LTR

Metadata Report

Symptom Questionnaire(SMQ)
Version 1.00

Key FieldField NameFull NameQuestion TextTypeLength and DecimalsExpected
*SITECenterC5Yes
*PROTProtocolC5Yes
*PROJIDParticipant IDC5Yes
*PROTSEGSegmentC1Yes
*DTASSESSDate of assessmentD8Yes
SMQCOUGHUsual coughDo you usually have a cough?C1Yes
SMQCOUAMCough amountDo you usually cough as much as 4 to 6 times a day, 4 or more days out of the week?C1Yes
SMQCOUMRCough in the morningDo you usually cough at all on getting up, or first thing in the morning?C1Yes
SMQCOUDNCough day or nightDo you usually cough at all during the rest of the day or night?C1Yes
SMQCOUMOCough consecutive monthsDo you usually cough like this on most days for three consecutive months during the year?C1Yes
SMQCOUYRNumber years coughFor how many years have you had this cough?N2(0)Yes
SMQPHLGMUsual phlegmDo you usually bring up phlegm from your chest?C1Yes
SMQPHLAMPhlegm amountDo you usually bring up phlegm like this as much as twice a day, 4 or more days out of the week?C1Yes
SMQPHLMRPhlegm in the morningDo you usually bring up phlegm at all on getting up, or first thing in the morning?C1Yes
SMQPHLDNPhlegm day or nightDo you usually bring up phlegm at all during the rest of the day or at night?C1Yes
SMQPHLMOPhlegm consecutive monthDo you bring up phlegm like this on most days for three consecutive months or more during the year?C1Yes
SMQPHLYRNumber years phlegmFor how many years have you had trouble with phlegm?N2(0)Yes
SMQCPEPICough and phlegm episodeHave you had periods or episodes of increased cough and phlegm lasting for three weeks or more each year?C1Yes
SMQCPLENCough phlegm ep lengthFor how long have you had at least one such episode per year?N2(0)Yes
SMQYRUNKYears unknownC1No
SMQWZCLDWheeze during coldWhen you have a cold?C1Yes
SMQWZOCCWheeze occassionallyOccasionally, apart from colds?C1Yes
SMQWZDNWheeze day or nightMost days or nights?C1Yes
SMQWZYRNumber years wheezeFor how many years has this been present?N2(0)Yes
SMQWZSBEWheeze SOB everHave you ever had an attack of wheezing that has made you feel short of breath?C1Yes
SMQWZAGEWheeze attack ageHow old were you when you had your first attack?N2(0)Yes
SMQWZEP2Wheeze two or more episodHave you had two or more such episodes?C1Yes
SMQWZMEVWheeze meds everHave you ever required medicine or treatment for the(se) attack(s)?C1Yes
SMQWZSBYWheeze SOB past yearHave you had an attack of wheezing that has made you feel short of breath in the past year?C1Yes
SMQWZPYEWheeze episodes past yearHave you had two or more such episodes in the past year?C1Yes
SMQWZMPYWheeze meds past yearHave you required medicine or a treatment for the(se) attack(s) in the past year?C1Yes
SMQBDISBreathlessness disabledAre you disabled from walking by any condition other than heart or lung disease?C1Yes
SMQBCONBreathlessness conditionIf Yes, describe the nature of the condition(s):M4Yes
SMQBSOBBreathlessness SOBAre you troubled by shortness of breath when hurrying on the level or walking up a slight hill?C1Yes
SMQBWALKBreathlessness walk slowDo you have to walk slower than people of your age on the level because of breathlessness?C1Yes
SMQBSTP1Breathlessness stop paceDo you ever have to stop for breath when walking at your own pace on the level?C1Yes
SMQBSTP2Breathlessness stop yardsDo you ever have to stop for breath after walking about 100 yards (or after a few minutes) on the level?C1Yes
SMQBADLBreathlessness activitiesAre you too breathless to leave the house or breathless on dressing or undressing?C1Yes
SMQCDFRQCold frequencyHow often do you get colds?C1Yes
SMQCDCHSCold go to chestDo your colds usually go to your chest (usually means more than half the time)?C1Yes
SMQCD12Cold in past 12 monthsHow often did you get colds in the past 12 months?C1Yes
SMQCD12CCold go to chest past 12Did your colds in the past 12 months usually go to your chest (usually means more than half the time)?C1Yes
SMQCHILLChest illness past 12 monDuring the past 12 months, have you had any chest illnesses that have kept you off work, indoors at home or in bed?C1Yes
SMQCHPHLChest illness phlegmDid you produce phlegm with any of these chest illnesses?C1Yes
SMQCHWKChest illness one weekIn the past 12 months, how many such illnesses did you have which lasted a week or more?N2(0)Yes
SMQLUNGLung troubleDid you have any lung trouble before the age of 16?C1Yes
SMQCHEVChest illness everDid you have any chest illness before the past 12 months?C1Yes
SMQCHSPChest illness specifyIf Yes, specify:C150Yes
SMQCOMMCommentsComments:M4No