once or Twice a Week |
7 | Two or Three Times a Month |
8 | About Once a Month |
9 | Less Than Once a Month But at Least Once a Year |
10 | Less Than Once a Year |
11 | Not At All |
99 | Unknown |
ID 3929
For Form: [Form 2]
For Variables: [QFVI1to3F]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Nearly Every Time |
2 | More Than Half the time |
3 | Less Than Half the time |
4 | Once in a While |
5 | Never |
7 | Variable Not Collected |
9 | Unknown |
ID 3930
For Form: [Form 2]
For Variables: [QFVI1to3FSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Nearly Every Time |
2 | More Than Half the time |
3 | Less Than Half the time |
4 | Once in a While |
5 | Never |
7 | Variable Not Collected |
9 | Unknown |
ID 3931
For Form: [Form 2]
For Variables: [QFVI4or5F]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Nearly Every Time |
2 | More Than Half the time |
3 | Less Than Half the time |
4 | Once in a While |
5 | Never |
7 | Variable Not Collected |
9 | Unknown |
ID 3932
For Form: [Form 2]
For Variables: [QFVI4or5FSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Nearly Every Time |
2 | More Than Half the time |
3 | Less Than Half the time |
4 | Once in a While |
5 | Never |
7 | Variable Not Collected |
9 | Unknown |
ID 3933
For Form: [Form 2]
For Variables: [QFVI6PlusF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Nearly Every Time |
2 | More Than Half the time |
3 | Less Than Half the time |
4 | Once in a While |
5 | Never |
7 | Variable Not Collected |
9 | Unknown |
ID 3934
For Form: [Form 2]
For Variables: [QFVI6PlusFSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Nearly Every Time |
2 | More Than Half the time |
3 | Less Than Half the time |
4 | Once in a While |
5 | Never |
7 | Variable Not Collected |
9 | Unknown |
ID 3935
For Form: [Form 2]
For Variables: [QFVIAnyF]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Three or More Times a Day |
2 | Two Times a Day |
3 | Once a Day |
4 | Nearly Every Day |
5 | Three or Four Times a Week |
6 | Once or Twice a Week |
7 | Two or Three Times a Month |
8 | About Once a Month |
9 | Less Than Once a Month but at Least Once a Year |
10 | Less Than Once a Year |
11 | Not at All |
77 | Variable Not Collected |
99 | Unknown |
ID 3936
For Form: [Form 2]
For Variables: [QFVIAnyFSO]
Code | Description |
|---|---|
0 | Variable Did Not Exist |
1 | Three or More Times a Day |
2 | Two Times a Day |
3 | Once a Day |
4 | Nearly Every Day |
5 | Three or Four Times a Week |
6 | Once or Twice a Week |
7 | Two or Three Times a Month |
8 | About Once a Month |
9 | Less Than Once a Month but at Least Once a Year |
10 | Less Than Once a Year |
11 | Not at All |
77 | Variable Not Collected |
99 | Unknown |
History
No history found for the Domain.