Annotated Form Gen 3 NOS Omni 2 Exam 3 - Data Collection Form Variables

Sep 27, 2026

Annotated data collection form for e_exam_ex03_3b_1069 Generation 3 Exam 3, mapping REDCap and SAS variable names and organizing participant information and imported validated fields. Captures core demographics and exam dates (site, names, DOB), computed measures (birth year, exam year, age), participant ID and sex. Includes medical encounter sections covering hospitalizations, emergency room visits, day surgery, and major illness, with repeated blocks for reasons, years, date details, hospital/location, and follow-up occurrences, using explicit coding and unknown options.

LanguageEnglish

CategoryExam

FormatPDF

Pages72

Reading Time3 h 1 min

AccessFree to download

Participant Information (A01)

Imported Validated Data for Data Management Use

Medical Encounters (M01)

Hospitalizations (not E.R.)

E.R. visits only?

Day surgery?

Major illness with visit to doctor?

Annotated data collection form for e_exam_ex03_ 3b_ 1069 Generation 3 Exam 3 Variables names in pink = REDCap variable names Variables name in blue = SAS variable names Participant Information (A01) | Date of this FHS exam (today's date) | | |/| | |/| | | | | | Date calendar | examdate
G3C0001 | | --- | --- | --- | | Site | | | 0 = Heart Study
1 = Nursing home
2 = Residence
3 = Other | site
G3C0002 | | First name | Character field | firstname
G3C0003 | | Last name | Character field | lastname
G3C0004 | | Date of Birth | | |/| | |/| | | | | | Date calendar | dob
G3C0005 | | Additional Comments | | | | --- | --- | --- | | Participant Information | Character field | acom_pi
G3C0006 | | Imported Validated Data for Data Management Use | | | | --- | --- | --- | | Year of birth | | | | | | Calculated field – birth year | dobyr | | Year of this FHS exam | | | | | | Calculated field – exam year | examyr | | Age (in years) | | | | Calculated field – age | age | | IDTYPE | | | | 2 = NOS
3 = Gen 3
72 = Omni Gen 2 | idtype
IDTYPE | | ID | | | | | | FHS ID (4-digit) | id
ID | | Sex | | | 1 = Male
2 = Female | sex
G3C0007 | | Date of last exam | | | | | | Date calendar | lastexamdate G3C0008 | | Year of last exam | | | | | | Calculated – last exam year | lastexamyr | | Date of last medical health update | | | | | | Date calendar | lastmhudate G3C0009 | | Date of last medical information | | | | | | Date calendar | lastmedinfodate G3C0010 | Medical Encounters (M01) 1st Examiner ID exid1 G3C0011 1st Examiner's Medical Professional Type 1 = Medical Doctor (MD); 2 = Nurse Practitioner (NP) G3C0011A Since your last provided medical information have you had any of the following? | Hospitalizations (not E.R.)? | | | | | 0 = No; 1 = Yes; 9 = Unknown | mehosp01
G3C0012 | | --- | --- | --- | --- | --- | | If “Yes” | | | | | | | Hospitalization | | | | | | | Reason | Character field | mehospreason01 G3C0013
mehospreason02 G3C0019
mehospreason03 G3C0025
mehospreason04 G3C0031 | | | | Year | | | | | 4 digit year | 9999 = Unknown | mehospy01 G3C0014
mehospy02 G3C0020
mehospy03 G3C0026
mehospy04 G3C0032 | | | | DATE details (e.g. 10/2, April, Summer, August-Nov. , Unknown etc. ) | Character field | mehospdatetext01 G3C0015
mehospdatetext02 G3C0021
mehospdatetext03 G3C0027
mehospdatetext04 G3C0033 | | | | Name of hospital | Character field | mehospname01 G3C0016
mehospname02 G3C0022
mehospname03 G3C0028
mehospname04 G3C0034 | | | | Location of hospital | Character field | mehosploc01 G3C0017
mehosploc02 G3C0023
mehosploc03 G3C0029
mehosploc04 G3C0035 | | | | Have you had another hospitalization? | | | 0 = No; 1 = Yes; 9 = Unknown | mehosp02 G3C0018
mehosp03 G3C0024
mehosp04 G3C0030 | | | | If “Yes” | | | Block of questions (“Reason” to “Have you had another hospitalization”) repeats 3 more times | E.R. visits only? | | | | | 0 = No; 1 = Yes; 9 = Unknown | meer01
G3C0036 | | --- | --- | --- | --- | --- | | If “Yes” | | | | | | | E. R. Visit | | | | | | | Reason | Character field | meerreason01 G3C0037
meerreason02 G3C0043
meerreason03 G3C0049
meerreason04 G3C0055 | | | | Year | | | | | 4 digit year | 9999 = Unknown | meery01 G3C0038
meery02 G3C0044
meery03 G3C0050
meery04 G3C0056 | | | | DATE details (e.g. 10/2, April, Summer, August-Nov. , Unknown etc. ) | Character field | meerdatetext01 G3C0039
meerdatetext02 G3C0045
meerdatetext03 G3C0051
meerdatetext04 G3C0057 | | | | Name of hospital | Character field | meerhospname01 G3C0040
meerhospname02 G3C0046
meerhospname03 G3C0052
meerhospname04 G3C0058 | | | | Location of hospital | Character field | meerhosploc01 G3C0041
meerhosploc02 G3C0047
meerhosploc03 G3C0053
meerhosploc04 G3C0059 | | | | Have you had anot

FAQs

What mapping does the form provide between systems?

It indicates that variables names in pink correspond to REDCap variable names, while variables names in blue correspond to SAS variable names.

Which participant information fields are collected in the form?

It collects site, first name, last name, and date of birth, along with a date related to the exam (FHS exam date).

How are medical encounters structured in the form?

Medical encounters are grouped into sections such as hospitalizations, E.R. visits, day surgery, and major illness, each using coded yes/no/unknown values and repeating blocks to capture reason, year, date details, and hospital or location information.

Sep 27, 2026

Uploaded by Lucas Martin