Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 2 | Followup | 686 | Follow-up evaluation date: | 1989-10-01 - Variable Added |
FOLLOW-UP DATE
FOLLOW-UP DATE
Definition
Date of Follow-up Evaluation
Form
[ ] Form 1
[X] Form 2
Source
Data Collector
Details
For date of follow-up evaluation, enter date when first data are collected (if data collection is done with more than one contact) with patient or significant other. If no follow-up data are collected from patient or significant other, code the reason (05/05/5555, 07/07/7777, etc.).
If a completed mailout is returned but not dated, the date of follow-up should be coded as the date the mailout was postmarked.
Court ordered rehab is considered as a form of incarceration for the purposes of the TBIMS, and should be coded accordingly.
Characteristics
For historical purposes only, a date of “09/09/9999 - Unknown” was a valid code, however, going forward, cases that are coded as “Followed” should always have a valid date.
Variables
Codes and Values
ID | Code | Description |
|---|---|---|
686 | 04/04/4444 | Expired |
686 | 05/05/5555 | Withdrew authorization |
686 | 07/07/7777 | Not Applicable: Includes refused, incarcerated and lost |
686 | 08/08/8888 | Not Applicable: Other ( No follow-up evaluation. [DROPPED] ) |
686 | 09/09/9999 | Unknown ( Collected via secondary source ) |
History
No history found for the Domain.
FOLLOW-UP DATE - CALCULATED
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 2 | AGEF | 573 | Age at Follow-Up | 1989-10-01 - Variable Added |
Form 2 | AGENoPHIF | 574 | Age at Follow-Up (No PHI Version) | 1989-10-01 - Variable Added |
Form 2 | DAYStoFUF | 3651 | Days From Injury to Followup | 1989-10-01 - Variable Added |
Form 2 | FUYearF | Year of the Follow-up interview |
Codes and Values
ID | Code | Description |
|---|---|---|
573 | 9999 | Unknown |
574 | 777 | 89 Years Old or Older |
574 | 999 | Unknown |
3651 | 999999 | Unknown |
History
No history found for the Domain.