ARCHIVE

Please enter notes …

ANXIETY: QOL ANXIETY - ARCHIVE

Definition

The TBI-QOL Anxiety Scale is Patient Reported Outcome assessment of anxiety. It is made up of items from the PROMIS and Neuro-QOL measurement systems. It can be administered via Computer Adaptive Testing (CAT) or via short forms. With CAT, the participant is administered items one at a time and, with each item, the computer prorates the score estimating the examinee’s level of anxiety. Generally, reliable scores can be obtained with as few as 4-5 items. As an alternative to CAT, short forms are also available. Final scores are linked on the PROMIS metric making scores directly comparable to PROMIS Anxiety.

TBIQOL Calculation

TBIQOL SF - is converted to TBI-QOL (Sum of all short form items) then use a lookup up table to obtain T-Score

TBIQOL Long form - T-Score = Theta * 10 + 50.0

If there are two or more scores (based on different scoring types) the following hierarchy is applied (Long Form, Short Form)

The type that is used for the score is listed under ANXTScoreType

Form

[ ] Form 1
[X] Form 2

Source

• Interview, Mail-Out (participant only)

Details

Though the TBI-QOL measure was developed and tested with individuals with TBI, the scores have been equated with those of the PROMIS Anxiety bank. This will allow direct comparison of TBI-QOL Anxiety scores with PROMIS anxiety scores. This will allow the TBIMS anxiety scores to be comparable to other studies that include PROMIS Anxiety.

QOL questions should not be administered to a significant other, or any other proxy. If the individual is unable to provide data, use code “10. Not Applicable: No data from person with TBI.”

If administering the Computer Adaptive version, preface questions with: “This next section will be entered directly into the computer and cannot be changed. Please think about your responses carefully before answering.”

If the TBI-QOL measures should need to be re-administered for any reason, the NDSC will use the last version submitted.

If clarification is needed repeat the word/question and answer based on what the word/question means to them.

Variables

Form Type	Variable	ID	Question	History
Form 2	ANXTScoreF	587	Anxiety Score	2010-04-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	ANXTScoreTypeF	3583	Method	2010-04-01 - Variable Added 2018-01-07 - Variable Removed
Form 2	AnxAwfulF	579	I felt something awful would happen	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	AnxCalmF	580	I had difficulty calming down	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	AnxHeartF	581	I had a racing or pounding heart	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	AnxHelpF	582	I felt like I needed help for my anxiety	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	AnxNervousF	583	I felt nervous	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	AnxPanicF	584	I had sudden feelings of panic	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	AnxTenseF	585	I felt tense	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	AnxTerrifiedF	586	I felt terrified	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	AnxUneasyF	588	I felt uneasy	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	AnxWorryF	589	Many situations made me worry	2013-10-01 - Variable Added 2018-07-01 - Variable Removed

Codes and Values

ID	Code	Description
579	0	Variable Did Not Exist
579	1	Never
579	2	Rarely
579	3	Sometimes
579	4	Often
579	5	Always
579	8	NA-long form used
579	9	Unknown
579	10	Not Applicable: No data from person with TBI
580	0	Variable Did Not Exist
580	1	Never
580	2	Rarely
580	3	Sometimes
580	4	Often
580	5	Always
580	8	NA-long form used
580	9	Unknown
580	10	Not Applicable: No data from person with TBI
581	0	Variable Did Not Exist
581	1	Never
581	2	Rarely
581	3	Sometimes
581	4	Often
581	5	Always
581	8	NA-long form used
581	9	Unknown
581	10	Not Applicable: No data from person with TBI
582	0	Variable Did Not Exist
582	1	Never
582	2	Rarely
582	3	Sometimes
582	4	Often
582	5	Always
582	8	NA-long form used
582	9	Unknown
582	10	Not Applicable: No data from person with TBI
583	0	Variable Did Not Exist
583	1	Never
583	2	Rarely
583	3	Sometimes
583	4	Often
583	5	Always
583	8	NA-long form used
583	9	Unknown
583	10	Not Applicable: No data from person with TBI
584	0	Variable Did Not Exist
584	1	Never
584	2	Rarely
584	3	Sometimes
584	4	Often
584	5	Always
584	9	Unknown
584	10	Not Applicable: No data from person with TBI
585	0	Variable Did Not Exist
585	1	Never
585	2	Rarely
585	3	Sometimes
585	4	Often
585	5	Always
585	8	NA-long form used
585	9	Unknown
585	10	Not Applicable: No data from person with TBI
586	0	Variable Did Not Exist
586	1	Never
586	2	Rarely
586	3	Sometimes
586	4	Often
586	5	Always
586	8	NA-long form used
586	9	Unknown
586	10	Not Applicable: No data from person with TBI
587	999	Unknown
588	0	Variable Did Not Exist
588	1	Never
588	2	Rarely
588	3	Sometimes
588	4	Often
588	5	Always
588	8	NA-long form used
588	9	Unknown
588	10	Not Applicable: No data from person with TBI
589	0	Variable Did Not Exist
589	1	Never
589	2	Rarely
589	3	Sometimes
589	4	Often
589	5	Always
589	8	NA-long form used
589	9	Unknown
589	10	Not Applicable: No data from person with TBI

History

Date	Description
2013-10-01	Added CODE: '10' - Not Applicable
2014-04-01	Added NOTE : If the TBI-QOL measures should need to be re-administered for any reason, the NDSC will use the last version submitted.
2014-04-01	Added NOTE : If administering the Computer Adaptive version, preface questions with: "This next section will be entered directly into the computer and can not be changed. Please think about your responses carefully before answering."
2015-03-02	Added NOTE : if clarification is needed repeat the word/question and answer based on what the word/question means to them

ASSOCIATED INJURIES: BONE FRACTURE - ARCHIVE

Definition

A break of a bone including open and closed fractures occurring at the same time as the brain injury. Each of the fractures are coded individually.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

If fewer than seven fractures were reported, then code remaining fields with 88. Do not leave blanks.

Spinal fractures should be coded “8” - not applicable for laterality if vertebral body fracture only. If pedicle, lamina or transverse process fracture, use appropriate laterality code.

Hemotympanurn is considered equivalent to a basilar skull fracture even if there is no fracture detected on x-ray.

Metacarpal, carpal, wrist, metatarsals, scapula, and clavicle fractures should be coded as “77=other bones”

If there are no fractures, code all fracture fields and laterality fields with 1. If there are less than 7 fractures, code all remaining fracture fields and laterality fields which have no fractures with 8.

If there is any question regarding which code to use for a particular bone fracture, please consult your staff physiatrist. Do not code fractures which fall within the same code more than once.

*Code for facial fractures= 13 was added 4/19/99, previous to that time, facial fractures were coded 02 - calvarial or 77 - other. This data was not recoded.

Variables

Form Type	Variable	ID	Question	History
Form 1	Fracture1	3450	Bone Fracture 1	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Fracture2	3451	Bone Fracture 2	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Fracture3	3452	Bone Fracture 3	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Fracture4	3453	Bone Fracture 4	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Fracture5	3454	Bone Fracture 5	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Fracture6	3455	Bone Fracture 6	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Fracture7	3456	Bone Fracture 7	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	FractureS1	3457	Fracture Side 1	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	FractureS2	3458	Fracture Side 2	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	FractureS3	3459	Fracture Side 3	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	FractureS4	3460	Fracture Side 4	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	FractureS5	3461	Fracture Side 5	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	FractureS6	3462	Fracture Side 6	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	FractureS7	3463	Fracture Side 7	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3450	1	None at All
3450	2	Calvarial ( Head, skull, excl. base of skull )
3450	3	Basilar ( Including hemotympanum )
3450	4	Maxillary ( Upper jaw )
3450	5	Mandibular ( Lower jaw )
3450	6	Ribs and/or Sternum ( Breastbone )
3450	7	Pelvis ( Hip )
3450	8	Humerus ( Upper arm )
3450	9	Radius and/or Ulna ( Forearm )
3450	10	Femur ( Thigh )
3450	11	Tibia and/or Fibula ( Lower leg )
3450	12	Spinal Column
3450	13	Facial Fractures ( Includes: orbital, LeForte, nasal, zygomatic arch, sinus [ethmoid, frontal] )
3450	77	Other Bones
3450	88	Not Applicable ( No further fractures were reported )
3450	99	Unknown
3451	1	None at All
3451	2	Calvarial ( Head, skull, excl. base of skull )
3451	3	Basilar ( Including hemotympanum )
3451	4	Maxillary ( Upper jaw )
3451	5	Mandibular ( Lower jaw )
3451	6	Ribs and/or Sternum ( Breastbone )
3451	7	Pelvis ( Hip )
3451	8	Humerus ( Upper arm )
3451	9	Radius and/or Ulna ( Forearm )
3451	10	Femur ( Thigh )
3451	11	Tibia and/or Fibula ( Lower leg )
3451	12	Spinal Column
3451	13	Facial Fractures ( Includes: orbital, LeForte, nasal, zygomatic arch, sinus [ethmoid, frontal] )
3451	77	Other Bones
3451	88	Not Applicable ( No further fractures were reported )
3451	99	Unknown
3452	1	None at all
3452	2	Calvarial ( Head, skull, excl. base of skull )
3452	3	Basilar ( Including hemotympanum )
3452	4	Maxillary ( Upper jaw )
3452	5	Mandibular ( Lower jaw )
3452	6	Ribs and/or Sternum ( Breastbone )
3452	7	Pelvis ( Hip )
3452	8	Humerus ( Upper arm )
3452	9	Radius and/or Ulna ( Forearm )
3452	10	Femur ( Thigh )
3452	11	Tibia and/or Fibula ( Lower leg )
3452	12	Spinal Column
3452	13	Facial Fractures ( Includes: orbital, LeForte, nasal, zygomatic arch, sinus [ethmoid, frontal] )
3452	77	Other Bones
3452	88	Not Applicable ( No further fractures were reported )
3452	99	Unknown
3453	1	None at all
3453	2	Calvarial ( Head, skull, excl. base of skull )
3453	3	Basilar ( Including hemotympanum )
3453	4	Maxillary ( Upper jaw )
3453	5	Mandibular ( Lower jaw )
3453	6	Ribs and/or Sternum ( Breastbone )
3453	7	Pelvis ( Hip )
3453	8	Humerus ( Upper arm )
3453	9	Radius and/or Ulna ( Forearm )
3453	10	Femur ( Thigh )
3453	11	Tibia and/or Fibula ( Lower leg )
3453	12	Spinal Column
3453	13	Facial Fractures ( Includes: orbital, LeForte, nasal, zygomatic arch, sinus [ethmoid, frontal] )
3453	77	Other Bones
3453	88	Not Applicable ( No further fractures were reported )
3453	99	Unknown
3454	1	None at all
3454	2	Calvarial ( Head, skull, excl. base of skull )
3454	3	Basilar ( Including hemotympanum )
3454	4	Maxillary ( Upper jaw )
3454	5	Mandibular ( Lower jaw )
3454	6	Ribs and/or Sternum ( Breastbone )
3454	7	Pelvis ( Hip )
3454	8	Humerus ( Upper arm )
3454	9	Radius and/or Ulna ( Forearm )
3454	10	Femur ( Thigh )
3454	11	Tibia and/or Fibula ( Lower leg )
3454	12	Spinal Column
3454	13	Facial Fractures ( Includes: orbital, LeForte, nasal, zygomatic arch, sinus [ethmoid, frontal] )
3454	77	Other Bones
3454	88	Not Applicable ( No further fractures were reported )
3454	99	Unknown
3455	1	None at all
3455	2	Calvarial ( Head, skull, excl. base of skull )
3455	3	Basilar ( Including hemotympanum )
3455	4	Maxillary ( Upper jaw )
3455	5	Mandibular ( Lower jaw )
3455	6	Ribs and/or Sternum ( Breastbone )
3455	7	Pelvis ( Hip )
3455	8	Humerus ( Upper arm )
3455	9	Radius and/or Ulna ( Forearm )
3455	10	Femur ( Thigh )
3455	11	Tibia and/or Fibula ( Lower leg )
3455	12	Spinal Column
3455	13	Facial Fractures ( Includes: orbital, LeForte, nasal, zygomatic arch, sinus [ethmoid, frontal] )
3455	77	Other Bones
3455	88	Not Applicable ( No further fractures were reported )
3455	99	Unknown
3456	1	None at all
3456	2	Calvarial ( Head, skull, excl. base of skull )
3456	3	Basilar ( Including hemotympanum )
3456	4	Maxillary ( Upper jaw )
3456	5	Mandibular ( Lower jaw )
3456	6	Ribs and/or Sternum ( Breastbone )
3456	7	Pelvis ( Hip )
3456	8	Humerus ( Upper arm )
3456	9	Radius and/or Ulna ( Forearm )
3456	10	Femur ( Thigh )
3456	11	Tibia and/or Fibula ( Lower leg )
3456	12	Spinal Column
3456	13	Facial Fractures ( Includes: orbital, LeForte, nasal, zygomatic arch, sinus [ethmoid, frontal] )
3456	77	Other Bones
3456	88	Not Applicable ( No further fractures were reported )
3456	99	Unknown
3457	1	Neither
3457	2	Left
3457	3	Right
3457	4	Bilateral
3457	5	Not Specified
3457	8	Not Applicable
3457	9	Unknown
3458	1	Neither
3458	2	Left
3458	3	Right
3458	4	Bilateral
3458	5	Not Specified
3458	8	Not Applicable
3458	9	Unknown
3459	1	Neither
3459	2	Left
3459	3	Right
3459	4	Bilateral
3459	5	Not Specified
3459	8	Not Applicable
3459	9	Unknown
3460	1	Neither
3460	2	Left
3460	3	Right
3460	4	Bilateral
3460	5	Not Specified
3460	8	Not Applicable
3460	9	Unknown
3461	1	Neither
3461	2	Left
3461	3	Right
3461	4	Bilateral
3461	5	Not Specified
3461	8	Not Applicable
3461	9	Unknown
3462	1	Neither
3462	2	Left
3462	3	Right
3462	4	Bilateral
3462	5	Not Specified
3462	8	Not Applicable
3462	9	Unknown
3463	1	Neither
3463	2	Left
3463	3	Right
3463	4	Bilateral
3463	5	Not Specified
3463	8	Not Applicable
3463	9	Unknown

History

No history found for the Domain.

ASSOCIATED INJURIES: CRANIAL NERVE - ARCHIVE

Definition

Injury to a cranial nerve occurring at the same time as the brain injury assessed at any time during initial acute care or rehabilitation hospitalization. These include injuries to the cranial nerve nuclei and/or peripheral cranial nerves, resulting in a lower motor neuron lesion, with the following exceptions: 1) Cranial nerve I (olfaction) and II (vision) have direct central projections; 2) Cranial nerve VII (facial movements) can be damaged peripherally at the nerve nucleus of nerve, or facial movement can be paralyzed centrally as a result of cortical or subcortical injury. When Cranial nerve VII is damaged centrally, half the face is paralyzed but the half forehead is spared (i.e., still moves); when it is damaged peripherally, half the forehead is paralyzed along with half of the lower face.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction - Acute and Rehabilitation Record
• Pocket Smell Test used to assess Cranial Nerve I

Details

Cranial Nerve I: Enter #correct on Pocket Smell Test.

The Pocket Smell test should be used to test cranial nerve I, this test can be administered as part of the neuropsychological battery or during physical examination at anytime during initial acute care or rehab-ilitation hospitalization. The Pocket Smell test can be ordered from Sensonics, Inc. 609 547-7702 *(order from the internet at: http://www.smelltest.com/index.htm). The Pocket Smell Test 75–3 panel pocket smell tests. The changes for CN I and CN VII go into effect as of admissions to acute care beginning 7/1/99. The old data for Cranial Nerve I will be re-coded to unknown. The old data for Cranial Nerve VII will be coded under Cranial Nerve VII (unknown if central or peripheral).

Characteristics

Coding scheme revised and laterality dropped 9/13/1994.
Pocket Smell Test added 7/1/1999

Variables

Form Type	Variable	ID	Question	History
Form 1	Crainial10	3384	Cranial Nerve X	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial11	3385	Cranial Nerve XI	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial12	3386	Cranial Nerve XII	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial2	3387	Cranial Nerve II	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial3	3388	Cranial Nerve III	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial4	3389	Cranial Nerve IV	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial5	3390	Cranial Nerve V	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial6	3391	Cranial Nerve VI	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial7	3392	Cranial Nerve VII	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial7Cent	3393	Central CN VII	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial7Perip	3394	Peripheral CN VII	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial8	3395	Cranial Nerve VII	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Crainial9	3396	Cranial Nerve IX	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Cranial1	3397	Cranial Nerve I -Pocket Smell Test	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3384	0	Variable Did Not Exist
3384	1	No Injury To Cranial Nerve
3384	2	Yes, Injury To Cranial Nerve
3384	7	Not Testable
3384	9	Unknown
3385	0	Variable Did Not Exist
3385	1	No Injury To Cranial Nerve
3385	2	Yes, Injury To Cranial Nerve
3385	7	Not Testable
3385	9	Unknown
3386	0	Variable Did Not Exist
3386	1	No Injury To Cranial Nerve
3386	2	Yes, Injury To Cranial Nerve
3386	7	Not Testable
3386	9	Unknown
3387	0	Variable Did Not Exist
3387	1	No Injury To Cranial Nerve
3387	2	Yes, Injury To Cranial Nerve
3387	7	Not Testable
3387	9	Unknown
3388	0	Variable Did Not Exist
3388	1	No Injury To Cranial Nerve
3388	2	Yes, Injury To Cranial Nerve
3388	7	Not Testable
3388	9	Unknown
3389	0	Variable Did Not Exist
3389	1	No Injury To Cranial Nerve
3389	2	Yes, Injury To Cranial Nerve
3389	7	Not Testable
3389	9	Unknown
3390	0	Variable Did Not Exist
3390	1	No Injury To Cranial Nerve
3390	2	Yes, Injury To Cranial Nerve
3390	7	Not Testable
3390	9	Unknown
3391	0	Variable Did Not Exist
3391	1	No Injury To Cranial Nerve
3391	2	Yes, Injury To Cranial Nerve
3391	7	Not Testable
3391	9	Unknown
3392	0	Variable Did Not Exist
3392	1	No Injury To Cranial Nerve
3392	2	Yes, Injury To Cranial Nerve
3392	7	Not Testable
3392	9	Unknown
3393	0	Variable Did Not Exist
3393	1	No Injury To Cranial Nerve
3393	2	Yes, Injury To Cranial Nerve
3393	7	Not Testable
3393	9	Unknown
3394	0	Variable Did Not Exist
3394	1	No Injury To Cranial Nerve
3394	2	Yes, Injury To Cranial Nerve
3394	7	Not Testable
3394	9	Unknown
3395	0	Variable Did Not Exist
3395	1	No Injury To Cranial Nerve
3395	2	Yes, Injury To Cranial Nerve
3395	7	Not Testable
3395	9	Unknown
3396	0	Variable Did Not Exist
3396	1	No Injury To Cranial Nerve
3396	2	Yes, Injury To Cranial Nerve
3396	7	Not Testable
3396	9	Unknown
3397	0	None
3397	1	One
3397	2	Two
3397	3	Three
3397	7	Not Testable
3397	8	Variable Did Not Exist
3397	9	Unknown

History

No history found for the Domain.

ASSOCIATED INJURIES: INTRA-ABDOMINAL - ARCHIVE

Definition

Trauma to the abdominal structures (e.g. liver, gall bladder, kidney, ureters, spleen, pancreas, uterus, ovaries, stomach, intestines, peritoneum and retroperitoneum).

Form

[X] Form 1
[ ] Form 2

Source

• Acute Medical Record Abstraction

Details

Only intra-abdominal injuries that occur at the same time as the brain injury should be reported.

Include injuries to the peritoneum and retroperitoneum.

Variables

Form Type	Variable	ID	Question	History
Form 1	Abdom	3333	Intra-abdominal Injury	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3333	2	Yes
3333	9	Unknown

History

No history found for the Domain.

ASSOCIATED INJURIES: PNEUMOTHORAX - ARCHIVE

Definition

Traumatic pneumothorax and/or hemothorax: The occurrence of air and/or fluid within the pleural space that can be demonstrated radiographically and requiring chest tube intervention.

Form

[X] Form 1
[ ] Form 2

Source

• Acute Medical Record Abstraction

Details

Only instances which are present at the time of admission to the Model System ED should be reported.

Variables

Form Type	Variable	ID	Question	History
Form 1	Pneumothorax	3501	Traumatic Pneumothorax and/or Hemothorax	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3501	1	No
3501	2	Yes
3501	9	Unknown

History

No history found for the Domain.

CARE: MOBILITY - ARCHIVE

Archive

Variables

Form Type	Variable	ID	Question	History
Form 1	MOBPtWalkA	3989	H1. Does the patient walk?	2019-10-01 - Variable Added 2020-01-01 - Variable Removed
Form 1	MOBPtWalkD	3989	H3. Does the patient walk?	2019-10-01 - Variable Added 2020-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3989	0	No - Walking goal is not clinically indicated
3989	1	No - Walking goal is clinically indicated
3989	2	Yes
3989	66	Variable did not exist

History

Date	Description
2019-10-01	Variable Added
2020-01-01	Variable Removed

CHARGES - ARCHIVE

Definition

Total charges for
a) Acute Hospitalization, and
b) Inpatient Rehabilitation

Form

[X] Form 1
[ ] Form 2

Source

• Collected from acute and rehabilitation facilities Billing Departments

Details

Include psychology charges in the total inpatient rehabilitation hospital charge, even if the psychology charges are direct billed and not included in the hospital bill.

Charge data should be directly related to acute care and inpatient rehabilitation lengths of stay, therefore: 1) do not include charges for intermittent acute stays during inpatient rehabilitation.

Charges associated with short-term rehabilitation interruptions greater than or equal to 72 hours should be collected and included in the acute care total.

For interruptions in System care of less than 72 hours, there is enough variation across centers in the nature of charges data that are available, that for purposes of analysis, homogeneity of the data cannot be assumed.

Rehab charges: should include psych, rec therapy, and social services. Physician charges should not be included.

Actual dollar cost - round to whole dollars only, no cents.

Characteristics

In 2003 four Model Systems had difficulty obtaining Acute Charges data; two of these also had difficulty obtaining Rehab Charges data (10% or more missing data).

History

• 04/01/2010 Dropped Charges variables
• 10/01/2009 Added NOTE : clarified that charges from short-term rehabilitation interruptions should be included under acute hospitalization charges.
• 04/01/2007 Added NOTE : regarding rehab charges - should include psych, rec therapy, and social services. Physician charges should not be included
• 01/10/2002 Revised the note regarding nonhomogeneity of data.
• 08/20/2001 Added NOTE : regarding nonhomogeneity of data.
• 10/01/1999 Dropped not applicable code.
• 04/01/1999 Added NOTE : regarding including direct billed psychology charges in rehab. Hospital charge total.
• 01/01/1995 Dropped Alternate Level of Care charges

Variables

Form Type	Variable	ID	Question	History
Form 1	ChgHosp	3359	Acute Hospitalization Charges	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 1	ChgRehab	3360	Inpatient Rehab Charges	1989-10-01 - Variable Added 2010-04-01 - Variable Removed

Codes and Values

ID	Code	Description
3359	99999999	Unknown
3360	99999999	Unknown

History

Date	Description
1995-01-01	changed DEFINITION: dropped Alternate Level of Care charges
1999-04-01	Added NOTE : regarding including direct billed psychology charges in rehab. Hospital charge total.
2001-08-20	Added NOTE : regarding nonhomogeneity of data.
2007-04-01	Added NOTE : regarding rehab charges - should include psych, rec therapy, and social services.
2009-10-01	Added NOTE : clarified that charges from short-term rehabilitation interruptions should be included under acute hospitalization charges.

CHIEF (CRAIG HOSPITAL INVENTORY OF ENVIRONMENTAL FACTORS) - ARCHIVE

Definition

The Craig Hospital Inventory of Environmental Factors (CHIEF) was developed to assess the frequency and severity with which the individual experiences problems due to common environmental causes of disability. The Short Form consists of the CHIEF’s 12 best items, as determined by empirical and conceptual criteria. The CHIEF is administered to only the person with brain injury.

Form

[ ] Form 1
[X] Form 2

Source

• Interview

Details

Operational definitions of the codes are as follows [still to be confirmed]:
daily = 4: Occurs at least once a day, typically
weekly = 3: Occurs less than once a day but at least once a week
monthly = 2: Occurs less than once a week but at least once a monthly
less than monthly= 1: Occurs less than once a month but it does occur
never = 0: No occurrence

The size of the problem (big or small) is the respondent’s own judgement. If the respondent has difficulty deciding whether the problem is usually large or small, ask the question repeatedly, rephrased in different ways, until the respondent makes a judgement.

• If the frequency part of any question is coded as 0=never, then size or magnitude part of the question does not need to be asked and should be automatically coded as 0. For further reference go to the CHIEF on the COMBI website at www.tbims.org/combi/chief/index.html

*The CHIEF is not copyrighted; TBIMS may copy as needed

*Interviewer may clarify and define/describe questions to participant as needed (prompting not yet standardized)

*Even if participant is living in SNF, use N/A only for Q7 and Q9.

*Code “Unknown” if participant is cognitively unable to answer.

*CHIEF may be sent out as a questionnaire.

Archived Variable Group

Reference

“Craig Hospital Inventory of Environmental Factors” (manual), Version 3.0, April 2001.

Variables

Form Type	Variable	ID	Question	History
Form 2	CHFAttHm	3602	CHIEF - In the past 12 months, how often have other people’s attitudes toward you been a problem at home?	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFAttHmProb	3603	CHIEF - Home Attitude Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFAttWk	3604	CHIEF - In the past 12 months, how often have other people’s attitudes toward you been a problem at school or work?	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFAttWkProb	3605	CHIEF - Attitude Work Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFBus	3606	CHIEF - In the past 12 months, how often did the policies and rules of businesses and organizations make problems for you?	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFBusProb	3607	CHIEF - Policies of Businesses Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFDisc	3608	CHIEF - In the past 12 months, how often did you experience prejudice or discrimination?	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFDiscProb	3609	CHIEF - Discrimination Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFEnv	3610	CHIEF - In the past 12 months, how often has the natural environment-temperature, terrain, climate - made it difficult to do what you want or need to do?	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFEnvProb	3611	CHIEF - Environment Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFGovt	3612	CHIEF - In the past 12 months, how often did government programs and policies make it difficult to do what you want or need to do?	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFGovtProb	3613	CHIEF - Government Programs Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFHmHlp	3614	CHIEF - In the past 12 months, how often did you need someone else’s help in your home and could not get it easily?	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFHmHlpProb	3615	CHIEF - Home Help Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFInfo	3616	CHIEF - In the past 12 months, how often has the information you wanted or needed not been available in a format you can use or understand?	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFInfoProb	3617	CHIEF - Information Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFServ	3618	CHIEF - In the past 12 months, how often has the availability of health care services and medical care been a problem for you?	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFServProb	3619	CHIEF - Health Care Services Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFSurrnd	3620	CHIEF - In the past 12 months, how often have other aspects of your surroundings - lighting, noise, crowds, etc - made it difficult to do what you want or need to do?	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFSurrndProb	3621	CHIEF - Surroundings Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFTrans	3622	CHIEF - In the past 12 months, how often has the availability of transportation been a problem for you?	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFTransProb	3623	CHIEF - Transportation Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFWkHlp	3624	CHIEF - In the past 12 months, how often did you need someone else’s help at school or work and could not get it easily??	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CHFWkHlpProb	3625	CHIEF - Work Help Big or Little Problem	2001-07-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3602	0	Never
3602	1	Less Than Monthly
3602	2	Montly
3602	3	Weekly
3602	4	Daily
3602	6	Variable Did Not Exist
3602	8	Not Applicable
3602	9	Unknown
3603	0	Never
3603	1	Little
3603	2	Big
3603	8	Not Applicable
3603	9	Unknown
3604	0	Never
3604	1	Less Than Monthly
3604	2	Montly
3604	3	Weekly
3604	4	Daily
3604	6	Variable Did Not Exist
3604	8	Not Applicable
3604	9	Unknown
3605	0	Never
3605	1	Little
3605	2	Big
3605	6	Variable Did Not Exist
3605	8	Not Applicable
3605	9	Unknown
3606	0	Never
3606	1	Less Than Monthly
3606	2	Montly
3606	3	Weekly
3606	4	Daily
3606	6	Variable Did Not Exist
3606	8	Not Applicable
3606	9	Unknown
3607	0	Never
3607	1	Little
3607	2	Big
3607	6	Variable Did Not Exist
3607	8	Not Applicable
3607	9	Unknown
3608	0	Never
3608	1	Less Than Monthly
3608	2	Montly
3608	3	Weekly
3608	4	Daily
3608	6	Variable Did Not Exist
3608	8	Not Applicable
3608	9	Unknown
3609	0	Never
3609	1	Little
3609	2	Big
3609	6	Variable Did Not Exist
3609	8	Not Applicable
3609	9	Unknown
3610	0	Never
3610	1	Less Than Monthly
3610	2	Montly
3610	3	Weekly
3610	4	Daily
3610	6	Variable Did Not Exist
3610	8	Not Applicable
3610	9	Unknown
3611	0	Never
3611	1	Little
3611	2	Big
3611	6	Variable Did Not Exist
3611	8	Not Applicable
3611	9	Unknown
3612	0	Never
3612	1	Less Than Monthly
3612	2	Montly
3612	3	Weekly
3612	4	Daily
3612	6	Variable Did Not Exist
3612	8	Not Applicable
3612	9	Unknown
3613	0	Never
3613	1	Little
3613	2	Big
3613	6	Variable Did Not Exist
3613	8	Not Applicable
3613	9	Unknown
3614	0	Never
3614	1	Less Than Monthly
3614	2	Montly
3614	3	Weekly
3614	4	Daily
3614	6	Variable Did Not Exist
3614	8	Not Applicable
3614	9	Unknown
3615	0	Never
3615	1	Little
3615	2	Big
3615	6	Variable Did Not Exist
3615	8	Not Applicable
3615	9	Unknown
3616	0	Never
3616	1	Less Than Monthly
3616	2	Montly
3616	3	Weekly
3616	4	Daily
3616	6	Variable Did Not Exist
3616	8	Not Applicable
3616	9	Unknown
3617	0	Never
3617	1	Little
3617	2	Big
3617	6	Variable Did Not Exist
3617	8	Not Applicable
3617	9	Unknown
3618	0	Never
3618	1	Less Than Monthly
3618	2	Montly
3618	3	Weekly
3618	4	Daily
3618	6	Variable Did Not Exist
3618	8	Not Applicable
3618	9	Unknown
3619	0	Never
3619	1	Little
3619	2	Big
3619	6	Variable Did Not Exist
3619	8	Not Applicable
3619	9	Unknown
3620	0	Never
3620	1	Less Than Monthly
3620	2	Montly
3620	3	Weekly
3620	4	Daily
3620	6	Variable Did Not Exist
3620	8	Not Applicable
3620	9	Unknown
3621	0	Never
3621	1	Little
3621	2	Big
3621	6	Variable Did Not Exist
3621	8	Not Applicable
3621	9	Unknown
3622	0	Never
3622	1	Less Than Monthly
3622	2	Montly
3622	3	Weekly
3622	4	Daily
3622	6	Variable Did Not Exist
3622	8	Not Applicable
3622	9	Unknown
3623	0	Never
3623	1	Little
3623	2	Big
3623	6	Variable Did Not Exist
3623	8	Not Applicable
3623	9	Unknown
3624	0	Never
3624	1	Less Than Monthly
3624	2	Montly
3624	3	Weekly
3624	4	Daily
3624	6	Variable Did Not Exist
3624	8	Not Applicable
3624	9	Unknown
3625	0	Never
3625	1	Little
3625	2	Big
3625	6	Variable Did Not Exist
3625	8	Not Applicable
3625	9	Unknown

History

No history found for the Domain.

CIQ (COMMUNITY INTEGRATION QUESTIONNAIRE) - ARCHIVE

Definition

Questions for the 15 items of the Community Integration Questionnaire (CIQ), as asked of the best source of information. The person with brain injury is the best source of information unless she or he is considered unreliable or is unavailable. Administer on “less dynamic” schedule (years 1, 2, 5, and every 5 yrs. thereafter).

CIQResp: Person(s) who provided the information used to answer CIQ. This should be the person with TBI unless he/she is unreliable or unavailable.

Form

[ ] Form 1
[X] Form 2

Source

• Interview, Mail-Out (participant or proxy

Details

Questions for the 15 items of the Community Integration Questionnaire (CIQ), as asked of the best source of information. The person with brain injury is the best source of information unless she or he is considered unreliable or is unavailable. Administer on “less dynamic” schedule (years 1, 2, 5, and every 5 yrs. thereafter).

The actual code for each question is entered into the computer database. The four CIQ subscale scores and the total CIQ scores will be calculated by the National Data Center. For details on calculating the subscale and total CIQ scores.

If the person with brain injury is living in a skilled nursing facility at the time of annual follow-up; the CIQ should still be completed. This will be taken into consideration during analysis of data.

Characteristics

7/1/2001 - best source can provide information. Prior to this, questions were asked of both participant and proxy.

Variables

Form Type	Variable	ID	Question	History
Form 2	CIQChildCare	3626	CIQ - Who usually cares for the children in your home?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQFinance	3627	CIQ - Who usually looks after your personal finances, such as banking or paying bills?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQFriend	3628	CIQ - Do you have a best friend with whom you confide?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQHouseWk	3629	CIQ - In your home who does normal everyday housework?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQLeisFreq	3630	CIQ - How many times per month do you participate in the following activities outside your home: Leisure activities such as movies, sports, restaurants?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQLeisure	3631	CIQ - When you participate in leisure activities do you usually do this alone or with others?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQMeal	3632	CIQ - Who usually prepares meals in your household?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQResp	3633	Respondent to CIQ	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQSchool	3634	CIQ - Please choose the answer that best corresponds to your current (during the past month) school/training program situation	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQShop	3635	CIQ - Who usually does shopping for groceries or other necessities in your household?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQShpFreq	3636	CIQ - How many times per month do you participate in the following activities outside your home: Shopping?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQSocial	3637	CIQ - Who usually plans social arrangements such as get-togethers with family and friends?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQTravel	3638	CIQ - How often do you travel outside the home?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQVisitFreq	3639	CIQ - How many times per month do you participate in the following activities outside your home: Visiting friends or relatives?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQVol	3640	CIQ - In the past month, how often did you engage in volunteer activities?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQWork	3641	CIQ - Please choose the answer that best corresponds to your current (during past month) work situation.	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3626	0	Someone Else
3626	1	Yourself and Someone Else
3626	2	Yourself Alone
3626	6	Not Testable
3626	7	Not Applicable
3626	8	Not Applicable: No Children under 17 years of age in the home
3626	9	Unknown
3627	0	Someone Else
3627	1	Yourself and Someone Else
3627	2	Yourself Alone
3627	6	Not Testabe
3627	7	Not Applicable
3627	9	Unknown
3628	0	No
3628	2	Yes
3628	6	Not Testabe
3628	7	Not Applicable
3628	9	Unknown
3629	0	Someone Else
3629	1	Yourself and Someone Else
3629	2	Yourself Alone
3629	6	Not Testable
3629	7	Not Applicable
3629	9	Unknown
3630	0	Never
3630	1	1 - 4 Times
3630	2	5 or More Times
3630	6	Not Testable
3630	7	Not Applicable
3630	9	Unknown
3631	0	Mostly Alone
3631	1	Combo Family or Friends with Head Injuries
3631	2	Combo Family or Friends with Head Injuries
3631	6	Not Testable
3631	7	Not Due
3631	9	Unknown
3632	0	Someone Else
3632	1	Yourself and Someone Else
3632	2	Yourself Alone
3632	6	Not Testable
3632	7	Not Applicable
3632	9	Unknown
3633	1	Person with TBI
3633	2	Significant Other
3633	3	Person with TBI and Significant Other
3633	6	Variable Did Not Exist
3633	7	Not Due
3633	9	Unknown
3634	a	Full Time
3634	b	Part Time
3634	c	Not Attending School
3634	6	Not Testable
3634	7	Not Applicable
3634	9	Unknown
3635	0	Someone Else
3635	1	Yourself and Someone Else
3635	2	Yourself Alone
3635	6	Not Testable
3635	7	Not Applicable
3635	9	Unknown
3636	0	Never
3636	1	1 - 4 Times
3636	2	5 or More Times
3636	6	Not Testable
3636	7	Not Applicable
3636	9	Unknown
3637	0	Someone Else
3637	1	Yourself and Someone Else
3637	2	Yourself Alone
3637	6	Not Testable
3637	7	Not Applicable
3637	9	Unknown
3638	0	Seldom/Never
3638	1	Almost Every Week
3638	2	Almost Every Day
3638	6	Not Testable
3638	7	Not Applicable
3638	9	Unknown
3639	0	Never
3639	1	1 - 4 Times
3639	2	5 or More Times
3639	6	Not Testable
3639	7	Not Applicable
3639	9	Unknown
3640	a	5 or More Times
3640	b	1 - 4 Times
3640	c	Never
3640	6	Not Testable
3640	7	Not Applicable
3640	9	Unknown
3641	a	Full Time: More Than 20 hrs/wk
3641	b	Part Time: 20 or More hrs/wk
3641	c	Not Working: Actively looking
3641	d	Not Working: Not looking
3641	6	Not Testable
3641	7	Not Applicable
3641	8	Retired: Age-related
3641	9	Unknown

History

No history found for the Domain.

COLLECTION METHODS - ARCHIVE

Definition

Accuracy of Premorbid Data - How accurate are the answers from the person with brain injury/family member/significant other to the premorbid history questions? - “In your recollection of events prior to the injury, how accurate do you believe your answers to these questions are?”

Form

[ ] Form 1
[X] Form 2

Source

Data collector to complete Accuracy of Premorbid Data to be completed by best source

Details

Use code “4” for both [IntMthdInd] and [IntMthdSo] if most of the data were obtained from a secondary source.

These data must have originally been collected within window and must be high quality.

Variables

Form Type	Variable	ID	Question	History
Form 1	AccuracyP	3334	In your recollection of events prior to your/the injury, how accurate do you believe your answers to these questions are?	1997-04-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	EntryDate		Date Form 1 data entered:	1989-10-01 - Variable Added 2023-07-01 - Variable Removed
Form 2	EntryDate	3698	Date Form 2 data entered:	1989-10-01 - Variable Added 2023-07-01 - Variable Removed
Form 2	IntMthdInd	716	Method of Data Collection - Person With TBI	1989-10-01 - Variable Added 2017-01-15 - Variable Removed
Form 2	IntMthdSO	717	Method of Interview Data Collection - Family Member/Significant Other	1989-10-01 - Variable Added 2017-01-15 - Variable Removed
Form 2	NoDataInd	727	Reason Person with TBI Not Providing Data	1989-10-01 - Variable Added 2017-01-15 - Variable Removed
Form 2	NotprovSO	3914	Reason Family Member/Significant Other Not Providing Data	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	SO	770	Identity of Significant Other	1989-10-01 - Variable Added 2017-01-15 - Variable Removed

Codes and Values

ID	Code	Description
716	1	In-person Interview
716	2	Telephone Interview
716	3	Questionnaire Mailing
716	4	Data Obtained From Secondary Source
716	6	Variable Did Not Exist
716	7	Not Applicable: Funding not available
716	8	Not Applicable: No Data Provided by Person with TBI
717	1	In-person Interview
717	2	Telephone Interview
717	3	Questionnaire Mailing
717	4	Data Obtained From Secondary Source
717	6	Variable Did Not Exist
717	7	Not Applicable: Funding not available
717	8	Not Applicable: No Data Provided by Significant Other
727	3	Physically or Cognitively Unable
727	4	Not Available ( Not at home, in the hospital or jail, is working or in school and not available for interview )
727	5	Stated Refusal
727	6	No Response to Contact ( Center staff know the whereabouts of the person with brain injury but he/she has not responded to contact )
727	7	Lost to Follow-up ( Unknown whereabouts of person with brain injury )
727	8	Language Barrier ( Person with brain injury does not speak English and no interpreter was available )
727	9	Expired
727	66	Variable Did Not Exist
727	77	Not Applicable: Funding not available ( No funding )
727	88	Not Applicable: Data was provided ( Interview data was provided by person with brain injury )
727	99	Unknown ( Reason why no interview data was provided by person with brain injury, or unknown reason why no follow-up was attempted. )
770	1	Spouse
770	2	Parent(s)
770	3	Sibling
770	4	Adult Child
770	5	Boyfriend, Girlfriend, Fiancee
770	7	Other Relative
770	8	Friend
770	9	Professional Caregiver
770	77	Other
770	88	Not Applicable: No family or significant other data
3334	0	Variable Did Not Exist
3334	1	Not At All Accurate
3334	2	Somewhat Accurate
3334	3	Mostly Accurate
3334	4	Very Accurate
3334	6	No Premorbid Data
3334	9	Unknown
3914	1	No Appropriate Significant Other
3914	4	Not Available ( Not at home, in the hospital or jail, is working or in school and not available for interview )
3914	5	Stated Refusal
3914	6	No Response ( Center staff know the whereabouts of the family member/significant other of person with brain injury but he/she has not responded to contact )
3914	7	Lost To Follow-up ( Unknown whereabouts of family member/significant other of person with brain injury )
3914	8	Language Barrier ( Family member/significant other of person with brain injury does not speak English and no interpreter was available )
3914	55	Not Applicable: Funding not available ( No funding )
3914	66	Patient Expired
3914	77	Not applicable: Interview not required
3914	88	Not Applicable: Data provided by other family member ( Interview data was provided by family member/significant other of person with brain injury )
3914	99	Unknown ( Reason why no interview data was provided by family member/significant other of person with brain injury, or unknown reason why no follow-up with family member/significant other of person with brain injury was attempted. )

History

Date	Description
1996-01-01	Added NOTE : clarified that this variable refers to interview data collection only.
2001-08-20	Added NOTE : about how to code if multiple methods are used to collect data.
2004-01-01	Added CODE : '7 - Not Applicable: Funding not available'
2004-04-01	Added NOTE : about code 7 not being in Form II.
2006-01-01	Added CODE : '4 - NA-data obtained out of window from secondary source'.
2006-01-01	Added CODE : '6 - Variable did not exist at time data were collected'.
2006-04-01	Added NOTE : "All possible effort is to be made to collect data from the participant or an SO. Data from other sources (as indicated by code "4" ) should be entered only if: (1)it has not been possible to obtain the data from the person or SO during the follow-up window, (2) those data were originally collected during the follow-up window, and (3) the data meet TBIMS standards for data collection procedures and data quality standards'.
2013-10-01	Added NOTE : "Interviewers should use their best judgment in determining whether a significant other has enough current knowledge of the participant to accurately answer follow-up questions."

COMPSEIZ - ARCHIVE

Form

[X] Form 1
[ ] Form 2

Source

• Form 1 - Abstraction (acute and rehab record)

Details

If seizure occurs exactly 24 hours post injury, use code 2.

If individual had premorbid seizures and drug treatment but no seizures during this hospitalization, code as “absent”.

Seizure can be witnessed by anyone, but must be confirmed as a seizure by the physician.

Variables

Form Type	Variable	ID	Question	History
Form 1	CC_Seiz	3358	Cranial Complications - Seizures	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3358	1	Absent
3358	2	First 24 Hours
3358	3	Greater Than 24 Hours To 7 Days
3358	4	More Than 7 Days
3358	9	Unknown

History

No history found for the Domain.

COVID - ARCHIVE

Definition

These variables document COVID-19 diagnosis and treatment received.

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 diagnosed multiple times with COVID-19, record the first diagnosis.

If participant was diagnosed with COVID while hospitalized for other reasons, do NOT code “Level of Care Received” as “Was hospitalized”, since COVID was discovered incidentally.

If participant was diagnosed with COVID while hospitalized for other reasons, AND COVID became problematic or the focus of acute care treatment (placed on a vent, or more intensive treatment of COVID symptoms was provided), then code “Level of Care Received” as “Was hospitalized”.

Variables

Form Type	Variable	ID	Question	History
Form 1	CVD19Care	7652	If 'Yes' to having had COVID-19, what level of care did you receive (or are you receiving):	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 1	CVD19Note		Note:	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 1	CVD19Pos	7649	To your knowledge, do you have, or have you had COVID-19?	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 1	CVD19PosMonth	7650	Month:	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 1	CVD19PosYear	7651	Year:	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 1	CVD19Vacc	7649	Have you received a COVID-19 vaccine?	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 1	CVD19VaccMonth	7650	Month:	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 1	CVD19VaccYear	7651	Year:	2021-10-01 - Variable Added 2023-04-01 - Variable Removed
Form 1	CVD19Vent	7649	If hospitalized for COVID, were you placed on a ventilator (breathing machine with tube down your throat)?	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 2	CVD19CareF	7657	What level of care did you receive (or are you receiving)?	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 2	CVD19NoteF		Note:	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 2	CVD19PosF	7654	To your knowledge, do you have, or have you had COVID-19?	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 2	CVD19PosMonthF	7655	Onset month:	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 2	CVD19PosYearF	7656	Onset year:	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 2	CVD19VaccF	7654	Have you received a COVID-19 vaccine?	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 2	CVD19VaccMonthF	7655	Month:	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 2	CVD19VaccYearF	7656	Year:	2021-10-01 - Variable Added 2024-01-15 - Variable Removed
Form 2	CVD19VentF	7654	If hospitalized, were you placed on a ventilator (breathing machine with tube down your throat)?	2021-10-01 - Variable Added 2024-01-15 - Variable Removed

Codes and Values

ID	Code	Description
7649	0	No
7649	1	Yes
7649	66	Variable Did Not Exist
7649	77	Refused
7649	88	Not Applicable
7649	99	Unknown
7650	1	January
7650	2	February
7650	3	March
7650	4	April
7650	5	May
7650	6	June
7650	7	July
7650	8	August
7650	9	September
7650	10	October
7650	11	November
7650	12	December
7650	666	Variable Did Not Exist
7650	777	Refused
7650	888	Not Applicable
7650	999	Unknown
7651	2019	2019
7651	2020	2020
7651	2021	2021
7651	2022	2022
7651	2023	2023
7651	66666	Variable Did Not Exist
7651	77777	Refused
7651	88888	Not Applicable
7651	99999	Unknown
7651	2023	2023
7652	1	Did not seek medical care
7652	2	Received medical care but was not hospitalized
7652	3	Was hospitalized
7652	66	Variable Did Not Exist
7652	77	Refused
7652	88	Not Applicable
7652	99	Unknown
7654	0	No
7654	1	Yes
7654	66	Variable Did Not Exist
7654	77	Refused
7654	88	Not Applicable
7654	99	Unknown
7655	1	January
7655	2	February
7655	3	March
7655	4	April
7655	5	May
7655	6	June
7655	7	July
7655	8	August
7655	9	September
7655	10	October
7655	11	November
7655	12	December
7655	666	Variable Did Not Exist
7655	777	Refused
7655	888	Not Applicable
7655	999	Unknown
7656	2019	2019
7656	2020	2020
7656	2021	2021
7656	2022	2022
7656	2023	2023
7656	66666	Variable Did Not Exist
7656	77777	Refused
7656	88888	Not Applicable
7656	99999	Unknown
7657	1	Did not seek medical care
7657	2	Received medical care but was not hospitalized
7657	3	Was hospitalized
7657	66	Variable Did Not Exist
7657	77	Refused
7657	88	Not Applicable
7657	99	Unknown

History

Date

Description

2022-04-01

Added NOTE: If participant was diagnosed with COVID while hospitalized for other reasons, do NOT code “Level of Care Received” as “Was hospitalized”, since COVID was discovered incidentally. If however, participant was diagnosed with COVID while hospitalized for other reasons, AND COVID became problematic or the focus of acute care treatment (placed on a vent, or more intensive treatment of COVID symptoms was provided), then code “Level of Care Received” as “Was hospitalized”.

CRANIAL COMPLICATIONS: CSF - ARCHIVE

Definition

Leaking of CSF from the wound, ears, or nose. Also, may be indirectly observed by pneumocephalus.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute and rehabilitation record)

Variables

Form Type	Variable	ID	Question	History
Form 1	CC_CSF	3354	Cranial Complications - Cerebrospinal Fluid (CSF) Leak	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3354	1	No
3354	2	Yes
3354	3	Suspected But Not Definite
3354	9	Unknown

History

No history found for the Domain.

CRANIAL COMPLICATIONS: HERNIATION - ARCHIVE

Definition

Must be documented by a physician. Brain herniation including uncal, transtentorial, tonsillar or cerebellar.

Form

[X] Form 1
[ ] Form 2

Source

• Acute and Rehabilitation Medical Record Abstraction

Variables

Form Type	Variable	ID	Question	History
Form 1	CC_Hern	3355	Cranial Complications - Herniation Syndrome	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3355	1	No
3355	2	Yes
3355	9	Unknown

History

No history found for the Domain.

CRANIAL COMPLICATIONS: HYDROCEPHALUS - ARCHIVE

Definition

Hydrocephalus/Vetriculo-peritoneal Shunt Enlargement of the ventricles such that shunting or draining is required.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute and rehabilitation record)

Details

If shunt is done strictly for measuring intracranial pressure and there is no indication of hydrocephalus. Do not code this variable.

This variable assesses whether there is a shunt present, not ventriculostomy.

Enter the date that the shunting or draining for the hydrocephalus occurred.

If patient had more than one occurrence of hydrocephalus requiring shunting or draining, enter the date of the first shunt or drain.

Variables

Form Type	Variable	ID	Question	History
Form 1	CC_Hydro	3356	Cranial Complications - Hydrocephalus/Vetriculo-peritoneal Shunt	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3356	07/07/7777	Patient Had Hydrocephalus, But The Date of Shunt or Drain Is Not Known
3356	08/08/8888	Not applicable: No hydrocephalus shunt or drain
3356	09/09/9999	Unknown, ifShunt or Drain Performed For Hydrocephalus

History

Date	Description
1995-07-01	Changed DEFINITION : revised coding to enter date of shunt instead of just yes, no. Added VP shunt to variable name.
1999-06-01	Added NOTE : regarding coding shunt with no hydrocephalus.
2001-08-20	Added NOTE : about ventriculostomy.

CRANIAL COMPLICATIONS: INFECTIONS - ARCHIVE

Definition

Patient has infections within the cranium, including meningitis, brain abscess, ventriculitis, or infected shunt or other foreign body.

Form

[X] Form 1
[ ] Form 2

Source

Form

• Form 1
• Form 2

Source

• Abstraction (acute and rehabilitation record)

Variables

Form Type	Variable	ID	Question	History
Form 1	CC_Infect	3357	Cranial Complications - Intracranial Infections	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3357	1	No
3357	2	Yes
3357	3	Suspected But Not Definite
3357	9	Unknown

History

No history found for the Domain.

CRANIAL SURGERY: CRANIOTOMY DATE - ARCHIVE

Definition

This variable documents the date on which surgery for removal of bone flap or prosthetic cranioplasty was performed, if performed during acute care.
Removal of bone flap without replacement during that procedure; also called craniectomy. (“Bone flap” is a section of skull.)

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

If more than one removal of bone flap occurs on different dates, document the date of the first occurrence.

Characteristics

SRGDEBBONE (Removal of Bone Flap) was collected from 1/01/1990 to 1/01/1995. No data available. Definition = This variable documents the date on which surgery for removal of bone flap or prosthetic cranioplasty was performed, if performed during acute care.

Variables

Form Type	Variable	ID	Question	History
Form 1	SurgDebBone	3542	Cranial - Debridement - Removal of Bone Flap Date	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3542	08/08/8888	Not Applicable: Surgery not performed
3542	09/09/9999	Unknown

History

No history found for the Domain.

CRANIAL SURGERY: DEBRIDEMENT FRONTAL - ARCHIVE

Definition

This variable documents the date on which debridement of a frontal contusion was performed.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

If more than one debridement of a frontal contusion occurs on different dates, document the date of the first occurrence.

If frontal lobectomy is performed, code under this variable.

Variables

Form Type	Variable	ID	Question	History
Form 1	SurgDebFront	3543	Cranial - Debridement - Frontal Contusion Date	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3543	08/08/8888	Not Applicable: Surgery not performed
3543	09/09/9999	Unknown

History

No history found for the Domain.

CRANIAL SURGERY: DEBRIDEMENT ICP - ARCHIVE

Definition

This variable documents the total length of time ICP monitor(s) was (were) in place

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

If patient has Camino placement, ventriculostomy, or Richmond Bolt, these indicate that an ICP monitor has been placed and this variable should be coded 2-5 or 8.

Variables

Form Type	Variable	ID	Question	History
Form 1	SurgDebICP	3544	Cranial - Debridement - Use of ICP Monitors	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3544	1	Not Done: No monitoring
3544	2	Monitored: Less Than 1 Day to 3 Days
3544	3	Monitored: Greater Than 3 Days to 7 Days
3544	4	Monitored: Greater Than 7 Days to 14 Days
3544	5	Monitored: Greater Than 14 Days
3544	8	Patient Monitored: Unknown number of days
3544	9	Unknown, if Monitored

History

No history found for the Domain.

CRANIAL SURGERY: DEBRIDEMENT OTHER - ARCHIVE

Definition

This variable documents the date on which debridement of contusion (other than frontal or temporal contusion) was performed.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

If more than one debridement of a contusion (other than frontal or temporal) occurs on different dates, document the date of the first occurrence.

If lobectomy is performed (other than frontal or temporal lobectomy, code under this variable.

Variables

Form Type	Variable	ID	Question	History
Form 1	SurgDebOther	3545	Cranial - Debridement - Other Contusion Date	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3545	08/08/8888	Not Applicable: Surgery not performed
3545	09/09/9999	Unknown

History

No history found for the Domain.

CRANIAL SURGERY: DEBRIDEMENT TEMPORAL - ARCHIVE

Definition

This variable documents the date on which debridement of temporal contusion was performed

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

If more than one debridement of a temporal contusion occurs on different dates, document the date of the first occurrence.

If temporal lobectomy is performed, code under this variable.

Variables

Form Type	Variable	ID	Question	History
Form 1	SurgDebTemp	3546	Cranial - Debridement - Temporal Contusion Date	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3546	08/08/8888	Not Applicable: Surgery not performed
3546	09/09/9999	Unknown

History

No history found for the Domain.

CRANIAL SURGERY: ELEVATION FRACTURE - ARCHIVE

Definition

This variable documents the date on which surgery for elevation of a depressed skull fracture was performed.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

If more than one elevation of a depressed skull fracture occurs on different dates, document the date of the first occurrence.

Note whether dural penetration occurred.

Variables

Form Type	Variable	ID	Question	History
Form 1	SurgElevDate	3547	Cranial - Debridement - Elevation od Depressed Skull Fx Date	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	SurgElevTyp	3548	Cranial - Debridement - Elevation od Depressed Skull Fx Type	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3547	08/08/8888	Not Applicable: Surgery not performed
3547	09/09/9999	Unknown
3548	1	Elevation Without Associated Dural Penetration
3548	2	Elevation With Associated Dural Penetration
3548	8	Not Applicable ( Surgery not performed )
3548	9	Unknown

History

No history found for the Domain.

CRANIAL SURGERY: EVACUATION EPIDURAL - ARCHIVE

Definition

This variable documents the date on which surgery for evacuation of epidural hemorrhage was performed.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

If more than one evacuation of an epidural hemorrhage occurs on different dates, document the date of the first occurrence.

Variables

Form Type	Variable	ID	Question	History
Form 1	SurgEvacEpi	3549	Cranial - Evacuation - Epidural Date	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3549	08/08/8888	Not Applicable: Surgery not performed
3549	09/09/9999	Unknown

History

No history found for the Domain.

CRANIAL SURGERY: EVACUATION INTRACEREBRAL - ARCHIVE

Definition

This variable documents the date on which traumatic and/or delayed intracerebral hemorrhage was evacuated

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

If more than one evacuation of a traumatic and/or delayed intracerebral hemorrhage occurs on different dates, document the date of the first occurrence.

Variables

Form Type	Variable	ID	Question	History
Form 1	SurgEvacInt	3550	Cranial - Evacuation - Traumatic/Delayed Intracebral Date	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3550	08/08/8888	Not Applicable: Surgery not performed
3550	09/09/9999	Unknown

History

No history found for the Domain.

CRANIAL SURGERY: EVACUATION SUBDURAL - ARCHIVE

Definition

This variable documents the date on which the subdural hemorrhage was evacuated.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

If more than one evacuation of an subdural hemorrhage occurs on different dates, document the date of the first occurrence.

Variables

Form Type	Variable	ID	Question	History
Form 1	SurgEvacSub	3551	Cranial - Evacuation - Sub-Dural Date	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3551	08/08/8888	Not Applicable : Surgery not performed
3551	09/09/9999	Unknown

History

No history found for the Domain.

CRANIAL SURGERY: RE-BLEEDING - ARCHIVE

Definition

This variable documents the date on which any re-operation was performed on a previous operative site due to re-bleeding.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

If more than one reoperation was performed on a previous operative site due to rebleeding on different dates, document the date of the first occurrence.

Variables

Form Type	Variable	ID	Question	History
Form 1	SurgBleed	3541	Cranial - Debridement - Reoperation due to Bleeding Date	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3541	08/08/8888	Not Applicable: Surgery not performed
3541	09/09/9999	Unknown

History

No history found for the Domain.

CRIMINAL ACTIVITY - ARCHIVE

Definition

Form 1 - Determine if the person with brain injury was arrested prior to his/her injury. If so, the number of arrests and whether the arrests were alcohol and/or drug related.
(1) Prior to your injury, were you ever arrested?
(2) If yes to #1, how many times?
(3) If yes to #1, how many were drug/alcohol related?

Form 2 - Determine if the person with brain injury has been arrested during the past year. If so, the number of arrests and whether the arrests were alcohol and/or drug related according to the person with brain injury at the time of their follow-up evaluation.
(1) Have you been arrested in the past year?
(2) If yes to #1, how many times?
(3) If yes to #1, how many were drug/alcohol related?

Form

[X] Form 1
[X] Form 2

Source

• Form 1 - Pre-Injury History (participant or proxy)
• Form 2 - Interview, Mail-Out (participant AND proxy)
• Form 2 - Interview, Mail-Out (participant or proxy) Item archived 4/1/2022

Details

Data collectors should list all the charges and denote the number that are alcohol or drug related (e.g., DUI) and the number that are not. A person under the influence at the time of the arrest is not considered an alcohol/drug-related arrest unless the charge was alcohol/drug related.

If person is arrested post-injury for a crime allegedly committed pre-injury, record the arrest as occuring pre-injury. (For “Arrests” archived 4/1/2022)

Characteristics

Some cases older than 1/1/97 have data for this variable because centers were encouraged to collect data retrospectively for older cases.

In 2003, two NIDILRR Model Systems had difficulty obtaining this information (10% or more missing data). These two centers also had difficulty collecting drug, alcohol and special education variables.

Variables

Form Type	Variable	ID	Question	History
Form 1	ArrestDrug	3337	Number of Drug/Alcohol Arrests	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	ArrestPrior	3338	Arrested prior to Injury	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	ArrestTimes	3339	Number of Times Arrested	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Incarcerate	513	Were you ever incarcerated for conviction of a felony?	1997-01-01 - Variable Added 2022-07-01 - Variable Removed
Form 2	ArrestsDAI	3584	Arrests - How many arrests were drug or alcohol related?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	ArrestsDASO	3585	Arrests (SO) - How many arrests were drug or alcohol-related offenses?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	ArrestsF	590	In the past year, have you been arrested?	1989-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	ArrestsNI	3586	Arrests - How many times arrested?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	ArrestsNSO	3587	Arrests (SO) - How many times arrested?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	ArrestsSO	3588	Arrests (SO) - During the past year, has XXX been arrested?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
513	66	Variable Did Not Exist
513	0	No
513	1	Yes
513	77	Refused
513	99	Unknown
590	0	No
590	1	Yes
590	77	Refused
590	88	Not Applicable: Variable not due this year
590	99	Unknown
3337	00	Variable Did Not Exist
3337	88	Not Applicable: No arrests
3337	99	Unknown
3338	0	Variable Did Not Exist
3338	1	No
3338	2	Yes
3338	9	Unknown
3339	00	Variable Did Not Exist
3339	88	Not Applicable: No arrests
3339	99	Unknown
3584	00	Variable Did Not Exist
3584	77	Not Applicable: Variable not due this year
3584	80	No Significant Other or Family Member
3584	88	Not Applicable: No drug or alcohol-related arrests
3584	99	Unknown
3585	00	Variable Did Not Exist
3585	77	Not Applicable: Variable not due this year
3585	80	No Significant Other or Family Member
3585	88	Not Applicable: No drug or alcohol-related arrests
3585	99	Unknown
3586	00	Variable Did Not Exist
3586	77	Not Applicable: Variable not due this year
3586	80	No Significant Other or Family Member
3586	88	Not Applicable: No arrests
3586	99	Unknown
3587	00	Variable Did Not Exist
3587	77	Not Applicable: Variable not due this year
3587	80	No Significant Other or Family Member
3587	88	Not Applicable: No arrests
3587	99	Unknown
3588	1	No
3588	2	Yes
3588	7	Not Applicable: Variable not due this year
3588	8	No Significant Other or Family Member
3588	9	Unknown

History

Date	Description
1994-08-19	Added NOTE : to refer to current follow-up period.
1997-01-01	Variable added to database.
1998-04-01	Changed CODE : added "No drug or alcohol-related arrests" to "88 - Not Applicable"
2001-08-20	Added NOTE : about pre-injury crimes in which the arrest is post-injury.
2003-01-01	Changed VARIABLE: replaced “During the last year” with “Since the last interview in [month, year]”.
2003-01-01	Changed NOTE : removed references to this variable being asked of the person with TBI.
2003-01-01	Deleted CODE : “7 -This variable not collected this year”.
2003-01-01	Deleted NOTE : related to number of arrests and number that were drug/alcohol related.
2003-10-01	Changed VARIABLE: replaced “Since the last interview in [month, year]” with “During the last year”.
2004-07-01	Added to CHARACTERISTICS OF DATA, an explanation for data in cases existing prior to implementation date (1/1/97).
2009-01-01	Added CODE : "7 - Refused".
2009-01-01	Added CODE : "6 - Not Applicable: Variable not due this year" reassigned from 7 to 6. Code 7= Refused.

CT - ARCHIVE

Definition

CT diagnoses based on a combination of reports taken from radio-graphic CT scan results within 7 days of injury.

“CT Data” form: See SOP 0. Current Forms

Code CTStatus as 99-unknown if CT scans/reports done, but unavailable

Form

[X] Form 1
[ ] Form 2

Source

To be coded by a CT certified individual from all CT reports of the head and/or neck dated within 7 days of injury.

Details

A properly trained person at the facility who has been certified following TBIMS procedures may code this variable.

Do not use MRI findings to code this variable.

If CT reports are not available from a system acute hospital, CT reports from non-system hospitals may be used if available.

CTA (CT angiography) reports should not be included.

Findings, including old infarcts and midline shift, should be coded as ‘present’ regardless of cause.

Characteristics

All CT variables were removed from data collection on 6/30/2025.

Training

Testing and certification of collectors of this variable is required. It is available from the National Data and Statistical Center.

A score of 80% or greater is required for certification.

Variables

Form Type	Variable	ID	Question	History
Form 1	CT5a1CorticalLFront	422	5a1. Left frontal	1989-10-01 - Variable Added 2025-06-30 - Variable REMOVED
Form 1	CT5a2CorticalRFront	422	5a2. Right frontal	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5a3CorticalNFront	422	5a3. Laterality N/S frontal	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5b1CorticalLTemp	422	5b1. Left temporal	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5b2CorticalRTemp	422	5b2. Right temporal	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5b3CorticalNTemp	422	5b3. Lat. N/S temporal	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5c1CorticalLPar	422	5c1. Left parietal	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5c2CorticalRPar	422	5c2. Right parietal	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5c3CorticalNPar	422	5c3. Lat. N/S parietal	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5d1CorticalLOcc	422	5d1. Left occipital	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5d2CorticalROcc	422	5d2. Right occipital	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5d3CorticalNOcc	422	5d3. Lat. N/S occipital:	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5e1CorticalLUnk	422	5e1. Left location N/S	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5e2CorticalRUnk	422	5e2. Right location N/S	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT5e3CorticalNUnk	422	5e3. Lat. N/S location N/S	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT6aNonCortL	423	6a1. Left	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT6aNonCortN	423	6a3. Lat. N/S	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT6aNonCortR	423	6a2. Right	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7a1AxialLEpi	424	7a1. Left epidural	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7a2AxialREpi	424	7a2. Right epidural	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7a3AxialNEpi	424	7a3. Lat. N/S epidural	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7b1AxialLSub	424	7b1. Left subdural (non-falcine)	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7b2AxialRSub	424	7b2. Right subdural (non-falcine)	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7b3AxialNSub	424	7b3. Lat. N/S subdural (non-falcine)	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7c1AxialLNS	424	7c1. Left location N/S	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7c2AxialRNS	424	7c2. Right location N/S	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7c3AxialNNS	424	7c3. Lat. N/S location N/S	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7d1FalcineSub	424	7d1. Falcine/tentorial subdural hemorrhage	2015-01-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7d2FalcineSAH	424	7d2. Falcine/tentorial subarachnoid hemorrhage	2015-01-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CT7d3FalcineUnk	424	7d3. Falcine/tentorial hemorrhage unspecified	2015-01-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CTComp	425	Extent of compression	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CTFrag	426	Intraparenchymal fragments	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CTIntracrain	427	1. Intracranial hemorrhage and/or contusions, extra-axial collections	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CTIntraventricular	428	4. Intraventricular hemorrhage	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CTPunctate	428	2. Punctate/petechial hemorrhages	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CTStatus	429	CT status	1989-10-01 - Variable Added 2025-06-30 - Variable Removed
Form 1	CTSubarachnioid	428	3. Subarachnoid hemorrhage	1989-10-01 - Variable Added 2025-06-30 - Variable Removed

Codes and Values

ID	Code	Description
422	0	No
422	1	Yes
422	66	Variable Did Not Exist
422	88	CT Not Done
422	99	Unknown
423	0	No
423	1	Yes
423	66	Variable Did Not Exist
423	88	CT Not Done
423	99	Unknown
424	0	No
424	1	Yes
424	66	Variable Did Not Exist
424	88	CT Not Done
424	99	Unknown
425	1	No Visible Intracranial Compression
425	2	Cisterns Are Present But Midline Shift is Noted of 1-5 mm.
425	3	Cisterns Compressed or Absent With Midline Shift of 0-5 mm. Compression
425	4	Midline Shift of Greater Than 5 mm.
425	5	Extent Not Specified
425	66	Variable Did Not Exist
425	88	CT Not Done
425	99	Unknown
426	0	No Fragment(s)
426	1	Yes Fragment(s)
426	66	Variable Did Not Exist
426	88	No CT done
426	99	Unknown
427	0	No Visible Pathology
427	1	Yes, Pathology Exists
427	66	Variable Did Not Exist
427	88	CT Not Done
427	99	Unknown
428	0	No
428	1	Yes
428	66	Variable Did Not Exist
428	88	CT Not Done
428	99	Unknown
429	0	CT Not Done
429	1	CT Done
429	66	Variable Did Not Exist
429	99	Unknown ( CT scans/reports done, but unavailable )

History

Date	Description
1996-05-15	Changed DEFINITION : dropped laterality for punctate, subarachnoid and intraventricular hemorrhages; dropped location for noncortical contusions. Retrospective coding to be done for all cases with system admissions as of 1/1/94. Use code 0 for all cases prior to that date if data was not collected.
1997-01-01	Added CODE : 0 for variable not in existence.
1998-09-01	Changed NOTE : regarding coding no fragments.
1999-04-01	Changed DEFINITION : substituted "non-hemorrhagic" for "bland" for description of contusion.
1999-04-01	Added NOTE : regarding not using MRI data.
2004-01-01	Added NOTE : that a trained person who is TBIMS certified may code this variable.
2005-01-01	Added CODE : '8 (CT not done)' to items B2-7.
2005-04-01	Added CODE : '9 - unknown' to all items in sections B2 through B6.
2007-04-01	Added NOTE : to code tentorial collections as SAH.
2013-01-01	Added NOTE : contact NDSC (instead of Santa Clara)
2014-10-01	Added NOTE: "If CT reports are not available from a system acute hospital, CT reports from non-system hospitals may be used if available."
2016-01-01	Changed DEFINITION : to include items 7d, 1,2 and 3 Falcine or Tentorial items.
2017-10-01	Added NOTE : CTA (CT angiography) reports should not be included.
2022-10-01	Added to TRAINING : "A score of 80% or greater is required for certification".
2024-07-01	Added NOTE: Findings, including old infarcts and midline shift, should be coded as 'present' regardless of cause.
2025-06-30	All CT variables were removed from data collection on 6/30/2025.

DEMOGRAPHICS: ADDRESS - ARCHIVE

Definition

Length of time at current address (number of days/months/years)

• Form 2 AdressInt, AddressLen -Interview, Mail-out (participant or proxy)

Number of days/months/years

Convert years to months if fractions are included in the years provided by the participant (i.e. 3 1/2 years = 3.5 * 12 = 42 months).

Convert months to days if fractions are included in the months provided by the participant (i.e. 3 1/2 months = 3.5 * 30 = 105 days).

Code only consecutive years living at current location.

Do not include time spent in prison.

As a general rule, if a person is living in a sub-acute facility or nursing home and then returns to home, if a person is there for less than 6 months, then use their home address. If more than 6 months, use the program/facility address.

Variables

Form Type	Variable	ID	Question	History
Form 2	AddressIntF	571	Interval:	2010-04-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	AddressLenF	572	Enter number of days/months/years:	2010-04-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	Street2F		Street address 2:	2010-04-01 - Variable Added 2023-04-01 - Variable Removed

Codes and Values

ID	Code	Description
571	1	Days
571	2	Months
571	3	Years
571	66	Variable Did Not Exist
571	88	Not Applicable: Authorization not given
571	99	Unknown
572	666	Variable Did Not Exist
572	888	Not Applicable: Authorization not given
572	999	Unknown

History

No history found for the Domain.

DEMOGRAPHICS: CULTURAL - ARCHIVE

Definition

Determine if English is the primary language or if the participant speaks sufficient English to participate in the study.

Form

[X] Form 1
[ ] Form 2

Source

• Form 1 - Pre-Injury History (participant or proxy)

Details

This should be considered a best source variable, meaning that caregivers can also be queried.

Variables

Form Type	Variable	ID	Question	History
Form 1	PrimLang	3502	Is English the Patients Primary Language?	2007-10-01 - Variable Added 2012-10-01 - Variable Removed

Codes and Values

ID	Code	Description
3502	1	Patient Does Not Speak English
3502	2	Patient's Primary Language is English
3502	3	Primary Language is Not English ( Patient spoke sufficient English to conduct an interview )
3502	6	Variable Did Not Exist
3502	9	Unknown

History

No history found for the Domain.

DEMOGRAPHICS: HOUSEHOLD - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	LivWhoDisOld	517	Person Living With after Discharge: Primary (Using Prior Coding)	1989-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 1	LivWhoInjOld	518	Person Living With at Injury: Primary (Using Prior Coding)	1989-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	LivWhoFOld	722	Who are you currently living with? (Using Prior Coding)	1989-10-01 - Variable Added 2022-04-01 - Variable Removed

Codes and Values

ID	Code	Description
517	1	Alone
517	2	Spouse or Significant Other
517	3	Other Family
517	4	Someone Else
517	88	Not Applicable: Expired in rehab
517	99	Unknown
518	1	Alone
518	2	Spouse or Significant Other
518	3	Other Family
518	4	Someone Else
518	99	Unknown
722	1	Alone
722	2	Spouse ( Includes common-law partners of 7 or more yrs )
722	3	Parent(s)
722	4	Sibling(s)
722	5	Child/Children ( Less than 21 years of age )
722	6	Other Relative(s) or Adult Child(ren) ( Greater than 21 years of age )
722	7	Roommate(s) or Friend(s)
722	8	Significant Other ( Partners, not married )
722	9	Other Patients ( In hospital or nursing home )
722	10	Other Residents ( Group living situation )
722	11	Personal Care Attendant
722	77	Other ( Includes correctional facility inmates )
722	99	Unknown

History

No history found for the Domain.

DEMOGRAPHICS: MARITAL - ARCHIVE

Definition

LngTrmUnion - Long-term union or partnership

MarChange - change of marital status since last successful follow-up,

Form

[X] Form 1
[X] Form 2

Source

• Form 1 LngTrmUnion - Pre-Injury History (participant or proxy)
• Form 2 FLngTrmUnion- Interview, Mail-Out (participant or proxy)
• Form 2 MarChange - Interview, Mail-Out (participant or proxy)

If married more than once, code to the most recent.

Characteristics

When first introduced on 4/1/2010, the change of marital status variable did not include a code for separated:

0 No Change
1 Divorce
2 Marriage
3 Widowed
4 Divorce & Marriage (In Either Order)
5 Widowed & Marriage (In Either Order)
6 Divorce, Marriage & Widowed (In Any Order)
7 Other
8 Variable Did Not Exist
9 Unknown

Due to the complete range of codes utilized, it was necessary to re-assign codes and re-code existing data in the database to accommodate the new code for separated added on 4/1/2011:

0 No Change
1 Separation
2 Divorce
3 Marriage
4 Widowed
5 Divorce & Marriage (In Either Order)
6 Widowed & Marriage (In Either Order)
7 Divorce, Marriage & Widowed (In Any Order)
8 Other
9 Unknown
66 Variable did not exist

Consequently, coding on data collection forms will not match database values for cases collected between 10/1/2010 and 3/31/2011.

Variables

Form Type	Variable	ID	Question	History
Form 1	LngTrmUnion	3483	Do you consider yourself to be in a long-term union or partnership?	2007-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	FLngTrmUnion	3717	Do you currently consider yourself to be in a long-term union or partnership?	2007-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	MarChangeF	725	Has your marital status changed?	2010-04-01 - Variable Added 2022-04-01 - Variable Removed

Codes and Values

ID	Code	Description
725	0	No Change
725	1	Separation
725	2	Divorce
725	3	Marriage
725	4	Widowed
725	5	Divorce and Marriage ( In either order )
725	6	Widowed and Marriage ( In either order )
725	7	Divorce, Marriage and Widowed ( In any order )
725	8	Other
725	66	Variable Did Not Exist
725	99	Unknown
3483	1	No
3483	2	Yes
3483	6	Variable Did Not Exist
3483	9	Unknown
3717	1	No
3717	2	Yes
3717	6	Variable Did Not Exist
3717	9	Unknown

History

No history found for the Domain.

DEMOGRAPHICS: RACE - ARCHIVE

Definition

Self-reported race.

For a list of the specific racial/ethnic groups that fall within each of the five categories (above), see the “2000 Census of Population and Housing” (US Department of Commerce, 2003), “Summary 1”: See - External Links. The race codes are in the “Technical Documentation” section, starting on page 587. (For TBIMS purposes, this list of race codes used in the 2000 census is sufficiently similar to the list used in the 1990 census.)

The following Bureau of the Census guidelines are to be used to code mixed race: in the event of a mixed white and other race, the other race is used; in the event of mixed races other than white, the race of the father is used.

Variables

Form Type	Variable	ID	Question	History
Form 1	Race	541	What is your race?	1989-10-01 - Variable Added 2023-04-01 - Variable Removed

Codes and Values

ID	Code	Description
541	1	White
541	2	Black
541	3	Asian/Pacific Islander
541	4	Native American
541	5	Hispanic Origin
541	6	Biracial or Multiracial
541	7	Other
541	88	Not Applicable
541	99	Unknown

History

No history found for the Domain.

DEPRESSION: QOL DEPRESSION - ARCHIVE

Definition

The TBI-QOL Depression Scale is Patient Reported Outcome assessment of depression. It is made up of items from the PROMIS and Neuro-QOL measurement systems. It can be administered via Computer Adaptive Testing (CAT) or via short forms. With CAT, the participant is administered items one at a time and, with each item, the computer prorates the score estimating the examinees level of depression. Generally, reliable scores can be obtained with as few as 4-5 items. As an alternative to CAT, short forms are also available.

Form

[ ] Form 1 [X] Form 2

Depression (also known as Major Depressive Disorder) is a common but serious mental health condition that profoundly affects a person’s feelings, thoughts, and actions. It’s more than just feeling “sad” or “blue” for a day or two.

---

What it Is

At its core, depression is characterized by a persistent, deep feeling of sadness and/or a significant loss of interest or pleasure in almost all daily activities (like hobbies, socializing, or work).

---

How it Affects a Person

For a person to be experiencing depression, these feelings must last for a minimum of two weeks and significantly interfere with their daily life. Other common signs and symptoms often experienced include:

• Changes in energy and sleep: Feeling extremely tired (fatigue) or having trouble sleeping (insomnia) or sleeping too much (hypersomnia).
• Changes in appetite: Significant weight loss or gain.
• Difficulty concentrating: Trouble making decisions, focusing, or remembering things.
• Negative self-talk: Feeling worthless or overly guilty.
• Physical changes: Feeling restless or slowed down to an extent noticeable by others.
• Thoughts of death or suicide.

Source

• Interview, Mail-Out (participant only)

Details

The TBI-QOL Depression CAT yields a standard score on a t-metric (mean of 50 and standard error of 10). It is a continuous variable.

Though the TBI-QOL measure was developed and tested with individuals with TBI, the scores have been equated with those of the PROMIS Depression bank. This will allow direct comparison of TBI-QOL Depression scores with PROMIS depression scores. This will allow the TBIMS depression scores to be comparable to other studies that include PROMIS Depression.

QOL questions should not be administered to a significant other, or any other proxy. If the individual is unable to provide data, use code “10. Not Applicable: No data from person with TBI.”

If administering the Computer Adaptive version, preface questions with: “This next section will be entered directly into the computer and cannot be changed. Please think about your responses carefully before answering.”

If the TBI-QOL measures should need to be re-administered for any reason, the NDSC will use the last version submitted.

If clarification is needed repeat the word/question and answer based on what the word/question means to them.

Variables

Form Type	Variable	ID	Question	History
Form 2	DEPTScoreF	636	Depression Score	2007-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	DEPTScoreTypeF	3652	Method	2007-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	DepCheerF	628	I felt that nothing could cheer me up	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	DepDepressedF	629	I felt depressed	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	DepEmptyF	630	I felt that my life was empty	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	DepForwardF	631	I felt that I had nothing to look forward to	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	DepGiveUpF	632	I felt that I wanted to give up on everything	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	DepHopeF	633	I felt hopeless	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	DepInterestF	634	I felt that nothing was interesting	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	DepLiveF	635	I felt I had no reason for living	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	DepUnhappyF	637	I felt unhappy	2013-10-01 - Variable Added 2018-07-01 - Variable Removed
Form 2	DepWorthlessF	638	I felt worthless	2013-10-01 - Variable Added 2018-07-01 - Variable Removed

Codes and Values

ID	Code	Description
628	0	Variable Did Not Exist
628	1	Never
628	2	Rarely
628	3	Sometimes
628	4	Often
628	5	Always
628	8	NA-long form used
628	9	Unknown
628	10	Not Applicable: No data from person with TBI
629	0	Variable Did Not Exist
629	1	Never
629	2	Rarely
629	3	Sometimes
629	4	Often
629	5	Always
629	8	NA-long form used
629	9	Unknown
629	10	Not Applicable: No data from person with TBI
630	0	Variable Did Not Exist
630	1	Never
630	2	Rarely
630	3	Sometimes
630	4	Often
630	5	Always
630	8	NA-long form used
630	9	Unknown
630	10	Not Applicable: No data from person with TBI
631	0	Variable Did Not Exist
631	1	Never
631	2	Rarely
631	3	Sometimes
631	4	Often
631	5	Always
631	8	NA-long form used
631	9	Unknown
631	10	Not Applicable: No data from person with TBI
632	0	Variable Did Not Exist
632	1	Never
632	2	Rarely
632	3	Sometimes
632	4	Often
632	5	Always
632	8	NA-long form used
632	9	Unknown
632	10	Not Applicable: No data from person with TBI
633	0	Variable Did Not Exist
633	1	Never
633	2	Rarely
633	3	Sometimes
633	4	Often
633	5	Always
633	8	NA-long form used
633	9	Unknown
633	10	Not Applicable: No data from person with TBI
634	0	Variable Did Not Exist
634	1	Never
634	2	Rarely
634	3	Sometimes
634	4	Often
634	5	Always
634	8	NA-long form used
634	9	Unknown
634	10	Not Applicable: No data from person with TBI
635	0	Variable Did Not Exist
635	1	Never
635	2	Rarely
635	3	Sometimes
635	4	Often
635	5	Always
635	8	NA-long form used
635	9	Unknown
635	10	Not Applicable: No data from person with TBI
636	999	Unknown
637	0	Variable Did Not Exist
637	1	Never
637	2	Rarely
637	3	Sometimes
637	4	Often
637	5	Always
637	8	NA-long form used
637	9	Unknown
637	10	Not Applicable: No data from person with TBI
638	0	Variable Did Not Exist
638	1	Never
638	2	Rarely
638	3	Sometimes
638	4	Often
638	5	Always
638	8	NA-long form used
638	9	Unknown
638	10	Not Applicable: No data from person with TBI

History

Date	Description
2014-04-01	Added NOTE : If the TBI-QOL measures should need to be re-administered for any reason, the NDSC will use the last version submitted.
2014-04-01	Added NOTE : If administering the Computer Adaptive version, preface questions with: "This next section will be entered directly into the computer and can not be changed. Please think about your responses carefully before answering."
2015-03-02	Added NOTE : if clarification is needed repeat the word/question and answer based on what the word/question means to them

DRS: FOLLOW-UP - ARCHIVE

Form

[ ] Form 1
[X] Form 2

Source

• Form 2 - Interview (participant or proxy)

Details

If DRS assessments cannot be completed within the 3 calendar day windows, they should still reflect the patients’ status within that time period. Every effort should be made to obtain the DRS assessments, however, if any items can not be assessed, use code 9. Do not leave blanks. If a patient has an intermittent acute care stay during inpatient rehabilitation, use the DRS scores from the first rehabilitation admission and the last definitive discharge. In addition, if a patient has an intermittent stay which is longer than 30 days, it is then considered a system discharge and the discharge date from rehabilitation is the system discharge date and the DRS scores should correspond to that date.

Total DRS score is calculated using a computer program. If DRS assessment was completed within the 3 calendar day window, enter the date the assessment was completed. If DRS assessment was not completed within the 3 calendar day window, but still reflects the patients’ status within that time period, enter the last date that the 3 calendar day window would have been open. If DRS assessment was not completed within the 3 calendar day window, and does not reflect the patients’ status within that time period, enter the date the assessment was completed.

Reference

Rappaport M, Hall KM, Hopkins K, Belleza T, Cope N. (1982). Disability Rating Scale for severe head trauma patients: Coma to community. Arch Phys Med & Rehabil, 63:118-123. rev 8/87.

Information about the DRS is available on the COMBI website.

Variables

Form Type	Variable	ID	Question	History
Form 2	DRSEmpF	3672	Employability:	1989-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	DRSEyeF	3673	Eye Opening:	1989-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	DRSFeedF	3674	Feeding:	1989-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	DRSFuncF	3675	Level Of Functioning:	1989-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	DRSGroomF	3676	Grooming:	1989-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	DRSMotF	3677	Motor Response:	1989-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	DRSToiletF	3678	Toileting:	1989-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	DRSVerF	3679	Communication Ability:	1989-10-01 - Variable Added 2012-10-01 - Variable Removed

Codes and Values

ID	Code	Description
3672	0	Not Restricted
3672	0.5	Between Not Restricted andSselective Jobs: Competitive ( Code no longer used )
3672	1	Selected Jobs: Competitive
3672	1.5	Between Selected Jobs and Sheltered Workshop ( Code no longer used )
3672	2	Sheltered Workshop: Non-competitive
3672	2.5	Between Sheltered Workshop and Not Employable ( Code no longer used )
3672	3	Not Employable
3672	9.9	Unknown
3673	0	Spontaneous
3673	1	To Speech
3673	2	To Pain
3673	3	None
3673	7	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3673	9	Unknown ( Or assessment not done )
3674	0	Complete
3674	0.5	Between Complete and Partial ( Code no longer used )
3674	1	Partial
3674	1.5	Between Partial and Minimal ( Code no longer used )
3674	2	Minimal
3674	2.5	Between Minimal and None ( Code no longer used )
3674	3	None
3674	7.7	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3674	9.9	Unknown
3675	0	Completely Independent
3675	0.5	Between Completely Independent and Independent in Special Environment ( Code no longer used )
3675	1	Independent in Special Environment
3675	1.5	Between Independent in Special Environment and Mildly Dependent ( Code no longer used )
3675	2	Mildly Dependent: Limited assistance ( Non-resid helper )
3675	2.5	Between Mildly Dependent and Moderately Dependent ( Code no longer used )
3675	3	Moderately Dependent: Moderate assistance ( Person in home )
3675	3.5	Between Moderately Dependent and Markedly Dependent ( Code no longer used )
3675	4	Markedly Dependent: Assist all major activities, all times
3675	4.5	Between Markedly Dependent and Totally Dependent ( Code no longer used )
3675	5	Totally Dependent: 24 hour nursing care
3675	9.9	Unknown
3676	0	Complete
3676	0.5	Between Complete and Partial ( Code no longer used )
3676	1.5	Between Partial and Minimal ( Code no longer used )
3676	2	Minimal
3676	2.5	Between Minimal and None ( Code no longer used )
3676	3	None
3676	7.7	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3676	9.9	Unknown
3677	0	Obeying
3677	1	Localizing
3677	2	Withdrawing
3677	3	Flexing
3677	4	Extending
3677	5	None
3677	7	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3677	9	Unknown ( Or assessment not done, or does not reflect patient's status during the 72 hour window )
3678	0	Complete
3678	0.5	Between Complete and Partial ( Code no longer used )
3678	1	Partial
3678	1.5	Between Partial and Minimal ( Code no longer used )
3678	2	Minimal
3678	2.5	Between Minimal and None ( Code no longer used )
3678	3	None
3678	7.7	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3678	9.9	Unknown ( Or assessment not done, or does not reflect patient's status during the 72 hour window )
3679	0	Oriented
3679	1	Confused
3679	2	Inappropriate
3679	3	Incomprehensible
3679	4	None
3679	7	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3679	9	Unknown ( Or assessment not done, or does not reflect patient's status during the 72 hour window )

History

No history found for the Domain.

EDUCATION: EDUCATION YEARS - ARCHIVE

Definition

Highest grade of school completed - collected categorically

Form

[X] Form 1 (EduYearsOld)
[X] Form 2

Source

• Form 1 - Pre-Injury History (participant or proxy)
• Form 2 - Interview, Mail-out (participant or proxy)

Highest grade of school completed at the time just prior to injury or at follow-up.

Variables

Form Type	Variable	ID	Question	History
Form 1	EduYearsOld	3416	What is the highest grade you have completed?	1989-10-01 - Variable Added 2001-07-01 - Variable Removed
Form 2	SchoolF	3946	Highest grade of school completed:	1989-10-01 - Variable Added 2001-07-01 - Variable Removed

Codes and Values

ID	Code	Description
3416	1.0	8th Grade or Less
3416	2.0	9th - 11th Grade
3416	2.5	GED
3416	3.5	High School Diploma
3416	4.0	Trade School
3416	5.0	Some College: No degree
3416	6.0	Associate Degree ( A.A./ - community college degree )
3416	7.0	Bachelor's Degree
3416	8.0	Master's Degree
3416	9.0	Doctorate ( Includes Ph.D., M.D., etc. )
3416	10.0	Other
3416	999.0	Unknown
3946	1.0	8th Grade or Less
3946	2.0	9th - 11th Grade
3946	2.5	GED
3946	3.5	High School
3946	4.0	Trade School
3946	5.0	Some College ( No diploma )
3946	6.0	Associate Degree ( Community college degree e.g. A.A. )
3946	7.0	Bachelor's Degree
3946	8.0	Master's Degree
3946	9.0	Doctorate ( Includes Ph.D., M.D., etc. )
3946	10.0	Other
3946	999.0	Unknown

History

No history found for the Domain.

EDUCATION: PROBLEMS - ARCHIVE

Definition

Dropped out before high school graduation, expelled, or failed to advance to next grade (held back)

Form

[X] Form 1
[ ] Form 2

Source

• Pre-Injury History (participant or proxy)

Variables

Form Type	Variable	ID	Question	History
Form 1	DropHS	3407	Did you ever have any of the following problems; Dropped out before high school graduation?	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Expelled	3424	Did you ever have any of the following problems; Expelled from School?	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	HeldBack	3477	Did you ever have any of the following problems; Held back a grade?	1997-01-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3407	0	No
3407	1	Yes
3407	2	Variable Did Not Exist
3407	9	Unknown
3424	0	No
3424	1	Yes
3424	2	Variable Did Not Exist
3424	9	Unknown
3477	0	No
3477	1	Yes
3477	2	Variable Did Not Exist
3477	9	Unknown

History

No history found for the Domain.

EMPLOYMENT: CURRENT EMPLOYMENT - ARCHIVE

Definition

Form 1 - Number of employers for whom the patient was competitively employed during the year prior to injury.

Form 2 - Code employment status at annual evaluation. Code up to two, if applicable. If more than two, list the 2 consuming the most time per week.

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

Do not include employment for sub-minimum wage, volunteer work, sheltered employment, employment with a job coach, or illegal activity. No minimum number of hours.

Each time an employer rehires the person, record as a new employer

Record self-employed persons as having one employer.

Contract workers and consultants are considered self-employed

If less than two employment categories are coded, then use code 88 in remaining fields. Do not leave blanks. If patient is in the hospital at the time of annual follow-up, employment status is that status existing at the time of admission to the hospital. Competitive sub-minimum wage employment such as babysitting, newspaper delivery, and piecework should be coded 77. If patient is disabled, code as “other” if patient is receiving income support for his/her disability, if not, code as “unemployed”. If patient is not working but receiving workman’s’ compensation, code as “other”. If more than one, use the following list to prioritize: competitive employment, degree-oriented education, home management (homemaker), supported employment, job-directed/on-the-job training, sheltered employment, non-directed coursework, volunteer activity, active leisure/retirement, disability-related retirement, and no productive activity.

If patient is in jail, code 77 (other), and 88 (No additional codes) .

If participant works in a foreign country, assume wage is not sub-minimum unless there is information to the contrary.

If participant is employed for only part of the month prior to the follow-up evaluation, code employment status as during the majority of the work days during that month.

Characteristics

A third Employment Status was collected until 9/13/1994. No data available.

Variables

Form Type	Variable	ID	Question	History
Form 1	Emp1Old	3417	Primary Employment Status	1989-10-01 - Variable Added 2004-04-01 - Variable Removed
Form 1	Emp2	482	At the time of your injury what was your secondary employment status?	2004-04-01 - Variable Added 2023-04-01 - Variable Removed
Form 1	Emp2Old	3418	Secondary Employment Status	1989-10-01 - Variable Added 2004-04-01 - Variable Removed
Form 2	Emp2F	3693	What is your current secondary employment status?	2003-01-01 - Variable Removed 2004-04-01 - Variable Added
Form 2	EmpaF	3694	Before your injury, what was your employment status?	1989-10-01 - Variable Added 2001-07-01 - Variable Removed
Form 2	Empb	3695	Before your injury, what was your employment status?	1989-10-01 - Variable Added 2001-07-01 - Variable Removed

Codes and Values

ID	Code	Description
482	2	Full Time Student ( Regular class )
482	3	Part Time Student ( Regular class )
482	4	Special Education / Other Non-Regular Education
482	5	Competitively Employed ( Minimum wage or greater, legal or illegal employment, *includes on leave with pay - not related to index injury. )
482	7	Taking Care of House or Family
482	8	Special Employed ( Sheltered workshop, supportive employment, has job coach )
482	9	Retired: Age-related
482	10	Unemployed: Looking ( Looking for work in the 4 weeks prior to injury )
482	11	Volunteer Work
482	12	Retired: Disability
482	13	Unemployed: Not looking ( Not looking for work in 4 weeks prior to injury for any reason )
482	14	Hospitalized Without Pay During Most of 4 Weeks Prior to Injury ( During Most of 4 Weeks Prior to Injury )
482	15	Retired: Other
482	16	On Leave From Work: Not receiving pay
482	55	Other
482	666	Variable Did Not Exist
482	777	Refused
482	888	Not Applicable
482	999	Unknown
3417	2	Full Time Student
3417	3	Part Time Student
3417	4	Special Education/Other Non-Regular Education
3417	5	Competitively Employed
3417	7	Taking Care of House or Family
3417	8	Special Employed
3417	9	Retired
3417	10	Unemployed
3417	11	Volunteer
3417	12	Other
3417	888	Not Applicable
3417	999	Unknown
3693	2	Full Time Student ( Regular class )
3693	3	Part Time Student ( Regular class )
3693	4	Special Education or Other Non-Regular Education
3693	5	Competitively Employed ( Minimum wage or greater, legal or illegal employment, *includes on leave with pay )
3693	7	Taking Care of House or Family
3693	8	Special Employed ( Sheltered workshop, supportive employment, has job coach )
3693	9	Retired ( Age )
3693	10	Unemployed: Looking ( Looking for work in the last 4 weeks )
3693	11	Volunteer Work
3693	12	Retired: Disability
3693	13	Unemployed: Not looking ( Not looking for work in last 4 weeks for any reason )
3693	14	Hospitalized Without Pay ( Not looking for work in the last 4 weeks )
3693	15	Retired: Other
3693	16	On Leave from Work ( Not receiving pay )
3693	55	Other
3693	66	Variable Did Not Exist
3693	77	Refused
3693	88	Not Applicable: No secondary employment status
3693	99	Unknown
3694	2	Full Time Student ( regular class )
3694	3	Part Time Student ( regular class )
3694	4	Special Education or Other Non-Regular Education
3694	5	Competitively Employed ( minimum wage or greater, legal or illegal employment )
3694	7	Homemaker
3694	8	Special Employed ( sheltered workshop, supportive employment, *has job coach )
3694	9	Retired ( age )
3694	10	Unemployed
3694	11	Volunteer Work
3694	12	Other
3694	13	No Additional Codes
3694	999	Unknown
3695	2	Full Time Student ( regular class )
3695	3	Par Ttime Student ( regular class )
3695	4	Special Education or Other Non-Regular Education
3695	5	Competitively Employed ( minimum wage or greater, legal or illegal employment )
3695	7	Homemaker
3695	8	Special Employed ( sheltered workshop, supportive employment, *has job coach )
3695	9	Retired ( age )
3695	10	Unemployed
3695	11	Volunteer Work
3695	77	Other
3695	88	No Additional Codes
3695	99	Unknown

History

No history found for the Domain.

EMPLOYMENT: EMPLOYERS LEFT - ARCHIVE

Definition

Number of times the patient left a job (competitive employment only) for any reason during the year prior to injury (pre-injury) /in the last year (follow-up).

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

Include: being fired, laid off, asked to resign, quit, left because work was completed. Count each time the patient left a particular job, if left more than once. Ask this question if the person has been competitively employed since the last evaluation even if not currently competitively employed.

Variables

Form Type	Variable	ID	Question	History
Form 1	EmpLeftJob	3419	Number of Times Left a Job	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	EmpLeftJobF	3696	Number of Times Left a Job	2001-07-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3419	66	Variable Did Not Exist
3419	88	Not Applicable: No competitive employment
3419	99	Unknown
3696	66	Variable Did Not Exist
3696	88	Not Applicable: No competitive employment since last evaluation
3696	99	Unknown

History

Date	Description
2002-01-01	Changed DEFINITION : added (competitive employment only)
2002-04-01	Changed CODE : added "Not competitevely employed" to code "88 - Not Applicable".
2002-07-01	Changed CODE : changed description to "No competitive employment since last evaluation" from "Not competitevely employed" for code "88 - Not Applicable".
2002-07-01	Added NOTE : "Ask this question if the person has been competitively employed since the last evaluation even if not currently competitively employed".

EMPLOYMENT: EMPLOYMENT - CALCULATED ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	JOBSTABILITY	515	Weeks Employed in Paid Competitive Employment	2001-07-01 - Variable Added 2023-07-01 - Variable REMOVED
Form 2	JOBSTABILITYF	719	Weeks of Paid Competitive Employment	2001-01-01 - Variable Removed 2023-07-01 - Variable REMOVED

Codes and Values

ID	Code	Description
515	666	Variable Did Not Exist
515	777	Refused
515	999	Unknown
719	66	Variable Did Not Exist
719	77	Refused
719	99	Unknown

History

No history found for the Domain.

EMPLOYMENT: HOURS WORKED - ARCHIVE

Definition

Average number of hours per week usually worked at all paid competitive jobs (minimum wage or greater) in the month prior to injury. Includes illegal employment (see Employment Status [EMP] for more information and for data collection instructions).

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

To be collected if participant is currently competitively employed or special employed/on modified duty.
Skip this question if the person is not currently competitively employed. Fractions are to be rounded to the nearest whole number. 0.5 should be rounded upward.

Code actual number of hours per week only for those cases coded “05. Competitively Employed” in either the primary or secondary status of Employment Status [EMP]. Otherwise this variable must be coded “888. Not Applicable: Not currently competitively employed.”

If patient was employed more than 98 hours per week, code as 98 hours.

If patient works two jobs, add all hours together to code.

For “as needed” or sporadic employment, hours per week are calculated from the hours worked in the month prior to the evaluation.

If the participant notes significant variation in the number of hours worked per week, an estimation of the average hours worked can be calculated based on the individual’s reported routine. For example, if the person works 60 hours per week for half of the year and 20 hours per week for the other half of the year, they could be averaged to 40 hours per week ((60 + 20) / 2 = 40). The key is for the interviewer to assist with the calculations but do so out-loud so that the participant can determine if the correct assumptions were made and the participant can agree and give approval of the final result.)

Code as “888 - NA” if the person is not currently competitively employed.

Characteristics

When missing data codes were changed from 88 and 99 to 888 and 999 (4/1/05), the TBINDC changed all 88 and 99 codes in the database to 888 and 999. (There were almost no other codes in the 80-100hr/wk range.)

Variables

Form Type	Variable	ID	Question	History
Form 1	EmpHr	483	Average number of hours worked per week in the month before injury?	1989-10-01 - Variable Added 2022-07-01 - Variable Removed
Form 2	EmpHrF	671	About how many hours per week do you work at a regular job?	1989-10-01 - Variable Added 2022-04-01 - Variable Removed

Codes and Values

ID	Code	Description
483	777	Refused
483	888	Not Applicable: Not competitively employed
483	999	Unknown
671	777	Refused
671	888	Not Applicable: Not currently competitively employed
671	999	Unknown

History

Date	Description
1995-07-01	Added NOTE : clarifying when to code variable in relationship to variable Employment status.
1998-09-01	Added NOTE : regarding coding hours greater than 98.
1999-04-02	Added NOTE : regarding hours for more than one job.
2001-07-01	Changed DEFINITION : from "Average number of hours per week paid competitive employment (minimum wage or greater) at time of injury" to "Average number of hours per week usually worked in all paid competitive jobs (minimum wage or greater) in the month prior to evaluation."
2002-01-01	Added NOTE : code this variable if “05 - competitive employment” is coded for employment status
2002-04-01	Changed NOTE : added “not competitively employed” to code “888 - Not Applicable”.
2002-07-01	Changed NOTE : added “currently” to code “888 - Not Applicable”.
2002-07-01	Added NOTE : added instruction to skip this question if the person is not currently competitively employed.
2006-01-01	Changed DEFINITION : added that this includes illegal employment.
2006-01-01	Added CODE : "777 - Refused".
2006-01-01	Added NOTE : code "999 - Unknown" if data collector does not ask question because employment was illegal.
2021-10-01	Added NOTE : o “If the participant notes significant variation in the number of hours worked per week, an estimation of the average hours worked can be calculated based on the individual’s reported routine. For example, if the person works 60 hours per week for half of the year and 20 hours per week for the other half of the year, they could be averaged to 40 hours per week ((60 + 20) / 2 = 40). The key is for the interviewer to assist with the calculations but do so out-loud so that the participant can determine if the correct assumptions were made and the participant can agree and give approval of the final result.)

EMPLOYMENT: NUMBER EMPLOYERS - ARCHIVE

Definition

Number of employers for whom the patient was competitively employed during the year prior to injury (pre-injury)/in the last year (follow-up).

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

Do not include employment for sub-minimum wage, volunteer work, sheltered employment, employment with a job coach, or illegal activity. No minimum number of hours.

Each time an employer rehires the person, record as a new employer

Record self-employed persons as having one employer.

Contract workers and consultants are considered self-employed

Ask this question if the person has been competitively employed since the last evaluation even if not currently competitively employed.

Variables

Form Type	Variable	ID	Question	History
Form 1	EmpNumber	3420	Number of Employers	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	EmpNumberF	3697	Number of Employers	2001-07-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3420	66	Variable Did Not Exist
3420	88	Not Applicable ( No competitive employment )
3420	99	Unknown
3697	66	Variable Did Not Exist
3697	88	Not Applicable: No competitive employment since last evaluation
3697	99	Unknown

History

No history found for the Domain.

EMPLOYMENT: VOCATIONAL SERVICES - ARCHIVE

Definition

To identify vocational service utilization ASK
“Some people get vocational services, which means therapy services mainly for the purpose of helping them return to work or to get and keep a job. These services could be from a therapist, coach, vocational rehab counselor, or some other professional who does work related rehabilitation.”

[Examples include services starting with the word “Job” (or “work” or “vocational”) such as: job; work;vocational;counseling, club, group, coaching, training, advising, program, education, development, placement service, trial, follow-up, follow-along, etc.]

1. Since your last follow-up on (MM/DD/YYYY), have you received any services like these to help you to return to work, or to get a job?

[Skip question (b) and code “n/a” if you already know that the participant has not worked at all during the queried interval]

2. Since your last follow-up on (MM/DD/YYYY), have you received any services like these after you started working, to help you keep or do well at the job?

Form

[ ] Form 1
[X] Form 2

Source

• Interview, Mail-out (participant or proxy)

Details

Vocation Services should be since the last follow-up (not the last year). The last follow-up is defined as “since the initial injury” for year 1 follow-ups. For subsequent follow-ups, the last follow-up is defined as “the last successful follow-up with the participant”.

Characteristics

Between 10/1/2007 and 3/31/2009, data were collected with an emphasis on “since the last scheduled follow-up”.

In the last year (for 1, 2 year follow-ups),
In the last 3 years (for 5 year follow-ups),
In the last 5 years (for 10 year follow-ups),
…have you received any services like these to help you return to work, or to get a job?

Starting 4/1/2009, data were collected with an emphasis on “since last successful follow-up”.

Since your last follow-up on (DD/MM/YYYY), have you received any services like these to help you return to work, or to get a job?

On 4/1/2008, added code: ‘7’ Retired: Age-related. to JobServices

Variables

Form Type	Variable	ID	Question	History
Form 2	JobServices	3745	Have you received any services like these to help you return to work or to get a job?	2007-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	JobServicesAfter	3746	Have you received any services like these after you started working, to help you keep or do well at the job?	2007-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	JobServicesComments	3747	Explanation of unknown on prior questions	2007-10-01 - Variable Added 2008-10-01 - Variable Removed

Codes and Values

ID	Code	Description
3745	1	No
3745	2	Yes
3745	6	Variable Did Not Exist
3745	7	Retired: Age-related
3745	9	Unknown
3746	1	No
3746	2	Yes
3746	6	Variable Did Not Exist
3746	7	Retired: Age-related
3746	8	Not Applicable: No paid job in interval queried
3746	9	Unknown

History

Date	Description
2008-04-01	Added CODE : "7 - Retired: Age Related"
2009-04-01	Added NOTE : Changed question from “since last scheduled follow-up” to “last successful follow-up”

EMPLOYMENT: WEEKS WORKED - ARCHIVE

Definition

Empwk - Number of weeks patient was competitively employed during the year prior to injury. Includes illegal employment (see Employment Status [EMP] for more information and for data collection instructions).

Empwkf
- At year 1 follow-up = Number of weeks of competitive employment during the year after injury. Includes illegal as well as legal employment.

• At all other followups = Number of weeks of competitive employment in the last year. Includes illegal as well as legal employment.

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

Include all weeks employed at minimum wage or higher. * Include vacation time and other types of leave if the person was paid during that time.

Round partial weeks up to the nearest whole week.

Weeks worked should be calculated by multiplying the number of months by 4.

If employment is infrequent but on a regularly scheduled basis, or if it is related to a specific function, then code the number of weeks during which the person has been employed. But, if days of employment are just random and the person might or might not do it again, then code the total number of weeks in which the person worked. (E.g., if the person worked 2 times a month for 9 months, then in the first situation 39 weeks should be coded. In the second situation 18 weeks should be coded.)

At follow-up, ask this question if the person has been competitively employed since the last evaluation, even if not currently competitively employed.

Variables

Form Type	Variable	ID	Question	History
Form 1	EmpWk	485	Number of weeks employed in the year before injury?	2001-07-01 - Variable Added 2022-07-01 - Variable Removed
Form 2	EmpWkF	673	In the past year, how many weeks did you work at a regular job?	2001-07-01 - Variable Added 2022-04-01 - Variable Removed

Codes and Values

ID	Code	Description
485	666	Variable Did Not Exist
485	777	Refused
485	888	Not Applicable: No competitive employment in the last year
485	999	Unknown
673	666	Variable Did Not Exist
673	777	Refused
673	888	Not Applicable: No competitive employment in the last year
673	999	Unknown

History

Date	Description
2002-04-01	Changed CODE : added “not competitively employed during prior year” to code “88 - Not Applicable”.
2002-07-01	Added NOTE : to ask this question even if person is not currently competitively employed.
2002-07-01	Changed CODE : to "88 - Not Applicable: no competitive employment in the last year"
2003-01-01	Added NOTE : about coding infrequent employment.
2004-07-01	Changed DEFINITION : changed time period from "since the last evaluation" to "in the last year"
2006-01-01	Changed DEFINITION : to include illegal employment.
2006-01-01	Added CODE : "77 - Refused".
2006-01-01	Added NOTE : to code "99 - Unknown" if data collector does not ask because employment was illegal.
2006-01-01	Deleted NOTE : that this include only legal employment.
2014-10-01	Added NOTE : Weeks worked should be calculated by multiplying the number of months by 4.

FAMILY ASSESSMENT - ARCHIVE

Definition

The McMaster Family Assessment Device (FAD) is designed to measure family functioning as described in the McMaster Model of Family Functioning. The General Functioning Scale of the FAD, used in Form II, is designed to distinguish dysfunctional families from well-functioning families. For the purposes of the TBIMS, the FAD is asked only of one significant other who considers him/herself to be a member of the person with brain injury’s family. See Appendix R for the items in the General Functioning Scale. Collect in follow-up years one and two.

Assess the impact of TBI on the family.

Form

[ ] Form 1
[X] Form 2

Source

• Interview (proxy only)

Details

Only collected at years 1 and 2.

The FAD is copyrighted; each Center must purchase a license, which includes the right to reproduce the data collection form.

Record the responses of only of one family member. It is not necessary to interview more than one family member.

Available in Spanish, French, Chinese, Hungarian, and Afrikaans

Variables

Form Type	Variable	ID	Question	History
Form 2	FADAcceptIndiv	3699	Family Assessment Device - Individuals are accepted for what they are	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADAcceptWe	3700	Family Assessment Device - We feel accepted for what we are	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADAvoid	3701	Family Assessment Device - We avoid discussing our fears or concerns	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADBadFeel	3702	Family Assessment Device - There are lots of bad feelings in the family	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADConfide	3703	Family Assessment Device - We confide in each other	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADCrisis	3704	Family Assessment Device - In times of crisis we can turn to each other for support	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADDecide	3705	Family Assessment Device - Making decisions is a problem for our family	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADExpress	3706	Family Assessment Device - We can express feelings to each other	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADGetAlong	3707	Family Assessment Device - We don't get along well together	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADMemberFam	3708	Family Assessment Device - Consider self a member of the family	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADMisunderstand	3709	Family Assessment Device - Planning family activities is difficult because we misunderstand each other	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADSad	3710	Family Assessment Device - We cannot talk to each other about the sadness we feel	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADSolve	3711	Family Assessment Device - We are able to make decisions about how to solve problems	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	FADTCC	3712	Family Assessment Device - Completion Code	2001-07-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3699	1	Strongly Agree
3699	2	Agree
3699	3	Disagree
3699	4	Strongly Disagree
3699	7	Not Due
3699	8	Not Applicable: No significant other
3699	9	Unknown
3700	1	Strongly Agree
3700	2	Agree
3700	3	Disagree
3700	4	Strongly Disagree
3700	7	Not Due
3700	8	Not Applicable: No significant other
3700	9	Unknown
3701	1	Strongly Agree
3701	2	Agree
3701	3	Disagree
3701	4	Strongly Disagree
3701	7	Not Due
3701	8	Not Applicable: No significant other
3701	9	Unknown
3702	1	Strongly Agree
3702	2	Agree
3702	3	Disagree
3702	4	Strongly Disagree
3702	7	Not Due
3702	8	Not Applicable: No significant other
3702	9	Unknown
3703	1	Strongly Agree
3703	2	Agree
3703	3	Disagree
3703	4	Strongly Disagree
3703	7	Not Due
3703	8	Not Applicable: No significant other
3703	9	Unknown
3704	1	Strongly Agree
3704	2	Agree
3704	3	Disagree
3704	4	Strongly Disagree
3704	7	Not Due
3704	8	Not Applicable: No significant other
3704	9	Unknown
3705	2	Agree
3705	3	Disagree
3705	4	Strongly Disagree
3705	7	Not Due
3705	8	Not Applicable: No significant other
3705	9	Unknown
3706	1	Strongly Agree
3706	2	Agree
3706	3	Disagree
3706	4	Strongly Disagree
3706	7	Not Due
3706	8	Not Applicable: No significant other
3706	9	Unknown
3707	1	Strongly Agree
3707	2	Agree
3707	3	Disagree
3707	4	Strongly Disagree
3707	7	Not Due
3707	8	Not Applicable: No significant other
3707	9	Unknown
3708	1	Strongly Agree
3708	2	Agree
3708	3	Disagree
3708	4	Strongly Disagree
3708	7	Not Due
3708	8	Not Applicable: No significant other
3708	9	Unknown
3709	1	Strongly Agree
3709	2	Agree
3709	3	Disagree
3709	4	Strongly Disagree
3709	7	Not Due
3709	8	Not Applicable: No significant other
3709	9	Unknown
3710	1	Strongly Agree
3710	2	Agree
3710	3	Disagree
3710	4	Strongly Disagree
3710	7	Not Due
3710	8	Not Applicable: No significant other
3710	9	Unknown
3711	1	Strongly Agree
3711	2	Agree
3711	3	Disagree
3711	4	Strongly Disagree
3711	7	Not Due
3711	8	Not Applicable: No significant other
3711	9	Unknown
3712	1	Not Due
3712	3	Lost to Follow-up or Expired
3712	4	Forms Mailed Not Returned
3712	5	Stated Refusal
3712	6	Variable Did Not Exist
3712	7	No Adequate Family Member
3712	8	Questionnaire Administered
3712	9	Unknown

History

No history found for the Domain.

FIM: BATHING - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMBathA	489	Bathing:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMBathD	490	Bathing:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
489	0	Activity Does Not Occur
489	1	Total Assist ( < 25% )
489	2	Maximal Assist ( 25 - 49% )
489	3	Moderate Assist ( 50 - 74% )
489	4	Minimal Assist ( >= 75% )
489	5	Supervision ( 100% )
489	6	Modified Independence ( Extra time, device )
489	7	Complete Independence ( Timely, safely )
489	99	Unknown: Assessed at more than 72 hours
489	66	Variable Did Not Exist
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: BED TRANSFER - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMBedTransA	489	Bed, chair, wheelchair transfers:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMBedTransD	490	Bed, chair, wheelchair transfers:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
489	0	Activity Does Not Occur
489	1	Total Assist ( < 25% )
489	2	Maximal Assist ( 25 - 49% )
489	3	Moderate Assist ( 50 - 74% )
489	4	Minimal Assist ( >= 75% )
489	5	Supervision ( 100% )
489	6	Modified Independence ( Extra time, device )
489	7	Complete Independence ( Timely, safely )
489	99	Unknown: Assessed at more than 72 hours
489	66	Variable Did Not Exist
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: BLADDER ACCIDENT - ARCHIVE

Because the admission FIM evaluation must be done at the end of the first 3 days after rehab admission, the assessment time period therefore includes the 4 days prior to rehab admission. If information is not available from this 4-day period, then treat only the 3 days after rehab admission as the assessment time period. No adjustment in scoring of items Bladder and Bowel Frequency of Accidents is made when the assessment time period is shorter than 7 days.

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMBladAccA	486	Bladder management - frequency of accidents:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMBladAccD	486	Bladder management - frequency of accidents:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
486	1	Five or More Accidents in the Past 7 Days
486	2	Four Accidents in the Past 7 Days
486	3	Three Accidents in the Past 7 Days
486	4	Two Accidents in the Past 7 Days
486	5	One Accident in the Past 7 Days
486	6	No Accidents: Uses device ( Catheter, ostomy )
486	7	No Accidents
486	99	Unknown: Assessed at more than 72 hours
486	66	Variable Did Not Exist

History

No history found for the Domain.

FIM: BLADDER ASSISTANCE - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMBladAsstA	490	Bladder management - level of assistance:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMBladAsstD	490	Bladder management - level of assistance:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: BLADDER MANAGEMENT - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMBladMgtA	490	Bladder management:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMBladMgtD	490	Bladder management:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: BOWEL ACCIDENT - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMBwlAccA	486	Bowel management - frequency of accidents:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMBwlAccD	486	Bowel management - frequency of accidents:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
486	1	Five or More Accidents in the Past 7 Days
486	2	Four Accidents in the Past 7 Days
486	3	Three Accidents in the Past 7 Days
486	4	Two Accidents in the Past 7 Days
486	5	One Accident in the Past 7 Days
486	6	No Accidents: Uses device ( Catheter, ostomy )
486	7	No Accidents
486	99	Unknown: Assessed at more than 72 hours
486	66	Variable Did Not Exist

History

No history found for the Domain.

FIM: BOWEL ASSISTANCE - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMBwlAsstA	490	Bowel management - level of assistance:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMBwlAsstD	490	Bowel management - level of assistance:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: BOWEL MANAGEMENT - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMBwlMgtA	490	Bowel management:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMBwlMgtD	490	Bowel management:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: COMPREHENSION - ARCHIVE

Definition

Comprehension mode includes visual comprehension and auditory comprehension.

Details

Primary mode of comprehension can be coded “B” for both, if visual and auditory comprehension are equally used.

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMCompModeA	3431	FIM1 - Comprehension Mode	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 1	FIMCompModeD	3432	Comprehension Mode	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	FIMCompModeF	3715	Comprehension – Mode:	1989-10-01 - Variable Added 2010-04-01 - Variable Removed

Codes and Values

ID	Code	Description
3431	a	Auditory Comprehension: More than 50% of the time
3431	b	Both Used Equally
3431	v	Visual Comprehension: More than 50% of the time
3431	9	Unknown: Assessed at more than 72 hours
3432	a	Auditory Comprehension: More than 50% of the time
3432	b	Both Used Equally
3432	v	Visual Comprehension: More than 50% of the time
3432	9	Unknown: Assessed at more than 72 hours
3715	8	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3715	9	Unknown
3715	a	Auditory Comprehension: More than 50% of the time
3715	b	Both Used Equally
3715	v	Visual Comprehension: More than 50% of the time

History

No history found for the Domain.

FIM: DRESSING LOWER - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMDrsdwnA	489	Dressing lower body:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMDrsdwnD	490	Dressing lower body:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
489	0	Activity Does Not Occur
489	1	Total Assist ( < 25% )
489	2	Maximal Assist ( 25 - 49% )
489	3	Moderate Assist ( 50 - 74% )
489	4	Minimal Assist ( >= 75% )
489	5	Supervision ( 100% )
489	6	Modified Independence ( Extra time, device )
489	7	Complete Independence ( Timely, safely )
489	99	Unknown: Assessed at more than 72 hours
489	66	Variable Did Not Exist
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: DRESSING UPPER - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMDrupA	489	Dressing upper body:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMDrupD	490	Dressing upper body:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
489	0	Activity Does Not Occur
489	1	Total Assist ( < 25% )
489	2	Maximal Assist ( 25 - 49% )
489	3	Moderate Assist ( 50 - 74% )
489	4	Minimal Assist ( >= 75% )
489	5	Supervision ( 100% )
489	6	Modified Independence ( Extra time, device )
489	7	Complete Independence ( Timely, safely )
489	99	Unknown: Assessed at more than 72 hours
489	66	Variable Did Not Exist
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: EATING - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMFeedA	489	Eating:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMFeedD	490	Eating:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
489	0	Activity Does Not Occur
489	1	Total Assist ( < 25% )
489	2	Maximal Assist ( 25 - 49% )
489	3	Moderate Assist ( 50 - 74% )
489	4	Minimal Assist ( >= 75% )
489	5	Supervision ( 100% )
489	6	Modified Independence ( Extra time, device )
489	7	Complete Independence ( Timely, safely )
489	99	Unknown: Assessed at more than 72 hours
489	66	Variable Did Not Exist
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: EXPRESSION - ARCHIVE

Definition

Expression modes include verbal and non-verbal.

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMExpressModeA	3435	FIM1 - Expression Mode	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 1	FIMExpressModeD	3436	Expression Mode	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	FIMExpressModeF	3716	Expression – Mode:	1989-10-01 - Variable Added 2010-04-01 - Variable Removed

Codes and Values

ID	Code	Description
3435	9	Unknown: Assessed at more than 72 hours
3435	b	Both Used Equally
3435	n	Nonverbal Expression: More than 50% of the time
3435	v	Verbal Expression: More than 50% of the time
3436	9	Unknown: Assessed at more than 72 hours
3436	b	Both Used Equally
3436	n	Nonverbal Expression: More than 50% of the time
3436	v	Verbal Expression: More than 50% of the time
3716	8	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3716	9	Unknown
3716	b	Both Used Equally
3716	n	Nonverbal Expression: More than 50% of the time
3716	v	Verbal Expression: More than 50% of the time

History

No history found for the Domain.

FIM: FIM - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMBathA_Old	3425	Bathing Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMBedTransA_Old	3426	Transfer Bed Chair Wheelchair Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMBladMgtA_Old	3427	Bladder Management Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMBladMgtD_Old	3428	Bladder Management Rehab Discharge	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMBwlMgtA_Old	3429	Bowel Management Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMBwlMgtD_Old	3430	Bowel Management Rehab Discharge	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMDrsdwnA_Old	3433	Dressing Lower Body Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMDrupA_Old	3434	Dressing Upper Body Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMFeedA_Old	3437	Feeding Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMGroomA_Old	3438	Grooming Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMStairsA_Old	3439	Locomotion Stairs Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMToilTransA_Old	3441	Transfer Toilet Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMToiletA_Old	3440	Toileting Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMTubTransA_Old	3442	Tub or Shower Rehab Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMWalkingA_Old	3443	Locomotion Walking on Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	FIMwcA_Old	3444	14b. Locomotion Wheelchair on Admission	1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	FIMBladMgtF_Old	3713		1900-01-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	FIMBwlMgtF_Old	3714		1900-01-01 - Variable Added 2002-04-01 - Variable Removed

Codes and Values

ID	Code	Description
3425	1	Total Assist ( < 25% )
3425	2	Maximal Assist ( 25 - 49% )
3425	3	Moderate Assist ( 50 - 74% )
3425	4	Minimal Assist ( >= 75% )
3425	5	Supervision ( 100% )
3425	6	Modified Independence ( Extra time, device )
3425	7	Complete Independence ( Timely, safely )
3425	66	Variable Did Not Exist
3426	01	Total Assist ( < 25% )
3426	02	Maximal Assist ( 25 - 49% )
3426	03	Moderate Assist ( 50 - 74% )
3426	04	Minimal Assist ( >= 75% )
3426	05	Supervision ( 100% )
3426	06	Modified Independence ( Extra time, device )
3426	07	Complete Independence ( Timely, safely )
3426	66	Variable Did Not Exist
3427	1	Total Assist ( < 25% )
3427	2	Maximal Assist ( 25 - 49% )
3427	3	Moderate Assist ( 50 - 74% )
3427	4	Minimal Assist ( >= 75% )
3427	5	Supervision ( 100% )
3427	6	Modified Independence ( Extra time, device )
3427	7	Complete Independence ( Timely, safely )
3427	66	Variable Did Not Exist
3428	1	Total Assist ( < 25% )
3428	2	Maximal Assist ( 25 - 49% )
3428	3	Moderate Assist ( 50 - 74% )
3428	4	Minimal Assist ( >= 75% )
3428	5	Supervision ( 100% )
3428	6	Modified Independence ( Extra time, device )
3428	7	Complete Independence ( Timely, safely )
3428	66	Variable Did Not Exist
3429	1	Total Assist ( < 25% )
3429	2	Maximal Assist ( 25 - 49% )
3429	3	Moderate Assist ( 50 - 74% )
3429	4	Minimal Assist ( >= 75% )
3429	5	Supervision ( 100% )
3429	6	Modified Independence ( Extra time, device )
3429	7	Complete Independence ( Timely, safely )
3429	66	Variable Did Not Exist
3430	1	Total Assist ( < 25% )
3430	2	Maximal Assist ( 25 - 49% )
3430	3	Moderate Assist ( 50 - 74% )
3430	4	Minimal Assist ( >= 75% )
3430	5	Supervision ( 100% )
3430	6	Modified Independence ( Extra time, device )
3430	7	Complete Independence ( Timely, safely )
3430	66	Variable Did Not Exist
3433	1	Total Assist ( < 25% )
3433	2	Maximal Assist ( 25 - 49% )
3433	3	Moderate Assist ( 50 - 74% )
3433	4	Minimal Assist ( >= 75% )
3433	5	Supervision ( 100% )
3433	6	Modified Independence ( Extra time, device )
3433	7	Complete Independence ( Timely, safely )
3433	66	Variable Did Not Exist
3434	1	Total Assist ( < 25% )
3434	2	Maximal Assist ( 25 - 49% )
3434	3	Moderate Assist ( 50 - 74% )
3434	4	Minimal Assist ( >= 75% )
3434	5	Supervision ( 100% )
3434	6	Modified Independence ( Extra time, device )
3434	7	Complete Independence ( Timely, safely )
3434	66	Variable Did Not Exist
3437	01	Total Assist ( < 25% )
3437	02	Maximal Assist ( 25 - 49% )
3437	03	Moderate Assist ( 50 - 74% )
3437	04	Minimal Assist ( >= 75% )
3437	05	Supervision ( 100% )
3437	06	Modified Independence ( Extra time, device )
3437	07	Complete Independence ( Timely, safely )
3437	66	Variable Did Not Exist
3438	1	Total Assist ( < 25% )
3438	2	Maximal Assist ( 25 - 49% )
3438	3	Moderate Assist ( 50 - 74% )
3438	4	Minimal Assist ( >= 75% )
3438	5	Supervision ( 100% )
3438	6	Modified Independence ( Extra time, device )
3438	7	Complete Independence ( Timely, safely )
3438	66	Variable Did Not Exist
3439	1	Total Assist ( < 25% )
3439	2	Maximal Assist ( 25 - 49% )
3439	3	Moderate Assist ( 50 - 74% )
3439	4	Minimal Assist ( >= 75% )
3439	5	Supervision ( 100% )
3439	6	Modified Independence ( Extra time, device )
3439	7	Complete Independence ( Timely, safely )
3439	66	Variable Did Not Exist
3440	1	Total Assist ( < 25% )
3440	2	Maximal Assist ( 25 - 49% )
3440	3	Moderate Assist ( 50 - 74% )
3440	4	Minimal Assist ( >= 75% )
3440	5	Supervision ( 100% )
3440	6	Modified Independence ( Extra time, device )
3440	7	Complete Independence ( Timely, safely )
3440	66	Variable Did Not Exist
3441	1	Total Assist ( < 25% )
3441	2	Maximal Assist ( 25 - 49% )
3441	3	Moderate Assist ( 50 - 74% )
3441	4	Minimal Assist ( >= 75% )
3441	5	Supervision ( 100% )
3441	6	Modified Independence ( Extra time, device )
3441	7	Complete Independence ( Timely, safely )
3441	66	Variable Did Not Exist
3442	1	Total Assist ( < 25% )
3442	2	Maximal Assist ( 25 - 49% )
3442	3	Moderate Assist ( 50 - 74% )
3442	4	Minimal Assist ( >= 75% )
3442	5	Supervision ( 100% )
3442	6	Modified Independence ( Extra time, device )
3442	7	Complete Independence ( Timely, safely )
3442	66	Variable Did Not Exist
3443	1	Total Assist ( < 25% )
3443	2	Maximal Assist ( 25 - 49% )
3443	3	Moderate Assist ( 50 - 74% )
3443	4	Minimal Assist ( >= 75% )
3443	5	Supervision ( 100% )
3443	6	Modified Independence ( Extra time, device )
3443	7	Complete Independence ( Timely, safely )
3443	9	Unknown: Assessed at more than 72 hours ( Activity does not occur )
3443	66	Variable Did Not Exist
3444	1	Total Assist ( < 25% )
3444	2	Maximal Assist ( 25 - 49% )
3444	3	Moderate Assist ( 50 - 74% )
3444	4	Minimal Assist ( >= 75% )
3444	5	Supervision ( 100% )
3444	6	Modified Independence ( Extra time, device )
3444	7	Complete Independence ( Timely, safely )
3444	8	Not Applicable ( Patient walking not using wheelchair )
3444	9	Unknown: Assessed at more than 72 hours ( Activity does not occur )
3444	66	Variable Did Not Exist

History

No history found for the Domain.

FIM: GROOMING - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMGroomA	489	Grooming:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMGroomD	490	Grooming:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
489	0	Activity Does Not Occur
489	1	Total Assist ( < 25% )
489	2	Maximal Assist ( 25 - 49% )
489	3	Moderate Assist ( 50 - 74% )
489	4	Minimal Assist ( >= 75% )
489	5	Supervision ( 100% )
489	6	Modified Independence ( Extra time, device )
489	7	Complete Independence ( Timely, safely )
489	99	Unknown: Assessed at more than 72 hours
489	66	Variable Did Not Exist
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: LOCOMOTION MODE - ARCHIVE

Definition

According to the UDS procedures for scoring the FIM instrument, “the mode of locomotion for FIM item Walking/Wheelchair must be the same on admission and discharge; if the subject changes the mode of locomotion from admission to discharge (usually wheelchair to walking), record the admission mode and score based on the most frequent mode of locomotion at discharge”. Therefore, for the TBI Model Systems FIM data collection for FIM Walking/Wheelchair, score both modes of locomotion (Walking and Wheelchair) on admission. The total admission score will be calculated by the computer and based on the UDS procedure described above (i.e., if the discharge mode is walking, the admission score for walking is used; if the discharge mode is wheelchair, the admission score for wheelchair is used.

For admission Walking/Wheelchair items, if patient is walking and not using wheelchair, code Wheelchair On Admission as “Not Applicable.” If patient is unable to walk on admission, code Walking On Admission as “1. Total Assist.” If, at discharge or at follow-up, patient is walking AND using a wheelchair, code Walking/Wheelchair - Mode At Discharge/Follow-Up as the more frequently used mode of locomotion. Do not use the code “b. Both” (as is indicated by UDS instructions). If FIM scores provided by your hospital include “b” codes, use all sources of information to determine the more frequent mode of locomotion at the time of evaluation and code either “w” or “c” as appropriate. If the more frequent mode of locomotion cannot be determined, code “Unknown.”

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMLocoD	490	Walking/Wheelchair:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMLocoModeD	491	Walking/Wheelchair mode:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMWalkingA	489	Walking:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMwcA	489	Wheelchair:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
489	0	Activity Does Not Occur
489	1	Total Assist ( < 25% )
489	2	Maximal Assist ( 25 - 49% )
489	3	Moderate Assist ( 50 - 74% )
489	4	Minimal Assist ( >= 75% )
489	5	Supervision ( 100% )
489	6	Modified Independence ( Extra time, device )
489	7	Complete Independence ( Timely, safely )
489	99	Unknown: Assessed at more than 72 hours
489	66	Variable Did Not Exist
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown
491	c	Wheelchair
491	w	Walk
491	66	Variable did not exist
491	99	Unknown: Assessed at more than 72 hours

History

No history found for the Domain.

FIM: STAIRS - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMStairsA	489	Stairs:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMStairsD	490	Stairs:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
489	0	Activity Does Not Occur
489	1	Total Assist ( < 25% )
489	2	Maximal Assist ( 25 - 49% )
489	3	Moderate Assist ( 50 - 74% )
489	4	Minimal Assist ( >= 75% )
489	5	Supervision ( 100% )
489	6	Modified Independence ( Extra time, device )
489	7	Complete Independence ( Timely, safely )
489	99	Unknown: Assessed at more than 72 hours
489	66	Variable Did Not Exist
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: TOILET TRANSFER - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMToilTransA	489	Toilet transfers:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMToilTransD	490	Toilet transfers:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
489	0	Activity Does Not Occur
489	1	Total Assist ( < 25% )
489	2	Maximal Assist ( 25 - 49% )
489	3	Moderate Assist ( 50 - 74% )
489	4	Minimal Assist ( >= 75% )
489	5	Supervision ( 100% )
489	6	Modified Independence ( Extra time, device )
489	7	Complete Independence ( Timely, safely )
489	99	Unknown: Assessed at more than 72 hours
489	66	Variable Did Not Exist
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: TOILETING - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMToiletA	489	Toileting:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMToiletD	490	Toileting:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
489	0	Activity Does Not Occur
489	1	Total Assist ( < 25% )
489	2	Maximal Assist ( 25 - 49% )
489	3	Moderate Assist ( 50 - 74% )
489	4	Minimal Assist ( >= 75% )
489	5	Supervision ( 100% )
489	6	Modified Independence ( Extra time, device )
489	7	Complete Independence ( Timely, safely )
489	99	Unknown: Assessed at more than 72 hours
489	66	Variable Did Not Exist
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FIM: TUB TRANSFER - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	FIMTubTransA	489	Tub or shower transfers:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed
Form 1	FIMTubTransD	490	Tub or shower transfers:	1989-10-01 - Variable Added 2020-06-30 - Variable Removed

Codes and Values

ID	Code	Description
489	0	Activity Does Not Occur
489	1	Total Assist ( < 25% )
489	2	Maximal Assist ( 25 - 49% )
489	3	Moderate Assist ( 50 - 74% )
489	4	Minimal Assist ( >= 75% )
489	5	Supervision ( 100% )
489	6	Modified Independence ( Extra time, device )
489	7	Complete Independence ( Timely, safely )
489	99	Unknown: Assessed at more than 72 hours
489	66	Variable Did Not Exist
490	1	Total Assist ( < 25% )
490	2	Maximal Assist ( 25 - 49% )
490	3	Moderate Assist ( 50 - 74% )
490	4	Minimal Assist ( >= 75% )
490	5	Supervision ( 100% )
490	6	Modified Independence ( Extra time, device )
490	7	Complete Independence ( Timely, safely )
490	66	Variable Did Not Exist
490	99	Unknown

History

No history found for the Domain.

FINANCE: INCOME - ARCHIVE

Definition

Family income of person with brain injury and sources of non-employment income for person with brain injury at follow-up evaluation as reported by the best source of information, which is the person with brain injury unless he or she is considered unreliable or is not available.

1. What is your total family income (approximate combined income of all members of the household)?
   (2a) Do you receive income from the following sources? (This applies only to the person with the brain injury.)
   

1. Supplemental Security Income (SSI)
   
2. Supplemental Security Disability (SSD)
   
3. Temporary Assistance to Needy Families (TA or TANF) (Formerly, Aid to Families with Dependent Children - AFDC)
   
4. State/Local Welfare (incl. General Relief, Home Relief)
   
5. Unemployment Insurance
   
6. Workers’ Compensation
   
7. Private Insurance
   
8. Income from Settlement
   
9. Other non-employment sources
   
10. VA Pension (VA only - not a TBIMS variable)
    
11. Military Pension (VA only - not a TBIMS variable)

INCOMERESP - Person(s) who provided the information for Income and Source questions. This should be the person with TBI unless he/she is unreliable or unavailable.
INCOMEFAM - Family income of person with brain injury, and sources of non-employment income for person with brain injury, as reported by family member or significant other at time of annual evaluation.

Form

[ ] Form 1
[X] Form 2

Source

• Interview, Mail-out (participant or best source)

Details

To collect this variable, see the instructions and advice in external link document “17c.Scripts and Strategies for Collecting Income Variable”.

For source: “Settlement”, exclude legal fees to be paid out of the settlement.

This variable can be collected along with Annual Earnings.

Links

Script Strategies to collect Family Income

Characteristics

All data on income level are available in the calculated variable “income”. In this variable, new data (starting 7/1/01) are merged with old data by transforming the new codes (06-11) into the old code “06”.

In 2003, the TBIMS had difficulty obtaining this information (24% missing data). Eleven Model Systems had 10% or more missing data.

Variables

Form Type	Variable	ID	Question	History
Form 2	IncAmtOth	3724	Monthly Amount - Other	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	IncAmtPvtIns	3725	Monthly Amount - Private Insurance	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	IncAmtSSDI	3727	Monthly Amount - SSDI	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	IncAmtSSI	3728	Monthly Amount - SSI	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	IncAmtSettle	3726	Monthly Amount - Settlement	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	IncAmtTANF	3729	Monthly Amount - TANF	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	IncAmtUnemp	3730	Monthly Amount - Unemployment Insurance	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	IncAmtWelfare	3731	Monthly Amount - Welfare	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	IncAmtWkComp	3732	Monthly Amount - Workers Comp	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	IncFamily	3733	Income - Family Income	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	IncIndiv	3734		1989-10-01 - Variable Added 2002-01-01 - Variable Removed
Form 2	IncRespondent	3735	Respondent to Income Questions	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	IncTypeOth	3736	Sources of Non-Employment Income - Other	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	IncTypePvtIns	3737	Sources of Non-Employment Income - Private Insurance	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	IncTypeSSDI	3739	Sources of Non-Employment Income - SSDI	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	IncTypeSSI	3740	Sources of Non-Employment Income - SSI	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	IncTypeSettle	3738	Sources of Non-Employment Income - Settlement	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	IncTypeTANF	3741	Sources of Non-Employment Income - TANF	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	IncTypeUnemp	3742	Sources of Non-Employment Income - Unemployment Insurance	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	IncTypeWelfare	3743	Sources of Non-Employment Income - Welfare	1989-10-01 - Variable Added 2010-04-01 - Variable Removed
Form 2	IncTypeWkComp	3744	Sources of Non-Employment Income - Workers Comp	1989-10-01 - Variable Added 2010-04-01 - Variable Removed

Codes and Values

ID	Code	Description
3732	1	No
3732	2	Yes
3732	6	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3732	7	Refused
3732	9	Unknown
3733	1	$9,999 or less
3733	2	$10,000 - $19,999
3733	3	$20,000 - $29,999
3733	4	$30,000 - $39,999
3733	5	$40,000 - $49,999
3733	6	$50,000 - $59,999
3733	7	$60,000 - $69,999
3733	8	$70,000 - $79,999
3733	9	$80,000 - $89,999
3733	10	$90,000 - $99,999
3733	11	100,000 or More
3733	55	Data Collected Before Codes 06-11 Existed ( Data exist in calculated variable "income". )
3733	66	Not Applicable: Variable not due this year ( Code no longer used; data now collected at all follow-ups )
3733	77	Refused
3733	88	Not Applicable: No income
3733	99	Unknown
3734	1	$9,999 or Less
3734	2	$10,000 - $19,999
3734	3	$20,000 - $29,999
3734	4	$30,000 - $39,999
3734	5	$40,000 - $49,999
3734	6	$50,000 or More
3734	66	Not Due
3734	77	Refused
3734	88	Not Applicable: No income
3734	99	Unknown
3736	1	No
3736	2	Yes
3736	6	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3736	7	Refused
3736	9	Unknown
3737	1	No
3737	2	Yes
3737	6	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3737	7	Refused
3737	9	Unknown
3738	1	No
3738	2	Yes
3738	6	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3738	7	Refused
3738	9	Unknown
3739	1	No
3739	2	Yes
3739	6	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3739	7	Refused
3739	9	Unknown
3740	1	No
3740	2	Yes
3740	6	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3740	7	Refused
3740	9	Unknown
3741	1	No
3741	2	Yes
3741	6	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3741	7	Refused
3741	9	Unknown
3742	1	No
3742	2	Yes
3742	6	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3742	7	Refused
3742	9	Unknown
3743	1	No
3743	2	Yes
3743	6	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3743	7	Refused
3743	9	Unknown
3744	1	No
3744	2	Yes
3744	6	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3744	7	Refused
3744	9	Unknown

History

Date	Description
1994-08-19	Added NOTE : clarified '1 - Family Income' by adding 'total'.
1994-08-19	Changed DEFINITION : removed statement from question 2 "Do you receive income from the following sources?" , "...in addition to employment income".
1996-04-01	Added CODE : 7 for additional CIQ questions not due this year.
2001-08-20	Added NOTE : about excluding legal fees from settlement amount.
2002-01-01	Added NOTE : that this variable can be collected along with 'Annual Earnings'.
2002-01-01	Added NOTE : about calculated variable that includes new and old cases.
2002-01-01	Added CODE : '99995 Variable did not exist'.
2002-01-01	Changed CODE : 99998 changed from 'NA not due this year' to 'NA no income from this source', which matches Form II.
2002-04-01	Added CODE : '55= Data collected before codes 06-11 existed'. (Data on such cases are available only in a calculated variable that merges current data with data based on the original 01-06 codes.)
2002-04-01	Changed CODE : replace '3 -AFDC' with '3 - TA'.
2003-01-01	Deleted CODE : '66=Not due' (because this variable is always collected in the new, less frequent follow-up schedule).
2004-04-01	Changed DEFINITION : replaced reference to 'annual evaluation' with 'follow-up evaluation'.
2004-07-01	Changed DEFINITION : removed reference to amount of income from supplemental sources.
2004-07-01	Changed CODE : added back the codes for "'Not due this year' plus a statement that the codes are no longer used.
2005-01-01	Changed COD : '88' from 'N/A-no salary' to 'N/A-no income'
2009-01-01	Added CODE : 7 = Refused for items 2a-i.
2009-01-01	Changed CODE : 'Variable not collected this year' (outdated code) reassigned from 7 to 6 for items 2a-i.

FINANCE: WAGE - ARCHIVE

Definition

Number of dollars per hour earned in main job during the month prior to injury (pre-injury) or during the month prior to the annual evaluation (follow-up) (competitive employment only).

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 wage changed during the month, code the amount made during the greatest proportion of the time.

Hourly wage can be calculated by dividing annual salary by number of hours worked per year.

If person is paid by salary but works more than 40 hrs./wk., still use 40 hrs./wk. (x 52 = 2080 hrs./yr.).

Ask only if participant is currently competitively employed

Variables

Form Type	Variable	ID	Question	History
Form 1	Wage	3576	Hourly Wage	2001-07-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	WageF	3978	Hourly Wage	2001-07-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3576	666.66	Variable Did Not Exist
3576	777.77	Refused
3576	888.88	Not Applicable ( No competitive employment in the month prior to injury )
3576	999.99	Unknown
3978	666.66	Variable Did Not Exist
3978	777.77	Stated Refusal to Answer
3978	888.88	Not Applicable: No competitive employment in the month prior to evaluation
3978	999.99	Unknown

History

No history found for the Domain.

FOLLOW-UP - ARCHIVE

Form

• Form 1
• Form 2

Source

• Form 2 - Interview, Mail-Out (participant or proxy)

Variables

Form Type	Variable	ID	Question	History
Form 2	BotherSeizF	601	On a scale of 1 to 5, with 1=no bother and 5=very bothersome, in the last year, how bothersome overall are your seizures in affecting your everyday life?	2017-10-01 - Variable Added 2019-01-15 - Variable Removed
Form 2	CognitiveSeizF	607	On a scale of 1 to 5, with 1=no bother and 5=very bothersome, in the last year, how bothersome are your seizures in affecting your cognitive functioning during everyday life?	2017-10-01 - Variable Added 2019-01-15 - Variable Removed
Form 2	EmotionalSeizF	668	On a scale of 1 to 5, with 1=no bother and 5=very bothersome, in the last year, how bothersome are your seizures in affecting your emotional functioning during everyday life?	2017-10-01 - Variable Added 2019-01-15 - Variable Removed
Form 2	PhysicalSeizF	734	On a scale of 1 to 5, with 1=no bother and 5=very bothersome, in the last year, how bothersome are your seizures in affecting your physical functioning during everyday life?	2017-10-01 - Variable Added 2019-01-15 - Variable Removed
Form 2	SeizAmt	766	How many seizures have you had in the past year?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	SeizInYr	767	(Since your discharge from rehab) or (In the past year) have you had a seizure?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	SeizSncTBI	768	Have you had a seizure(s) since your traumatic brain injury?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	Seizures	3947	Have you been told by a physician that you have had a seizure since your last annual follow-up interview?	1989-10-01 - Variable Added 2005-01-01 - Variable Removed

Codes and Values

ID	Code	Description
601	1	No bother at all
601	2	Some bother
601	3	Moderate bother
601	4	Bothersome
601	5	Very Bothersome
601	6	Variable did not exist
601	8	Not Applicable: No Seizures
601	9	Unknown
601	10	Not Applicable: No data from person with TBI
607	1	No bother at all
607	2	Some bother
607	3	Moderate bother
607	4	Bothersome
607	5	Very Bothersome
607	6	Variable did not exist
607	8	Not Applicable: No Seizures
607	9	Unknown
607	10	Not Applicable: No data from person with TBI
668	1	No bother at all
668	2	Some bother
668	3	Moderate bother
668	4	Bothersome
668	5	Very Bothersome
668	6	Variable did not exist
668	8	Not Applicable: No Seizures
668	9	Unknown
668	10	Not Applicable: No data from person with TBI
734	1	No bother at all
734	2	Some bother
734	3	Moderate bother
734	4	Bothersome
734	5	Very Bothersome
734	6	Variable did not exist
734	8	Not Applicable: No Seizures
734	9	Unknown
734	10	Not Applicable: No data from person with TBI
766	0	Variable Did Not Exist
766	1	One
766	2	2 - 4
766	3	5 - 20
766	4	More than 20
766	8	Not Applicable: No Seizures
766	9	Unknown
767	0	Variable Did Not Exist
767	1	No
767	2	Yes
767	8	Not Applicable: No Seizures
767	9	Unknown
768	0	Variable Did Not Exist
768	1	No
768	2	Yes
768	9	Unknown
3947	1	No Seizure
3947	2	One Seizure
3947	3	More Than One Seizure
3947	9	Unknown

History

No history found for the Domain.

GENERAL HEALTH: GENERAL FUNCTIONING - ARCHIVE

Definition

General Functioning includes appraisal of changes in functional status since discharge from rehab or since the previous follow-up.
- In the area of taking care of yourself and your basic needs at home, like eating, getting bathed and dressed and ready for the day, and using the bathroom, are you doing?
- In the area of physical function, moving around and getting around either on foot or in a wheelchair, getting up and down stairs, and getting in and out of bed, are you doing
- In the area of mental function, like remembering things, communicating and getting along with others, and solving everyday problems, are you doing better, worse, or about the same compared to about (# of years since prior follow-up) years ago?
- In the area of emotional function, like managing your moods and dealing with everyday stress, are you doing better, worse or about the same compared to (# of years since prior follow-up) year(s).

Form

[ ] Form 1
[X] Form 2

Source

• Interview, Mail-out (participant or proxy)

Details

• These questions may be collected from the participant or a proxy if the participant is not available.

Variables

Form Type	Variable	ID	Question	History
Form 2	GeneralCareYourselfF	692	In the area of taking care of yourself and your basic needs at home, like eating, getting bathed and dressed and ready for the day, and using the bathroom, are you doing better, worse, or about the same compared to about (# of years since prior follow-up) years ago?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	GeneralEmotionalFunctionF	692	In the area of emotional function, like managing your moods and dealing with everyday stress, are you doing better, worse or about the same compared to (# of years since prior follow-up) years ago?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	GeneralMentalFunctionF	692	In the area of mental function, like remembering things, communicating and getting along with others, and solving everyday problems, are you doing better, worse, or about the same compared to about (# of years since prior follow-up) years ago?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	GeneralPhyFunctionF	692	In the area of physical function, moving around and getting around either on foot or in a wheelchair, getting up and down stairs, and getting in and out of bed, are you doing better, worse, or about the same compared to about (# of years since prior follow-up) years ago?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed

Codes and Values

ID	Code	Description
692	1	Better
692	2	About The Same
692	3	Worse
692	66	Variable Did Not Exist
692	99	Unknown

History

No history found for the Domain.

GENERAL HEALTH: GENERAL HEALTH - ARCHIVE

Definition

Physical Health over past year - Rating of physical health now compared to one year ago or since discharge from rehab
- Compared to (after your discharge from the rehab center) or (one year ago), how would you rate your physical health in general now? - Thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?

Emotional Health - Rating of emotional health in general now compared to one year ago or since discharge from rehab
- Compared to (after your discharge from the rehab center) or (one year ago), how would you rate your emotional health in general, now (such as feeling anxious, depressed, irritable)?

Form

[ ] Form 1
[X] Form 2

Source

• Interview, Mail-out (participant only)

Variables

Form Type	Variable	ID	Question	History
Form 2	EmotProbF	693	Compared to (after your discharge from the rehab center) or (one year ago), how would you rate your emotional health in general, now (such as feeling anxious, depressed, irritable)?	2012-10-01 - Variable Added 2019-01-15 - Variable Deleted
Form 2	PhysHlthDaysF	3998	Thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?	2012-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	PhysHlthF	693	Compared to (after your discharge from the rehab center) or (one year ago), how would you rate your physical health in general now?	2012-10-01 - Variable Added 2019-01-15 - Variable Deleted

Codes and Values

ID	Code	Description
693	1	Excellent
693	2	Very Good
693	3	Good
693	4	Fair
693	5	Poor
693	66	Variable Did Not Exist
693	82	Not Applicable - No data From Person With TBI
693	99	Unknown
3998	666	Variable Did Not Exist
3998	888	Not Applicable - No Data From Person with TBI
3998	999	Unknown

History

No history found for the Domain.

INJURY COMORBIDITIES: ICD DIAGNOSIS - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	DIAGICD1	443	ICD Diagnosis Code 1	1900-01-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD10	444	ICD Diagnosis Code 10	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD11	445	ICD Diagnosis Code 11	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD12	446	ICD Diagnosis Code 12	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD13	447	ICD Diagnosis Code 13	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD14	448	ICD Diagnosis Code 14	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD15	449	ICD Diagnosis Code 15	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD16	450	ICD Diagnosis Code 16	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD17	451	ICD Diagnosis Code 17	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD18	452	ICD Diagnosis Code 18	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD19	453	ICD Diagnosis Code 19	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD2	454	ICD Diagnosis Code 2	1900-01-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD20	455	ICD Diagnosis Code 20	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD3	456	ICD Diagnosis Code 3	1900-01-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD4	457	ICD Diagnosis Code 4	1900-01-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD5	458	ICD Diagnosis Code 5	1900-01-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD6	459	ICD Diagnosis Code 6	1900-01-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD7	460	ICD Diagnosis Code 7	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD8	461	ICD Diagnosis Code 8	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	DIAGICD9	462	ICD Diagnosis Code 9	2007-10-01 - Variable Added 2017-10-01 - Variable Removed

Codes and Values

ID	Code	Description
443	66666	Variable Did Not Exist
443	88888	No Other Codes
443	99999	Unknown
444	66666	Variable Did Not Exist
444	88888	No Other Codes
444	99999	Unknown
445	66666	Variable Did Not Exist
445	88888	No Other Codes
445	99999	Unknown
446	66666	Variable Did Not Exist
446	88888	No Other Codes
446	99999	Unknown
447	66666	Variable Did Not Exist
447	88888	No Other Codes
447	99999	Unknown
448	66666	Variable Did Not Exist
448	88888	No Other Codes
448	99999	Unknown
449	66666	Variable Did Not Exist
449	88888	No Other Codes
449	99999	Unknown
450	66666	Variable Did Not Exist
450	88888	No Other Codes
450	99999	Unknown
451	66666	Variable Did Not Exist
451	88888	No Other Codes
451	99999	Unknown
452	66666	Variable Did Not Exist
452	88888	No Other Codes
452	99999	Unknown
453	66666	Variable Did Not Exist
453	88888	No Other Codes
453	99999	Unknown
454	66666	Variable Did Not Exist
454	88888	No Other Codes
454	99999	Unknown
455	66666	Variable Did Not Exist
455	88888	No Other Codes
455	99999	Unknown
456	66666	Variable Did Not Exist
456	88888	No Other Codes
456	99999	Unknown
457	66666	Variable Did Not Exist
457	88888	No Other Codes
457	99999	Unknown
458	66666	Variable Did Not Exist
458	88888	No Other Codes
458	99999	Unknown
459	66666	Variable Did Not Exist
459	88888	No Other Codes
459	99999	Unknown
460	66666	Variable Did Not Exist
460	88888	No Other Codes
460	99999	Unknown
461	66666	Variable Did Not Exist
461	88888	No Other Codes
461	99999	Unknown
462	66666	Variable Did Not Exist
462	88888	No Other Codes
462	99999	Unknown

History

No history found for the Domain.

KEYS - ARCHIVE

Please enter notes …

Variables

Form Type	Variable	ID	Question	History
Form 1	GUID_pseudoF		Created GUID:	2015-01-01 - Variable Added 2023-01-15 - Variable Removed
Form 1	Version		Version of form:	1989-10-01 - Variable Added 2023-04-01 - Variable Removed
Form 2	VersionF		Version of form:	1989-10-01 - Variable Added 2023-04-01 - Variable Removed

Codes and Values

No codes found for the given group IDs.

History

No history found for the Domain.

MENTAL HEALTH: PSYCHIATRIC HOSPITALIZATION - ARCHIVE

Definition

Form 1 - PsychHosp and PsychHospPrior

Form 2 - PRespondent and PsyHospF - Determine if the person with brain injury has had psychiatric hospitalizations during the past year; according to the best source of information, which is the person with the brain injury unless she or he is considered unreliable or unavailable.

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	PsychHosp	3503	Psychiatric Hospitalizations	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	PsychHospPrior	3504	Year Prior Psyciatric Hospitalizations	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	PRespondent	3922	Respondent to Physchiatric Questions	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	PsyHospF	741	In the past year, have you been hospitalized for a psychiatric disorder?	1997-01-01 - Variable Added 2015-04-01 - Variable Removed

Codes and Values

ID	Code	Description
741	0	Variable Did Not Exist
741	1	No
741	2	Yes
741	6	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
741	7	Refused
741	9	Unknown
3503	0	Variable Did Not Exist
3503	1	No
3503	2	Yes
3503	9	Unknown
3504	0	Variable Did Not Exist
3504	1	No
3504	2	Yes
3504	9	Unknown
3922	1	Person with TBI
3922	2	Significant Other
3922	3	Person with TBI and Significant Other
3922	6	Variable Did Not Exist
3922	7	Not Due
3922	8
3922	9	Unknown

History

No history found for the Domain.

MENTAL HEALTH: SUICIDE - ARCHIVE

Definition

Suicide Archived Variables

Variables

Form Type	Variable	ID	Question	History
Form 1	SuicideEver	3539	Attempted Suicide	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	SuicideYrPrior	3540	Year Prior to Injury Suicide Attempt	1997-01-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3539	0	Variable Did Not Exist
3539	1	No
3539	2	Yes
3539	9	Unknown
3540	0	Variable Did Not Exist
3540	1	No
3540	2	Yes
3540	9	Unknown

History

No history found for the Domain.

NEUROPSYCH: APHASIA - ARCHIVE

Definition

The raw score and test completion code for the Multilingual Aphasia Examination Token Test. See REFERENCE for details.

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

Raw score (total correct), range = 0 – 44
77 = NA-untestable. Patient unable to reliably complete this test because of cognitive/behavior problems. Autofills when TCC=2.
88 = NA-special version of Battery. Test omitted because abbreviated version of Battery was administered (foreign language or visual impairment). For more information see V150. Autofills when TCC=8.
*99 = NA-patient unavailable. Not tested–due to early discharge, insufficient staffing, scheduling difficulty, refusal. Autofills when TCC=3.

Reference

Benton, A. L., Hamsher, K. deS., Sivan, A. B. (1994). Multilingual Aphasia Examination Manual (3rd ed.). Iowa City, IA: AJA Associates, Inc.

Variables

Form Type	Variable	ID	Question	History
Form 1	MaeRS	3484	Multilingual Aphasia Exam Raw Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	MaeTCC	3485	Multilingual Aphasia Exam Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	MaeRSF	3749	Multilingual Aphasia Exam - Raw Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	MaeTCCF	3750	Multilingual Aphasia Exam - Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3484	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3484	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language or visual impairment) )
3484	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3485	1	Test Completed: Use data
3485	2	Test Attempted: Not completed
3485	3	Test Not Attempted
3485	8	Not Applicable: Special version of battery administered
3749	55	Not Applicable: Battery not due
3749	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3749	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language or visual impairment). )
3749	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3750	1	Test Completed: Use data
3750	2	Test Attempted: Not completed
3750	3	Test Not Attempted
3750	5	Not Applicable: Variable not due this year
3750	8	Not Applicable: Special version of battery administered

History

No history found for the Domain.

NEUROPSYCH: BATTERY - ARCHIVE

Definition

These variables document selected neuropsychological tests administered at the time of annual follow-up evaluation. The Battery Completion Code (below) indicates for a given patient the status of administration of the overall Battery. Test Completion Codes indicate for a given patient the status of administration of individual tests. Follow-up neuropsychological testing will be done for follow-up years 1, 2, 5 and every 5 years thereafter. Refer to each test’s manual for more details on test administration and scoring.

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

All patients must be tested if they are in your qualified rehabilitation facility (including subacute if one is part of your rehabilitation system) at 4 weeks (+/- 2 weeks) post injury. Patients that are too impaired to be tested (i.e., unable to follow simple commands or so agitated as to pose an imminent safety risk to themselves or the examiner) should not be tested. It is not required that testing be attempted on these patients on a subsequent occasion, although if time and resources permit, follow up attempts to retest are encouraged. These cases will not be counted as missing test data for benchmark (target) purposes.

Neuropsychological data collected from disoriented patients should not be included in the National Database.

In general, the tests should be administered within a week of the patient clearing PTA. In some circumstances this may not be possible because the patient was not yet on the rehabilitation service or the patient was discharged from rehabilitation before emerging from PTA. If the patient comes to rehabilitation out of PTA, h/she should be tested as soon as possible. If a patient is discharged in PTA but is oriented and tested within 4 weeks of discharge, the data may be included in the Form I.

Attempt to complete testing regardless of their PTA status. It’s better to attempt testing rather than having no data.

Patients who were not tested due to failure to approach, scheduling problems, etc. will be counted as missing data for benchmark purposes.

Patients who were not available during the testing window (4 weeks +/- 2 weeks) due to being discharged from rehabilitation prior to 2 weeks post-injury or not admitted to rehabilitation before 6 weeks post-injury will not be counted as missing data for benchmark purposes. However, these patients should be tested if possible even though the testing will occur outside the window as these data may be useful for some analyses. If battery is completed or partially completed, but outside the testing window use code 1 or 2.

Testing can be performed by a trained research assistant. Record the date of testing and assign appropriate test and battery completion codes. Test scores should be left blank if the test was not administered.

Testing should be completed within 24 hours whenever possible. Once initiated, if testing is not completed within 72 hours(3 days), the tests not administered should be considered missing data. The first date of testing should be recorded as the Battery Start Date.

Use Battery Completion Code 8 and date code 08/08/8888 for Form IIs completed on years when neuropsychological testing is not due (i.e., 3, 4, 6, etc.).

If testing does not occur because the patient did not emerge from PTA before discharge and did not return for testing as an outpatient within 4 weeks, code the battery completion code as “2=battery not given” and all test completion codes as “3=test not attempted”.

TESTING PATIENTS WITH IMPAIRMENTS: Administer the appropriate impairment battery as outlined below if the impairment is significant and well defined before beginning the testing session. (E.g., the patient is visually impaired in both eyes, so the Visual Impairment Battery will be administered.) The Battery Completion Code [BCC] will reflect the battery administered, and the Test Completion Code [TCC] for tests not administered will be “3”. If an impairment becomes significant during administration of a standard battery, the BCC will reflect the impairment. The TCC would be 1 for tests completed if the examiner felt the data to be valid. Any tests discontinued or not administered would be coded as appropriate 2 or 3. E.g., the patient developed visual problems and was unable to complete Trail Making A and B, Block Design, and Symbol Digit Modality Test, but was able to complete Token Test and Peg Board. The BCC would be 7 and the TCC for the completed tests would be 1, and 3 for tests not administered.

Test Completion Codes: These codes are assigned to indicate whether a test was administered and the quality of the patient’s performance. Ideally, every patient will be able to complete each test despite physical, intellectual, or behavioral problems. It is very likely that some patients will be unable to complete some tests according to standard procedures. Test completion codes are used to help clarify the quality of the patient’s performance and subsequent scores in a particular cognitive area.
1-Test administered – patient responded in a manner consistent with the demands of the test. Patient may have performed well or poorly . No validity problems Enter the patient’s score. The patient need not complete the Trail Making Test Part A or B within time limits to receive this code if he/she was making progress on the test.
2-Test administration attempted – patient could not or would not respond in a manner consistent with the demands of the test as a result of the severity of brain injury. The lowest possible score is assigned (can include the patient who draws a smiley face on TMT, talks about going home on CVLT-II instead of giving words, etc.) This code should also be used for a patient who initially complies with the task demand but then refuses to complete the test, gives up, or begins responding in a manner inconsistent with the task demands. Enter the worst raw score and corresponding standardized T-score for the test.
3-Test administration not attempted – test not completed due to non-neurological factors outside the control of the site, such as intubation, peripheral injuries, or systemic illness throughout the testing window.
4-Test administration not attempted – Non-English speaking patient.
5-Test administration not attempted – site specific reasons such as unavailability of materials or staff to complete the test, or discharge of patient.
7-Test administration not attempted – patient refused
8-Not applicable – no tests administered
9-Unknown

Variables

Form Type	Variable	ID	Question	History
Form 1	BatteryCC	406	Battery Completion Code	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	BatteryCC_Old	3342	Battery Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	BatteryDate	407	Battery Start Date	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	NeurStartDate	3491	Neuropsychological Battery Start Date	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	BatteryCCF	3591	Battery Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NeuroNotAdmin	3757	Reason Battery Not Administered	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NeuroNotAdminOth	3758	Other Reason Battery Not Administered	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NeuroStartDateF	3759	Date Started	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
406	0	Variable Did Not Exist
406	1	Standard Administration of Battery
406	2	Partial Administration
406	3	Standard or Partial Administration in a Language Other Than English
406	4	Battery Not Given: Patient not testable due to effects of TBI
406	5	Battery Not Given: Non-English speaking patient
406	6	Battery Not Given: Patient not in rehab during the specified window
406	7	Battery Not Given: Other reasons, site specific
406	77	Battery Not Given: Patient was fully oriented and refused, or family refused on patient's behalf
406	99	Unknown
407	06/06/6666	Variable Did Not Exist
407	08/08/8888	Not Applicable: Battery not given
407	09/09/9999	Unknown
3342	1	Partial Completion ( Some tests not given/completed )
3342	2	Not Applicable: Battery not given
3342	3	Standard Administration of Battery
3342	4	Spanish Version Administered
3342	5	Other Language Version Administered
3342	6	Motor Impairment Version Administered
3342	7	Visual Impairment Version Administered
3491	08/08/8888	Not Applicable
3491	09/09/9999	Unknown
3591	1	Partial Completion ( Some tests not given/completed )
3591	2	Battery Not Given
3591	3	Standard Administration of Battery
3591	4	Spanish Version Administered
3591	5	Other Language Version Administered
3591	6	Motor Impairment Version Administered
3591	7	Visual Impairment Version Administered
3591	8	Battery Not Due This Follow-up year
3757	0	Variable Did Not Exist
3757	1	Neuropsychological Battery Not Due
3757	2	Is Still in Persistent Vegetative State
3757	3	Is Unable to be Tested Due to Severe Cognitive or Behavioral Problems
3757	4	Is Working and Unable or Unwilling to Schedule Appointment
3757	5	Is Attending School and Unable or Unwilling to Schedule Appointment
3757	6	Is Unable to Arrange Transportation to Travel to The Center
3757	7	Was Scheduled to Return to the Center for Testing, but did not Show for Appointment
3757	8	Has Stated Refusal to Take Part in Neuropsychological Testing
3757	9	Has Not Responded to Contact
3757	10	Other Reasons
3757	88	Not Applicable
3757	99	Unknown
3759	08/08/8888	Not Applicable
3759	09/09/9999	Unknown

History

Date	Description
2008-04-01	Added NOTE : If battery is completed or partially completed but outside the testing window use code 1 or 2
2008-04-01	Added CODE : 8 NA No Tests administered. To be used only when Battery completion code is 4-7
2008-10-01	Added CODE : Battery completion code changed 99 to Unknown, added 77 patient refused. Added 7 patient refused to test completion codes
2010-07-01	Deleted CODE : for test completion code 5 regarding patient refusal, as refusals should be included under code 7 which was added 10/1/2008.
2013-10-01	Changed CODE : clarified code '77 -Refused' to include "or family refused on patient's behalf."
2014-02-26	Added NOTE : regarding the completion of neuropsych battery within 72 hours.

NEUROPSYCH: BENTON - ARCHIVE

Definition

The total score on the Benton Visual Discrimination Test and test completion code. See REFERENCE for details.

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

Record total score, range = 0-32.

Reference

Benton, A. L., Sivan, A. B., Hamsher, K. deS., Varney, N. R., & Spreen, O. (1994). Contributions to neuropsychological assessment (2nd ed.). New York: Oxford University Press.

Variables

Form Type	Variable	ID	Question	History
Form 1	BenTCC	3343	Benton Visual Discrimination Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	BenTS	3344	Benton Visual Discrimination Total Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	BenTCCF	3592	Benton Visual Discrimination Test - Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	BenTSF	3593	Benton Visual Discrimination Test - Total Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3343	1	Test Completed: Use data
3343	2	Test Attempted: Not completed
3343	3	Test Not Attempted
3343	8	Not Applicable: Special version of battery administered
3344	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3344	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (visual impairment) )
3344	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3592	1	Test Completed: Use data
3592	2	Test Attempted: Not completed
3592	3	Test Not Attempted
3592	5	Not Applicable: Variable not due this year
3592	8	Not Applicable: Special version of battery administered
3593	55	Not Applicable: Battery not due
3593	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3593	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (visual impairment) )
3593	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )

History

No history found for the Domain.

NEUROPSYCH: BTACT - ARCHIVE

Definition

BTACT - Archived Variables

Variables

Form Type	Variable	ID	Question	History
Form 1	BackCountAtt	399	Backward counting times attempted	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 1	BackDigitAtt	403	Backward digit span times attempted	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 1	DelayWordRecallAtt	439	Delayed recall times attempted	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 1	FluencyAtt	496	Fluency times attempted	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 1	ReasonAtt	543	Reason times attempted:	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 1	WordRecallAtt	563	Word recall times attempted	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 2	BackCountAttF	591	Backward counting times attempted	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 2	BackDigitAttF	597	Backward digit span times attempted	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 2	DelayWordRecallAttF	620	Delayed recall times attempted	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 2	FluencyAttF	681	Fluency times attempted:	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 2	ReasonAttF	748	Reason times attempted:	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 2	WordRecallAttF	784	Word recall times attempted	2017-10-01 - Variable Added 2018-10-01 - Variable Removed

Codes and Values

ID	Code	Description
399	1	1st attempt
399	2	2nd attempt
399	3	3rd attempt
399	4	4th attempt
399	5	5th attempt
399	66	Variable Did Not Exist
399	99	Not Applicable: Test not given
403	1	1st attempt
403	2	2nd attempt
403	3	3rd attempt
403	4	4th attempt
403	5	5th attempt
403	66	Variable Did Not Exist
403	99	Not Applicable: Test not given
439	1	1st attempt
439	2	2nd attempt
439	3	3rd attempt
439	4	4th attempt
439	5	5th attempt
439	66	Variable Did Not Exist
439	99	Not Applicable: Test not given
496	1	1st attempt
496	2	2nd attempt
496	3	3rd attempt
496	4	4th attempt
496	5	5th attempt
496	66	Variable Did Not Exist
496	99	Not Applicable: Test not given
543	1	1st attempt
543	2	2nd attempt
543	3	3rd attempt
543	4	4th attempt
543	5	5th attempt
543	66	Variable Did Not Exist
543	99	Not Applicable: Test not given
563	1	1st attempt
563	2	2nd attempt
563	3	3rd attempt
563	4	4th attempt
563	5	5th attempt
563	66	Variable Did Not Exist
563	99	Not Applicable: Test not given
591	1	1st attempt
591	2	2nd attempt
591	3	3rd attempt
591	4	4th attempt
591	5	5th attempt
591	66	Variable Did Not Exist
591	88	Not Applicable: Test not given
597	1	1st attempt
597	2	2nd attempt
597	3	3rd attempt
597	4	4th attempt
597	5	5th attempt
597	66	Variable Did Not Exist
597	88	Not Applicable: Test not given
620	1	1st attempt
620	2	2nd attempt
620	3	3rd attempt
620	4	4th attempt
620	5	5th attempt
620	66	Variable Did Not Exist
620	88	Not Applicable: Test not given
681	1	1st attempt
681	2	2nd attempt
681	3	3rd attempt
681	4	4th attempt
681	5	5th attempt
681	66	Variable Did Not Exist
681	88	Not Applicable: Test not given
748	1	1st attempt
748	2	2nd attempt
748	3	3rd attempt
748	4	4th attempt
748	5	5th attempt
748	66	Variable Did Not Exist
748	88	Not Applicable: Test not given
784	1	1st attempt
784	2	2nd attempt
784	3	3rd attempt
784	4	4th attempt
784	5	5th attempt
784	66	Variable Did Not Exist
784	99	Not Applicable: Test not given

History

No history found for the Domain.

NEUROPSYCH: COWAT - ARCHIVE

Definition

The Adjusted Score, and test completion code for the Controlled Oral Word Association Test. See REFERENCE for details.

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

Record age and education adjusted score, ranges = 0 - 99.

Reference

Benton, A. L., Sivan, A. B., Hamsher, K. deS., Varney, N. R., & Spreen, O. (1994). Contributions to neuropsychological assessment (2nd ed.). New York: Oxford University Press.

Variables

Form Type	Variable	ID	Question	History
Form 1	COWATCC	3383	Controlled Oral Word Association Test Completion Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	COWAadj	3382	Controlled Oral Word Association Adjusted Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	COWATCCF	3649	Controlled Oral Word Association - Test Completion code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	COWAadjF	3648	Controlled Oral Word Association - Adjusted Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3382	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3382	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (visual impairment) )
3382	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3383	1	Test Completed: Use data
3383	2	Test Attempted: Not completed
3383	3	Test Not Attempted
3383	8	Not Applicable: Special version of battery administered
3648	555	Not Applicable: Battery not due
3648	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3648	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (visual impairment) )
3648	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3649	1	Test Completed: Use data
3649	2	Test Attempted: Not completed
3649	3	Test Not Attempted
3649	5	Not Applicable: Variable not due this year
3649	8	Not Applicable: Special version of battery administered

History

No history found for the Domain.

NEUROPSYCH: CVLT - ARCHIVE

Definition

The California Verbal Learning Test® (CVLT®-II) is a test of the strategies and processes involved in learning and remembering verbal material. Test Completion Codes: These codes are assigned to indicate whether a test was administered and the quality of the patient’s performance. Ideally, every patient will be able to complete each test despite physical, intellectual, or behavioral problems. It is very likely that some patients will be unable to complete some tests according to standard procedures. Test completion codes are used to help clarify the quality of the patient’s performance and subsequent scores in a particular cognitive area.

1 Test administered – patient responded in a manner consistent with the demands of the test. Patient may have performed well or poorly . No validity problems Enter the patient’s score. The patient need not complete the Trail Making Test Part A or B within time limits to receive this code if he/she was making progress on the test.
2 Test administration attempted – patient could not or would not respond in a manner consistent with the demands of the test as a result of the severity of brain injury. The lowest possible score is assigned (can include the patient who draws a smiley face on TMT, talks about going home on CVLT-II instead of giving words, etc.) This code should also be used for a patient who initially complies with the task demand but then refuses to complete the test, gives up, or begins responding in a manner inconsistent with the task demands. Enter the worst raw score and corresponding standardized T-score for the test.
3 Test administration not attempted – test not completed due to non-neurological factors outside the control of the site, such as intubation, peripheral injuries, or systemic illness throughout the testing window.
4 Test administration not attempted – Non-English speaking patient.
5 Test administration not attempted – site specific reasons such as unavailability of materials or staff to complete the test, or discharge of patient.
7 Test administration not attempted – patient refused
8 Not applicable – no tests administered
9 Unknown

Form

[X] Form 1
[ ] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay

Details

Test should not be administered to individuals who are not proficient in English.

The lowest possible Trials 1-5 Recall Correct is 0 and the highest possible is 80.

The lowest possible T-score is 5 and the highest possible is 100.

Test scores should be left blank if the test was not administered.

Enter the total raw score (range 0-80) and T-score (range 5-100) for Trials 1-5 Free Recall Correct of the Alternate Form. See SOURCE for details. Only the score from the 5 learning trial is being entered in the database.

Reference

Delis DC, Dramer JH, Kaplan E, Ober BA (2000). California Verbal Learning Test Second Edition (CVLT®-II) - Adult Version Manual. San Antonio, TX: The Psychological Corporation. The California Verbal Learning Test II Trials 1 – 5, alternate version: It is available for purchase at: http://harcourtassessment.com.

Variables

Form Type	Variable	ID	Question	History
Form 1	CVLTCC	430	CVLT Test Completion Code	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	CVLTRS	3398	CVLT Trials 1-5 Raw Score	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	CVLTTS	3399	CVLT Trials 1-5 T-Score	2007-10-01 - Variable Added 2017-10-01 - Variable Removed

Codes and Values

ID	Code	Description
430	0	Variable Did Not Exist
430	1	Test Administered
430	2	Test Attempted
430	3	Test Not Attempted: Due to non-neurological factors
430	4	Test Not Attempted: Non-English speaking patient
430	5	Test Not Attempted: Other reasons, site specific
430	7	Test Not Attempted: Patient Refused
430	8	Not Applicable: No Tests Administered
430	9	Unknown

History

Date	Description
2008-04-01	Changed CODE : to reflect 5 as the lower limit for T-scores
2008-10-01	Added NOTE : test should not be administered to individuals who are not proficient in English.
2009-10-01	Changed CODES: provided range of possible T-Scores

NEUROPSYCH: DIGIT SPAN - ARCHIVE

Definition

The total scores for the Digit Span Test, forward and backward, and test completion code. See REFERENCE for details.

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

Record total scores, forward and backward, range = 0 - 12.

Reference

Wechsler, D. (1987). Wechsler Memory Scale – Revised. New York: Psychological Corp.

Variables

Form Type	Variable	ID	Question	History
Form 1	DigitBackTS	3400	Digit Span Total Score Backward	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	DigitForeTC	3401	Digit Span Total Score Forward	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	DigitTCC	3402	Digit Span Total Score Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DigitBackTSF	3653	Digit Span Backward Total Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DigitForeTSF	3654	Digit Span Forward Total Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DigitTCCF	3655	Digit Span Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3400	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3400	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3400	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3401	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3401	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3401	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3402	1	Test Completed: Use data
3402	2	Test Attempted: Not completed
3402	3	Test Not Attempted
3402	8	Not Applicable: Special version of battery administered
3653	55	Not Applicable: Battery not due
3653	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3653	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3653	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3654	55	Not Applicable: Battery not due
3654	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3654	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3654	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3655	1	Test Completed: Use data
3655	2	Test Attempted: Not completed
3655	3	Test Not Attempted
3655	5	Not Applicable: Variable not due this year
3655	8	Not Applicable: Special version of battery administered

History

No history found for the Domain.

NEUROPSYCH: GOAT - ARCHIVE

Definition

The total error points for the GOAT test and the test completion code. See REFERENCE for details. Information about the Modified GOAT is provided in NOTES.

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

Modified GOAT

Indications: Patients who are unable to respond verbally but are capable of following instructions and signaling their response may be given a modified version of the GOAT. Modified GOA T scores are used to determine length of PTA only. They should not be entered into the database. Two consecutive modified GOAT scores of 61 or greater within a period of 24-72 hours indicates emergence from PTA.
Directions: Present three alternatives in addition to the correct choice, both visually (on an index card) and orally. Point to each choice on the index card as you present it orally. Ask the patient to nod his/her head or lift a finger when you mention the correct choice. This modified procedure can be used for all questions on the GOAT except questions 4 and 5, which require elaboration. The three response alternatives for each question should be arranged vertically in large print on an index card. The examiner should develop multiple sets of response alternatives for serially testing patients who are unable to verbalize because of aphasia, intubation, or other reasons.
Scoring: Error points will be scored for each question similar to the procedure used in the standard administration of the GOAT. The total error points are recorded on the form and then deducted from 80, reflecting omission of questions 4 and 5. Accordingly, resolution of PTA corresponds with a modified GOAT score of at least 61 on the multiple choice administration

Adhere to published instructions for administration of the GOAT at follow-up as well as at inpatient evaluations. For example, a correct response to question 3 (date of admission to hospital) must include the day, month, and year of hospital admission, even if the person does not recall this date due to the passage of time rather than to PTA.

For GOAT question 3, either the date of admission to the rehab hospital or date of admission to the acute hospital are acceptable answers.

Reference

Levin, HS, O’Donnell, VM, & Grossman, RG. (1979). The Galveston Orientation and Amnesia Test: A practical scale to assess cognition after head injury. Journal of Nervous and Mental Diseases, 167, 675-684.

Variables

Form Type	Variable	ID	Question	History
Form 1	GOAT	3473	GOAT Total Error Points	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	GOATTCC	3474	GOAT Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	GOATF	3722	GOAT - Total Error Points	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	GOATTCCF	3723	GOAT - Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3473	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3474	01	Test Completed: Use data
3474	02	Test Attempted: Not completed
3474	03	Test Not Attempted
3474	08	Not Applicable: Special version of battery administered
3722	555	Not Applicable: Battery not due
3722	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3723	1	Test Completed: Use data
3723	2	Test Attempted: Not completed
3723	3	Test Not Attempted
3723	5	Not Applicable: Variable not due this year
3723	8	Not Applicable: Special version of battery administered

History

No history found for the Domain.

NEUROPSYCH: O-LOG - ARCHIVE

Definition

The Orientation Log provides a standardized assessment on awareness of location, time and reason for hospitalization.

Test Completion Codes: These codes are assigned to indicate whether a test was administered and the quality of the patient’s performance. Ideally, every patient will be able to complete each test despite physical, intellectual, or behavioral problems. It is very likely that some patients will be unable to complete some tests according to standard procedures. Test completion codes are used to help clarify the quality of the patient’s performance and subsequent scores in a particular cognitive area.
1 Test administered – patient responded in a manner consistent with the demands of the test. Patient may have performed well or poorly . No validity problems Enter the patient’s score. The patient need not complete the Trail Making Test Part A or B within time limits to receive this code if he/she was making progress on the test.
2 Test administration attempted – patient could not or would not respond in a manner consistent with the demands of the test as a result of the severity of brain injury. The lowest possible score is assigned (can include the patient who draws a smiley face on TMT, talks about going home on CVLT-II instead of giving words, etc.) This code should also be used for a patient who initially complies with the task demand but then refuses to complete the test, gives up, or begins responding in a manner inconsistent with the task demands. Enter the worst raw score and corresponding standardized T-score for the test.
3 Test administration not attempted – test not completed due to non-neurological factors outside the control of the site, such as intubation, peripheral injuries, or systemic illness throughout the testing window.
4 Test administration not attempted – Non-English speaking patient.
5 Test administration not attempted – site specific reasons such as unavailability of materials or staff to complete the test, or discharge of patient.
7 Test administration not attempted – patient refused

Form

[X] Form 1
[ ] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay

Details

The O-Log is comprised of 10 questions focusing on awareness of location, time, and reason for hospitalization. Patient responses are scored according to the following criteria:
3 = correct spontaneously or upon first free recall attempt;
2 = correct upon logical cueing (e.g., “That was yesterday, so today must be …”);
1 = correct upon multiple choice or phonemic cueing; and
0 = incorrect despite cueing, inappropriate, or unable.

Incorrect responses should be followed by cueing at the next highest level. In the place domain, “Hospital” in any context is sufficient for Kind of Place. In the domain of time, Month, Date, Year, and Day of Week must be exact; however, Clock Time can be correct to within 30 minutes (plus or minus). Patients are allowed to look at a clock without penalty when responding to the Clock Time item.

The Etiology/Event item focuses on the person’s awareness of what happened to them (with the response being a car wreck, fall, etc., as appropriate), while the Pathology/Deficits focuses on awareness of the injury sustained (with the response being head injury or TBI). Other injuries can be mentioned but only the awareness of TBI is scored.

Test scores should be left blank if the test was not administered. Enter the O-Log total score only. Score range is 0-30. The lowest possible score is a 0.

Links

PART-O Manual

Reference

Jackson WT, Novack TA, Dowler RN. Effective serial measurement of cognitive orientation in rehabilitation: Reliability of the Orientation Log. Archives of Physical Medicine and Rehabilitation, 1998; 79: 718-20. The O-Log form is available at http://www.tbims.org/combi/olog/olog.pdf.

Variables

Form Type	Variable	ID	Question	History
Form 1	OLOGTCC	532	O-Log Test Completion Code	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	OLOGTS	3492	O-Log Total Score	2007-10-01 - Variable Added 2017-10-01 - Variable Removed

Codes and Values

ID	Code	Description
532	0	Variable Did Not Exist
532	1	Test Administered
532	2	Test Attempted
532	3	Test Not Attempted: Due to non-neurological factors
532	4	Test Not Attempted: Non-English speaking patient
532	5	Test Not Attempted: : Other reasons, site specific
532	7	Test Not Attempted: Patient Refused
532	8	Not Applicable: No Test Administered
532	9	Unknown

History

No history found for the Domain.

NEUROPSYCH: PEGBOARD - ARCHIVE

Definition

The pre-injury dominant hand, hand used to complete test, time needed to complete Grooved Pegboard test, number of pegs placed, and test completion code. Use the TBIMS instructions in NOTES. See REFERENCE for details.

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

Use the following TBIMS protocol: Place the pegboard in the mid-line position in front of the subject with the board near the subject’s edge of the table and the peg tray immediately behind the board.

Say, “I want to see how quickly you can put the metal pegs into the holes in the board. Notice that each hole and each peg has a groove along one side.” (Point to a hole and to a peg.) “To get the peg in the hole, the peg must be turned so the grooves will match.” Demonstrate one row from left to right then remove the pegs.

The subject is to begin in the upper left-hand corner if he/she is right-handed, or the upper right-hand corner if he/she is left-handed. Only the dominant hand is tested. If the patient has switched dominant hands due to his/her injury, use the hand which he/she now considers dominant.

Say, “When I say ‘go’, you are to begin putting the pegs into the holes as fast as you can, using your right (or left) hand only. You are to proceed across each row in turn without skipping any holes, going from left to right (say ‘right to left’ if left-handed). Work as fast as you can. Go.” Time each trial and note the number of times the patient drops pegs.

Repeat instruction twice as necessary using manual demonstration of correct use of apparatus. If necessary, position the subject’s hand appropriately to use the apparatus. if subject places a peg out of order, remind subject that he/she is to work across each row and point with finger to show proper direction.

DISCONTINUE: There is no time limit and the subject is to continue until he/she is finished. However, discontinue if repeated instructions and demonstration prove to be ineffective after 5 minutes. Record 300 seconds if person is trying but fails to complete.

*If the participant is unable to do the task with the dominant hand, it is scored as missing data.

Record time to completion in seconds: range = 20-300

Record number of pegs placed: range = 0-25

Reference

Heaton, R. K., Grant, I., Matthews, C. G. (1991). Comprehensive norms for an expanded Halstead-Reitan Battery. Demographic corrections, research findings, and clinical Applications. Odessa, FL: Psychological Assessment Resources.

Benton, A. L., Sivan, A. B., Hamser, K. DeS., Varney, N. R., & Spreen, O. (1994). Contributions to neuropsychological assessment (2nd ed.). New York: Oxford University Press.

Variables

Form Type	Variable	ID	Question	History
Form 1	PegHand	3494	Grooved Pegboard Hand Used to Complete Test	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	PegNumber	3495	Grooved Pegboard Number of Pegs Placed	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	PegPreHand	3496	Grooved Pegboard Pre-Injury Dominant Hand	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	PegTCC	3497	Grooved Pegboard Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	PegTime	3498	Grooved Pegboard Time (Seconds)	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	PegHandF	3918	Grooved Pegboard - Hand Used to Complete Test	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	PegNumberF	3919	Grooved Pegboard - Number of Pegs Placed	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	PegTTCF	3921	Grooved Pegboard - Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	PegTimeF	3920	Grooved Pegboard - Time	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3494	L	Left
3494	R	Right
3494	7	Not Applicable: Untestable
3494	8	Not Applicable: Special version of battery
3494	9	Not Applicable: Patient unavailable
3495	77	Not Applicable: Untestable
3495	88	Not Applicable: Special version of battery
3495	99	Not Applicable: Patient unavailable
3496	L	Left
3496	R	Right
3496	7	Not Applicable: Untestable
3496	8	Not Applicable: Special version of battery
3496	9	Not Applicable: Patient unavailable
3497	1	Test Completed: Use data
3497	2	Test Attempted: Not completed
3497	3	Test Not Attempted
3497	8	Not Applicable: Special version of battery administered
3498	777	Not Applicable: Untestable
3498	888	Not Applicable: Special version of battery
3498	999	Not Applicable: Patient unavailable
3918	5	Not Applicable: Battery not due
3918	7	Not Applicable: Untestable
3918	8	Not Applicable: Special version of battery
3918	9	Not Applicable: Patient unavailable
3918	L	Left
3918	R	Right
3919	55	Not Applicable: Battery not due
3919	77	Not Applicable: Untestable
3919	88	Not Applicable: Special version of battery
3919	99	Not Applicable: Patient unavailable
3920	555	Not Applicable: Battery not due
3920	777	Not Applicable: Untestable
3920	888	Not Applicable: Special version of battery
3920	999	Not Applicable: Patient unavailable
3921	1	Test Completed: Use data
3921	2	Test Attempted: Not completed
3921	3	Test Not Attempted
3921	5	Not Applicable: Variable not due this year
3921	8	Not Applicable: Special version of battery administered

History

No history found for the Domain.

NEUROPSYCH: REITAN - ARCHIVE

Definition

The time in seconds; test completion codes for Trails A and B of the Reitan Trail Making Test. See REFERENCE for details.

The Reitan Trail Making Tests are tests of attention and mental flexibility, speed of sequencing, visual search and motor functions.

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

If Trails A is not completed in 92 seconds, avoid confusion and record 93 seconds instead on the data summary sheet. If the test is completed in precisely 92 seconds, record 92 seconds on the data summary sheet. Then derive T-score.

If Trails B is not completed in 300 seconds, avoid confusion and record 301 seconds instead on the data summary sheet. If the test is completed in precisely 300 seconds, record 300 seconds on the data summary sheet. Then derive T-score.

The most impaired possible raw score for Trails A is 93 seconds and a T-score of 13.

The most impaired possible raw score for Trails B is 301 seconds and a T-score of 12.

Data should reflect the latest version of the Heaton Manual.

When testing participants 16-19 years of age, use the norms for age 20 (the lowest age in the norms book). This same rationale should be followed for years of education less than the lowest level of 7 years in the norms book.

Regarding race and ethnicity, if the tester cannot determine whether to use the Caucasian or African American norms in the Heaton manual (2004), s/he should ask the participant or participant’s family member to identify his/her race. If s/he does not indicate either Hispanic or African American (Black), then the tester should use the Caucasian norms.

Hispanic individuals should be scored using the African American norms (see page 70 in the Heaton manual [2004]).

Participants who are not proficient in English or for other reasons who have difficulty with the alphabet should not be tested. When in question, assessment of the participant’s facility with the alphabet should be undertaken prior to the decision to test.

Non-English speaking Hispanic individuals can be tested if there is an appropriate translator available and the participant demonstrates sufficient mastery of the alphabet. However, only the raw scores are to be entered. No normative data are to be used and those fields are to be left blank.

Other non-English speaking participants should not be tested, even with a translator, due to probable dissimilarities in the alphabet.

The decision to test or not test individuals who do not speak English or who have English as a second language will be left to the discretion of the individual center. If these individuals are not tested, it will not be considered missing data.

For participants if they are unable to write, do not administer Trails A or B, and code the Test Completion Code as “3-Test Not Attempted, Due to Non-Neurological Reasons”. The Heaton norms used are based solely on the written version and not necessarily comparable with the oral version of the tests.

Test scores should be left blank if the test was not administered.

If Trails A was completed, but participant is unable or refuses to complete Trails B, test completion code of “2 - Attempted” should be used and no score would be recorded.

Record total times in seconds for Trails A and Trails B. If the test is not completed in five minutes, that fact as well as 300 seconds is recorded on the data summary sheet. If the test is completed in precisely 300 seconds, avoid confusion and record 299 instead.

For the Trails A and Trails B, record the time in seconds, range = 10-300.

For Trails A and Trails B, record the time in seconds, (range = 0-92 for Trails A and 0-300 for Trails B) and corresponding T-score (range = 0-99 for Trails A and Trails B). See SOURCE for details.

Reference

Reitan, R. M. & Wolfson, D. (1993). The Halstead-Reitan neuropsychological test battery: Theory and clinical interpretation (2nd ed.). Tucson, Arizona: Neuropsychological Press. Heaton R K, Miller W, Taylor MJ, Grant I. (2004). Revised comprehensive norms for an expanded Halstead-Reitan Battery. Demographically adjusted neuropsychological norms for African American and Caucasian adults. Odessa, FL: Psychological Assessment Resources. It is available for purchase at: http://www.reitanlabs.com

Heaton, R. K., Grant, I., Matthews, C. G. (1991). Comprehensive norms for an expanded Halstead-Reitan Battery. Demographic corrections, research findings, and clinical applications. Odessa, FL: Psychological Assessment Resources.

Variables

Form Type	Variable	ID	Question	History
Form 1	TRAILSaCC	560	Reitan Trails A Test Completion Code	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	TRAILSaRS	3564	Reitan Trails A Raw Score	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	TRAILSaTS	3567	Reitan Trails A T-Score	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	TRAILSbCC	561	Reitan Trails B Test Completion Code	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	TRAILSbRS	3568	Reitan Trails B Raw Score	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	TRAILSbTS	3571	Reitan Trails B T-Score	2007-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	TrailsATCC_Old	3565	Reitan Trailmaking A Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	TrailsATime	3566	Reitan Trailmaking A Time	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	TrailsBTCC	3569	Reitan Trailmaking B Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	TrailsBTime	3570	Reitan Trailmaking B Time	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	TrailsATCCF	3971	Reitan Trailmaking - Trail A Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	TrailsATimeF	3972	Reitan Trailmaking - Trail A Seconds	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	TrailsBTCCF	3973	Reitan Trailmaking - Trail B Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	TrailsBTimeF	3974	Reitan Trailmaking - Trail B Seconds	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
560	0	Variable Did Not Exist
560	1	Test Administered
560	2	Test Attempted
560	3	Test Not Attempted: Due to non-neurological factors
560	4	Test Not Attempted: Non-English speaking patient
560	5	Test Not Attempted: Other Reasons, site specific
560	7	Test Not Attempted: Patient Refused
560	8	Not Applicable: No Tests Administered
560	9	Unknown
561	0	Variable Did Not Exist
561	1	Test Administered
561	2	Test Attempted
561	3	Test Not Attempted: Due to non-neurological factors
561	4	Test Not Attempted: Non-English speaking patient
561	5	Test Not Attempted: Other Reasons, site specific
561	7	Test Not Attempted: Patient Refused
561	8	Not Applicable: No Tests Administered
561	9	Unknown
3565	1	Test Completed: Use data
3565	2	Test Attempted: Not completed
3565	3	Test Not Attempted
3565	8	Not Applicable: Special version of battery administered
3566	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3566	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (participant’s native language uses a different alphabet than English or participant has significant motor impairment or visual impairment) )
3566	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3569	1	Test Completed: Use data
3569	2	Test Attempted: Not completed
3569	3	Test Not Attempted
3569	8	Not Applicable: Special version of battery administered
3570	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3570	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (participant’s native language uses a different alphabet than English or participant has significant motor impairment or visual impairment) )
3570	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3971	1	Test Completed: Use data
3971	2	Test Attempted: Not completed
3971	3	Test Not Attempted
3971	5	Not Applicable: Variable not due this year
3971	8	Not Applicable: Special version of battery administered
3972	555	Not Applicable: Battery not due
3972	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3972	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (participant’s native language uses a different alphabet than English or participant has significant motor impairment or visual impairment) )
3972	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3973	1	Test Completed: Use data
3973	2	Test Attempted: Not completed
3973	3	Test Not Attempted
3973	5	Not Applicable: Variable not due this year
3973	8	Not Applicable: Special version of battery administered
3974	555	Not Applicable: Battery not due
3974	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3974	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (participant’s native language uses a different alphabet than English or participant has significant motor impairment or visual impairment) )
3974	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )

History

Date	Description
2008-04-01	Added NOTE : Data should reflect the latest version of the Heaton Manual
2008-04-01	Added NOTE : If there is a participant who is 16-19 years of age use the norms for age 20 (the lowest age in the norms book)
2008-07-01	Added LINK : to the Heaton Manual
2008-10-01	Added NOTE : Clarified the use of norms for Caucasian and African American. Changed the range of possible t-scores to 0-99. Re-ordered the source documents (placed Heaton first)

NEUROPSYCH: REY - ARCHIVE

Definition

The total number correct for trials I - V, Alternate List, Short Delay Free Recall (trial VI), 30-minute delayed recall (trial VII), and test completion code. See REFERENCE for details.

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

In trial VII the respondent is asked to recall the words used in trials I-VI (not the words in the alternate trial) after 30 minutes have passed since completion of trial VI. During these 30 minutes, as many as possible of the remaining tests in the neuropsychological battery are to be performed (Symbol Digit Modalities, Reitan Trail Making, WAIS-R Block Design, Wisconsin Card Sorting Test). No memory tests are to be performed during the 30 minute delay. Do not begin a test during the delay period if it may cause trial VII to start late.

Reference

Schmidt, M. (1996). The Rey Auditory and Verbal Learning Test. Western Psychological Services. Order from PAR (ID-4294-BK;$65;www.parinc.com).

Variables

Form Type	Variable	ID	Question	History
Form 1	Rey1	3518	Rey Auditory Verbal Learning Total Correct Trial I	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Rey2	3519	Rey Auditory Verbal Learning Total Correct Trial II	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Rey3	3520	Rey Auditory Verbal Learning Total Correct Trial III	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Rey4	3521	Rey Auditory Verbal Learning Total Correct Trial IV	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Rey5	3522	Rey Auditory Verbal Learning Total Correct Trial V	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Rey6	3523	Rey Auditory Verbal Learning Total Correct Trial VI	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	Rey7	3524	Rey Auditory Verbal Learning Total Correct Trial VII	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	ReyALT	3525	Rey Auditory Verbal Learning Total Correct Trial ALT	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	ReyTCC	3526	Rey Auditory Verbal Learning Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	Rey1F	3937	Rey Auditory Verbal Learning - Total I	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	Rey2F	3938	Rey Auditory Verbal Learning - Total II	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	Rey3F	3939	Rey Auditory Verbal Learning - Total III	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	Rey4F	3940	Rey Auditory Verbal Learning - Total IV	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	Rey5F	3941	Rey Auditory Verbal Learning - Total V	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	Rey6F	3942	Rey Auditory Verbal Learning - Total VI	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	Rey7F	3943	Rey Auditory Verbal Learning - Total VII	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	ReyAltF	3944	Rey Auditory Verbal Learning - Total Alternate	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	ReyTTCF	3945	Rey Auditory Verbal Learning - Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3518	55	Not Applicable: Battery not due
3518	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3518	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3518	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3519	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3519	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3519	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3520	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3520	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3520	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3521	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3521	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3521	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3522	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3522	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3522	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3523	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3523	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3523	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3524	66	Variable Did Not Exist
3524	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3524	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3524	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3525	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3525	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3525	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3526	1	Test Completed: Use data
3526	2	Test Attempted: Not completed
3526	3	Test Not Attempted
3526	8	Not Applicable: Special version of battery administered
3937	55	Not Applicable: Battery not due
3937	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3937	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3937	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3938	55	Not Applicable: Battery not due
3938	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3938	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3938	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3939	55	Not Applicable: Battery not due
3939	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3939	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3939	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3940	55	Not Applicable: Battery not due
3940	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3940	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3940	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3941	55	Not Applicable: Battery not due
3941	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3941	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3941	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3942	55	Not Applicable: Battery not due
3942	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3942	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3942	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3943	55	Not Applicable: Battery not due
3943	66	Variable Did Not Exist ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3943	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3943	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3943	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3944	55	Not Applicable: Battery not due
3944	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3944	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language other than Spanish) )
3944	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3945	1	Test Completed: Use data
3945	2	Test Attempted: Not completed
3945	3	Test Not Attempted
3945	5	Not Applicable: Variable not due this year
3945	8	Not Applicable: Special version of battery administered

History

No history found for the Domain.

NEUROPSYCH: SYMBOL DIGIT - ARCHIVE

Definition

The number of correct responses for the written and oral portions of the Symbol Digit Modalities and the respective test completion codes. See REFERENCE for details.

Form

[X] Form 1 [X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

Record the number correct responses for written and oral tests, range = 0-110.

Reference

Smith, A. (1973). Symbol Digit Modalities Test. Manual. Los Angeles: Western Psychological Services.

Variables

Form Type	Variable	ID	Question	History
Form 1	SymOralTC	3553	Symbol Digit Modality Oral Total Correct	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	SymOralTCC	3554	Symbol Digit Modality Oral Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	SymWriTC	3555	Symbol Digit Modality Written Total Correct	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	SymWriTCC	3556	Symbol Digit Modality Written Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	SymOralTCCF	3963	Symbol Digit Modalities Oral - Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	SymOralTCF	3964	Symbol Digit Modalities Oral - Total Correct	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	SymWriTCCF	3965	Symbol Digit Modalities Written - Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	SymWriTCF	3966	Symbol Digit Modalities Written- Total Correct	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3553	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3553	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (visual impairment) )
3553	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3554	1	Test Completed: Use data
3554	2	Test Attempted: Not completed
3554	3	Test Not Attempted
3554	8	Not Applicable: Special version of battery administered
3555	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3555	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (visual impairment) )
3555	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3556	1	Test Completed: Use data
3556	2	Test Attempted: Not completed
3556	3	Test Not Attempted
3556	8	Not Applicable: Special version of battery administered
3963	1	Test Completed: Use data
3963	2	Test Attempted: Not completed
3963	3	Test Not Attempted
3963	5	Not Applicable: Variable not due this year
3963	8	Not Applicable: Special version of battery administered
3964	555	Not Applicable: Battery not due
3964	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3964	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (visual impairment) )
3964	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3965	1	Test Completed: Use data
3965	2	Test Attempted: Not completed
3965	3	Test Not Attempted
3965	5	Not Applicable: Variable not due this year
3965	8	Not Applicable: Special version of battery administered
3966	555	Not Applicable: Battery not due
3966	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3966	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (visual impairment) )
3966	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )

History

No history found for the Domain.

NEUROPSYCH: WAIS-R - ARCHIVE

Definition

The raw score, age scaled score, and test completion code for the WAIS-R Block Design test. See REFERENCE for details.

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

Record the raw score, range = 0-51 and age scaled score, range = 1-19.

Reference

Wechsler, D. (1981). Wechsler Adult Intelligence Scale-Revised. Manual New York: Psychological Corporation.

Variables

Form Type	Variable	ID	Question	History
Form 1	BlackAge	3345	Block Design (WAIS-R) Age Scaled Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	BlockRS	3346	Block Design (WAIS-R) Raw Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	BlockTCC	3347	Block Design (WAIS-R) Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	BlockAgeF	3594	Block Design Aged Scale Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	BlockTCCF	3595	Block Design Test completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	BlockTCF	3596	Block Design Raw Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3345	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3345	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (motor impairment, visual impairment) )
3345	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3346	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3346	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (motor impairment, visual impairment) )
3346	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3347	1	Test Completed: Use data
3347	2	Test Attempted: Not completed
3347	3	Test Not Attempted
3347	8	Not Applicable: Special version of battery administered
3594	55	Not Applicable: Battery not due
3594	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3594	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (motor impairment, visual impairment.) )
3594	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3595	1	Test Completed: Use data
3595	2	Test Attempted: Not completed
3595	3	Test Not Attempted
3595	5	Not Applicable: Variable not due this year
3595	8	Not Applicable: Special version of battery administered
3596	55	Not Applicable: Battery not due
3596	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3596	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (motor impairment, visual impairment.) )
3596	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )

History

No history found for the Domain.

NEUROPSYCH: WECHSLER DELAYED - ARCHIVE

Definition

The total combined scores for the Wechsler Logical Memory Test Delayed Recall Story A and B

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

Record combined total scores for Story A and B, range = 0 – 50.

Variables

Form Type	Variable	ID	Question	History
Form 1	MemDelayTCC	3486	Wechsler Logical Memory Delayed Recall Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	MemDelayTS	3487	Wechsler Logical Memory Delayed Recall Total Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	MemDelayTCCF	3751	Wechsler Logical Memory - Delayed Recal Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	MemDelayTCF	3752	Wechsler Logical Memory - Delayed Recal Total Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3486	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3486	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language) )
3486	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3487	1	Test Completed: Use data
3487	2	Test Attempted: Not completed
3487	3	Test Not Attempted
3487	8	Not Applicable: Special version of battery administered
3751	1	Test Completed: Use data
3751	2	Test Attempted: Not completed
3751	3	Test Not Attempted
3751	5	Not Applicable: Variable not due this year
3751	8	Not Applicable: Special version of battery administered
3752	55	Not Applicable: Battery not due
3752	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3752	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language) )
3752	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )

History

No history found for the Domain.

NEUROPSYCH: WECHSLER IMMEDIATE - ARCHIVE

Definition

The total combined scores for the Wechsler Logical Memory Test Immediate Recall Story A and B

Form

[X] Form 1
[X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

Record combined total scores for Story A and B, range = 0 – 50.

Reference

Wechsler, D. (1987). Wechsler Memory Scale – Revised. New York: Psychological Corp.

Variables

Form Type	Variable	ID	Question	History
Form 1	MemImTCC	3488	Wechsler Logical Memory Immediate Recall Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	MemImTS	3489	Wechsler Logical Memory Immediate Recall Total Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	MemImmTCCF	3753	Wechsler Logical Memory - Immediate Recal Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	MemImmTSF	3754	Wechsler Logical Memory - Immediate Recal Total Score	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3488	1	Test Completed: Use data
3488	2	Test Attempted: Not completed
3488	3	Test Not Attempted
3488	8	Not Applicable: Special version of battery administered
3489	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3489	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language) )
3489	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3753	1	Test Completed: Use data
3753	2	Test Attempted: Not completed
3753	3	Test Not Attempted
3753	5	Not Applicable: Variable not due this year
3753	8	Not Applicable: Special version of battery administered
3754	55	Not Applicable: Battery not due
3754	77	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3754	88	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language) )
3754	99	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )

History

No history found for the Domain.

NEUROPSYCH: WISCONSIN - ARCHIVE

Definition

The number of perseverative responses, number of categories completed, and test completion code for the Wisconsin Card Sorting Test. See REFERENCE for details.

Form

[X] Form 1 [X] Form 2

Source

• Form I - Neuropsych Testing administered during rehabilitation stay
• Form II - Neuropsych Testing administered in conjunction with follow-up interview

Details

Record the number of perseverative responses, range = 0-126 [obsolete code: “999 = unknown number of perseverative responses” recoded as “998”]

Record the number of categories, range=0-6.

Computer administration of the WCST is acceptable.

Reference

Heaton, R. K., Chelune, G. J., Talley, J. L., Kay, G. C. & Curtiss, G. (1993). Wisconsin Card Sorting Test Manual. Odessa, FL: Psychological Assessment Resources, Inc.

Variables

Form Type	Variable	ID	Question	History
Form 1	CardCats	3350	Wisconson Card Sorting Number of Categories	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	CardPersev	3352	Wisconson Card Sorting Number of Perseverative Responses	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	CardTCC	3353	Wisconson Card Sorting Test Completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CardCatsF	3599	Wisconsin Card Sorting - Number of Categories	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CardPersevF	3600	Wisconsin Card Sorting - Number of Perseverative Reponses	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CardTCCF	3601	Wisconsin Card Sorting - Test completion Code	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3350	7	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3350	8	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language, visual impairment) )
3350	9	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3352	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3352	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language, visual impairment) )
3352	998	Unknown Number of Perseverative Responses
3352	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3353	1	Test Completed: Use data
3353	2	Test Attempted: Not completed
3353	3	Test Not Attempted
3353	8	Not Applicable: Special version of battery administered
3599	5	Not Applicable: Battery not due
3599	7	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3599	8	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language, visual impairment) )
3599	9	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3600	555	Not Applicable: Battery not due
3600	777	Not Applicable: Untestable ( Patient unable to reliably complete this test because of cognitive/behavior problems )
3600	888	Not Applicable: Special version of battery ( Test omitted because abbreviated version of Battery was administered (foreign language, visual impairment) )
3600	998	Unknown Number of Perseverative Responses
3600	999	Not Applicable: Patient unavailable ( Not tested due to early discharge, insufficient staffing, scheduling difficulty, refusal )
3601	5	Not Applicable: Variable not due this year

History

No history found for the Domain.

NFI (NEUROBEHAVIORAL FUNCTIONING INVENTORY) - ARCHIVE

Definition

The NFI-R and NFIFAM is comprised of six independent scales reflecting problems frequently experienced by TBI patients: Depression, Somatic, Memory/Attention, Communication, Aggression, and Motor. Separate patient and family forms of the NFI-R were designed to collect the unique perspectives offered by both the injured individual and a second party family observer. Normative scales are provided for both patient and family member ratings of patient behavior based upon patient age and the amount of time the patient was unconscious at the time of injury.

Form

[ ] Form 1
[X] Form 2

Source

• Interview, Mail-out (participant and proxy)

Details

Questions for the 76 items of the Neurobehavioral Functioning Inventory (NFI-R), as asked of the person with brain injury and a significant other/family member at the time of the annual evaluation.

The NFI-R can be mailed to the patient in advance of the follow-up appointment, so that the questionnaire can be completed ahead of time. The actual code for each question is entered into the computer database. The six scales will be calculated by the National Data Center. For details on calculating the scale scores, see Appendix L of the TBI Model Systems National Database Syllabus.

If a person with brain injury is living in a skilled nursing facility at the time of annual follow-up; the NFI-R should still be completed. This will be taken into consideration during analysis of data.

If the NFI is self-administered and the patient: 1) leaves an item blank, code that item as unknown/missing; 2) checks more than one response for an item, code the response with the highest number; 3) feels a question is not applicable to them, code as unknown/missing.

*The NFI is administered to persons who speak foreign languages and to persons with visual impairment.

Variables

Form Type	Variable	ID	Question	History
Form 2	NFIApetite	3760	Poor appetite	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIApetiteSO	3761	Neurobehavioral Function (SO) - Poor appetite	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIAppl	3762	Neurobehavioral Function - Forget to turn off appliances	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIApplSO	3763	Neurobehavioral Function (SO) - Forgets to turn off appliances	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIAppoint	3764	Neurobehavioral Function - Forget or miss appointments	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIAppointSO	3765	Neurobehavioral Function (SO) - Forgets or misses appointments	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIArgue	3766	Neurobehavioral Function - Argue	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIArgueSO	3767	Neurobehavioral Function (SO) - Argues	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIAsleep	3768	Neurobehavioral Function - Trouble falling asleep	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIAsleepSO	3769	Neurobehavioral Function (SO) - Trouble falling asleep	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBalance	3770	Neurobehavioral Function - Lose balance	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBalanceSO	3771	Neurobehavioral Function (SO) - Loses balance	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBlackout	3772	Neurobehavioral Function - Blackout spells	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBlackoutSO	3773	Neurobehavioral Function (SO) - Blackout spells	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBloat	3774	Neurobehavioral Function - Stomach bloated	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBloatSO	3775	Neurobehavioral Function (SO) - Stomach bloated	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBlurry	3776	Neurobehavioral Function - Double or blurred vision	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBlurrySO	3777	Neurobehavioral Function (SO) - Double or blurred vision	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBored	3778	Neurobehavioral Function - Bored	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBoredSO	3779	Neurobehavioral Function (SO) - Bored	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBreak	3780	Neurobehavioral Function - Break or throw things	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIBreakSO	3781	Neurobehavioral Function (SO) - Breaks or throw things	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIComfort	3782	Neurobehavioral Function - Uncomfortable around others	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIComfortSO	3783	Neurobehavioral Function (SO) - Uncomfortable around others	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIComment	3784	Neurobehavioral Function - Inappropriate comments or behavior	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFICommentSO	3785	Neurobehavioral Function (SO) - Inappropriate comments or behavior	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIConfidence	3786	Neurobehavioral Function - No confidence	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIConfidenceSO	3787	Neurobehavioral Function (SO) - No confidence	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIConfused	3788	Neurobehavioral Function - Confused	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIConfusedSO	3789	Neurobehavioral Function (SO) - Confused	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFICurse	3790	Neurobehavioral Function - Curse at others	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFICurseSO	3793	Neurobehavioral Function (SO) - Curses at others	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFICurseSelf	3791	Neurobehavioral Function - Curse at yourself	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFICurseSelfSO	3792	Neurobehavioral Function (SO) - Curses at yourself	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIDisctractSO	3794	Neurobehavioral Function (SO) - Easily distracted	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIDistract	3795	Neurobehavioral Function - Easily distracted	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIDizzy	3796	Neurobehavioral Function - Dizzy	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIDizzySO	3797	Neurobehavioral Function (SO) - Dizzy	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIDoCHoresSO	3799	Neurobehavioral Function (SO) - Difficulty performing chores	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIDoChores	3798	Neurobehavioral Function - Difficulty performing chores	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIDrop	3800	Neurobehavioral Function - Drop things	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIDropSO	3801	Neurobehavioral Function (SO) - Drops things	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIEnjoy	3802	Neurobehavioral Function - Difficulty enjoying activities	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIEnjoySO	3803	Neurobehavioral Function (SO) - Difficulty enjoying activities	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIFood	3804	Neurobehavioral Function - Food doesn't taste right	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIFoodSO	3805	Neurobehavioral Function (SO) - Food doesn't taste right	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIForget	3806	Neurobehavioral Function - Forget if you have done things	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIForgetChores	3807	Neurobehavioral Function - Forget to do chores or work	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIForgetChoresSO	3808	Neurobehavioral Function (SO) - Forgets to do chores or work	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIForgetSO	3809	Neurobehavioral Function (SO) - Forgets he/she has done things	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIFrusterate	3810	Neurobehavioral Function - Frustrated	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIFrustrateSO	3811	Neurobehavioral Function (SO) - Frustrated	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIGetLost	3812	Neurobehavioral Function - Lose way, get lost	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIGetLostSO	3813	Neurobehavioral Function (SO) - Loses way, gets lost	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHeadache	3814	Neurobehavioral Function - Headaches	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHeadacheSO	3815	Neurobehavioral Function (SO) - Headaches	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHearing	3816	Neurobehavioral Function - Trouble hearing	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHearingSO	3817	Neurobehavioral Function (SO) - Trouble hearing	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHit	3818	Neurobehavioral Function - Hit or push others	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHitsSO	3819	Neurobehavioral Function (SO) - Hits or pushes others	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHomeAlone	3820	Neurobehavioral Function - Cannot be left at home alone	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHomeAloneSO	3821	Neurobehavioral Function (SO) - Cannot be left at home alone	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHopeless	3822	Neurobehavioral Function - Feel hopeless	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHopelessSO	3823	Neurobehavioral Function (SO) - Feels hopeless	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHurtOth	3824	Neurobehavioral Function - Threaten to hurt others	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHurtOthSO	3825	Neurobehavioral Function (SO) - Threatens to hurt others	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHurtSelf	3826	Neurobehavioral Function - Threaten to hurt yourself	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIHurtSelfSO	3827	Neurobehavioral Function (SO) - Threatens to hurt self	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIInstruct	3828	Neurobehavioral Function - Trouble following instructions	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIInstructSO	3829	Neurobehavioral Function (SO) - Trouble following instructions	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFILate	3830	Neurobehavioral Function - Late for appointments	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFILateSO	3831	Neurobehavioral Function (SO) - Late for appointments	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFILift	3832	Neurobehavioral Function - Difficulty lifting heavy objects	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFILiftSO	3833	Neurobehavioral Function (SO) - Difficulty lifting heavy objects	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFILonely	3834	Neurobehavioral Function - Lonely	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFILonelySO	3835	Neurobehavioral Function (SO) - Lonely	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFILoseTime	3836	Neurobehavioral Function - Lose track of time, day or date	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFILoseTimeSO	3837	Neurobehavioral Function (SO) - Loses track of time, day or date	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIMakeConver	3838	Neurobehavioral Function - Difficulty making conversation	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIMakeConverSO	3839	Neurobehavioral Function (SO) - Difficulty making conversation	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIMeds	3840	Neurobehavioral Function - Forget to take medication	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIMedsSO	3841	Neurobehavioral Function (SO) - Forgets to take medication	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIMisplace	3842	Neurobehavioral Function - Misplace things	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIMisplaceSO	3843	Neurobehavioral Function (SO) - Misplaces things	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIMissWk	3844	Neurobehavioral Function - Miss or cannot attend work/school	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIMissWkSO	3845	Neurobehavioral Function (SO) - Misses or cannot attend work/school	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIMove	3846	Neurobehavioral Function - Move slowly	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIMoveSO	3847	Neurobehavioral Function (SO) - Moves slowly	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFINames	3848	Neurobehavioral Function - Forget people's names	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFINamesSO	3849	Neurobehavioral Function (SO) - Forgets people's names	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFINausea	3850	Neurobehavioral Function - Nauseous	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFINauseaSO	3851	Neurobehavioral Function (SO) - Nauseous	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFINight	3852	Neurobehavioral Function - Nightmares	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFINightSO	3853	Neurobehavioral Function (SO) - Nightmares	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIOrganize	3854	Neurobehavioral Function - Disorganized	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIOrganizeSO	3855	Neurobehavioral Function (SO) - Disorganized	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIPhone	3856	Neurobehavioral Function - Forget phone numbers	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIPhoneSO	3857	Neurobehavioral Function (SO) - Forgets phone numbers	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIPoorCon	3858	Neurobehavioral Function - Concentration is poor	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIPoorConSO	3859	Neurobehavioral Function (SO) - Concentration is poor	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIPronounce	3860	Neurobehavioral Function - Difficulty pronouncing words	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIPronounceSO	3861	Neurobehavioral Function (SO) - Difficulty pronouncing words	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIRead	3862	Neurobehavioral Function - Forget what you read	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIReadSLowSO	3864	Neurobehavioral Function (SO) - Reads slowly	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIReadSO	3865	Neurobehavioral Function (SO) - Forgets what he/she read	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIReadSlow	3863	Neurobehavioral Function - Read slowly	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIRestless	3866	Neurobehavioral Function - Restless	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIRestlessSO	3867	Neurobehavioral Function (SO) - Restless	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIRinging	3868	Neurobehavioral Function - Ringing in ears	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIRingingSO	3869	Neurobehavioral Function (SO) - Ringing in ears	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIRude	3870	Neurobehavioral Function - Rude to others	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIRudeSO	3871	Neurobehavioral Function (SO) - Rude to others	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFISad	3872	Neurobehavioral Function - Sad, blue	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFISadSO	3873	Neurobehavioral Function (SO) - Sad, blue	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIScared	3874	Neurobehavioral Function - Scared or frightened	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIScaredSO	3875	Neurobehavioral Function (SO) - Scared or frightened	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFISeiz	3876	Neurobehavioral Function - Seizures	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFISeizSO	3877	Neurobehavioral Function (SO) - Seizures	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFISense	3878	Neurobehavioral Function - Speech doesn't make sense	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFISenseSO	3879	Neurobehavioral Function (SO) - Speech doesn't make sense	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFISit	3880	Neurobehavioral Function - Sit with nothing to do	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFISitSO	3881	Neurobehavioral Function (SO) - Sits with nothing to do	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFISpell	3882	Neurobehavioral Function - Make spelling mistakes	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFISpellSO	3883	Neurobehavioral Function (SO) - Makes spelling mistakes	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIStomach	3884	Neurobehavioral Function - Stomach hurts	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIStomachSO	3885	Neurobehavioral Function (SO) - Stomach hurts	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFITCC	3888	Neurobehavioral Function - Completion Code	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFITCCSO	3889	Neurobehavioral Function (SO) - Completion Code	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFITalk	3886	Neurobehavioral Function - Talk too fast or slow	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFITalkSO	3887	Neurobehavioral Function (SO) -Talks too fast or slow	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIThoughts	3890	Neurobehavioral Function - Can't get mind off certain thoughts	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIThoughtsSO	3891	Neurobehavioral Function (SO) - Can't get mind off certain thoughts	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFITrain	3892	Neurobehavioral Function - Lose train of thought	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFITrainSO	3893	Neurobehavioral Function (SO) - Loses train of thought	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFITrip	3894	Neurobehavioral Function - Trip over things	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFITripSO	3895	Neurobehavioral Function (SO) - Trips over things	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFITwitch	3896	Neurobehavioral Function - Muscles tingle or twitch	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFITwitchSO	3897	Neurobehavioral Function (SO) - Muscles tingle or twitch	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIUnderstand	3898	Neurobehavioral Function - Trouble understanding conversation	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIUnderstandSO	3899	Neurobehavioral Function (SO) - Trouble understanding conversation	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIWeak	3900	Neurobehavioral Function - Weak	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIWeakSO	3901	Neurobehavioral Function (SO) - Weak	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIWords	3902	Neurobehavioral Function - Difficulty thinking of the right word	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIWordsSO	3903	Neurobehavioral Function (SO) - Difficulty thinking of the right word	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIWorth	3904	Neurobehavioral Function - Feel worthless	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIWorthSO	3905	Neurobehavioral Function (SO) - Feels worthless	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIWrite	3906	Neurobehavioral Function - Write slowly	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIWriteSO	3907	Neurobehavioral Function (SO) - Writes slowly	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIWriting	3908	Neurobehavioral Function - My writing is hard to read	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIWritingSO	3909	Neurobehavioral Function (SO) - Writing is hard to read	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIYell	3910	Neurobehavioral Function - Scream or yell	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIYellSO	3911	Neurobehavioral Function (SO) - Screams or yells	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIYesterday	3912	Neurobehavioral Function - Forget yesterday's events	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	NFIYesterdaySO	3913	Neurobehavioral Function (SO) - Forgets yesterday's events	1997-01-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3760	0	Variable Did Not Exist
3760	1	Never
3760	2	Rarely
3760	3	Sometime
3760	4	Often
3760	5	Always
3760	7	Not Applicable: Variable not due this year
3760	9	Unknown ( Includes missing )
3761	0	Variable Did Not Exist
3761	1	Never
3761	2	Rarely
3761	3	Sometime
3761	4	Often
3761	5	Always
3761	7	Not Applicable: Variable not due this year
3761	8	No Significant Other
3761	9	Unknown ( Includes missing )
3762	0	Variable Did Not Exist
3762	1	Never
3762	2	Rarely
3762	3	Sometime
3762	4	Often
3762	5	Always
3762	7	Variable Did Not Exist
3762	9	Unknown ( Includes missing )
3763	0	Variable Did Not Exist
3763	1	Never
3763	2	Rarely
3763	3	Sometime
3763	4	Often
3763	5	Always
3763	7	Not Applicable: Variable not due this year
3763	8	No Significant Other
3763	9	Unknown ( Includes missing )
3764	0	Variable Did Not Exist
3764	1	Never
3764	2	Rarely
3764	3	Sometime
3764	4	Often
3764	5	Always
3764	7	Not Applicable: Variable not due this year
3764	9	Unknown ( Incudes missing )
3765	0	Variable Did Not Exist
3765	1	Never
3765	2	Rarely
3765	3	Sometime
3765	4	Often
3765	5	Always
3765	7	Not Applicable: Variable not due this year
3765	8	No Significant Other
3765	9	Unknown ( Includes missing )
3766	0	Variable Did Not Exist
3766	1	Never
3766	2	Rarely
3766	3	Sometime
3766	4	Often
3766	5	Always
3766	7	Not Applicable: Variable not due this year
3766	9	Unknown ( Includes missing )
3767	0	Variable Did Not Exist
3767	1	Never
3767	2	Rarely
3767	3	Sometime
3767	4	Often
3767	5	Always
3767	7	Not Applicable: Variable not due this year
3767	8	No Significant Other
3767	9	Unknown ( Includes missing )
3768	0	Variable Did Not Exist
3768	1	Never
3768	2	Rarely
3768	3	Sometime
3768	4	Often
3768	5	Always
3768	7	Not Applicable: Variable not due this year
3768	9	Unknown ( Includes missing )
3769	0	Variable Did Not Exist
3769	1	Never
3769	2	Rarely
3769	3	Sometime
3769	4	Often
3769	5	Always
3769	7	Not Applicable: Variable not due this year
3769	8	No Significant Other
3769	9	Unknown ( Includes missing )
3770	0	Variable Did Not Exist
3770	1	Never
3770	2	Rarely
3770	3	Sometime
3770	4	Often
3770	5	Always
3770	7	Not Applicable: Variable not due this year
3770	9	Unknown ( Includes missing )
3771	0	Variable Did Not Exist
3771	1	Never
3771	2	Rarely
3771	3	Sometime
3771	4	Often
3771	5	Always
3771	7	Not Applicable: Variable not due this year
3771	8	No Significnat Other
3771	9	Unknown ( Includes missing )
3772	0	Variable Did Not Exist
3772	1	Never
3772	2	Rarely
3772	3	Sometime
3772	4	Often
3772	5	Always
3772	7	Not Applicable: Variable not due this year
3772	9	Unknown ( Includes missing )
3773	0	Variable Did Not Exist
3773	1	Never
3773	2	Rarely
3773	3	Sometime
3773	4	Often
3773	5	Always
3773	7	Not Applicable: Variable not due this year
3773	8	No Significant Other
3773	9	Unknown ( Includes missing )
3774	0	Variable Did Not Exist
3774	1	Never
3774	2	Rarely
3774	3	Sometime
3774	4	Often
3774	5	Always
3774	7	Not Applicable: Variable not due this year
3774	9	Unknown ( Includes missing )
3775	0	Variable Did Not Exist
3775	1	Never
3775	2	Rarely
3775	3	Sometime
3775	4	Often
3775	5	Always
3775	7	Not Applicable: Variable not due this year
3775	8	No Significant Other
3775	9	Unknown ( Includes missing )
3776	0	Variable Did Not Exist
3776	1	Never
3776	2	Rarely
3776	3	Sometime
3776	4	Often
3776	5	Always
3776	7	Not Applicable: Variable not due this year
3776	9	Unknown ( Includes missing )
3777	0	Variable Did Not Exist
3777	1	Never
3777	2	Rarely
3777	3	Sometime
3777	4	Often
3777	5	Always
3777	7	Not Applicable: Variable not due this year
3777	8	No Significant Other
3777	9	Unknown ( Includes missing )
3778	0	Variable Did Not Exist
3778	1	Never
3778	2	Rarely
3778	3	Sometime
3778	4	Often
3778	5	Always
3778	7	Not Applicable: Variable not due this year
3778	9	Unknown ( Includes missing )
3779	0	Variable Did Not Exist
3779	1	Never
3779	2	Rarely
3779	3	Sometime
3779	4	Often
3779	5	Always
3779	7	Not Applicable: Variable not due this year
3779	8	No Significant Other
3779	9	Unknown/Missing ( Includes missing )
3780	0	Variable Did Not Exist
3780	1	Never
3780	2	Rarely
3780	3	Sometime
3780	4	Often
3780	5	Always
3780	7	Not Applicable: Variable not due this year
3780	9	Unknown/Missing ( Includes missing )
3781	0	Variable Did Not Exist
3781	1	Never
3781	2	Rarely
3781	3	Sometime
3781	4	Often
3781	5	Always
3781	7	Not Applicable: Variable not due this year
3781	8	No Significant Other
3781	9	Unknown/Missing ( Includes missing )
3782	0	Variable Did Not Exist
3782	1	Never
3782	2	Rarely
3782	3	Sometime
3782	4	Often
3782	5	Always
3782	7	Not Applicable: Variable not due this year
3782	9	Unknown/Missing ( Includes missing )
3783	0	Variable Did Not Exist
3783	1	Never
3783	2	Rarely
3783	3	Sometime
3783	4	Often
3783	5	Always
3783	7	Not Applicable: Variable not due this year
3783	8	No Significant Other
3783	9	Unknown/Missing ( Includes missing )
3784	0	Variable Did Not Exist
3784	1	Never
3784	2	Rarely
3784	3	Sometime
3784	4	Often
3784	5	Always
3784	7	Not Applicable: Variable not due this year
3784	9	Unknown/Missing ( Includes missing )
3785	0	Variable Did Not Exist
3785	1	Never
3785	2	Rarely
3785	3	Sometime
3785	4	Often
3785	5	Always
3785	7	Not Applicable: Variable not due this year
3785	8	No Significant Other
3785	9	Unknown/Missing ( Includes missing )
3786	0	Variable Did Not Exist
3786	1	Never
3786	2	Rarely
3786	3	Sometime
3786	4	Often
3786	5	Always
3786	7	Not Applicable: Variable not due this year
3786	9	Unknown/Missing ( Includes missing )
3787	0	Variable Did Not Exist
3787	1	Never
3787	2	Rarely
3787	3	Sometime
3787	4	Often
3787	5	Always
3787	7	Not Applicable: Variable not due this year
3787	8	No Significant Other
3787	9	Unknown/Missing ( Includes missing )
3788	0	Variable Did Not Exist
3788	1	Never
3788	2	Rarely
3788	3	Sometime
3788	4	Often
3788	5	Always
3788	7	Not Applicable: Variable not due this year
3788	9	Unknown/Missing ( Includes missing )
3789	0	Variable Did Not Exist
3789	1	Never
3789	2	Rarely
3789	3	Sometime
3789	4	Often
3789	5	Always
3789	7	Not Applicable: Variable not due this year
3789	8	No Significant Other
3790	0	Variable Did Not Exist
3790	1	Never
3790	2	Rarely
3790	3	Sometime
3790	4	Often
3790	5	Always
3790	7	Not Applicable: Variable not due this year
3790	9	Unknown/Missing ( Includes missing )
3791	0	Variable Did Not Exist
3791	1	Never
3791	2	Rarely
3791	3	Sometime
3791	4	Often
3791	5	Always
3791	7	Not Applicable: Variable not due this year
3791	9	Unknown/Missing ( Includes missing )
3792	0	Variable Did Not Exist
3792	1	Never
3792	2	Rarely
3792	3	Sometime
3792	4	Often
3792	5	Always
3792	7	Not Applicable: Variable not due this year
3792	8	No Significant Other
3792	9	Unknown/Missing ( Includes missing )
3793	0	Variable Did Not Exist
3793	1	Never
3793	2	Rarely
3793	3	Sometime
3793	4	Often
3793	5	Always
3793	7	Not Applicable: Variable not due this year
3793	8	No Significant Other
3793	9	Unknown/Missing ( Includes missing )
3794	0	Variable Did Not Exist
3794	1	Never
3794	2	Rarely
3794	3	Sometime
3794	4	Often
3794	5	Always
3794	7	Not Applicable: Variable not due this year
3794	8	No Significant Other
3794	9	Unknown/Missing ( Includes missing )
3795	0	Variable Did Not Exist
3795	1	Never
3795	2	Rarely
3795	3	Sometime
3795	4	Often
3795	5	Always
3795	7	Not Applicable: Variable not due this year
3795	9	Unknown/Missing ( Includes missing )
3796	0	Variable Did Not Exist
3796	1	Never
3796	2	Rarely
3796	3	Sometime
3796	4	Often
3796	5	Always
3796	7	Not Applicable: Variable not due this year
3796	9	Unknown/Missing ( Includes missing )
3797	0	Variable Did Not Exist
3797	1	Never
3797	2	Rarely
3797	3	Sometime
3797	4	Often
3797	5	Always
3797	7	Not Applicable: Variable not due this year
3797	8	No Significant Other
3797	9	Unknown/Missing ( Includes missing )
3798	0	Variable Did Not Exist
3798	1	Never
3798	2	Rarely
3798	3	Sometime
3798	4	Often
3798	5	Always
3798	7	Not Applicable: Variable not due this year
3798	9	Unknown/Missing ( Includes missing )
3799	0	Variable Did Not Exist
3799	1	Never
3799	2	Rarely
3799	3	Sometime
3799	4	Often
3799	5	Always
3799	7	Not Applicable: Variable not due this year
3799	8	No Significant Other
3799	9	Unknown/Missing ( Includes missing )
3800	0	Variable Did Not Exist
3800	1	Never
3800	2	Rarely
3800	3	Sometime
3800	4	Often
3800	5	Always
3800	7	Not Applicable: Variable not due this year
3800	9	Unknown/Missing ( Includes missing )
3801	0	Variable Did Not Exist
3801	1	Never
3801	2	Rarely
3801	3	Sometime
3801	4	Often
3801	5	Always
3801	7	Not Applicable: Variable not due this year
3801	8	No Significant Other
3801	9	Unknown/Missing ( Includes missing )
3802	0	Variable Did Not Exist
3802	1	Never
3802	2	Rarely
3802	3	Sometime
3802	4	Often
3802	5	Always
3802	7	Not Applicable: Variable not due this year
3802	9	Unknown/Missing ( Includes missing )
3803	0	Variable Did Not Exist
3803	1	Never
3803	2	Rarely
3803	3	Sometime
3803	4	Often
3803	5	Always
3803	7	Not Applicable: Variable not due this year
3803	8	No Significant Other
3803	9	Unknown/Missing ( Includes missing )
3804	0	Variable Did Not Exist
3804	1	Never
3804	2	Rarely
3804	3	Sometime
3804	4	Often
3804	5	Always
3804	7	Not Applicable: Variable not due this year
3804	9	Unknown/Missing ( Includes missing )
3805	0	Variable Did Not Exist
3805	1	Never
3805	2	Rarely
3805	3	Sometime
3805	4	Often
3805	5	Always
3805	7	Not Applicable: Variable not due this year
3805	8	No Significant Other
3805	9	Unknown/Missing ( Includes missing )
3806	0	Variable Did Not Exist
3806	1	Never
3806	2	Rarely
3806	3	Sometime
3806	4	Often
3806	5	Always
3806	7	Not Applicable: Variable not due this year
3806	9	Unknown/Missing ( Includes missing )
3807	0	Variable Did Not Exist
3807	1	Never
3807	2	Rarely
3807	3	Sometime
3807	4	Often
3807	5	Always
3807	7	Not Applicable: Variable not due this year
3807	9	Unknown/Missing ( Includes missing )
3808	0	Variable Did Not Exist
3808	1	Never
3808	2	Rarely
3808	3	Sometime
3808	4	Often
3808	5	Always
3808	7	Not Applicable: Variable not due this year
3808	8	No Significant Other
3808	9	Unknown/Missing ( Includes missing )
3809	0	Variable Did Not Exist
3809	1	Never
3809	2	Rarely
3809	3	Sometime
3809	4	Often
3809	5	Always
3809	7	Not Applicable: Variable not due this year
3809	8	No Significant Other
3809	9	Unknown/Missing ( Includes missing )
3810	0	Variable Did Not Exist
3810	1	Never
3810	2	Rarely
3810	3	Sometime
3810	4	Often
3810	5	Always
3810	7	Not Applicable: Variable not due this year
3810	9	Unknown/Missing ( Includes missing )
3811	0	Variable Did Not Exist
3811	1	Never
3811	2	Rarely
3811	3	Sometime
3811	4	Often
3811	5	Always
3811	7	Not Applicable: Variable not due this year
3811	8	No Significant Other
3811	9	Unknown/Missing ( Includes missing )
3812	0	Variable Did Not Exist
3812	1	Never
3812	2	Rarely
3812	3	Sometime
3812	4	Often
3812	5	Always
3812	7	Not Applicable: Variable not due this year
3812	9	Unknown/Missing ( Includes missing )
3813	0	Variable Did Not Exist
3813	1	Never
3813	2	Rarely
3813	3	Sometime
3813	4	Often
3813	5	Always
3813	7	Not Applicable: Variable not due this year
3813	8	No Significant Other
3813	9	Unknown/Missing ( Includes missing )
3814	0	Variable Did Not Exist
3814	1	Never
3814	2	Rarely
3814	3	Sometime
3814	4	Often
3814	5	Always
3814	7	Not Applicable: Variable not due this year
3814	9	Unknown/Missing ( Includes missing )
3815	0	Variable Did Not Exist
3815	1	Never
3815	2	Rarely
3815	3	Sometime
3815	4	Often
3815	5	Always
3815	7	Not Applicable: Variable not due this year
3815	8	No Significant Other
3815	9	Unknown/Missing ( Includes missing )
3816	0	Variable Did Not Exist
3816	1	Never
3816	2	Rarely
3816	3	Sometime
3816	4	Often
3816	5	Always
3816	7	Not Applicable: Variable not due this year
3816	9	Unknown/Missing ( Includes missing )
3817	0	Variable Did Not Exist
3817	1	Never
3817	2	Rarely
3817	3	Sometime
3817	4	Often
3817	5	Always
3817	7	Not Applicable: Variable not due this year
3817	8	No Significant Other
3817	9	Unknown/Missing ( Includes missing )
3818	0	Variable Did Not Exist
3818	1	Never
3818	2	Rarely
3818	3	Sometime
3818	4	Often
3818	5	Always
3818	7	Not Applicable: Variable not due this year
3818	9	Unknown/Missing ( Includes missing )
3819	0	Variable Did Not Exist
3819	1	Never
3819	2	Rarely
3819	3	Sometime
3819	4	Often
3819	5	Always
3819	7	Not Applicable: Variable not due this year
3819	8	No Significant Other
3819	9	Unknown/Missing ( Includes missing )
3820	0	Variable Did Not Exist
3820	1	Never
3820	2	Rarely
3820	3	Sometime
3820	4	Often
3820	5	Always
3820	7	Not Applicable: Variable not due this year
3820	9	Unknown/Missing ( Includes missing )
3821	0	Variable Did Not Exist
3821	1	Never
3821	2	Rarely
3821	3	Sometime
3821	4	Often
3821	5	Always
3821	7	Not Applicable: Variable not due this year
3821	8	No Significant Other
3821	9	Unknown/Missing ( Includes missing )
3822	0	Variable Did Not Exist
3822	1	Never
3822	2	Rarely
3822	3	Sometime
3822	4	Often
3822	5	Always
3822	7	Not Applicable: Variable not due this year
3822	9	Unknown/Missing ( Includes missing )
3823	0	Variable Did Not Exist
3823	1	Never
3823	2	Rarely
3823	3	Sometime
3823	4	Often
3823	5	Always
3823	7	Not Applicable: Variable not due this year
3823	9	Unknown/Missing ( Includes missing )
3824	0	Variable Did Not Exist
3824	1	Never
3824	2	Rarely
3824	3	Sometime
3824	4	Often
3824	5	Always
3824	7	Not Applicable: Variable not due this year
3824	9	Unknown/Missing ( Includes missing )
3825	0	Variable Did Not Exist
3825	1	Never
3825	2	Rarely
3825	3	Sometime
3825	4	Often
3825	5	Always
3825	7	Not Applicable: Variable not due this year
3825	8	No Significant Other
3825	9	Unknown/Missing ( Includes missing )
3826	0	Variable Did Not Exist
3826	1	Never
3826	2	Rarely
3826	3	Sometime
3826	4	Often
3826	5	Always
3826	7	Not Applicable: Variable not due this year
3826	9	Unknown/Missing ( Includes missing )
3827	0	Variable Did Not Exist
3827	1	Never
3827	2	Rarely
3827	3	Sometime
3827	4	Often
3827	5	Always
3827	7	Not Applicable: Variable not due this year
3827	8	No Significant Other
3827	9	Unknown/Missing ( Includes missing )
3828	0	Variable Did Not Exist
3828	1	Never
3828	2	Rarely
3828	3	Sometime
3828	4	Often
3828	5	Always
3828	7	Not Applicable: Variable not due this year
3828	9	Unknown/Missing ( Includes missing )
3829	0	Variable Did Not Exist
3829	1	Never
3829	2	Rarely
3829	3	Sometime
3829	4	Often
3829	5	Always
3829	7	Not Applicable: Variable not due this year
3829	8	No Significant Other
3829	9	Unknown/Missing ( Includes missing )
3830	0	Variable Did Not Exist
3830	1	Never
3830	2	Rarely
3830	3	Sometime
3830	4	Often
3830	5	Always
3830	7	Not Applicable: Variable not due this year
3830	9	Unknown/Missing ( Includes missing )
3831	0	Variable Did Not Exist
3831	1	Never
3831	2	Rarely
3831	3	Sometime
3831	4	Often
3831	5	Always
3831	7	Not Applicable: Variable not due this year
3831	8	No Significant Other
3831	9	Unknown/Missing ( Includes missing )
3832	0	Variable Did Not Exist
3832	1	Never
3832	2	Rarely
3832	3	Sometime
3832	4	Often
3832	5	Always
3832	7	Not Applicable: Variable not due this year
3832	9	Unknown/Missing ( Includes missing )
3833	0	Variable Did Not Exist
3833	1	Never
3833	2	Rarely
3833	3	Sometime
3833	4	Often
3833	5	Always
3833	7	Not Applicable: Variable not due this year
3833	8	No Significant Other
3833	9	Unknown/Missing ( Includes missing )
3834	0	Variable Did Not Exist
3834	1	Never
3834	2	Rarely
3834	3	Sometime
3834	4	Often
3834	5	Always
3834	7	Not Applicable: Variable not due this year
3834	9	Unknown/Missing ( Includes missing )
3835	0	Variable Did Not Exist
3835	1	Never
3835	2	Rarely
3835	3	Sometime
3835	4	Often
3835	5	Always
3835	7	Not Applicable: Variable not due this year
3835	8	No Significant Other
3835	9	Unknown/Missing ( Includes missing )
3836	0	Variable Did Not Exist
3836	1	Never
3836	2	Rarely
3836	3	Sometime
3836	4	Often
3836	5	Always
3836	7	Not Applicable: Variable not due this year
3836	9	Unknown/Missing ( Includes missing )
3837	0	Variable Did Not Exist
3837	1	Never
3837	2	Rarely
3837	3	Sometime
3837	4	Often
3837	5	Always
3837	7	Not Applicable: Variable not due this year
3837	8	No Significant Other
3837	9	Unknown/Missing ( Includes missing )
3838	0	Variable Did Not Exist
3838	1	Never
3838	2	Rarely
3838	3	Sometime
3838	4	Often
3838	5	Always
3838	7	Not Applicable: Variable not due this year
3838	9	Unknown/Missing ( Includes missing )
3839	0	Variable Did Not Exist
3839	1	Never
3839	2	Rarely
3839	3	Sometime
3839	4	Often
3839	5	Always
3839	7	Not Applicable: Variable not due this year
3839	8	No Significant Other
3839	9	Unknown/Missing ( Includes missing )
3840	0	Variable Did Not Exist
3840	1	Never
3840	2	Rarely
3840	3	Sometime
3840	4	Often
3840	5	Always
3840	7	Not Applicable: Variable not due this year
3840	9	Unknown/Missing ( Includes missing )
3841	0	Variable Did Not Exist
3841	1	Never
3841	2	Rarely
3841	3	Sometime
3841	4	Often
3841	5	Always
3841	7	Not Applicable: Variable not due this year
3841	8	No Significant Other
3841	9	Unknown/Missing ( Includes missing )
3842	0	Variable Did Not Exist
3842	1	Never
3842	2	Rarely
3842	3	Sometime
3842	4	Often
3842	5	Always
3842	7	Not Applicable: Variable not due this year
3842	9	Unknown/Missing ( Includes missing )
3843	0	Variable Did Not Exist
3843	1	Never
3843	2	Rarely
3843	3	Sometime
3843	4	Often
3843	5	Always
3843	7	Not Applicable: Variable not due this year
3843	8	No Significant Other
3843	9	Unknown/Missing ( Includes missing )
3844	0	Variable Did Not Exist
3844	1	Never
3844	2	Rarely
3844	3	Sometime
3844	4	Often
3844	5	Always
3844	7	Not Applicable: Variable not due this year
3844	9	Unknown/Missing ( Includes missing )
3845	0	Variable Did Not Exist
3845	1	Never
3845	2	Rarely
3845	3	Sometime
3845	4	Often
3845	5	Always
3845	7	Not Applicable: Variable not due this year
3845	8	No Significant Other
3845	9	Unknown/Missing ( Includes missing )
3846	0	Variable Did Not Exist
3846	1	Never
3846	2	Rarely
3846	3	Sometime
3846	4	Often
3846	5	Always
3846	7	Not Applicable: Variable not due this year
3846	9	Unknown/Missing ( Includes missing )
3847	0	Variable Did Not Exist
3847	1	Never
3847	2	Rarely
3847	3	Sometime
3847	4	Often
3847	5	Always
3847	7	Not Applicable: Variable not due this year
3847	8	No Significant Other
3847	9	Unknown/Missing ( Includes missing )
3848	0	Variable Did Not Exist
3848	1	Never
3848	2	Rarely
3848	3	Sometime
3848	4	Often
3848	5	Always
3848	7	Not Applicable: Variable not due this year
3848	9	Unknown/Missing ( Includes missing )
3849	0	Variable Did Not Exist
3849	1	Never
3849	2	Rarely
3849	3	Sometime
3849	4	Often
3849	5	Always
3849	7	Not Applicable: Variable not due this year
3849	8	No Significant Other ( Includes missing )
3849	9	Unknown/Missing
3850	0	Variable Did Not Exist
3850	1	Never
3850	2	Rarely
3850	3	Sometime
3850	4	Often
3850	5	Always
3850	7	Not Applicable: Variable not due this year
3850	9	Unknown/Missing ( Includes missing )
3851	0	Variable Did Not Exist
3851	1	Never
3851	2	Rarely
3851	3	Sometime
3851	4	Often
3851	5	Always
3851	7	Not Applicable: Variable not due this year
3851	8	No Significant Other
3851	9	Unknown/Missing ( Includes missing )
3852	0	Variable Did Not Exist
3852	1	Never
3852	2	Rarely
3852	3	Sometime
3852	4	Often
3852	5	Always
3852	7	Not Applicable: Variable not due this year
3852	9	Unknown/Missing ( Includes missing )
3853	0	Variable Did Not Exist
3853	1	Never
3853	2	Rarely
3853	3	Sometime
3853	4	Often
3853	5	Always
3853	7	Not Applicable: Variable not due this year
3853	8	No Significant Other
3853	9	Unknown/Missing ( Includes missing )
3854	0	Variable Did Not Exist
3854	1	Never
3854	2	Rarely
3854	3	Sometime
3854	4	Often
3854	5	Always
3854	7	Not Applicable: Variable not due this year
3854	9	Unknown/Missing ( Includes missing )
3855	0	Variable Did Not Exist
3855	1	Never
3855	2	Rarely
3855	3	Sometime
3855	4	Often
3855	5	Always
3855	7	Not Applicable: Variable not due this year
3855	8	No Significant Other
3855	9	Unknown/Missing ( Includes missing )
3856	0	Variable Did Not Exist
3856	1	Never
3856	2	Rarely
3856	3	Sometime
3856	4	Often
3856	7	Not Applicable: Variable not due this year
3856	9	Unknown/Missing ( Includes missing )
3857	0	Variable Did Not Exist
3857	1	Never
3857	2	Rarely
3857	3	Sometime
3857	4	Often
3857	5	Always
3857	7	Not Applicable: Variable not due this year
3857	8	No Significant Other
3857	9	Unknown/Missing ( Includes missing )
3858	0	Variable Did Not Exist
3858	1	Never
3858	2	Rarely
3858	3	Sometime
3858	4	Often
3858	5	Always
3858	7	Not Applicable: Variable not due this year
3858	9	Unknown/Missing ( Includes missing )
3859	0	Variable Did Not Exist
3859	1	Never
3859	2	Rarely
3859	3	Sometime
3859	4	Often
3859	5	Always
3859	7	Not Applicable: Variable not due this year
3859	8	No Significant Other
3859	9	Unknown/Missing ( Includes missing )
3860	0	Variable Did Not Exist
3860	1	Never
3860	2	Rarely
3860	3	Sometime
3860	4	Often
3860	5	Always
3860	7	Not Applicable: Variable not due this year
3860	9	Unknown/Missing ( Includes missing )
3861	0	Variable Did Not Exist
3861	1	Never
3861	2	Rarely
3861	3	Sometime
3861	4	Often
3861	5	Always
3861	7	Not Applicable: Variable not due this year
3861	8	No Significant Other
3861	9	Unknown/Missing ( Includes missing )
3862	0	Variable Did Not Exist
3862	1	Never
3862	2	Rarely
3862	3	Sometime
3862	4	Often
3862	5	Always
3862	7	Not Applicable: Variable not due this year
3862	9	Unknown/Missing ( Includes missing )
3863	0	Variable Did Not Exist
3863	1	Never
3863	2	Rarely
3863	3	Sometime
3863	4	Often
3863	5	Always
3863	7	Not Applicable: Variable not due this year
3863	9	Unknown/Missing ( Includes missing )
3864	0	Variable Did Not Exist
3864	1	Never
3864	2	Rarely
3864	3	Sometime
3864	4	Often
3864	5	Always
3864	7	Not Applicable: Variable not due this year
3864	8	No Significant Other
3864	9	Unknown/Missing ( Includes missing )
3865	0	Variable Did Not Exist
3865	1	Never
3865	2	Rarely
3865	3	Sometime
3865	4	Often
3865	5	Always
3865	7	Not Applicable: Variable not due this year
3865	8	No Significant Other
3865	9	Unknown/Missing ( Includes missing )
3866	1	Never
3866	2	Rarely
3866	3	Sometime
3866	4	Often
3866	5	Always
3866	7	Not Applicable: Variable not due this year
3866	9	Unknown/Missing ( Includes missing )
3867	1	Never
3867	2	Rarely
3867	3	Sometime
3867	4	Often
3867	5	Always
3867	7	Not Applicable: Variable not due this year
3867	8	No Significant Other
3867	9	Unknown/Missing ( Includes missing )
3868	0	Variable Did Not Exist
3868	1	Never
3868	2	Rarely
3868	3	Sometime
3868	4	Often
3868	5	Always
3868	7	Not Applicable: Variable not due this year
3868	9	Unknown/Missing ( Includes missing )
3869	0	Variable Did Not Exist
3869	1	Never
3869	2	Rarely
3869	3	Sometime
3869	4	Often
3869	5	Always
3869	7	Not Applicable: Variable not due this year
3869	8	No Significant Other
3869	9	Unknown/Missing ( Includes missing )
3870	0	Variable Did Not Exist
3870	1	Never
3870	2	Rarely
3870	3	Sometime
3870	4	Often
3870	5	Always
3870	7	Not Applicable: Variable not due this year
3870	9	Unknown/Missing ( Includes missing )
3871	0	Variable Did Not Exist
3871	1	Never
3871	2	Rarely
3871	3	Sometime
3871	4	Often
3871	5	Always
3871	7	Not Applicable: Variable not due this year
3871	8	No Significant Other
3871	9	Unknown/Missing ( Includes missing )
3872	0	Variable Did Not Exist
3872	1	Never
3872	2	Rarely
3872	3	Sometime
3872	4	Often
3872	5	Always
3872	7	Not Applicable: Variable not due this year
3872	9	Unknown/Missing ( Includes missing )
3873	0	Variable Did Not Exist
3873	1	Never
3873	2	Rarely
3873	3	Sometime
3873	4	Often
3873	5	Always
3873	7	Not Applicable: Variable not due this year
3873	8	No Significant Other
3873	9	Unknown/Missing ( Includes missing )
3874	0	Variable Did Not Exist
3874	1	Never
3874	2	Rarely
3874	3	Sometime
3874	4	Often
3874	5	Always
3874	7	Not Applicable: Variable not due this year
3874	9	Unknown/Missing ( Includes missing )
3875	0	Variable Did Not Exist
3875	1	Never
3875	2	Rarely
3875	3	Sometime
3875	4	Often
3875	5	Always
3875	7	Not Applicable: Variable not due this year
3875	8	No Significant Other
3875	9	Unknown/Missing ( Includes missing )
3876	0	Variable Did Not Exist
3876	1	Never
3876	2	Rarely
3876	3	Sometime
3876	4	Often
3876	5	Always
3876	7	Not Applicable: Variable not due this year
3876	9	Unknown/Missing ( Includes missing )
3877	0	Variable Did Not Exist
3877	1	Never
3877	2	Rarely
3877	3	Sometime
3877	4	Often
3877	5	Always
3877	7	Not Applicable: Variable not due this year
3877	8	No Significant Other
3877	9	Unknown/Missing ( Includes missing )
3878	0	Variable Did Not Exist
3878	1	Never
3878	2	Rarely
3878	3	Sometime
3878	4	Often
3878	5	Always
3878	7	Not Applicable: Variable not due this year
3878	9	Unknown/Missing ( Includes missing )
3879	0	Variable Did Not Exist
3879	1	Never
3879	2	Rarely
3879	3	Sometime
3879	4	Often
3879	5	Always
3879	7	Not Applicable: Variable not due this year
3879	8	No Significant Other
3879	9	Unknown/Missing ( Includes missing )
3880	0	Variable Did Not Exist
3880	1	Never
3880	2	Rarely
3880	3	Sometime
3880	4	Often
3880	5	Always
3880	7	Not Applicable: Variable not due this year
3880	9	Unknown/Missing ( Includes missing )
3881	0	Variable Did Not Exist
3881	1	Never
3881	2	Rarely
3881	3	Sometime
3881	4	Often
3881	5	Always
3881	7	Not Applicable: Variable not due this year
3881	8	No Significant Other
3881	9	Unknown/Missing ( Includes missing )
3882	0	Variable Did Not Exist
3882	1	Never
3882	2	Rarely
3882	3	Sometime
3882	4	Often
3882	5	Always
3882	7	Not Applicable: Variable not due this year
3882	9	Unknown/Missing ( Includes missing )
3883	0	Variable Did Not Exist
3883	1	Never
3883	2	Rarely
3883	3	Sometime
3883	4	Often
3883	5	Always
3883	7	Not Applicable: Variable not due this year
3883	8	No Significant Other
3883	9	Unknown/Missing ( Includes missing )
3884	0	Variable Did Not Exist
3884	1	Never
3884	2	Rarely
3884	3	Sometime
3884	4	Often
3884	5	Always
3884	7	Not Applicable: Variable not due this year
3884	9	Unknown/Missing ( Includes missing )
3885	0	Variable Did Not Exist
3885	1	Never
3885	2	Rarely
3885	3	Sometime
3885	4	Often
3885	5	Always
3885	7	Not Applicable: Variable not due this year
3885	8	No Significant Other
3885	9	Unknown/Missing ( Includes missing )
3886	0	Variable Did Not Exist
3886	1	Never
3886	2	Rarely
3886	3	Sometime
3886	4	Often
3886	5	Always
3886	7	Not Applicable: Variable not due this year
3886	9	Unknown/Missing ( Includes missing )
3887	0	Variable Did Not Exist
3887	1	Never
3887	2	Rarely
3887	3	Sometime
3887	4	Often
3887	5	Always
3887	7	Not Applicable: Variable not due this year
3887	8	No Significant Other
3887	9	Unknown/Missing ( Includes missing )
3888	0	Variable Did Not Exist
3888	1	Not Applicable: Variable not due this year
3888	2	Still in PVS
3888	3	Incomplete-Severe Cognitive or Behavioral Problems
3888	4	Forms Mailed but Not Returned
3888	5	Stated Refusal
3888	6	Lost to Follow-up or Expired During Follow-up Year
3888	8	Not Applicable: Questionnaire administered
3888	9	Unknown Why Questionnaire Not Administered
3889	0	Variable Did Not Exist
3889	1	Not Applicable: Variable not due this year
3889	2	Still in PVS
3889	4	Forms Mailed but Not Returned
3889	5	Stated Refusal
3889	6	Lost to Follow-up or Expired During Follow-up Year
3889	7	No Significant Other or Family Member Available
3889	8	Not Applicable: Questionnaire administered
3889	9	Unknown Why Questionnaire Not Administered
3890	0	Variable Did Not Exist
3890	1	Never
3890	2	Rarely
3890	3	Sometime
3890	4	Often
3890	5	Always
3890	7	Not Applicable: Variable not due this year
3890	9	Unknown/Missing
3891	0	Variable Did Not Exist
3891	1	Never
3891	2	Rarely
3891	3	Sometime
3891	4	Often
3891	5	Always
3891	7	Not Applicable: Variable not due this year
3891	8	No Significant Other
3891	9	Unknown/Missing
3892	0	Variable Did Not Exist
3892	1	Never
3892	2	Rarely
3892	3	Sometime
3892	4	Often
3892	5	Always
3892	7	Not Applicable: Variable not due this year
3892	9	Unknown/Missing
3893	0	Variable Did Not Exist
3893	1	Never
3893	2	Rarely
3893	3	Sometime
3893	4	Often
3893	5	Always
3893	7	Not Applicable: Variable not due this year
3893	8	No Significant Other
3893	9	Unknown/Missing
3894	0	Variable Did Not Exist
3894	1	Never
3894	2	Rarely
3894	3	Sometime
3894	4	Often
3894	5	Always
3894	7	Not Applicable: Variable not due this year
3894	9	Unknown/Missing
3895	0	Variable Did Not Exist
3895	1	Never
3895	2	Rarely
3895	3	Sometime
3895	4	Often
3895	5	Always
3895	7	Not Applicable: Variable not due this year
3895	8	No Significant Other
3895	9	Unknown/Missing
3896	0	Variable Did Not Exist
3896	1	Never
3896	2	Rarely
3896	3	Sometime
3896	4	Often
3896	5	Always
3896	7	Not Applicable: Variable not due this year
3896	9	Unknown/Missing
3897	0	Variable Did Not Exist
3897	1	Never
3897	2	Rarely
3897	3	Sometime
3897	4	Often
3897	5	Always
3897	7	Not Applicable: Variable not due this year
3897	8	No Significant Other
3897	9	Unknown/Missing
3898	0	Variable Did Not Exist
3898	1	Never
3898	2	Rarely
3898	3	Sometime
3898	4	Often
3898	5	Always
3898	7	Not Applicable: Variable not due this year
3898	9	Unknown/Missing
3899	0	Variable Did Not Exist
3899	1	Never
3899	2	Rarely
3899	3	Sometime
3899	4	Often
3899	5	Always
3899	7	Not Applicable: Variable not due this year
3899	8	No Significant Other
3899	9	Unknown/Missing
3900	0	Variable Did Not Exist
3900	1	Never
3900	2	Rarely
3900	3	Sometime
3900	4	Often
3900	5	Always
3900	7	Not Applicable: Variable not due this year
3900	9	Unknown/Missing
3901	0	Variable Did Not Exist
3901	1	Never
3901	2	Rarely
3901	3	Sometime
3901	4	Often
3901	5	Always
3901	7	Not Applicable: Variable not due this year
3901	8	No Significant Other
3901	9	Unknown/Missing
3902	0	Variable Did Not Exist
3902	1	Never
3902	2	Rarely
3902	3	Sometime
3902	4	Often
3902	5	Always
3902	7	Not Applicable: Variable not due this year
3902	9	Unknown/Missing
3903	0	Variable Did Not Exist
3903	1	Never
3903	2	Rarely
3903	3	Sometime
3903	4	Often
3903	5	Always
3903	7	Not Applicable: Variable not due this year
3903	8	No Significant Other
3903	9	Unknown/Missing
3904	0	Variable Did Not Exist
3904	1	Never
3904	2	Rarely
3904	3	Sometime
3904	4	Often
3904	5	Always
3904	7	Not Applicable: Variable not due this year
3904	9	Unknown/Missing
3905	0	Variable Did Not Exist
3905	1	Never
3905	2	Rarely
3905	3	Sometime
3905	4	Often
3905	5	Always
3905	7	Not Applicable: Variable not due this year
3905	8	No Significant Other
3905	9	Unknown/Missing
3906	0	Variable Did Not Exist
3906	1	Never
3906	2	Rarely
3906	3	Sometime
3906	4	Often
3906	5	Always
3906	7	Not Applicable: Variable not due this year
3906	9	Unknown/Missing
3907	0	Variable Did Not Exist
3907	1	Never
3907	2	Rarely
3907	3	Sometime
3907	4	Often
3907	5	Always
3907	7	Not Applicable: Variable not due this year
3907	8	No Significant Other
3907	9	Unknown/Missing
3908	0	Variable Did Not Exist
3908	1	Never
3908	2	Rarely
3908	3	Sometime
3908	4	Often
3908	5	Always
3908	7	Not Applicable: Variable not due this year
3908	9	Unknown/Missing
3909	0	Variable Did Not Exist
3909	1	Never
3909	2	Rarely
3909	3	Sometime
3909	4	Often
3909	5	Always
3909	7	Not Applicable: Variable not due this year
3909	8	No Significant Other
3909	9	Unknown/Missing
3910	0	Variable Did Not Exist
3910	1	Never
3910	2	Rarely
3910	3	Sometime
3910	4	Often
3910	5	Always
3910	7	Not Applicable: Variable not due this year
3910	9	Unknown/Missing
3911	1	Never
3911	2	Rarely
3911	3	Sometime
3911	4	Often
3911	5	Always
3911	7	Not Applicable: Variable not due this year
3911	8	No Significant Other
3911	9	Unknown/Missing
3912	0	Variable Did Not Exist
3912	1	Never
3912	2	Rarely
3912	3	Sometime
3912	4	Often
3912	5	Always
3912	7	Not Applicable: Variable not due this year
3912	9	Unknown/Missing
3913	0	Variable Did Not Exist
3913	1	Never
3913	2	Rarely
3913	3	Sometime
3913	4	Often
3913	5	Always
3913	7	Not Applicable: Variable not due this year
3913	8	No Significant Other
3913	9	Unknown

History

No history found for the Domain.

NHANES (NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY - ARCHIVE

Definition

Types of conditions diagnosed, along with if the onset was before, after or about the same time as the TBI, and age that they were first told they have the condition. All definitions provided below are from Mayo Clinic (http://www.mayoclinic.org) except chronic pain. If a participant asks for a definition of the disease, it is acceptable to tell them the following:

Heart Arrhythmia: Occurs when the electrical impulses that coordinate heartbeats don’t work properly and cause the heart to beat too fast, too slow, or irregularly
Emphysema or asthma or COPD: a type of chronic lung disease that causes difficulty breathing and is commonly associated with smoking
Pneumonia: Lung infection caused by bacteria, viruses, or fungi
Sleep disorder like sleep apnea: A medical problem with drops in oxygen levels during sleep that prevents a person from sleeping normally; other examples are narcolepsy and restless legs syndrome Cataracts: A clouding of the normally clear lens of your eye. For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-up window.
Chronic Pain: Pain is actually a symptom, not a diagnosis. Pain is a self-report item. However, there are diagnosis in which chronic pain is a central feature. While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap – sprained back, serious infection, or there may be an ongoing cause of pain – arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system). A person may have two or more co-existing chronic pain conditions. Such conditions can include chronic fatigue syndrome, endometriosis, fibromyalgia, inflammatory bowel disease, interstitial cystitis, temporomandibular joint dysfunction, and vulvodynia. It is not known whether these disorders share a common cause
Alcoholism: Pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking
Drug addiction: disease that affects a person’s brain and behavior and leads to an inability to control the use of a legal or illegal drugs or medications.
Depression: Mood disorder with persistent feelings of sadness with or without loss of interest. This problem interferes with daily activities and cause significant distress
Anxiety: disorder with persistent, intense, and excessive worry and fear about everyday situations. This problem interferes with daily activities and cause significant distress
Bipolar disorder or manic depression: Mental health condition that causes extreme mood phases that include emotional highs (mania or hypomania) and lows (depression). This problem interferes with daily activities and cause significant distress
Attention deficit disorder (ADD)/Attention deficit hyperactivity disorder (ADHD): Includes a combination of persistent problems such as difficulty paying attention, hyperactivity, and impulsive behavior across settings. This problem interferes with daily activities and can cause significant distress
Obsessive-compulsive disorder: features a pattern of unwanted thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress
High Blood Cholesterol Day, Month, Year If high cholesterol reported, date cholesterol last tested by a doctor.

Form

[ ] Form 1 [X] Form 2

Source

• Interview, Mail-out (participant or proxy)

Details

This measure can be collected from best source available during the Form 2 interview for all participants. Conditions with positive responses will remain positive and should not be asked again on subsequent follow-ups.

For conditions that are present, the follow-up questions should be asked:
- ‘Was that before, after or about the same time as your TBI (insert number of years since TBI)?’, followed by; ‘How old were you when a doctor or other health professional first told you that you had this condition?’

If the participant has difficulty remembering their age at time of diagnosis, they will be asked:
- ‘How many years ago did a doctor or other health professional first tell you that you had this condition?’

First administration: For participants being administered the NHANES for the first time since study enrollment ask “has a doctor or other health professional ever told you that you had…” for each medical condition. For each health condition endorsed with “yes” the data collector will follow-up with “at what age were you diagnosed?”

Follow-up administration: For participants who were previously administered the NHANES, and are now being administered a follow up NHANES ask, “In the past year has a doctor or other health professional told you that you have…” For any health condition endorsed with “Yes” follow up with additional questions (e.g., ‘At what age were you diagnosed?’).

Age: On questions asking for the age of diagnosis, obtain the age of diagnosis. It is permissible for participant to estimate if they have an idea for when they were diagnosed, but should not make up a random age if they truly have no idea. Prompt if the diagnosis occurred during childhood, adolescence, their 20s, their 30s, etc.

If a health condition was diagnosed prior to one year, enter “0”.

Before, after or about the same time as TBI: A 6 month window on either side of the injury date would be considered to be ‘about the same time’ as TBI.

If the participant has difficulty remembering their age at time of diagnosis, they will be asked:
* ‘How many years ago did a doctor or other health professional first tell you that you had this condition?’

Do not accept self-diagnosis or a diagnosis that does not come from a doctor or other health professional. “Doctor” is meant to include health care providers who diagnose medical conditions.

The following are acceptable: - Medical Doctors (MD) in all medical specialties including Psychiatrists - Doctors of Osteopathic Medicine (DO) - Physician Assistants (PA) -Nurse Practitioners (NP) - Psychologists, Neuropsychologists (Ph.D. or Psy.D) - Podiatrists (DPM)

Not acceptable (these providers treat but do not diagnose) - Speech Pathologists (SLP) - Registered Nurses (RN) - Physical Therapists (PT) - Social Workers (LSW, LICSW) - Occupational Therapists (OT) - Naturopathic Doctors (ND) - Counselors (LMHC, LMFT, CRC) - Chiropractors (DC)

Other Heart Conditions - Arrhythmias Include low blood pressure ONLY if symptomatic

Hypertension If high blood pressure reported, date last tested by a doctor.

Reference

Variables were sourced through the following existing surveys. For items 1-8: * Medicare survey questions #20, 22-26, 32, 33 * Medicare Health Outcomes Survey (MHOS)
* Medicare Survey: SAMPLING METHODOLOGY

2009 Cohort 12 Baseline Sampling
CMS identified beneficiaries who were eligible for sampling as follows: * MAOs with fewer than 500 members were not required to report HOS. * For MAOs with 500 to 1,200 members, all eligible members were included in the sample. * For MAOs with more than 1,200 members and less than 3,000 members, a simple random sample of 1,200 members was selected for the baseline survey. * For MAOs with 3,000 or more members, members who responded to the 2008 Cohort 11 Baseline survey were excluded from the 2009 Cohort 12 Baseline sample. * Members were defined as eligible if they did not have End Stage Renal Disease (ESRD). The six months enrollment requirement was waived beginning in 2009.

For a more detailed discussion on sampling, data collection and submission please refer to the HEDIS 2009 Volume 6 manual1 and the Medicare HOS website at www.hosonline.org.
National Committee for Quality Assurance. HEDIS® 2009, Volume 6: Specifications for the Medicare Health Outcomes Survey. Washington, DC: NCQA Publication, 2009. Not sure how to access the comparative data; there is an application to use the data, to use the full survey or parts of the survey.

National Health and Nutrition Examination Survey (NHANES)
The NHANES interview includes demographic, socioeconomic, dietary, and health-related questions. The examination component consists of medical, dental, and physiological measurements, as well as laboratory tests administered by highly trained medical personnel.
Findings from this survey will be used to determine the prevalence of major diseases and risk factors for diseases. Information will be used to assess nutritional status and its association with health promotion and disease prevention. NHANES findings are also the basis for national standards for such measurements as height, weight, and blood pressure. Data from this survey will be used in epidemiological studies and health sciences research, which help develop sound public health policy, direct and design health programs and services, and expand the health knowledge for the Nation. Datasource/Methods: Personal interviews, physical exams, lab tests, nutritional assessment, DNA repository Targeted sample size: 5,000 people/year, all ages. Oversample 60+, blacks & Hispanics Data: Data is available for 1999-2008; the most recent data set available is 2007-2008

National Health Interview Survey (NHIS)
The National Health Interview Survey (NHIS) has monitored the health of the nation since 1957. NHIS data on a broad range of health topics are collected through personal household interviews. For over 50 years, the U.S. Census Bureau has been the data collection agent for the National Health Interview Survey. Survey results have been instrumental in providing data to track health status, health care access, and progress toward achieving national health objectives.

Characteristics

The following Health Condition items were collected from 10/01/2012 to 10/01/2017. See Health Conditions - Archive for more information.
- Cancer
- COPD
- Diabetes
- Heart Attack
- Heart Conditions
- Heart Failure
- High Blood Pressure
- Liver Disease
- Stroke

On 4/1/2022, collection of age diagnosed, along with the following NHANES items were removed from Data Collection.
- OtherHeartConditions - Heart arrhythmias
- Emphysema - Emphysema or asthma or COPD
- Pneumonia
- SleepDisorder - Sleep disorder like sleep apnea - Cataracts
- ChronicPain
- Alcoholism
- DrugAddiction
- Depression
- Anxiety
- BipolarDisorder - Bipolar disorder or manic-depression - ADDADHD - Attention deficit disorder (ADD) / Attention deficit hyperactivity disorder (ADHD)
- OCD - Obsessive-compulsive disorder

Variables

Form Type	Variable	ID	Question	History
Form 2	ADDADHDAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	ADDADHDF	714	Attention deficit disorder (ADD) / Attention deficit hyperactivity disorder (ADHD)?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	ADDADHDTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	AlcoholismAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	AlcoholismF	714	Alcoholism?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	AlcoholismTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	AnxietyAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	AnxietyF	714	Anxiety?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	AnxietyTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	BipolarDisorderAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	BipolarDisorderF	714	Bipolar disorder or manic-depression?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	BipolarDisorderTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	CataractsAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	CataractsF	714	Cataracts?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	CataractsTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	ChronicPainAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	ChronicPainF	714	Chronic pain?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	ChronicPainTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	CongHFAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	DementiaAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	DepressionAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Removed Variable
Form 2	DepressionHlthF	714	Depression?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	DepressionHlthTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	DiabetesAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	DiabetesInsulinF	640	Use Insulin?	2017-10-01 - Variable Added 2019-01-15 - Variable Removed
Form 2	DiabetesPregnantF	641	Pregnant?	2017-10-01 - Variable Added 2019-01-15 - Variable Deleted
Form 2	DrugAddictionAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	DrugAddictionF	714	Drug addiction?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	DrugAddictionTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	EmphysemaAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Removed Variable
Form 2	EmphysemaF	714	Emphysema or asthma or chronic obstructive pulmonary disease (COPD)?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	EmphysemaTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	HighBloodCholesterolAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Removed Variable
Form 2	HighBloodCholesterolDayF	706	Day	2017-10-01 - Variable Added 2018-04-01 - Variable Removed
Form 2	HighBloodCholesterolMonthF	707	Month	2017-10-01 - Variable Added 2018-04-01 - Variable Removed
Form 2	HighBloodCholesterolYearF	708	Year	2017-10-01 - Variable Added 2018-04-01 - Variable Removed
Form 2	HyperAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	HyperDayF	711	Day	2017-10-01 - Variable Added 2018-04-01 - Variable Removed
Form 2	HyperMonthF	712	Month	2017-10-01 - Variable Added 2018-04-01 - Variable Removed
Form 2	HyperYearF	715	Year	2017-10-01 - Variable Added 2018-04-01 - Variable Removed
Form 2	LiverAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Removed Variable
Form 2	MovementDisorderAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	MyocardialInfarctionAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	OCDF	714	Obsessive-compulsive disorder?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	OCDTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	ObsessiveCompulsiveDisorderAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	OsteoarthritisAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	OtherHeartConditionsAgeF	710	Age	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	OtherHeartConditionsF	714	Heart arrhythmias?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	OtherHeartConditionsTBIOnsetF	713	Onset	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	PTSDAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	PanicAttacksAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	PneumoniaAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	PneumoniaF	714	Pneumonia?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	PneumoniaTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	RheumatoidAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	SleepDisorderAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	SleepDisorderF	714	Sleep disorder like sleep apnea?	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	SleepDisorderTBIOnsetF	713	Onset:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed
Form 2	StrokeAgeF	710	Age:	2017-10-01 - Variable Added 2022-04-01 - Variable Removed

Codes and Values

ID	Code	Description
640	1	No
640	2	Yes
640	6	Variable Did Not Exist
640	8	N/A
640	9	Unknown
641	1	No
641	2	Yes
641	6	Variable Did Not Exist
641	8	N/A
641	9	Unknown
706	6	Variable Did Not Exist
706	88	N/A
706	99	Unknown
707	6	Variable Did Not Exist
707	88	N/A
707	99	Unknown
708	6	Variable Did Not Exist
708	88	N/A
708	99	Unknown
710	666	Variable Did Not Exist
710	888	N/A
710	999	Unknown
711	6	Variable Did Not Exist
711	88	N/A
711	99	Unknown
712	6	Variable Did Not Exist
712	88	N/A
712	99	Unknown
713	1	Before TBI
713	2	Same Time As TBI
713	3	After TBI
713	66	Variable Did Not Exist
713	88	N/A
713	99	Unknown
714	0	No
714	1	Yes
714	66	Variable Did Not Exist
714	88	N/A
714	99	Unknown
715	6	Variable Did Not Exist
715	88	N/A
715	99	Unknown

History

No history found for the Domain.

NHANES: HEALTH CONDITIONS - ARCHIVE

Definition

Form I - Is there documentation in the record that the participant ever had… 1. Hypertension or high blood pressure? 2. Congestive heart failure? 3. A myocardial infarction or heart attack? 4. Other heart conditions such as problems with heart valves or the rhythm of your heartbeat? 5. A stroke? 6. Emphysema or asthma or chronic obstructive pulmonary disease (COPD)? 7. Diabetes, high blood sugar, or sugar in the urine? 8. Any cancer? 9. Liver disease (such as hepatitis)?

Emphysema or asthma or COPD - Emphysema is a type of chronic lung disease that causes difficulty breathing and is commonly associated with smoking. Asthma is a condition in which airways narrow and swell and produce extra mucus which triggers coughing, wheezing, and shortness of breath. Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease that causes obstructed airflow from the lungs leading to breathing difficulty, coughing, and wheezing

Form

• Form 1
• Form 2

Source

• Form 1 - Abstraction (acute and rehab record)
• Form 2 - Interview, Mail-Out (participant or proxy)

Details

This measure is to be collected from the medical record for all participants. Review of discharge summaries, history and physicals, and rehabilitation physician progress notes is adequate. Any new condition that occurs during the acute or rehab stay should be counted, along with conditions listed in the patient’s prior health history.

Unknown code is to be used when no records are available or records state “unknown medical history”.

If a condition is documented in one medical record source but not another, then keep. For example, if mentioned in the acute record, but not in the rehab record it should be kept. Vice versa, if mentioned in the rehab record but not in the acute record it should be kept.

Do not include condition if only mentioned by interview.

Code CAD under “other heart conditions” unless chart or person mentions myocardial infarction (MI), heart attack, or congestive heart failure (CHF). If MI, heart attack, or CHF is also noted then use those categories.

Low blood pressure is only a problem if symptomatic. If not symptomatic it should not be counted in any of the health conditions.

Only long-lasting conditions should be included, so incidences such as “hypertensive on admission to the ER” would not be included.

Do not include condition if only found as an ICD code.

Reference

For items 1-8: Medicare survey questions #20, 22-26, 32, 33 Medicare Survey: SAMPLING METHODOLOGY 2009 Cohort 12 Baseline Sampling CMS identified beneficiaries who were eligible for sampling as follows: * MAOs with fewer than 500 members were not required to report HOS. * For MAOs with 500 to 1,200 members, all eligible members were included in the sample. * For MAOs with more than 1,200 members and less than 3,000 members, a simple random sample of 1,200 members was selected for the baseline survey. * For MAOs with 3,000 or more members, members who responded to the 2008 Cohort 11 Baseline survey were excluded from the 2009 Cohort 12 Baseline sample. * Members were defined as eligible if they did not have End Stage Renal Disease (ESRD). The six months enrollment requirement was waived beginning in 2009.

For a more detailed discussion on sampling, data collection and submission please refer to the HEDIS 2009 Volume 6 manual1 and the Medicare HOS website at www.hosonline.org. National Committee for Quality Assurance. HEDIS® 2009, Volume 6: Specifications for the Medicare Health Outcomes Survey. Washington, DC: NCQA Publication, 2009. Not sure how to access the comparative data; there is an application to use the data, to use the full survey or parts of the survey.

National Health and Nutrition Examination Survey (NHANES) The NHANES interview includes demographic, socioeconomic, dietary, and health-related questions. The examination component consists of medical, dental, and physiological measurements, as well as laboratory tests administered by highly trained medical personnel. Findings from this survey will be used to determine the prevalence of major diseases and risk factors for diseases. Information will be used to assess nutritional status and its association with health promotion and disease prevention. NHANES findings are also the basis for national standards for such measurements as height, weight, and blood pressure. Data from this survey will be used in epidemiological studies and health sciences research, which help develop sound public health policy, direct and design health programs and services, and expand the health knowledge for the Nation.

Data source/Methods: Personal interviews, physical exams, lab tests, nutritional assessment, DNA repository Targeted sample size: 5,000 people/year, all ages. Oversample 60+, blacks & Hispanics Data: Data is available for 1999-2008; the most recent data set available is 2007-2008

NHIS National Health Interview Survey (NHIS) The National Health Interview Survey (NHIS) has monitored the health of the nation since 1957. NHIS data on a broad range of health topics are collected through personal household interviews. For over 50 years, the U.S. Census Bureau has been the data collection agent for the National Health Interview Survey. Survey results have been instrumental in providing data to track health status, health care access, and progress toward achieving national health objectives.

Characteristics

These variables were removed from the database on 10/01/2017 and replaced with items selected from the NHANES.

Variables

Form Type	Variable	ID	Question	History
Form 1	COPD	419	Emphysema or asthma or chronic obstructive pulmonary disease (COPD)?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	Cancer	413	Cancer?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	Diabetes	442	Diabetes, high blood sugar or sugar in the urine?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	HeartAttackOld	508	A myocardial infarction or heart attack?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	HeartCond	508	Other heart conditions such as problems with heart valves or the rhythm of your heartbeat?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	HeartFailure	509	Congestive heart failure?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	HighBP	511	Hypertension or high blood pressure?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	LiverDiseaseOld	516	Liver disease (such as hepatitis)?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 1	StrokeOld	557	Stroke?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	COPDF	615	Emphysema or asthma or chronic obstructive pulmonary disease (COPD)?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	CancerF	605	Cancer?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	DiabetesHighBloodSugarFOLD	639	Diabetes, high blood sugar or sugar in the urine?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	HeartAttackFOLD	702	A myocardial infarction or heart attack?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	HeartCondF	702	Other heart conditions such as problems with heart valves or the rhythm of your heartbeat?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	HeartFailureF	703	Congestive heart failure?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	HighBPF	709	Hypertension or high blood pressure?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	LiverDiseaseFOLD	721	Liver disease (such as hepatitis)?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	StrokeFOld	776	Stroke?	2012-10-01 - Variable Added 2017-10-01 - Variable Removed

Codes and Values

ID	Code	Description
413	0	Variable Did Not Exist
413	1	No
413	2	Yes
413	7	Refused
413	9	Unknown ( No Records available, or records state "unknown medical history" )
419	0	Variable Did Not Exist
419	1	No
419	2	Yes
419	7	Refused
419	9	Unknown ( No Records available, or records state "unknown medical history" )
442	0	Variable Did Not Exist
442	1	No
442	2	Yes
442	7	Refused
442	9	Unknown ( No Records available, or records state "unknown medical history" )
508	0	Variable Did Not Exist
508	0	Variable Did Not Exist
508	1	No
508	1	No
508	2	Yes
508	2	Yes
508	7	Refused
508	7	Refused
508	9	Unknown ( No Records available, or records state "unknown medical history" )
508	9	Unknown
509	0	Variable Did Not Exist
509	1	No
509	2	Yes
509	7	Refused
509	9	Unknown ( No Records available, or records state "unknown medical history" )
511	0	Variable Did Not Exist
511	1	No
511	2	Yes
511	7	Refused
511	9	Unknown ( No Records available, or records state "unknown medical history" )
516	0	Variable Did Not Exist
516	1	No
516	2	Yes
516	7	Refused
516	9	Unknown ( No Records available, or records state "unknown medical history" )
557	0	Variable Did Not Exist
557	1	No
557	2	Yes
557	7	Refused
557	9	Unknown ( No Records available, or records state "unknown medical history" )
605	0	Variable Did Not Exist
605	1	No
605	2	Yes
605	7	Refused
605	9	Unknown
615	0	Variable Did Not Exist
615	1	No
615	2	Yes
615	7	Refused
615	9	Unknown
639	0	Variable Did Not Exist
639	1	No
639	2	Yes
639	7	Refused
639	9	Unknown
702	0	Variable Did Not Exist
702	1	No
702	2	Yes
702	7	Refused
703	0	Variable Did Not Exist
703	1	No
703	2	Yes
703	7	Refused
703	9	Unknown
709	0	Variable Did Not Exist
709	1	No
709	2	Yes
709	7	Refused
709	9	Unknown
721	0	Variable Did Not Exist
721	1	No
721	2	Yes
721	7	Refused
721	9	Unknown
776	0	Variable Did Not Exist
776	1	No
776	2	Yes
776	7	Refused
776	9	Unknown

History

Date	Description
2013-10-01	Added NOTE : unknown code to be used for cases with no records available, or records that state "unknown medical history"
2016-01-01	Added NOTE : to not include conditions mentioned by interview only, or found in ICD codes.
2016-01-01	Changed DEFINITION : removed "rehab" from the questions
2016-07-01	Added NOTE : 'Review of discharge summaries, history and physicals, and rehabilitation physician progress notes is adequate.'

NON-CRANIAL COMPLICATIONS: CARDIOPULMONARY ARREST - ARCHIVE

Definition

This variable documents cardiopulmonary arrest.

Form

[X] Form 1
[ ] Form 2

Source

• Form 1 - Abstraction (acute and rehab record)

Variables

Form Type	Variable	ID	Question	History
Form 1	CardioArrest	3351	Other Complications - Cardiopulmonary Arrest	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3351	1	Absent
3351	2	Present
3351	9	Unknown

History

No history found for the Domain.

NON-CRANIAL COMPLICATIONS: COAGULOPATHY - ARCHIVE

Definition

This variable documents any disorder of coagulation of such severity that it requires the administration of platelets, fresh frozen plasma, or cryoprecipitates (blood factors). *For example= hemophilia, Christmas disease, factor 7 or 8 deficiency, or sickle cell anemia.

Form

[X] Form 1
[ ] Form 2

Source

• Form 1 - Abstraction (acute and rehab record)

Variables

Form Type	Variable	ID	Question	History
Form 1	Coagulopathy	3376	Other Complications - Coagulopathy	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3376	1	Absent
3376	2	Present
3376	9	Unknown

History

No history found for the Domain.

NON-CRANIAL COMPLICATIONS: DEEP VEIN THROMBOSIS - ARCHIVE

Definition

Deep-vein Thrombosis (DVT) is defined as an occlusion of the venous system. Code only DVT’s below the diaphragm. Code only DVT’s confirmed by Doppler, ultrasound or venogram. If DVT is confirmed to be present, code the location and whether the patient received treatment with IV Heparin, Coumadin or a Filter.

Form

[X] Form 1
[ ] Form 2

Source

• Form 1 - Abstraction (acute and rehab record)

Details

1. Occurrence and location of DVT
2. Treatment for confirmed DVT

Variables

Form Type	Variable	ID	Question	History
Form 1	DVTLocation	3414	Other Complications - Deep Vein Thrombosis Location	1996-04-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	DVTTreat	3415	Other Complications - Deep Vein Thrombosis Treatment	1996-04-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3414	0	Variable Did Not Exist ( Only use this code if patient was admitted to the Model System prior to 4/1/96 )
3414	1	No Thrombophlebitis: DVT, *below the diaphragm
3414	2	Yes, Thrombophlebitis: DVT in right lower extremity
3414	3	Yes, Thrombophlebitis: DVT in left lower extremity
3414	4	Yes, Thrombophlebitis: DVT in bilateral lower extremities
3414	5	Yes, DVT: Laterality not specified or other location below diaphragm
3414	9	Unknown, if DVT
3415	0	Variable Did Not Exist
3415	1	DVT confirmed: Treated ( Treated with IV Heparin, Coumadin, Low Molecular Weight Heparin, Inferior Vena Cava (IVC) filter (filters: Greenfield, birdsnest, umbrella), and/or other type of treatment )
3415	2	* ( Collapsed codes 1-3 for type of treatment )
3415	3	* ( Collapsed codes 1-3 for type of treatment )
3415	4	DVT confirmed: No treatment
3415	8	Not Applicable: No DVT confirmed
3415	9	Unknown

History

No history found for the Domain.

NON-CRANIAL COMPLICATIONS: PNEUMONITIS-PNEUMONIA - ARCHIVE

Definition

This variable indicates a state of lung tissue inflammation documented by X-ray.

Form

[X] Form 1
[ ] Form 2

Source

• Form 1 - Abstraction (acute and rehab record)

Details

Must have at least “probable” infiltrate when coding “present” for this variable.

If patient treated for pneumonia but x-ray was *not done, do not code as pneumonia, must have x-ray confirmation.

Variables

Form Type	Variable	ID	Question	History
Form 1	Pneumonia	3500	Other Complications - Pneumonitis/Pneumonia	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3500	1	Absent
3500	2	Present
3500	9	Unknown

History

No history found for the Domain.

NON-CRANIAL COMPLICATIONS: RESPIRATORY FAILURE -ARCHIVE

Definition

Requiring ventilation greater than one week

Form

[X] Form 1
[ ] Form 2

Source

• Form 1 - Abstraction (acute and rehab record)

Details

If patient is chemically paralyzed and on mechanical ventilation for greater than one week, code as respiratory failure present.

If patient is taken off ventilation, but failed extubation and put back on vent, add days on vent. together to determine if ventilation greater than one week, only if failed extubation is less than 48 hours in duration.

Patient is considered “off ventilation” when he/she is extubated.

If patient is on mechanical ventilation, it is coded as respiratory failure present, regardless of reason for ventilation.

Variables

Form Type	Variable	ID	Question	History
Form 1	RespFail	3517	Other Complications - Respiratory Failure	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3517	1	Absent
3517	2	Present
3517	9	Unknown

History

No history found for the Domain.

NON-CRANIAL COMPLICATIONS: SEPTIC SHOCK - ARCHIVE

Definition

An infection associated with hypotension, involving pathogens in the blood stream (i.e., positive blood cultures). Physician must indicate that above condition is septic shock.

Form

[X] Form 1
[ ] Form 2

Source

• Form 1 - Abstraction (acute and rehab record)

Variables

Form Type	Variable	ID	Question	History
Form 1	Septic	3529	Other Complications - Septic Shock	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3529	1	Absent
3529	2	Present
3529	9	Unknown

History

No history found for the Domain.

NON-CRANIAL COMPLICATIONS: URINARY TRACT INFECTION - ARCHIVE

Definition

An infection associated with hypotension, involving pathogens in the blood stream (i.e., positive blood cultures).

Form

[X] Form 1
[ ] Form 2

Source

• Form 1 - Abstraction (acute and rehab record)

Variables

Form Type	Variable	ID	Question	History
Form 1	UTI	3573	Non-Cranial Complications - Urinary Tract Infection	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3573	1	Absent
3573	2	Present ( Over 100,000 colonies and WBCs in urine )
3573	3	Treated for UTI ( Colony count unknown )
3573	9	Unknown

History

No history found for the Domain.

NON-CRANIAL SURGERY: FRACTURES - ARCHIVE

Definition

Open or closed reduction, internal or external fixation of fracture(s). This includes only those reductions and fixations which require a surgical procedure.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

Internal fixations include pinning, screws, rodding, fusions, bone grafting, etc. External fixations include halo, external fixation device for pelvic fracture, etc.

ORIF of oral/facial bones is coded under variable NSRGORAL – Non-Cranial Surgery - Oral or Maxillo- Mandibulo-facial.

Variables

Form Type	Variable	ID	Question	History
Form 1	FixFracture	3445	Non-Cranial - Open/Closed Reduct,Int/Ex Fix of Fracture	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3445	1	No
3445	2	Yes
3445	9	Unknown

History

No history found for the Domain.

NON-CRANIAL SURGERY: GASTROSTOMY - ARCHIVE

Definition

Percutaneous placement or surgical opening of stomach with insertion of drainage tube

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

Gastrostomy may initially be for draining until bowel function returns then can be used for feeding, code as yes if used for either.

*Do not confuse with nasogastric or oralgastric tubes (which are not coded).

Variables

Form Type	Variable	ID	Question	History
Form 1	Gastrostomy	3464	Non-Cranial - Gastrostomy	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3464	1	No
3464	2	Yes
3464	9	Unknown

History

No history found for the Domain.

NON-CRANIAL SURGERY: JEJUNOSTOMY - ARCHIVE

Definition

Surgical opening of jejunum with insertion of drainage tube.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

Jejunostomy may initially be for draining until bowel function returns then can be used for feeding, code as yes if used for either.

*Do not confuse with nasogastric or oralgastric tube (which are not coded)

Variables

Form Type	Variable	ID	Question	History
Form 1	Jejunostomy	3480	Non-Cranial - Jejunostomy	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3480	1	No
3480	2	Yes
3480	9	Unknown

History

No history found for the Domain.

NON-CRANIAL SURGERY: LAPAROTOMY - ARCHIVE

Definition

This variable documents any surgical incision (including mini-laparotomy and laparoscopy) and exploration of the abdomen to determine abdominal site of bleeding.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

Peritoneal lavage is to be coded under NSRGLAV (Peritoneal Lavage)

Variables

Form Type	Variable	ID	Question	History
Form 1	Laparotomy	3481	Non-Cranial - Laparotomy/Minilap	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3481	1	No
3481	2	Yes: Positive as the Source of Bleeding
3481	3	Yes: Negative as the Source of Bleeding
3481	9	Unknown

History

No history found for the Domain.

NON-CRANIAL SURGERY: ORAL FACIAL - ARCHIVE

Definition

Any surgical procedure performed on the oral cavity or the maxillo- or mandibulo- facial areas.

Form

[X] Form 1 [ ] Form 2

Source

• Abstraction (acute record)

Details

List others on coding sheet.

Do not code enucleation of eye.

Code ORIF of oral/facial bones under this variable.

Variables

Form Type	Variable	ID	Question	History
Form 1	OralFacial	3493	Non-Cranial - Oral/Maxi-/Mandi- Facial	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3493	1	No
3493	2	Yes
3493	9	Unknown

History

No history found for the Domain.

NON-CRANIAL SURGERY: PERITONEAL LAVAGE - ARCHIVE

Definition

Diagnostic lavage via either puncture or incision to determine abdominal site of bleeding.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

Medical Record documentation for this variable may read “DPL negative” or “DPL positive”.

Laparotomy, mini-laparotomy and laparoscopy is to be coded under Var. 170o.

Variables

Form Type	Variable	ID	Question	History
Form 1	PeritonealLavage	3499	Non-Cranial - Peritoneal Lavage	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3499	1	No
3499	2	Yes, Positive As The Source of Bleeding
3499	3	Yes, Negative As The Source of Bleeding
3499	9	Unknown

History

No history found for the Domain.

NON-CRANIAL SURGERY: THORACOSTOMY - ARCHIVE

Definition

Chest tube(s) inserted through chest wall into lung.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

Chest tube(s) inserted through chest wall into lung.

Variables

Form Type	Variable	ID	Question	History
Form 1	TubeThoracostomy	3572	Non-Cranial - Tube Thoracostomy	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3572	1	Not done
3572	2	Either Right or Left: Unilateral
3572	4	Bilateral
3572	9	Unknown

History

No history found for the Domain.

NON-CRANIAL SURGERY: THORACOTOMY - ARCHIVE

Definition

Surgical incision in the chest wall *except for reasons of placing a chest gtube. Patient may have thoracotomy and also tube thoracostomy (chest tube).

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Variables

Form Type	Variable	ID	Question	History
Form 1	Thoracotomy	3558	Non-Cranial - Thoracotomy	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3558	1	No
3558	2	Yes
3558	9	Unknown

History

No history found for the Domain.

NON-CRANIAL SURGERY: TRACHEOSTOMY - ARCHIVE

Definition

Surgical incision of the trachea for insertion of a tube to relieve upper airway obstruction and facilitate ventilation.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

Code as yes regardless of where tracheostomy performed (e.g., by EMS or at a community hospital prior to admission to model system.

Variables

Form Type	Variable	ID	Question	History
Form 1	Tracheostomy	3563	Non-Cranial - Tracheostomy	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3563	1	No
3563	2	Yes
3563	9	Unknown

History

No history found for the Domain.

PART-O: PART-O - ARCHIVED

Variables

Form Type	Variable	ID	Question	History
Form 2	PRTClub	3923	In a typical month, how many times do you participate in a club or organization, such as the PTA, a choir, sorority, hobby group, neighborhood organization, brain injury or other support group?	2007-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	PRTContEd	3924	Now, I’d like you to think about the last three months. In that time, have you taken adult education classes, GED classes, continuing education, special courses, or used other opportunities for learning, for instance, seminars or conferences?	2007-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	PRTDrive	3925	In a typical week, how many hours do you drive or ride in a car? This includes all types of private transportation.	2007-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	PRTMaint	3926	In a typical week, how many hours do you spend in home maintenance activities, such as home repairs, home improvements and gardening?	2007-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	PRTSpend	3927	What best describes how you spend your days in a typical month?	2007-10-01 - Variable Added 2012-10-01 - Variable Removed
Form 2	PRTTrans	3928	In a typical week, how many hours do you ride in trains, buses, taxis and other public transportation? This includes public transportation for people with disabilities.	2007-10-01 - Variable Added 2012-10-01 - Variable Removed

Codes and Values

ID	Code	Description
3923	0	None
3923	1	One Time
3923	2	Two Times
3923	3	Three Times
3923	4	Four Times
3923	5	Five or More Times
3923	6	Variable Did Not Exist
3923	7	Refused
3923	9	Don't Know/Not Sure
3924	1	No
3924	2	Yes
3924	6	Variable Did Not Exist
3924	7	Refused
3924	9	Don't Know/Not Sure
3925	0	None
3925	1	1 - 4 Hours
3925	2	5 - 9 Hours
3925	3	10 - 19 Hours
3925	4	20 - 34 Hours
3925	5	35 or More Hours
3925	6	Variable Did Not Exist
3925	7	Refused
3925	9	Don't Know/Not Sure
3926	0	None
3926	1	1 - 4 Hours
3926	2	5 - 9 Hours
3926	3	10 - 19 Hours
3926	4	20 - 34 Hours
3926	5	35 or More Hours
3926	6	Variable Did Not Exist
3926	7	Refused
3926	9	Don't Know/Not Sure
3927	0	I Rarely Leave My Bed
3927	1	I Rarely Leave My Room ( but I do get out of bed )
3927	2	I Rarely Leave My House ( but I do get out of my room )
3927	3	I Rarely Leave My Block or Neighborhood ( but I do get out of the house )
3927	4	I Travel Beyond My Block or Neighborhood
3927	6	Variable Did Not Exist
3927	7	Refused
3927	9	Don't Know/Not Sure
3928	0	None
3928	1	1 - 4 Hours
3928	2	5 - 9 Hours
3928	3	10 - 19 Hours
3928	4	20 - 34 Hours
3928	5	35 or More Hours
3928	6	Variable Did Not Exist
3928	7	Refused
3928	9	Don't Know/Not Sure

History

No history found for the Domain.

PATHWAYS: ACUTE - ARCHIVE

Definition

ER Admission Time

Form

[X] Form 1
[ ] Form 2

Best approximation of time at admission to ED.

Variables

Form Type	Variable	ID	Question	History
Form 1	ERTime	3422	Time of ER Admission	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

No codes found for the given group IDs.

History

Date	Description
1994-09-13	Deleted these date variables: "admitted to acute care", "first acute rehab services", "admitted to/discharged from an alternate level of care".
1994-09-13	Added NOTE : for clarification of ALC (alternative level of care).
1995-07-01	Clarified code 99:99. Now refers only to unknown time of ED admit.
2003-01-01	Deleted 101B: Times of Injury and ER Admission

PATHWAYS: INJURY - ARCHIVE

Definition

Time of Injury

Form

[X] Form 1
[ ] Form 2

Source

• Form 1 - Abstraction (acute record)

Details

Best approximation of time of injury (e.g. EMS dispatch time, etc.) can be utilized within a 24 hour time frame of admission to model system ED.

Recorded in military time.

Characteristics

ERTime - Time of ER Admission was collected from 4/1/2002 to unknown date. Data not available.
Codes used - HH:MM Military time (00:00 - 23:59) * 77:77 Unknown exact time of injury, but less than 8 hours prior to arrival at Model System ED. (use this code only for cases admitted to the system prior to 5/25/95). * 88:88 Unknown exact time of injury, but less than 24 hours prior to arrival at Model System ED. (use this code only for cases admitted to the system on or after 5/25/95. * 99:99 Unknown time of ED admit

Variables

Form Type	Variable	ID	Question	History
Form 1	InjuryTime	3478	Time of Injury	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

No codes found for the given group IDs.

History

Date	Description
1995-07-01	Added CODE : for unknown time less than 8 hours or less than 24 hours to correspond to new inclusion criteria.

PAYOR SOURCE - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 1	AcutePay1old	3335	Primary Acute Payor	1989-10-01 - Variable Added 2016-01-01 - Variable Removed
Form 1	AcutePay2old	3336	Secondary Acute Payor	1989-10-01 - Variable Added 2016-01-01 - Variable Removed
Form 1	RehabPay1old	3515	Primary Rehabilitation Payor	1989-10-01 - Variable Added 2016-01-01 - Variable Removed
Form 1	RehabPay2old	3516	Secondary Rehabilitation Payor	1989-10-01 - Variable Added 2016-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3335	1	Medicare
3335	2	Medicaid
3335	3	Workers Compensation
3335	4	Private Insurance: Other ( BC/BS, employee insurance, privately purchased policies, etc. )
3335	5	Private Insurance: Other
3335	6	HMO ( Health Maintenance Organization )
3335	7	Self or Private Pay
3335	8	State or County ( State Crippled Children, Department Of Rehab, etc. )
3335	9	Department of Rehabilitation
3335	10	Auto Insurance
3335	11	PPO
3335	12	TRICARE/TRIWEST ( Formerly CHAMPUS )
3335	14	Hospital Free Care
3335	15	Medicare: Traditionally administered
3335	16	Medicaid: Traditionally administered
3335	17	Medicare: Managed care administered
3335	18	Medicaid: Managed care administered
3335	55	Payor Source Pending
3335	77	Other
3335	88	Not Applicable: No secondary payor
3335	99	Unknown
3336	1	Medicare
3336	2	Medicaid
3336	3	Workers Compensation
3336	4	Private Insurance: Other ( BC/BS, employee insurance, privately purchased policies, etc. )
3336	5	Private Insurance: Other
3336	6	HMO ( Health Maintenance Organization )
3336	7	Self or Private Pay
3336	8	State or County ( State Crippled Children, Department Of Rehab, etc. )
3336	9	Department of Rehabilitation
3336	10	Auto Insurance
3336	11	PPO
3336	12	TRICARE/TRIWEST ( Formerly CHAMPUS )
3336	14	Hospital Free Care
3336	15	Medicare: Traditionally administered
3336	16	Medicaid: Traditionally administered
3336	17	Medicare: Managed care administered
3336	18	Medicaid: Managed care administered
3336	55	Payor Source Pending
3336	77	Other
3336	88	Not Applicable: No secondary payor
3336	99	Unknown
3515	1	Medicare
3515	2	Medicaid
3515	3	Workers Compensation
3515	4	Private Insurance: Other ( BC/BS, employee insurance, privately purchased policies, etc. )
3515	5	Private Insurance: Other
3515	6	HMO ( Health Maintenance Organization )
3515	7	Self or Private Pay
3515	8	State or County ( State Crippled Children, Department Of Rehab, etc. )
3515	9	Department of Rehabilitation
3515	10	Auto Insurance
3515	11	PPO
3515	12	TRICARE/TRIWEST ( Formerly CHAMPUS )
3515	14	Hospital Free Care
3515	15	Medicare: Traditionally administered
3515	16	Medicaid: Traditionally administered
3515	17	Medicare: Managed care administered
3515	18	Medicaid: Managed care administered
3515	55	Payor Source Pending
3515	77	Other
3515	88	Not Applicable: No secondary payor
3515	99	Unknown
3516	1	Medicare
3516	2	Medicaid
3516	3	Workers Compensation
3516	4	Private Insurance: Other ( BC/BS, employee insurance, privately purchased policies, etc. )
3516	5	Private Insurance: Other
3516	6	HMO ( Health Maintenance Organization )
3516	7	Self or Private Pay
3516	8	State or County ( State Crippled Children, Department Of Rehab, etc. )
3516	9	Department of Rehabilitation
3516	10	Auto Insurance
3516	11	PPO
3516	12	TRICARE/TRIWEST ( Formerly CHAMPUS )
3516	14	Hospital Free Care
3516	15	Medicare: Traditionally administered
3516	16	Medicaid: Traditionally administered
3516	17	Medicare: Managed care administered
3516	18	Medicaid: Managed care administered
3516	55	Payor Source Pending
3516	77	Other
3516	88	Not Applicable: No secondary payor
3516	99	Unknown

History

No history found for the Domain.

PHYSICAL EXAM: BALANCE - ARCHIVE

Definition

Includes subjective feeling of movement within or around oneself characterized by dizziness, vertigo. Evaluate both dynamic standing and sitting balance measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation (Form 1) and first annual follow-up evaluation only (Form 2).

Form

[X] Form 1
[X] Form 2

Source

• Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
• Form 2 - In-person physical exam completed by data collector.

Variables

Form Type	Variable	ID	Question	History
Form 1	BalanceSit	3340	Dynamic Balance Sitting	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	BalanceStand	3341	Dynamic Balance Standing	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	BalanceSitF	3589	PE - Dynamic Balance Sitting	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	BalanceStandF	3590	PE - Dynamic Balance Standing	1989-10-01 - Variable Added 2002-04-01 - Variable Removed

Codes and Values

ID	Code	Description
3340	1	Grossly Normal
3340	2	Mildly Impaired ( Can maintain dynamic balance with some difficulty )
3340	3	Grossly Impaired ( Cannot maintain dynamic balance )
3340	7	Not Testable
3340	9	Unknown
3341	1	Grossly Normal
3341	2	Mildly Impaired ( Can maintain dynamic balance with some difficulty )
3341	3	Grossly Impaired ( Cannot maintain dynamic balance )
3341	7	Not Testable
3341	9	Unknown
3589	0	Variable Did Not Exist
3589	1	Grossly Normal
3589	2	Mildly Impaired ( Can maintain dynamic balance with some difficulty )
3589	3	Grossly Impaired ( Cannot maintain dynamic balance )
3589	7	Not Testable
3589	8	Not Applicable: Not first year follow-up
3589	9	Unknown ( No evaluation performed )
3590	0	Variable Did Not Exist
3590	1	Grossly Normal
3590	2	Mildly Impaired ( Can maintain dynamic balance with some difficulty )
3590	3	Grossly Impaired ( Cannot maintain dynamic balance )
3590	7	Not Testable
3590	8	Not Applicable: Not first year follow-up
3590	9	Unknown ( No evaluation performed )

History

No history found for the Domain.

PHYSICAL EXAM: COORDINATION - ARCHIVE

Definition

This variable describes the coordination in all four extremities as identified by the finger-to-nose test and the heel-to-shin test measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation (Form 1) and first annual follow-up evaluation only (Form 2).

Form

[X] Form 1
[X] Form 2

Source

• Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
• Form 2 - In-person physical exam completed by data collector.

Details

Must be documented as “finger to nose” and “heel to shin” testing. If this documentation is not present, use the “unknown” code (9). Data are collected for the right and left, upper and lower extremities.

Variables

Form Type	Variable	ID	Question	History
Form 1	CoordLLE	3377	Cerebellar Motor Coordination Left Lower Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	CoordLUE	3378	Cerebellar Motor Coordination Left Upper Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	CoordRLE	3379	Cerebellar Motor Coordination Right Lower Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	CoordRUE	3380	Cerebellar Motor Coordination Right Upper Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	CoordLLEF	3643	PE - Cerebellar Motor Coordination Left LE	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	CoordLUEF	3644	PE - Cerebellar Motor Coordination Left UE	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	CoordRLEF	3645	PE - Cerebellar Motor Coordination Right LE	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	CoordRUEF	3646	PE - Cerebellar Motor Coordination Right UE	1989-10-01 - Variable Added 2002-04-01 - Variable Removed

Codes and Values

ID	Code	Description
3377	1	Normal Coordination
3377	2	Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed )
3377	3	Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed )
3377	4	Severe Incoordination/Ataxia ( Unable to perform test )
3377	7	Not Testable
3377	9	Unknown
3378	1	Normal Coordination
3378	2	Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed )
3378	3	Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed )
3378	4	Severe Incoordination/Ataxia ( Unable to perform test )
3378	7	Not Testable
3378	9	Unknown
3379	1	Normal Coordination
3379	2	Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed )
3379	3	Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed )
3379	4	Severe Incoordination/Ataxia ( Unable to perform test )
3379	7	Not Testable
3379	9	Unknown
3380	1	Normal Coordination
3380	2	Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed )
3380	3	Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed )
3380	4	Severe Incoordination/Ataxia ( Unable to perform test )
3380	7	Not Testable
3380	9	Unknown
3643	0	Variable Did Not Exist
3643	1	Normal Coordination
3643	2	Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed )
3643	3	Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed )
3643	4	Severe Incoordination/Ataxia ( Unable to perform test )
3643	7	Not Testable
3643	8	Not Applicable: Not first year follow-up
3643	9	Unknown: No evaluation performed
3644	0	Variable Did Not Exist
3644	1	Normal Coordination
3644	2	Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed )
3644	3	Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed )
3644	4	Severe Incoordination/Ataxia ( Unable to perform test )
3644	7	Not Testable
3644	8	Not Applicable: Not first year follow-up
3644	9	Unknown: No evaluation performed
3645	0	Variable Did Not Exist
3645	1	Normal Coordination
3645	2	Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed )
3645	3	Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed )
3645	4	Severe Incoordination/Ataxia ( Unable to perform test )
3645	7	Not Testable
3645	8	Not Applicable: Not first year follow-up
3645	9	Unknown: No evaluation performed
3646	0	Variable Did Not Exist
3646	1	Normal Coordination
3646	2	Mild Incoordination/Ataxia ( Ability to perform test, however, slowness and/or tremors are observed )
3646	3	Moderate Incoordination/Ataxia ( Inconsistentlyperforms test, with slowness and tremors observed )
3646	4	Severe Incoordination/Ataxia ( Unable to perform test )
3646	7	Not Testable
3646	8	Not Applicable: Not first year follow-up
3646	9	Unknown: No evaluation performed

History

No history found for the Domain.

PHYSICAL EXAM: MUSCLE STRENGTH - ARCHIVE

Definition

This variable describes the patient’s amount of voluntary muscle strength. Record overall average strength of extremity measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation (Form 1) and first annual follow-up evaluation only (Form 2).

Form

[X] Form 1
[X] Form 2

Source

• Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
• Form 2 - In-person physical exam completed by data collector.

Details

Although classical manual muscle examination is often difficult in persons with spasticity/rigidity, functionally the patient must be able to demonstrate this strength (movement) despite the increased muscle tone.

Data are collected for the right and left, upper and lower extremities.

Variables

Form Type	Variable	ID	Question	History
Form 1	StrngthLLE	3534	Voluntary Muscle Strength - Left Lower Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	StrngthLUE	3535	Voluntary Muscle Strength - Left Upper Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	StrngthRLE	3536	Voluntary Muscle Strength - Right Lower Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	StrngthRUE	3537	Voluntary Muscle Strength - Right Upper Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	StrngthLLEF	3951	PE - Voluntary Muscle Strength Left LE	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	StrngthLUEF	3952	PE - Voluntary Muscle Strength Left UE	1989-10-01 - Variable Added 1994-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	StrngthRLEF	3953	PE - Voluntary Muscle Strength Right LE	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	StrngthRUEF	3954	PE - Voluntary Muscle Strength Right UE	1989-10-01 - Variable Added 2002-04-01 - Variable Removed

Codes and Values

ID	Code	Description
3534	0	0/5 - None
3534	1	1/5
3534	2	2/5
3534	3	3/5
3534	4	4/5
3534	5	5/5 - Full Strength
3534	7	Not Testable
3534	9	Unknown
3535	0	0/5 - None
3535	1	1/5
3535	2	2/5
3535	3	3/5
3535	4	4/5
3535	5	5/5 - Full Strength
3535	7	Not Testable
3535	9	Unknown
3536	0	0/5 - None
3536	1	1/5
3536	2	2/5
3536	3	3/5
3536	4	4/5
3536	5	5/5 - Full Strength
3536	7	Not Testable
3536	9	Unknown
3537	0	0/5 - None
3537	1	1/5
3537	2	2/5
3537	3	3/5
3537	4	4/5
3537	5	5/5 - Full Strength
3537	7	Not Testable
3537	9	Unknown
3951	0	0/5 - None
3951	1	1/5
3951	2	2/5
3951	3	3/5
3951	4	4/5
3951	5	5/5 - Full strength
3951	6	Variable Did Not Exist
3951	7	Not Testable
3951	8	Not Applicable: Not first year follow-up
3951	9	Unknown: No evaluation performed
3952	0	0/5 - None
3952	1	1/5
3952	2	2/5
3952	3	3/5
3952	4	4/5
3952	5	5/5 - Full strength
3952	6	Variable Did Not Exist
3952	7	Not Testable
3952	8	Not Applicable: Not first year follow-up
3952	9	Unknown: No evaluation performed
3953	0	0/5 - None
3953	1	1/5
3953	2	2/5
3953	3	3/5
3953	4	4/5
3953	5	5/5 - Full strength
3953	6	Variable Did Not Exist
3953	7	Not Testable
3953	8	Not Applicable: Not first year follow-up
3953	9	Unknown: No evaluation performed
3954	0	0/5 - None
3954	1	1/5
3954	2	2/5
3954	3	3/5
3954	4	4/5
3954	5	5/5 - Full Strength
3954	6	Variable Did Not Exist
3954	7	Not Testable
3954	8	Not Applicable: Not first year follow-up
3954	9	Unknown: No evaluation performed ( No evaluation performed )

History

No history found for the Domain.

PHYSICAL EXAM: MUSCLE TONE - ARCHIVE

Definition

This variable documents the patient’s muscle tone measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation (Form 1) and first annual follow-up evaluation only (Form 2).

Form

[X] Form 1
[X] Form 2

Source

• Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
• Form 2 - In-person physical exam completed by data collector.

Details

Data are collected for the right and left, upper and lower extremities.

Variables

Form Type	Variable	ID	Question	History
Form 1	ToneLLE	3559	Muscle Tone - Left Lower Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	ToneLUE	3560	Muscle Tone - Left Upper Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	ToneRLE	3561	Muscle Tone - Right Lower Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 1	ToneRUE	3562	Muscle Tone - Right Upper Extremity	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	ToneLLEF	3967	PE - Muscle Tone Left LE	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	ToneLUEF	3968	PE - Muscle Tone Left UE	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	ToneRLEF	3969	PE - Muscle Tone Right LE	1989-10-01 - Variable Added 2002-04-01 - Variable Removed
Form 2	ToneRUEF	3970	PE - Muscle Tone Right UE	1989-10-01 - Variable Added 2002-04-01 - Variable Removed

Codes and Values

ID	Code	Description
3559	1	Normal ( No deficits )
3559	2	Hypotonia ( Decreased muscle tone )
3559	3	Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) )
3559	7	Not Testable ( Limb missing, unable to be ranged )
3559	9	Unknown
3560	1	Normal ( No deficits )
3560	2	Hypotonia ( Decreased muscle tone )
3560	3	Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) )
3560	7	Not Testable ( Limb missing, unable to be ranged )
3560	9	Unknown
3561	1	Normal ( No deficits )
3561	2	Hypotonia ( Decreased muscle tone )
3561	3	Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) )
3561	7	Not Testable ( Limb missing, unable to be ranged )
3561	9	Unknown
3562	1	Normal ( No deficits )
3562	2	Hypotonia ( Decreased muscle tone )
3562	3	Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) )
3562	7	Not Testable ( Limb missing, unable to be ranged )
3562	9	Unknown
3967	0	Variable Did Not Exist
3967	1	Normal ( No deficits )
3967	2	Hypotonia ( Decreased muscle tone )
3967	3	Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) )
3967	7	Not Testable ( Limb missing, unable to be ranged )
3967	8	Not Applicable: Not first year follow-up
3967	9	Unknown ( No evaluation performed )
3968	0	Variable Did Not Exist
3968	1	Normal ( No deficits )
3968	2	Hypotonia ( Decreased muscle tone )
3968	3	Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) )
3968	7	Not Testable ( Limb missing, unable to be ranged )
3968	8	Not Applicable: Not first year follow-up
3968	9	Unknown ( No evaluation performed )
3969	0	Variable Did Not Exist
3969	1	Normal ( No deficits )
3969	2	Hypotonia ( Decreased muscle tone )
3969	3	Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) )
3969	7	Not Testable ( Limb missing, unable to be ranged )
3969	8	Not Applicable: Not first year follow-up
3969	9	Unknown ( No evaluation performed )
3970	0	Variable Did Not Exist
3970	1	Normal ( No deficits )
3970	2	Hypotonia ( Decreased muscle tone )
3970	3	Hypertonia ( Increased muscle tone (including extra-pyramidal i.e. cogwheel rigidity) )
3970	7	Not Testable ( Limb missing, unable to be ranged )
3970	8	Not Applicable: Not first year follow-up
3970	9	Unknown ( No evaluation performed )

History

No history found for the Domain.

PHYSICAL EXAM: SWALLOWING - ARCHIVE

Definition

Measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation, and at the time of first annual follow-up evaluation (Form 2).

Form

[X] Form 1
[X] Form 2

Source

• Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
• Form 2 - In-person physical exam completed by data collector.

Variables

Form Type	Variable	ID	Question	History
Form 1	Swallowing	3552	Swallowing	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	SwallowingF	3957	PE - Swallowing	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3552	1	Grossly Normal
3552	2	Impaired
3552	3	Absent
3552	7	Not Testable
3552	9	Unknown
3957	0	Variable Did Not Exist
3957	1	Grossly Normal
3957	2	Impaired
3957	3	Absent
3957	7	Not Testable
3957	8	Not Applicable: Not first year follow-up
3957	9	Unknown ( No evaluation performed )

History

No history found for the Domain.

PHYSICAL EXAM: VISION - ARCHIVE

Definition

This variable describes the patient’s visual function, based on best corrected vision measured at time of the physiatric physical evaluation performed within 72 hours following admission to rehabilitation (Form 1) and at time of the first annual follow-up evaluation (Form 2).

Form

[X] Form 1
[X] Form 2

Source

• Form 1 - Physical exam completed by designated staff (physician, physical therapist, etc.)
• Form 2 - In-person physical exam completed by data collector.

Details

Examining clinician must use judgement in determining whether inability to count fingers is due to vision vs. cognitive problems. If not testable code as such.

Legally blind = maximal visual acuity of the better eye, after correction, of 20/200 or less, or a total diameter of the visual field in that eye of 20 degrees or less.

If more than one code applies, the physician should determine which is the most severe and code that one.

Variables

Form Type	Variable	ID	Question	History
Form 1	Vision	3575	Vision	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	VisionF	3977	PE - Vision	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3575	1	Grossly Normal ( No deficits (glasses may be worn) )
3575	2	Hemianopsia ( Blindness for half the visual field in both eyes unless blind in one eye (unless there is something additional wrong in one eye) )
3575	3	Impaired Monocular Visual Acuity ( Inability to count fingers (glasses on if appropriate), either eye, and/or monocular field cut )
3575	4	Hemianopsia and Impaired Monocular Visual Acuity
3575	5	Legally Bind
3575	6	Diplopia ( Double vision )
3575	7	Not Testable
3575	9	Unknown
3977	0	Variable Did Not Exist
3977	1	Grossly Normal ( No deficits (glasses may be worn) )
3977	2	Hemianopsia ( Blindness for half the visual field in both eyes unless blind in one eye (unless there is something additional wrong in one eye) )
3977	3	Impaired Monocular Visual Acuity ( Inability to count fingers (glasses on if appropriate), either eye, and/or monocular field cut )
3977	4	Hemianopsia and Impaired Monocular Visual Acuity
3977	5	Legally Blind
3977	6	Diplopia ( Double vision )
3977	7	Not Testable
3977	8	Not Applicable: Not first year follow-up
3977	9	Unknown ( No evaluation performed )

History

No history found for the Domain.

PRE-INJURY CONDITIONS: PRE-INJURY CONDITIONS ARCHIVE

Previously, participants were asked about any preinjury “Blindness, deafness, or a severe vision or hearing impairment” until the questions were split into 2 questions on 7/1/2020 - “Blindness or a severe vision impairment” and “Deafness, or a severe hearing impairment”.

Variables

Form Type	Variable	ID	Question	History
Form 1	PreconImpair	533	Blindness, deafness, or a severe vision or hearing impairment:	2005-07-01 - Variable Added 2020-07-01 - Variable Removed

Codes and Values

ID	Code	Description
533	0	No
533	1	Yes
533	66	Variable Did Not Exist
533	99	Unknown

History

Date	Description
2020-07-01	Variable DELETED

REHOSPITALIZATION - ARCHIVE

Definition

The reason for each rehospitalization since inpatient rehabilitation discharge or in the past year (whichever is shorter).

Rehospitalization reasons 1 thru 5

Form

[ ] Form 1
[X] Form 2

Source

• Form 2 - Interview, Mail-out (participant or proxy)

Details

Code up to five hospitalizations.

If more than five hospitalizations, have your Medical Director prioritize which five to code.

This variable includes all types of hospitalizations (i.e., an inpatient stay in any hospital, whether part of a TBI Model System or not).

An admission of 24 hours or more for ‘observation’ should be considered a hospitalization, and a determination should be made regarding why the rehospitalization occurred. Any stays less than 24 hours will not be considered a hospitalization.

Characteristics

Prior to 1/1/02 the code “9. Unknown” did not distinguish between “unknown if rehospitalized” and “unknown reason for rehospitalization”. On 1/1/02 “9. Unknown” was clarified to mean “unknown reason for rehospitalization”. On 1/1/04 the code “99. Unknown, if Rehospitalized” was added. Thus, between 1/1/02 and 1/1/04 there was no way to record rehospitalization for unknown reason.

Variables

Form Type	Variable	ID	Question	History
Form 2	Rehosp1F	753	1 Reason	1989-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	Rehosp1lv1F	754	Rehospitalization Reason 1 Level 1	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 2	Rehosp2	756	2 Reason	1989-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	Rehosp2lv1F	757	Rehospitalization Reason 2 Level 1	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 2	Rehosp3	758	3 Reason	1989-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	Rehosp3lv1F	759	Rehospitalization Reason 3 Level 1	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 2	Rehosp4	760	4 Reason	1989-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	Rehosp4lv1F	761	Rehospitalization Reason 4 Level 1	2017-10-01 - Variable Added 2018-10-01 - Variable Removed
Form 2	Rehosp5	762	5 Reason	1989-10-01 - Variable Added 2017-10-01 - Variable Removed
Form 2	Rehosp5lv1F	763	Rehospitalization Reason 5 Level 1	2017-10-01 - Variable Added 2018-10-01 - Variable Removed

Codes and Values

ID	Code	Description
753	0	Rehabilitation ( Inpatient )
753	1	Seizures
753	2	Neurologic Disorder: Non-seizure
753	3	Psychiatric
753	4	Infectious
753	5	Orthopedic
753	6	General Health Maintenance or OB/Gyn
753	7	Other: Not specified elsewhere
753	88	Not Applicable: No rehospitalizations / no further rehospitalizations
753	9	Rehospitalized: Reason unknown
753	66	Variable Did Not Exist ( Used only with variables REHOSP (3-5)] )
753	99	Unknown
754	1	Infectious and parasitic diseases
754	2	Neoplasms
754	3	Endocrine; nutritional; and metabolic diseases and immunity disorders
754	4	Diseases of the blood and blood-forming organs
754	5	Mental illness
754	6	Diseases of the nervous system and sense organs
754	7	Diseases of the circulatory system
754	8	Diseases of the respiratory system
754	9	Diseases of the digestive system
754	10	Diseases of the genitourinary system
754	11	Complications of pregnancy; childbirth; and the puerperium
754	12	Diseases of the skin and subcutaneous tissue
754	13	Diseases of the musculoskeletal system and connective tissue
754	14	Congenital anomalies
754	15	Certain conditions originating in the perinatal period
754	16	Injury and poisoning
754	17	Symptoms; signs; and ill-defined conditions and factors influencing health status
754	18	Residual codes; unclassified; all E codes
754	66	Variable did not exist
754	77	Participant hospitalized, reason unknown
754	88	N/A
754	99	Unknown whether participant was hospitalized
756	0	Rehabilitation ( Inpatient )
756	1	Seizures
756	2	Neurologic Disorder: Non-seizure
756	3	Psychiatric
756	4	Infectious
756	5	Orthopedic
756	6	General Health Maintenance or OB/Gyn
756	7	Other: Not specified elsewhere
756	8	Not Applicable: No rehospitalizations / no further rehospitalizations
756	9	Rehospitalized: Reason unknown
756	66	Variable Did Not Exist
756	99	Unknown
757	1	Infectious and parasitic diseases
757	2	Neoplasms
757	3	Endocrine; nutritional; and metabolic diseases and immunity disorders
757	4	Diseases of the blood and blood-forming organs
757	5	Mental illness
757	6	Diseases of the nervous system and sense organs
757	7	Diseases of the circulatory system
757	8	Diseases of the respiratory system
757	9	Diseases of the digestive system
757	10	Diseases of the genitourinary system
757	11	Complications of pregnancy; childbirth; and the puerperium
757	12	Diseases of the skin and subcutaneous tissue
757	13	Diseases of the musculoskeletal system and connective tissue
757	14	Congenital anomalies
757	15	Certain conditions originating in the perinatal period
757	16	Injury and poisoning
757	17	Symptoms; signs; and ill-defined conditions and factors influencing health status
757	18	Residual codes; unclassified; all E codes
757	66	Variable did not exist
757	77	Participant hospitalized, reason unknown
757	88	N/A
757	99	Unknown whether participant was hospitalized
758	0	Rehabilitation ( Inpatient )
758	1	Seizures
758	2	Neurologic Disorder: Non-seizure
758	3	Psychiatric
758	4	Infectious
758	5	Orthopedic
758	6	General Health Maintenance or OB/Gyn
758	7	Other: Not specified elsewhere
758	8	Not Applicable: No rehospitalizations / no further rehospitalizations
758	9	Rehospitalized: Reason unknown
758	66	Variable Did Not Exist
758	99	Unknown
759	1	Infectious and parasitic diseases
759	2	Neoplasms
759	3	Endocrine; nutritional; and metabolic diseases and immunity disorders
759	4	Diseases of the blood and blood-forming organs
759	5	Mental illness
759	6	Diseases of the nervous system and sense organs
759	7	Diseases of the circulatory system
759	8	Diseases of the respiratory system
759	9	Diseases of the digestive system
759	10	Diseases of the genitourinary system
759	11	Complications of pregnancy; childbirth; and the puerperium
759	12	Diseases of the skin and subcutaneous tissue
759	13	Diseases of the musculoskeletal system and connective tissue
759	14	Congenital anomalies
759	15	Certain conditions originating in the perinatal period
759	16	Injury and poisoning
759	17	Symptoms; signs; and ill-defined conditions and factors influencing health status
759	18	Residual codes; unclassified; all E codes
759	66	Variable did not exist
759	77	Participant hospitalized, reason unknown
759	88	N/A
759	99	Unknown whether participant was hospitalized
760	0	Rehabilitation ( Inpatient )
760	1	Seizures
760	2	Neurologic Disorder: Non-seizure
760	3	Psychiatric
760	4	Infectious
760	5	Orthopedic
760	6	General Health Maintenance or OB/Gyn
760	7	Other: Not specified elsewhere
760	8	Not Applicable: No rehospitalizations / no further rehospitalizations
760	9	Rehospitalized: Reason unknown
760	66	Variable Did Not Exist
760	99	Unknown
761	1	Infectious and parasitic diseases
761	2	Neoplasms
761	3	Endocrine; nutritional; and metabolic diseases and immunity disorders
761	4	Diseases of the blood and blood-forming organs
761	5	Mental illness
761	6	Diseases of the nervous system and sense organs
761	7	Diseases of the circulatory system
761	8	Diseases of the respiratory system
761	9	Diseases of the digestive system
761	10	Diseases of the genitourinary system
761	11	Complications of pregnancy; childbirth; and the puerperium
761	12	Diseases of the skin and subcutaneous tissue
761	13	Diseases of the musculoskeletal system and connective tissue
761	14	Congenital anomalies
761	15	Certain conditions originating in the perinatal period
761	16	Injury and poisoning
761	17	Symptoms; signs; and ill-defined conditions and factors influencing health status
761	18	Residual codes; unclassified; all E codes
761	66	Variable did not exist
761	77	Participant hospitalized, reason unknown
761	88	N/A
761	99	Unknown whether participant was hospitalized
762	0	Rehabilitation ( Inpatient )
762	1	Seizures
762	2	Neurologic Disorder: Non-seizure
762	3	Psychiatric
762	4	Infectious
762	5	Orthopedic
762	6	General Health Maintenance or OB/Gyn
762	7	Other: Not specified elsewhere
762	8	Not Applicable: No rehospitalizations / no further rehospitalizations
762	9	Rehospitalized: Reason unknown
762	66	Variable Did Not Exist
762	99	Unknown
763	1	Infectious and parasitic diseases
763	2	Neoplasms
763	3	Endocrine; nutritional; and metabolic diseases and immunity disorders
763	4	Diseases of the blood and blood-forming organs
763	5	Mental illness
763	6	Diseases of the nervous system and sense organs
763	7	Diseases of the circulatory system
763	8	Diseases of the respiratory system
763	9	Diseases of the digestive system
763	10	Diseases of the genitourinary system
763	11	Complications of pregnancy; childbirth; and the puerperium
763	12	Diseases of the skin and subcutaneous tissue
763	13	Diseases of the musculoskeletal system and connective tissue
763	14	Congenital anomalies
763	15	Certain conditions originating in the perinatal period
763	16	Injury and poisoning
763	17	Symptoms; signs; and ill-defined conditions and factors influencing health status
763	18	Residual codes; unclassified; all E codes
763	66	Variable did not exist
763	77	Participant hospitalized, reason unknown
763	88	N/A
763	99	Unknown whether participant was hospitalized

History

No history found for the Domain.

SERVICE INTERVENTIONS - ARCHIVE

Definition

Actual billable hours attributed to each of four therapy services (physical therapy, occupational therapy, speech/language pathology, psychology), including technician and assistant time. Each of the four therapies must be collected separately. A billable hour consists of at least 50 minutes of actual therapy time (i.e., up to 10 minutes of documentation time), this would equal 60 minutes of therapy time.

Form

[X] Form 1
[ ] Form 2

Source

• Billing department (rehabilitation facility)

Details

Record the total number of minutes of each type of intervention from admission to inpatient rehabilitation through rehabilitation discharge.

Centers which can not obtain billable hours may collect actual therapy time for each of four therapy types (and add up to 1/6 extra time for documentation). Family conference time may be included only if patient was present. Therapeutic Recreation should NOT be included.

Variables

Form Type	Variable	ID	Question	History
Form 1	ServiceOT	3530	Service - Occupational Therapy Minutes	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	ServicePT	3532	Service - Physical Therapy Minutes	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	ServicePsych	3531	Service - Psychology Minutes	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	ServiceSpeech	3533	Service - Speech Pathology Minutes	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3530	00000	No Service Provided
3530	88888	Not Applicable ( Service provided, but total number of minutes not specified )
3530	99999	Unknown if Service Provided
3531	00000	No Service Provided
3531	88888	Not Applicable ( Service provided, but total number of minutes not specified )
3531	99999	Unknown if Service Provided
3532	00000	No Service Provided
3532	88888	Not Applicable ( Service provided, but total number of minutes not specified )
3532	99999	Unknown if Service Provided
3533	00000	No Service Provided
3533	88888	Not Applicable ( Service provided, but total number of minutes not specified )
3533	99999	Unknown if Service Provided

History

No history found for the Domain.

SEVERITY: GCS (GLASGOW COMA SCALE) - ARCHIVE

Definition

Glasgow Coma Scale while subject is in care of the Emergency Medical Service.

1. On admission to Model System emergency department
2. Highest score recorded in the 24 hours following *first EMS contact
3. Lowest score recorded in the 24 hours following *first EMS contact

Form

[X] Form 1
[ ] Form 2

Source

• Form 1 - Abstraction (acute record)

Details

Highest and lowest GCS scores should be recorded for all three responses (eyes, verbal, and motor) at once.

Highest and Lowest scores recorded in the 24 hours following first EMS contact include the Model System EMS and ED admission scores if recorded.

If only 1 GCS is recorded, use that score for all three assessments. If patient is in barbiturate coma or paralyzed by use of Pavalin at the time of assessment, record individual items as 7 and total as 77. The coma or paralysis must be induced by medical personnel and not by patient.

Only code “chemically induced coma” with neuromuscular blocking agents or barbiturates.

If patient is intubated at the time of assessment, record the verbal score as 8 and the total score as 88. For the purposes of analysis, these cases will not be included unless specified for recoding during analysis.

If patient is intubated and in chemically-induced coma or paralysis, code 8 for verbal response and 7’s for eye opening, motor response and total GCS.

Utilize the highest and lowest motor score on the GCS as a guide for determining the highest and lowest GCS scores recorded in the 24 hours following *first EMS contact.

GCS scores recorded when the patient is chemically paralyzed should not be included as the highest or lowest GCS scores.

GCS scores recorded when the patient is intubated can be included as the highest or lowest GCS scores by using the motor score or the Becker conversion score .

Reference

Teasdale G, Jennett B (1976) Assessment and Prognosis of Coma After Head Injury, Acta Neurochir 34, 45-55.

Variables

Form Type	Variable	ID	Question	History
Form 1	GCSEyeHi	3465	GCS Eye Opening High	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	GCSEyeLo	3466	GCS Eye Opening Low	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	GCSMotHi	3467	GCS Motor High	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	GCSMotLo	3468	GCS Motor Low	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	GCSTotHi	3469	GCS Total ED High	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	GCSTotLo	3470	GCS Total ED Low	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	GCSVerHi	3471	GCS Verbal High	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	GCSVerLo	3472	GCS Verbal Low	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3465	1	None
3465	2	To Pain
3465	3	To Voice
3465	4	Spontaneous
3465	7	Patient Chemically Paralyzed ( Or in chemically-induced coma for treatment purposes;*sedated )
3465	9	Unknown Eye Opening Response
3466	1	None
3466	2	To Pain
3466	3	To Voice
3466	4	Spontaneous
3466	7	Patient Chemically Paralyzed ( Or in chemically-induced coma for treatment purposes;*sedated )
3466	9	Unknown Eye Opening Response
3467	1	None
3467	2	Extension to Pain
3467	3	Flexion to Pain
3467	4	Withdraws from Pain
3467	5	Localizes Pain
3467	6	Obeys Commands
3467	7	Patient Chemically Paralyzed ( Or in chemically-induced coma for treatment purposes;*sedated )
3467	9	Unknown Motor Response
3468	1	None
3468	2	Extension to Pain
3468	3	Flexion to Pain
3468	4	Withdraws from Pain
3468	5	Localizes Pain
3468	6	Obeys Commands
3468	7	Patient Chemically Paralyzed ( Or in chemically-induced coma for treatment purposes;*sedated )
3468	9	Unknown Motor Response
3469	77	Patient Chemically Paralyzed ( Or in chemically-induced coma for treatment purposes;*sedated )
3469	88	Patient Intubated at time of Scoring
3469	99	Unknown Total GCS Score
3470	77	Patient Chemically Paralyzed ( Or in chemically-induced coma for treatment purposes;*sedated )
3470	88	Patient Intubated at time of Scoring
3470	99	Unknown Total GCS Score
3471	1	None
3471	2	Incomprehensible Sounds
3471	3	Inappropriate Speech
3471	4	Confused
3471	5	Oriented
3471	7	Patient Chemically Paralyzed ( Or in chemically-induced coma for treatment purposes;*sedated )
3471	8	Patient Intubated at time of Scoring
3471	9	Unknown Verbal Response
3472	1	None
3472	2	Incomprehensible Sounds
3472	3	Inappropriate Speech
3472	4	Confused
3472	5	Oriented
3472	7	Patient Chemically Paralyzed ( Or in chemically-induced coma for treatment purposes;*sedated )
3472	8	Patient Intubated at time of Scoring
3472	9	Unknown Verbal Response

History

Date	Description
1994-02-01	Added NOTE : to clarify which GCS scores to use.
1995-01-01	Dropped 88 and 8=Not applicable codes.
1995-07-01	Added NOTE : highest/lowest now collected within 24 hours of injury; this includes EMS and initial ED score.
1995-07-01	Added CODES : 7 for individual items and 77 for total = chemically induced coma or paralysis. Added code T=intubated for verbal item and TT=intubated for total. Dropped eye swelling and intubation items.
1996-04-01	Changed CODES : for patient intubated from "T" and "TT" to "8" and "88".
1999-04-01	Added NOTE : regarding determining highest and lowest GCS scores when patient is chemically paralyzed and/or intubated.
1999-07-01	Added NOTE : revised definition for highest and lowest scores to be within 24 hours following first EMS contact.
1999-10-01	Added NOTE : which stated for highest and lowest score can use model system EMS and ED GCS.
2003-01-01	Deleted NOTE : “highest score” and “lowest score” for all GCS variables and all related instructions.

SEVERITY: PUPILLARY RESPONSE - ARCHIVE

Definition

This variable describes pupillary response to light stimulation at time of the initial neurological evaluation following injury (System Admission) and the worst results during the first 24 hrs. after injury.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (acute record)

Details

Document left (OS) and right (OD) pupils separately. Worst scores for each eye may be from different exams during the first 24-hour period after injury.

Worst score within the first 24 hours post-injury can include Model System ED, but not any EMS data.

If only one reading is available within the first 24 hours post injury, use it as the initial and worst score.

Variables

Form Type	Variable	ID	Question	History
Form 1	PupilInitL	3505	Pupillary Response - Initial Eye Left	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	PupilInitR	3506	Pupillary Response - Initial Eye Right	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	PupilWorstL	3507	Pupillary Response - Worst Eye Left	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	PupilWorstR	3508	Pupillary Response - Worst Eye Right	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3505	1	Brisk or Normal Reaction (BR) +
3505	2	Sluggish Reaction (SR) +
3505	3	No Reaction (NR)
3505	7	Not Applicable: Closed by swelling
3505	8	Not Applicable: Eye absent or blind
3505	9	Unknown ( Or eye sutured closed )
3506	1	Brisk or Normal Reaction (BR) +
3506	2	Sluggish Reaction (SR) +
3506	3	No Reaction (NR)
3506	7	Not Applicable: Closed by swelling
3506	8	Not Applicable: Eye absent or blind
3506	9	Unknown ( Or eye sutured closed )
3507	1	Brisk or Normal Reaction (BR) +
3507	2	Sluggish Reaction (SR) +
3507	3	No Reaction (NR)
3507	7	Not Applicable: Closed by swelling
3507	8	Not Applicable: Eye absent or blind
3507	9	Unknown ( Or eye sutured closed )
3508	1	Brisk or Normal Reaction (BR) +
3508	2	Sluggish Reaction (SR) +
3508	3	No Reaction (NR)
3508	7	Not Applicable: Closed by swelling
3508	8	Not Applicable: Eye absent or blind
3508	9	Unknown ( Or eye sutured closed )

History

Date	Description
1999-04-01	Changed CODE : to unknown code "(or eye suture closed)"
2001-10-01	Changed CODE : "4 - Closed by swelling" to "7 - Closed by swelling" to avoid misinterpretation of "4" as a scale score.
2002-01-01	Changed CODE : added "N/A" to code "7" and code "8" to further clarify that it is not in the hierarchy.

SEVERITY: RANCHO - ARCHIVE

Definition

Rancho Los Amigos Scale is completed at the following times: a)Within 72 hours following admission to inpatient rehabilitation, and b) Discharge from inpatient rehabilitation.

Form

[X] Form 1
[ ] Form 2

Source

• Abstraction (rehab record)

Details

If Rancho Level assessment is not completed within the 72 hour windows, they should still reflect the patients’ status within that time period. If this is not possible and the assessments are done out of the 72 hour window, use code 9. Every effort should be made to obtain the Rancho level, however, if not assessed, use code 9. Do not leave blanks.

Variables

Form Type	Variable	ID	Question	History
Form 1	RanchoA	3513	Rancho Los Amigo Scale Rehab Admission	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	RanchoD	3514	Rancho Los Amigo Scale Rehab Discharge	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3513	1	Level I No Response ( Patient does not respond to external stimuli and appears asleep )
3513	2	Level II Generalized Response ( Patient reacts to external stimuli in nonspecific, inconsistent, and nonpurposeful manner with stereotypic and limited responses )
3513	3	Level III Localized Response ( Patient responds specifically and inconsistently with delays to stimuli, but may follow simple commands for motor action )
3513	4	Level IV Confused, Agitated Response ( Patient exhibits bizarre, nonpurposeful, incoherent or inappropriate behaviors, has no short term recall, attention is short and nonselective )
3513	5	Level V Confused, Inappropriate, Nonagitated Response ( Patient gives random, fragmented, and nonpurposeful responses to complex or unstructured stimuli. Simple commands are followed consistently, memory and selective attention are impaired, and new information is not retained. )
3513	6	Level VI Confused, Appropriate Response ( Patient gives context appropriate, goal directed responses, dependent upon external input for direction. There is carry over for relearned, but not for new tasks, and recent memory problems persist )
3513	7	Level VII Automatic, Appropriate Response ( Patient behaves appropriately in familiar settings, performs daily routines automatically, and shows carry over for new learning at lower than normal rates. Patient initiates social interactions, but judgment remains impaired. )
3513	8	Level VIII Purposeful, Appropriate Response ( Patient orients and responds to the environment, but abstract reasoning abilities are decreased relative to premorbid levels )
3513	9	Unknown ( Or assessment done outside of 72 hour window )
3514	1	Level I No Response ( Patient does not respond to external stimuli and appears asleep )
3514	2	Level II Generalized Response ( Patient reacts to external stimuli in nonspecific, inconsistent, and nonpurposeful manner with stereotypic and limited responses )
3514	3	Level III Localized Response ( Patient responds specifically and inconsistently with delays to stimuli, but may follow simple commands for motor action )
3514	4	Level IV Confused, Agitated Response ( Patient exhibits bizarre, nonpurposeful, incoherent or inappropriate behaviors, has no short term recall, attention is short and nonselective )
3514	5	Level V Confused, Inappropriate, Nonagitated Response ( Patient gives random, fragmented, and nonpurposeful responses to complex or unstructured stimuli. Simple commands are followed consistently, memory and selective attention are impaired, and new information is not retained. )
3514	6	Level VI Confused, Appropriate Response ( Patient gives context appropriate, goal directed responses, dependent upon external input for direction. There is carry over for relearned, but not for new tasks, and recent memory problems persist )
3514	7	Level VII Automatic, Appropriate Response ( Patient behaves appropriately in familiar settings, performs daily routines automatically, and shows carry over for new learning at lower than normal rates. Patient initiates social interactions, but judgment remains impaired. )
3514	8	Level VIII Purposeful, Appropriate Response ( Patient orients and responds to the environment, but abstract reasoning abilities are decreased relative to premorbid levels )
3514	9	Unknown ( Or assessment done outside of 72 hour window )

History

Date	Description
1994-02-01	Deleted NOTE : references to Level I data collection and Acute discharge assessment.
1994-02-01	Deleted CODES : Dates of assessment and "88 - N/A" code.
1994-09-13	Added CODE : "99 - Unknown".
1999-10-01	Changed CODE : "99 - Unknown" to "9 - Unknown".

SEVERITY: RTS - ARCHIVE

Definition

Revised Trauma Score while subject is in care of Emergency Medical Service.

Respiratory Rate – code actual rate per minute (use 3 characters)

Systolic Blood Pressure – code actual blood pressure (use 3 characters)

Form

[X] Form 1
[ ] Form 2

Source

*Form 1 - Abstraction (acute record)

Details

Computer will calculate Revised Trauma Score from these data and the EMS GCS.

If patient was brought to the hospital by some method other than EMS, code 999 for Systolic Blood Pressure and Respiratory Rate.

If data is available from more than one EMS, use first available EMS data.

If a range rather than a single score is given for Respiratory Rate or Systolic Blood Pressure, enter the RAW SCORE that (a) produces the worst code, using the coding equivalents below, and (b) is closest to the midpoint of the range. (“Worst code”= numerically lowest code.) See the EXAMPLE.

If respiratory rate is between 10 and 29, Respiratory Score=4. If respiratory rate is 30 or above, Respiratory Score=3. If respiratory rate is between 6 and 9, Respiratory Score=2. If respiratory rate is between 1 and 5, Respiratory Score=l. If respiratory rate is 0, Respiratory Score=0. If systolic blood pressure is 90 or above, Systolic Blood Pressure Score=4. If systolic blood pressure is between 76 and 89, Systolic Blood Pressure Score=3. If systolic blood pressure is between 50 and 75, Systolic Blood Pressure Score=2. If systolic blood pressure is between 1 and 49, Systolic Blood Pressure Score= 1. If systolic blood pressure is 0, Systolic Blood Pressure Score=0.

EXAMPLE:

Scoring when a single rate (rather than range of rates) is provided:

At admission to ED, patient had a respiratory rate of 30/minute and a systolic blood pressure of 80mmHg. a. Respiratory rate 030 c. Systolic blood pressure 080

Determining a single rate when a range of rates is provided:

At admission to ED, patient had a respiratory rate of between 8 and 12 per minute.

First step: Determine which scores within the range produce the worst code. a. Use the respiratory rate coding equivalences (in NOTES) to determine the code equivalences for the scores within with range. -> Within the range 8-12, the scores 8 and 9 equal code “2” (see line 3 of the coding equivalences) -> Within the range 8-12, the scores 10, 11, and 12 equal code “4” (see line 1 of the coding equivalences) b. Determine which of these codes is the worst code. -> “2” is lower than “4”, so “2” is the worst code. c. Identify the score or scores that equal the worst code. -> Scores 8 and 9 equal “2”, the worst code. (If only one score equals the worst code, enter that score. Do the additional steps below only if more than one score equals the worst code.) Second step: Having determined which scores equal the worst code, identify which one of these scores is closest to the midpoint of the range. Enter that score into the database. a. Identify the midpoint of the range. -> The range is 8-12, which includes 8,9,10,11,12. The midpoint score (the middle score) is 10. b. Identify which of the scores that equal the worst code is nearest to the midpoint. -> 8 and 9 equal the worst code. 9 is closer to 10 (the midpoint) than is 8. c. Enter “9” into the database

Variables

Form Type	Variable	ID	Question	History
Form 1	RTSEMSBP	3527	ED Revised Trauma Score - Systolic Blood Pressure	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	RTSEMSRep	3528	ED Revised Trauma Score - Respiratory Rate	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3527	888	Unmeasurable
3527	999	Unknown or No EMS
3528	888	Unmeasurable: Bagged
3528	999	Unknown or No EMS

History

No history found for the Domain.

SEXUAL ACTIVITY - ARCHIVE

Definition

Are you satisfied with your sexual activity? (asked at time of annual evaluation)

1 Satisfied 2 Not Satisfied 7 N/A, these questions not due this year 9 Unknown

Form

[ ] Form 1
[X] Form 2

Source

• Form 2 - Interview (participant only)

Details

Are you satisfied with your sexual activity? (asked at time of annual evaluation)

Variables

Form Type	Variable	ID	Question	History
Form 2	SexualAct	3948	Sexuality - Sexual Activity	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3948	1	Satisfied
3948	2	Not Satisfied
3948	7	Not Applicable: Variable not due this year
3948	9	Unknown

History

Date	Description
1994-08-01	Changed QUESTION : from "how satisfied are you with your sexual relationships" to "are you satisfied with your sexual activity".
1996-04-01	Added CODE : 7 for additional CIQ questions not due this year.

SRS (SUPERVISION RATING SCALE) - ARCHIVE

See subdomain notes

Definition

The Supervision Rating Scale is used to rate the amount of supervision that the person with brain injury actually receives by choosing one of the thirteen categories below. This rating is determined by the interviewer with information from the person with TBI and/or others at the time of the follow-up evaluation. “Supervision” means that someone is responsible for being with the person with brain injury. For more information, see External Links.

A copy of the SRS Structured Interview Form and Guide are available in External Links.

SRS

Definition

The Supervision Rating Scale is used to rate the amount of supervision that the person with brain injury actually receives by choosing one of the thirteen categories below. This rating is determined by the interviewer with information from the person with TBI and/or others at the time of the follow-up evaluation. “Supervision” means that someone is responsible for being with the person with brain injury. For more information, see External Links.

A copy of the SRS Structured Interview Form and Guide are available in External Links

Form

[ ] Form 1 [X] Form 2

Source

• Form 2 - Interview (participant or proxy)

Details

The SRS score should reflect the actual amount of supervision the individual receives, regardless of the reason why the supervision is required.

The SRS looks at how much supervision the participant actually receives, regardless of whether they need it or not.

A rating of “1- Lives Alone or Independently” can be given if it is clear that the other adults in the home are not providing supervision. One way to tell this is if the person’s comings and goings are clearly unsupervised by other adults (e.g. the person with BI is working early morning or late night, and leaves home or returns home without involving the other adults; Or if the person with TBI goes on outings and returns home while other adults are asleep; Or the person with BI performs major responsibilities unsupervised by other adults who may be present such as caring for sick children overnight while the spouse sleeps; Or the person routinely does activities that are potentially risky such as operating dangerous machinery, without involving the others.

If the participant lives by themselves in different building on same property, but is being checked on once a day, code 5; if it is more frequent than every eight hours, code 6 or 7.

Guidelines for using the Structured Interview for the SRS (SISRS) 1. Use the SISRS questions as worded. Do not rephrase the questions. If the respondent asks what a question means, say it again more slowly, emphasizing and pausing after each key word.

2. Be careful not to put respondents who are caregivers on the defensive as to whether they are providing adequate supervision, because this is likely to bias their answers. Caregiver-respondents may suspect that you are the hospital checking up on them or that you will tell the hospital about them if you believe that they are not providing sufficient care. To minimize the likelihood of putting caregiver-respondents on the defensive, start off with: “Now we have some questions about how independent PERSON is.”

3. Record the level of supervision that the person actually receives as indicated by the SISRS scoring criteria.

   1. Even if a caregiver is overly protective and provides more supervision than the person needs, do not record less supervision than the SISRS indicates that the caregiver is providing.

   2. Even if a caregiver is negligent and is providing less supervision than the person needs, do not record more supervision than the SISRS indicates that the caregiver is providing—not even if lack of supervision has had bad consequences for the participant.

      3. Even if you know that the SRS score generated by the SISRS is inconsistent with the amount of supervision that the person is actually receiving, record the SRS score provided by the SISRS. (But see #4, below.)

4. If you run into a situation in which the SISRS doesn’t seem to apply very well or produces an SRS score that does not accurately indicate the amount of supervision that you know the person is receiving:

   1. Record the score generated by the SISRS. But, make a note that this score may be changed in the future if the coding instructions for the SISRS are amended to fix this problem.
      
   2. Describe on the Data Listserv the situation that resulted in the SISRS producing this inaccurate score, so the problem can be discussed.

Links

SRS Guide
Frequently Asked Questions for SRS (COMBI)
SRS Syllabus (COMBI)
SRS Rating Form (COMBI)
Properties of SRS (COMBI)
References for SRS (COMBI)
Introduction to SRS (COMBI)
SRS Structured Interview

Reference

Boake, C. Supervision Rating Scale: A measure of functional outcome from brain injury. Archives of Physical Medicine and Rehabilitation. 1996;77(8):765-772. For an abstract, see External Links

Characteristics

Errors on the Form II data collection form starting 7/1/00 were corrected on 7/1/01 as follows:

• Heading: “Overnight supervision” replaces “Independent at night”.
  
• Label for 03: “Supervised only at night” replaces “Usually supervised during day”.
  
• Label for 04: “Supervised at night and selected day times” replaces “Supervision always at night and at selected day times”.
  
• Label for 05: “Supervised at night and part-time during day; not supervised during working hours (full time)” replaces “Supervised at night, and most day times, except during work”.
  
• Heading for Level 4: “Full time indirect supervision” replaces “Full time supervision”.
  
• Label for 08: “Full time indirect supervision; does not check more than once every 30 minutes” replaces “Full time direct supervision, at least every 30 minutes”.
  
• Label for 09: “Same as 08, and requires overnight safety precautions (lock, etc.” replaces “Same as 08, and requires special safety precautions (lock, etc.)”.
  
• Label for 10: “Full time direct supervision; checked more than once every thirty minutes” replaces “Full time supervision, more than once every thirty minutes”.
  
• Label for 11: “Full time direct supervision in confined, controlled setting” replaces “Full time supervision in confined, controlled setting”.

Data collected using the incorrect codes were deleted from V297, trichotomized to eliminate the effect of the label errors, and are stored in a separate database. Current data are also saved as a trichotomized variable (“SRScalc”) and can be merged with the deleted data, upon request. The trichotomization is: 01=independent (01); 02=part-time supervision (02-07); 03=full-time supervision (08-13).

In October 2004 it was determined that certain Model Systems had been coding independent persons as “2” if living with one or more adults (e.g., spouse). Most but not all such cases can be corrected by the Model Systems. Starting with database 9.8 the TBINDC will:
(1) archive the current, flawed variable,
(2) make available a new variable in which codes 1 and 2 are collapsed into a single category (thereby making all SRS data consistent across all centers), and
(3) fix the current variable by deleting incorrectly coded cases that cannot be corrected. (It is expected that about 130 cases will be deleted.) Data will continue to be entered into the current variable.[/u]

Two different version of calculated SRS are available.

SRS was removed from TBIMS data collection on 1/15/2019

Variables

Form Type	Variable	ID	Question	History
Form 2	SRSF	771	Supervision Rating Scale (click 'Help' for structured interview)	1998-04-01 - Variable Added 2019-01-15 - Variable Removed

Codes and Values

ID	Code	Description
771	1	Lives Alone or Independently ( Other persons can live with the person with brain injury, but they cannot take responsibility for supervision (for example, a child or elderly person). *If person is independent and living with one or more other adults, code "1". )
771	2	Unsupervised at Night, Sometimes During the Day ( The person with brain injury lives with one or more persons who could be responsible for supervision (for example, a spouse or roommate), but they are all sometimes absent overnight. )
771	3	Supervised Only at Night ( One or more supervising persons are always present overnight but they are all sometimes absent for the rest of the day. )
771	4	Supervised at Night and Selected Day Times ( But is allowed on independent outings. )
771	5	Supervised at Night and Part Time During the Day ( Not during full time working hours )
771	6	Supervised at Night and Most of Day Except for Few Unsupervised Hours ( Supervising persons are all sometimes absent for periods longer than one hour, but less than the time needed to hold a full-time job away from home. )
771	7	Only Unsupervised for Periods Less Than One Hour at a Time ( Persons are all sometimes absent for periods shorter than one hour. )
771	8	Full Time Indirect Supervision ( At least one supervising person is always present, but the supervising person does not check on the person with brain injury more than once every 30 minutes )
771	9	Same as # 8 but Requires Overnight Safety Precautious ( A deadbolt on outside door )
771	10	Full Time Direct Supervision ( At least one supervising person is always present and the supervising person checks on the person with brain injury more than once every thirty minutes )
771	11	Full Time Direct Supervision in Confined, Controlled Setting ( A locked ward )
771	12	Same as #11 but with Constant Visual Watch ( An escape watch or suicide watch )
771	13	Person is in Physical Restraints
771	666	Variable Did not Exist
771	999	Unknown

History

No history found for the Domain.

SUBSTANCE USE: ALCOHOL - ARCHIVE

Definition

Significant Other report of alcohol use of participant.

1. During the past month, has __ had at least one drink of any alcoholic beverage such as beer, wine, wine coolers, or liquor?
2. During the past month, how many days per week or per month did __ drink any alcoholic beverages, on the average?
3. 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?
4. 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

Form Type	Variable	ID	Question	History
Form 1	ALCMonth	394	Days per month:	1999-10-01 - Variable Added 2022-07-01 - Variable Removed
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 2003-01-01 - Variable Removed
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 2003-01-01 - Variable Removed
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 2003-01-01 - Variable Removed
Form 2	ALCMonthF	575	Days per month:	1999-10-01 - Variable Added 2022-04-01 - Variable Removed
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 2003-01-01 - Variable Removed
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 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
394	666	Variable Did Not Exist
394	777	Refused
394	888	Not Applicable
394	999	Unknown
575	666	Variable Did Not Exist
575	777	Refused
575	881	Not Applicable
575	882	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
575	999	Unknown
3578	00	None
3578	55	Not Applicable: Variable not due this year
3578	60	No Significant Other
3578	66	Not Applicable
3578	77	Don't Know/Not Sure
3578	88	Variable Did Not Exist
3578	99	Refused
3579	1	No
3579	2	Yes
3579	5	Not Applicable: Variable not due this year
3579	6	No Significant Other
3579	7	Don’t Know/Not Sure
3579	8	Variable Did Not Exist
3579	9	Refused
3580	55	Not Applicable: Variable not due this year
3580	60	No Significant Other
3580	66	Not Applicable
3580	77	Don't Know/Not Sure
3580	88	Variable Did Not Exist
3580	99	Refused
3581	55	Not Applicable: Variable not due this year
3581	60	No Significant Other
3581	66	Not Applicable
3581	77	Don't Know/Not Sure
3581	88	Variable Did Not Exist
3581	99	Refused
3582	55	Not Applicable: Variable not due this year
3582	60	No Significant Other
3582	66	Not Applicable
3582	77	Don't Know/Not Sure
3582	88	Variable Did Not Exist
3582	99	Refused

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.

SUBSTANCE USE: 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 1999-10-01 - Variable Removed
Form 1	DrinkCut	3404	CAGE 1. Did you feel you ought to cut down drinking?	1989-10-01 - Variable Added 1999-10-01 - Variable Removed
Form 1	DrinkGuilty	3405	CAGE 3. Did you feel bad or guilty about drinking?	1989-10-01 - Variable Added 1999-10-01 - Variable Removed
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 1999-10-01 - Variable Removed
Form 2	DrinkAnnoyF	3656	CAGE 2. Did people annoy you by criticizing your drinking? (TBI)	1989-10-01 - Variable Added 1999-10-01 - Variable Removed
Form 2	DrinkAnnoyFSO	3657	CAGE 2. Have people annoyed ___ by criticizing his/her drinking?	1989-10-01 - Variable Added 1999-10-01 - Variable Removed
Form 2	DrinkCutF	3658	CAGE 1. Did you feel you ought to cut down drinking? (TBI)	1989-10-01 - Variable Added 1999-10-01 - Variable Removed
Form 2	DrinkCutFSO	3659	CAGE 1. Has ___ felt he/she ought to cut down drinking?	1989-10-01 - Variable Added 1999-10-01 - Variable Removed
Form 2	DrinkGuiltyF	3660	CAGE 3. Did you feel bad or guilty about drinking? (TBI)	1989-10-01 - Variable Added 1999-10-01 - Variable Removed
Form 2	DrinkGuiltyFSO	3661	CAGE 3. Has ___ felt bad or guilty about drinking?	1989-10-01 - Variable Added 1999-10-01 - Variable Removed
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 1999-10-01 - Variable Removed
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 1999-10-01 - Variable Removed

Codes and Values

ID	Code	Description
3403	0	Variable Did Not Exist
3403	1	No
3403	2	Yes
3403	9	Unknown
3404	0	Variable Did Not Exist
3404	1	No
3404	2	Yes
3404	9	Unknown
3405	0	Variable Did Not Exist
3405	1	No
3405	2	Yes
3405	9	Unknown
3406	0	Variable Did Not Exist
3406	1	No
3406	2	Yes
3406	9	Unknown
3656	0	Variable Did Not Exist
3656	1	No
3656	2	Yes
3656	7	Variable Did not Exist
3656	9	Unknown
3657	0	Variable Did Not Exist
3657	1	No
3657	2	Yes
3657	7	Variable Did not Exist
3657	9	Unknown
3658	0	Variable Did Not Exist
3658	1	No
3658	2	Yes
3658	7	Variable Did not Exist
3658	9	Unknown
3659	0	Variable Did Not Exist
3659	1	No
3659	2	Yes
3659	7	Variable Did not Exist
3659	9	Unknown
3660	0	Variable Did Not Exist
3660	1	No
3660	2	Yes
3660	7	Variable Did not Exist
3660	9	Unknown
3661	0	Variable Did Not Exist
3661	1	No
3661	2	Yes
3661	7	Variable Did not Exist
3661	9	Unknown
3662	0	Variable Did Not Exist
3662	1	No
3662	2	Yes
3662	7	Variable Did not Exist
3662	9	Unknown
3663	0	Variable Did Not Exist
3663	1	No
3663	2	Yes
3663	7	Variable Did not Exist
3663	9	Unknown

History

No history found for the Domain.

SUBSTANCE USE: 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 2022-07-01 - Variable Removed
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 2022-04-01 - Variable Removed

Codes and Values

ID	Code	Description
555	1	Not At All
555	2	Some Days
555	3	Everyday
555	66	Variable Did Not Exist
555	77	Refused
555	99	Unknown
769	1	Not At All
769	2	Some Days
769	3	Everyday
769	66	Variable Did Not Exist
769	77	Refused
769	99	Unknown

History

No history found for the Domain.

SUBSTANCE USE: 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.

1. 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 2003-01-01 - Variable Removed
Form 1	DrugType2	3409	Type of Drug Used 2	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	DrugType3	3410	Type of Drug Used 3	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	DrugType4	3411	Type of Drug Used 4	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	DrugType5	3412	Type of Drug Used 5	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 1	DrugTypeOth	3413	Type of Drug Used Other	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugType1F	3681	Drug Used 1	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugType1FSO	3682	Drug Used 1 (SO)	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugType2F	3683	Drug Used 2	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugType2FSO	3684	Drug Used 2 (SO)	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugType3F	3685	Drug Used 3	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugType3FSO	3686	Drug Used 3 (SO)	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugType4F	3687	Drug Used 4	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugType4FSO	3688	Drug Used 4 (SO)	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugType5F	3689	Drug Used 5	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugType5FSO	3690	Drug Used 5 (SO)	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugTypeOthF	3691	Other Drug Used	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	DrugTypeOthFSO	3692	Other Drug Used (SO)	1997-01-01 - Variable Added 2003-01-01 - Variable Removed
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 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3408	0	Variable Did Not Exist
3408	1	No Drug Use
3408	2	Crack/Cocaine
3408	3	Pot/Marijuana
3408	4	LSD/Hallucinogens
3408	5	Heroin/Opiates
3408	6	Speed/Stimulants
3408	7	Variable Did Not Exist
3408	8	Not Applicable: No other drug use
3408	9	Unknown
3409	0	Variable Did Not Exist
3409	1	No Drug Use
3409	2	Crack/Cocaine
3409	3	Pot/Marijuana
3409	4	LSD/Hallucinogens
3409	5	Heroin/Opiates
3409	6	Speed/Stimulants
3409	7	Variable Did Not Exist
3409	8	Not Applicable: No other drug use
3409	9	Unknown
3410	0	Variable Did Not Exist
3410	1	No Drug Use
3410	2	Crack/Cocaine
3410	3	Pot/Marijuana
3410	4	LSD/Hallucinogens
3410	5	Heroin/Opiates
3410	6	Speed/Stimulants
3410	7	Variable Did Not Exist
3410	8	Not Applicable: No other drug use
3410	9	Unknown
3411	0	Variable Did Not Exist
3411	1	No Drug Use
3411	2	Crack/Cocaine
3411	3	Pot/Marijuana
3411	4	LSD/Hallucinogens
3411	5	Heroin/Opiates
3411	6	Speed/Stimulants
3411	7	Variable Did Not Exist
3411	8	Not Applicable: No other drug use
3411	9	Unknown
3412	0	Variable Did Not Exist
3412	1	No Drug Use
3412	2	Crack/Cocaine
3412	3	Pot/Marijuana
3412	4	LSD/Hallucinogens
3412	5	Heroin/Opiates
3412	6	Speed/Stimulants
3412	7	Variable Did Not Exist
3412	8	Not Applicable: No other drug use
3412	9	Unknown
3680	1	No
3680	2	Yes
3680	7	Not Applicable: Variable not due this year
3680	8	No Significant Other or Family Member
3680	9	Unknown
3681	0	Variable Did Not Exist
3681	1	No Drug Use
3681	2	Crack/Cocaine
3681	3	Pot/Marijuana
3681	4	LSD/Hallucinogens
3681	5	Heroin/Opiates
3681	6	Speed/Stimulants
3681	7	Variable Did not Exist
3681	8	Not Applicable: No other drug use
3681	9	Unknown
3682	0	Variable Did Not Exist
3682	1	No Drug Use
3682	2	Crack/Cocaine
3682	3	Pot/Marijuana
3682	4	LSD/Hallucinogens
3682	5	Heroin/Opiates
3682	6	Speed/Stimulants
3682	7	Variable Did not Exist
3682	8	Not Applicable: No other drug use
3682	9	Unknown
3683	0	Variable Did Not Exist
3683	1	No Drug Use
3683	2	Crack/Cocaine
3683	3	Pot/Marijuana
3683	4	LSD/Hallucinogens
3683	5	Heroin/Opiates
3683	6	Speed/Stimulants
3683	7	Variable Did not Exist
3683	8	Not Applicable: No other drug use
3683	9	Unknown
3684	0	Variable Did Not Exist
3684	1	No Drug Use
3684	2	Crack/Cocaine
3684	3	Pot/Marijuana
3684	4	LSD/Hallucinogens
3684	5	Heroin/Opiates
3684	6	Speed/Stimulants
3684	7	Variable Did not Exist
3684	8	Not Applicable: No other drug use
3684	9	Unknown
3685	0	Variable Did Not Exist
3685	1	No Drug Use
3685	2	Crack/Cocaine
3685	3	Pot/Marijuana
3685	4	LSD/Hallucinogens
3685	5	Heroin/Opiates
3685	6	Speed/Stimulants
3685	7	Variable Did not Exist
3685	8	Not Applicable: No other drug use
3685	9	Unknown
3686	0	Variable Did Not Exist
3686	1	No Drug Use
3686	2	Crack/Cocaine
3686	3	Pot/Marijuana
3686	4	LSD/Hallucinogens
3686	5	Heroin/Opiates
3686	6	Speed/Stimulants
3686	7	Variable Did not Exist
3686	8	Not Applicable: No other drug use
3686	9	Unknown
3687	0	Variable Did Not Exist
3687	1	No Drug Use
3687	2	Crack/Cocaine
3687	3	Pot/Marijuana
3687	4	LSD/Hallucinogens
3687	5	Heroin/Opiates
3687	6	Speed/Stimulants
3687	7	Variable Did not Exist
3687	8	Not Applicable: No other drug use
3687	9	Unknown
3688	0	Variable Did Not Exist
3688	1	No Drug Use
3688	2	Crack/Cocaine
3688	3	Pot/Marijuana
3688	4	LSD/Hallucinogens
3688	5	Heroin/Opiates
3688	6	Speed/Stimulants
3688	7	Variable Did not Exist
3688	8	Not Applicable: No other drug use
3688	9	Unknown
3689	0	Variable Did Not Exist
3689	1	No Drug Use
3689	2	Crack/Cocaine
3689	3	Pot/Marijuana
3689	4	LSD/Hallucinogens
3689	5	Heroin/Opiates
3689	6	Speed/Stimulants
3689	7	Variable Did not Exist
3689	8	Not Applicable: No other drug use
3689	9	Unknown
3690	0	Variable Did Not Exist
3690	1	No Drug Use
3690	2	Crack/Cocaine
3690	3	Pot/Marijuana
3690	4	LSD/Hallucinogens
3690	5	Heroin/Opiates
3690	6	Speed/Stimulants
3690	7	Variable Did not Exist
3690	8	Not Applicable: No other drug use
3690	9	Unknown

History

Date	Description
1998-09-01	Added NOTE : regarding contradictory information from patient.

SUBSTANCE USE: 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 2012-12-10 - Variable Removed

Codes and Values

ID	Code	Description
3423	000	Test completed: No ethanol found
3423	777	Positive, But Unknown Level of Ethanol
3423	888	Not Tested
3423	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

SUBSTANCE USE: 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 1999-10-01 - Variable Removed
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 1999-10-01 - Variable Removed
Form 1	QFVI6Plus	3511	QFVI 2. When you drank alcohol, how often did you have 6 or more drinks?	1989-10-01 - Variable Added 1999-10-01 - Variable Removed
Form 1	QFVIAny	3512	QFVI 1. How often did you have one or more drinks containing alcohol?	1989-10-01 - Variable Added 1999-10-01 - Variable Removed
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 1999-10-01 - Variable Removed
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 1999-10-01 - Variable Removed
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 1999-10-01 - Variable Removed
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 1999-10-01 - Variable Removed
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 1999-10-01 - Variable Removed
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 1999-10-01 - Variable Removed
Form 2	QFVIAnyF	3935	QFVI 1. How often did you have one or more drinks containing alcohol? (TBI)	1989-10-01 - Variable Added 1999-10-01 - Variable Removed
Form 2	QFVIAnyFSO	3936	QFVI 1. How often did you have one or more drinks containing alcohol? (SO)	1989-10-01 - Variable Added 1999-10-01 - Variable Removed

Codes and Values

ID	Code	Description
3509	0	Variable Did Not Exist
3509	1	Nearly Every Time
3509	2	More Than Half the Time
3509	3	Less Than Half the Time
3509	4	Once in a While
3509	5	Never
3509	9	Unknown
3510	0	Variable Did Not Exist
3510	1	Nearly Every Time
3510	2	More Than Half the Time
3510	3	Less Than Half the Time
3510	4	Once in a While
3510	5	Never
3510	9	Unknown
3511	0	Variable Did Not Exist
3511	1	Nearly every time
3511	2	More Than Half the Time
3511	3	Less Than Half the Time
3511	4	Once in a While
3511	5	Never
3511	9	Unknown
3512	0	Variable Did Not Exist
3512	1	Three or More Times a Day
3512	2	Two Times a Day
3512	3	Once a Day
3512	4	Nearly Every Day
3512	5	Three or Four Times a Week
3512	6	Once or Twice a Week
3512	7	Two or Three Times a Month
3512	8	About Once a Month
3512	9	Less Than Once a Month But at Least Once a Year
3512	10	Less Than Once a Year
3512	11	Not At All
3512	99	Unknown
3929	0	Variable Did Not Exist
3929	1	Nearly Every Time
3929	2	More Than Half the time
3929	3	Less Than Half the time
3929	4	Once in a While
3929	5	Never
3929	7	Variable Not Collected
3929	9	Unknown
3930	0	Variable Did Not Exist
3930	1	Nearly Every Time
3930	2	More Than Half the time
3930	3	Less Than Half the time
3930	4	Once in a While
3930	5	Never
3930	7	Variable Not Collected
3930	9	Unknown
3931	0	Variable Did Not Exist
3931	1	Nearly Every Time
3931	2	More Than Half the time
3931	3	Less Than Half the time
3931	4	Once in a While
3931	5	Never
3931	7	Variable Not Collected
3931	9	Unknown
3932	0	Variable Did Not Exist
3932	1	Nearly Every Time
3932	2	More Than Half the time
3932	3	Less Than Half the time
3932	4	Once in a While
3932	5	Never
3932	7	Variable Not Collected
3932	9	Unknown
3933	0	Variable Did Not Exist
3933	1	Nearly Every Time
3933	2	More Than Half the time
3933	3	Less Than Half the time
3933	4	Once in a While
3933	5	Never
3933	7	Variable Not Collected
3933	9	Unknown
3934	0	Variable Did Not Exist
3934	1	Nearly Every Time
3934	2	More Than Half the time
3934	3	Less Than Half the time
3934	4	Once in a While
3934	5	Never
3934	7	Variable Not Collected
3934	9	Unknown
3935	0	Variable Did Not Exist
3935	1	Three or More Times a Day
3935	2	Two Times a Day
3935	3	Once a Day
3935	4	Nearly Every Day
3935	5	Three or Four Times a Week
3935	6	Once or Twice a Week
3935	7	Two or Three Times a Month
3935	8	About Once a Month
3935	9	Less Than Once a Month but at Least Once a Year
3935	10	Less Than Once a Year
3935	11	Not at All
3935	77	Variable Not Collected
3935	99	Unknown
3936	0	Variable Did Not Exist
3936	1	Three or More Times a Day
3936	2	Two Times a Day
3936	3	Once a Day
3936	4	Nearly Every Day
3936	5	Three or Four Times a Week
3936	6	Once or Twice a Week
3936	7	Two or Three Times a Month
3936	8	About Once a Month
3936	9	Less Than Once a Month but at Least Once a Year
3936	10	Less Than Once a Year
3936	11	Not at All
3936	77	Variable Not Collected
3936	99	Unknown

History

No history found for the Domain.

SWLS SO (SATISFACTION WITH LIFE SCALE - SIGNIFICANT OTHER) - ARCHIVE

Definition

The family member/significant other of the person with brain injury should rate THEIR OWN satisfaction with life by indicating his/her level of agreement with the five questions below at the time of the person with brain injury’s annual evaluation.

Form

[ ] Form 1
[X] Form 2

Source

• Form 2 - Interview, Mail-Out (participant or proxy)

Variables

Form Type	Variable	ID	Question	History
Form 2	SWLSCondSO	3958	SWLS (SO) - The conditions of my life are excellent	1998-04-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	SWLSIdealSO	3959	SWLS (SO) - In most ways my life is close to my ideal	1998-04-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	SWLSImprtSO	3960	SWLS (SO) - So far I have gotten the important things I want in life	1998-04-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	SWLSLiveOverSO	3961	SWLS (SO) - If I could live my life over, I would change almost nothing	1998-04-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	SWLSSAtSO	3962	SWLS (SO) - I am satisfied with my life	1998-04-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3958	0	Variable Did Not Exist
3958	1	Strongly Disagree
3958	2	Disagree
3958	3	Slightly Disagree
3958	4	Neither Agree nor Disagree
3958	5	Slightly Agree
3958	6	Agree
3958	7	Strongly Agree
3958	8	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3958	9	Unknown
3958	10	Not Applicable: No data from person with TBI
3959	0	Variable Did Not Exist
3959	1	Strongly Disagree
3959	2	Disagree
3959	3	Slightly disagree
3959	4	Neither Agree nor Disagree
3959	5	Slightly Agree
3959	6	Agree
3959	7	Strongly Agree
3959	8	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3959	9	Unknown
3959	10	Not Applicable: No sisgnificant other
3960	0	Variable Did Not Exist
3960	1	Strongly Disagree
3960	2	Disagree
3960	3	Slightly Disagree
3960	4	Neither Agree nor Disagree
3960	5	Slightly Agree
3960	6	Agree
3960	7	Strongly Agree
3960	8	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3960	9	Unknown
3960	10	Not Applicable: No data from person with TBI
3961	0	Variable Did Not Exist
3961	1	Strongly Disagree
3961	2	Disagree
3961	3	Slightly Disagree
3961	4	Neither Agree nor Disagree
3961	5	Slightly Agree
3961	6	Agree
3961	7	Strongly Agree
3961	8	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3961	9	Unknown
3961	10	Not Applicable: No data from person with TBI
3962	0	Variable Did Not Exist
3962	1	Strongly Disagree
3962	2	Disagree
3962	3	Slightly Disagree
3962	4	Neither Agree nor Disagree
3962	5	Slightly Agree
3962	6	Agree
3962	7	Strongly Agree
3962	8	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
3962	9	Unknown
3962	10	Not Applicable: No data from person with TBI

History

No history found for the Domain.

SWLS: WLS - ARCHIVE

Variables

Form Type	Variable	ID	Question	History
Form 2	SWLSLiveOverF	778	If I could live my life over, I would change almost nothing:	1997-01-01 - Variable Added 2022-04-01 - Variable Removed

Codes and Values

ID	Code	Description
778	1	Strongly Disagree
778	2	Disagree
778	3	Slightly Disagree
778	4	Neither Agree nor Disagree
778	5	Slightly Agree
778	6	Agree
778	7	Strongly Agree
778	66	Variable Did Not Exist
778	81	Not Applicable: Variable not due this year ( Code no longer used; data now collected in all follow-up years )
778	82	Not Applicable: No data from person with TBI
778	99	Unknown

History

No history found for the Domain.

TBI HISTORY: OSU TBI-ID - ARCHIVE

Definition

OSU TBI-ID archived variables include

TBIChoking TBIOverdose

Form

[ ] Form 1
[X] Form 2

Source

• Interview (participant or proxy)

Variables

Form Type	Variable	ID	Question	History
Form 2	TBIChokingF	780	Number from choking	2010-04-01 - Variable Added 2015-01-15 - Variable Removed
Form 2	TBIOverdoseF	782	Number from overdose	2010-04-01 - Variable Added 2015-01-15 - Variable Removed

Codes and Values

ID	Code	Description
780	666	Variable Did Not Exist
780	777	Refused
780	888	Not Applicable
780	999	Unknown
782	0	None
782	666	Variable Did Not Exist
782	777	Refused
782	888	Not Applicable
782	999	Unknown

History

No history found for the Domain.

TBI HISTORY: TBI PRIOR - ARCHIVE

Definition

History of TBI occurring prior to the current TBI for which the patient is being treated.

Traumatic brain injury is defined as damage to brain tissue caused by an external mechanical force as evidenced by: loss of consciousness due to brain trauma, or post traumatic amnesia (PTA), or skull fracture, or objective neurological findings that can be reasonably attributed to TBI on physical examination or mental status examination.

The patient must have been admitted to a hospital for treatment of this previous TBI.

Details

Penetrating wounds with criteria listed above are included. Lacerations and/or bruises of the scalp or forehead without other criteria listed above are excluded. Primary anoxic encephalopathy is excluded.

If respondent recalls that the reason for a prior hospitalization included TBI, code “Yes”.

Common terms may include: head injury, concussion, being knocked out.

Variables

Form Type	Variable	ID	Question	History
Form 1	TBI	775	History of TBI Requiring Hospitalization	1989-10-01 - Variable Added 2010-04-01 - Variable Removed

Codes and Values

ID	Code	Description
775	666	Variable Did Not Exist
775	888	N/A
775	999	Unknown

History

Date	Description
1994-02-01	Changed DEFINITION: to match model system case definition.

TBI HISTORY: TBI SUBSEQUENT - ARCHIVE

Definition

Subsequent traumatic brain injury in a patient who is identified in Form I as having a traumatic brain injury. This must be diagnosed by a physician. The injury does not have to be so severe as to require rehospitalization.

Traumatic brain injury is to be defined as:

1. Loss of consciousness due to new brain trauma,

2. Post-traumatic amnesia due to new brain trauma, or

3. Objective neurologic finding that can be reasonably attributed to subsequent brain injury on physical or mental status examination

Any one of the above criteria will suffice.

Form

[ ] Form 1
[X] Form 2

Source

• Form 2 - Interview, Mail-Out (participant or proxy)

Details

Subsequent TBI should be since the last follow-up (not the last year). The last follow-up is defined as “since the initial injury” for year 1 follow-ups.

For subsequent follow-ups, the last follow-up is defined as “the last successful follow-up with the participant”.

The data collector should know the date of the last successful follow-up prior to initiating the interview, and reference that date in the question - i.e. “Since your last follow-up on MM/DD/YYYY…”

Common terms may include: head injury, concussion, being knocked out.

If patient had more than one subsequent brain injury during the current follow-up year, enter the date of the first one.

Variables

Form Type	Variable	ID	Question	History
Form 2	SubsTBI	3956	When did the head injury/injuries that were diagnosed by a physician occur?	1989-10-01 - Variable Added 2010-04-01 - Variable Removed

Codes and Values

ID	Code	Description
3956	666666	Variable Did Not Exist
3956	777777	Patient Had a Subsequent Brain Injury During the Current Follow-up Year, but the Date is Not Known
3956	888888	Not Applicable: No subsequent brain injury
3956	999999	Unknown if Subsequent Brain Injury

History

No history found for the Domain.

TRANSPORTATION - ARCHIVE

Definition

SO Response to Primary Transportation Mode

Form

[ ] Form 1
[X] Form 2

Source

• Form 2 - Interview, Mail-Out (proxy)

Details

SO Response to Primary Transportation Mode

Variables

Form Type	Variable	ID	Question	History
Form 2	TransSO	3975	SO Response to Primary Transportation	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID	Code	Description
3975	1	Person with TBI
3975	2	Significant Other
3975	3	Person with TBI and Significant Other
3975	6	Variable Did Not Exist
3975	7	Not Applicable: Variable not due this year
3975	9	Unknown

History

Date	Description
1998-04-15	Added CODE : Split “N/A” code into “N/A, not due this year” and “N/A, no SO”.
2001-07-01	V292b became a “Best source of information” variable, incorporating V293b. (This "best source" variable was originally named V300b, but reverted to V292b before a change in the database occurred.)