############################################################# ## ## COMI_BACK_EN.txt ## ############################################################# Date : 27.4.2015 IV_DATE_QUESTION (Date of evaluation) Type : date ------------------------------------------------------------------------------------ IV_LOCATION_QUESTION (Location) Type : radiobutton Data type : integer Answers: 1 = general ------------------------------------------------------------------------------------ IV_PROCEDURE_QUESTION (Examination interval) Type : dropdown Data type : integer Answers: 1 = before surgery 2 = 4 weeks 3 = 6 weeks 4 = 2 months 5 = 3 months 6 = 6 months 7 = 9 months 8 = 1 year 9 = 2 years 10 = 3 years 11 = 4 years 12 = 5 years 13 = other Rules: Include question rules: Value 13 (other) activates question(s) - OTHER_IV_PROC_QUESTION (Please specify other examination interval) Exclude question rules: Value 1 (before surgery) deactivates question(s) - ASSESSMENT_RESULT (11. Overall, how much did the treatment that you received (the operation) help your back problem?) - COMPLICATIONS (8a. Did any COMPLICATIONS arise as a consequence of your operation IN OUR HOSPITAL
(e.g. problems with wound healing, paralysis, sensory disturbances)?) - COMPL_BOTHERSOME (8b. How bothersome were these complications?) - FURTHER_OPS (9. SINCE THE OPERATION in our hospital, have you had any FURTHER operation(s) on your lumbar
spine (back) in our or in other hospitals?) - OTHER_COMPLICATIONS (If yes,please describe these) - SATISFACTION (10. OVER THE COURSE OF TREATMENT for your back problem, how satisfied were you with your overall
medical care IN OUR HOSPITAL?) ------------------------------------------------------------------------------------ OTHER_IV_PROC_QUESTION (Please specify other examination interval) Type : string Depends on question(s): IV_PROCEDURE_QUESTION ------------------------------------------------------------------------------------ LOCATION (1. Which of the following problems troubles you THE MOST?) Type : radiobutton Data type : integer Answers: 1 = back pain 2 = leg/buttock pain (sciatica) 3 = sensory disturbances in the back/leg/buttocks e.g. tingling, ‘pins and needles’, numbness 4 = none of the above ------------------------------------------------------------------------------------ PAIN_BACK (2.a How severe was your BACK PAIN in the last week?) Type : real Min-Max answers : 0 to 10 ------------------------------------------------------------------------------------ PAIN_LEG (2.b How severe was your LEG PAIN (SCIATICA)/BUTTOCK PAIN in the last week?) Type : real Min-Max answers : 0 to 10 ------------------------------------------------------------------------------------ BACK_NORMAL_TASKS (3. During the PAST WEEK, how much did your back problem INTERFERE WITH YOUR NORMAL WORK
(including both work outside the home and housework)?) Type : dropdown Data type : integer Answers: 1 = not at all 2 = a little bit 3 = moderately 4 = quite a bit 5 = extremely ------------------------------------------------------------------------------------ BACK_REST (4. If you had to spend THE REST OF YOUR LIFE WITH THE SYMPTOMS YOU HAVE RIGHT NOW,
how would you feel about it?) Type : dropdown Data type : integer Answers: 1 = very satisfied 2 = somewhat satisfied 3 = neither satisfied nor dissatisfied 4 = somewhat dissatisfied 5 = very dissatisfied ------------------------------------------------------------------------------------ LIFE_QUALITY (5. Please reflect ON THE LAST WEEK. How would you rate your quality of life?) Type : dropdown Data type : integer Answers: 1 = very good 2 = good 3 = moderate 4 = bad 5 = very bad ------------------------------------------------------------------------------------ BACK_USUAL_ACT (6. DURING THE PAST 4 WEEKS, how many days did you CUT DOWN ON THE THINGS YOU USUALLY DO
(work, housework, school, recreational activities) because of your back problem)) Type : dropdown Data type : integer Answers: 1 = none 2 = between 1 and 7 days 3 = between 8 and 14 days 4 = between 15 and 21 days 5 = more than 21 days ------------------------------------------------------------------------------------ BACK_WORK (7. DURING THE PAST 4 WEEKS, how many days did your back problem KEEP YOU FROM GOING TO WORK
(job, school, housework)?) Type : dropdown Data type : integer Answers: 1 = none 2 = between 1 and 7 days 3 = between 8 and 14 days 4 = between 15 and 21 days 5 = more than 21 days ------------------------------------------------------------------------------------ COMPLICATIONS (8a. Did any COMPLICATIONS arise as a consequence of your operation IN OUR HOSPITAL
(e.g. problems with wound healing, paralysis, sensory disturbances)?) Type : dropdown Data type : integer Answers: 1 = no 2 = yes Rules: Exclude question rules: Value 1 (no) deactivates question(s) - COMPL_BOTHERSOME (8b. How bothersome were these complications?) - OTHER_COMPLICATIONS (If yes,please describe these) Depends on question(s): IV_PROCEDURE_QUESTION ------------------------------------------------------------------------------------ OTHER_COMPLICATIONS (If yes,please describe these) Type : string Optional question Depends on question(s): IV_PROCEDURE_QUESTION, COMPLICATIONS ------------------------------------------------------------------------------------ COMPL_BOTHERSOME (8b. How bothersome were these complications?) Type : dropdown Data type : integer Answers: 1 = not at all bothersome 2 = slightly bothersome 3 = moderately bothersome 4 = very bothersome 5 = extremely bothersome Depends on question(s): COMPLICATIONS, IV_PROCEDURE_QUESTION ------------------------------------------------------------------------------------ FURTHER_OPS (9. SINCE THE OPERATION in our hospital, have you had any FURTHER operation(s) on your lumbar
spine (back) in our or in other hospitals?) Type : dropdown Data type : integer Answers: 1 = no 2 = yes, but at a different level of the spine 3 = yes, at the same level of the spine (same segment) Depends on question(s): IV_PROCEDURE_QUESTION ------------------------------------------------------------------------------------ SATISFACTION (10. OVER THE COURSE OF TREATMENT for your back problem, how satisfied were you with your overall
medical care IN OUR HOSPITAL?) Type : dropdown Data type : integer Answers: 1 = very satisfied 2 = somewhat satisfied 3 = neither satisfied nor dissatisfied 4 = somewhat dissatisfied 5 = very dissatisfied Depends on question(s): IV_PROCEDURE_QUESTION ------------------------------------------------------------------------------------ ASSESSMENT_RESULT (11. Overall, how much did the treatment that you received (the operation) help your back problem?) Type : dropdown Data type : integer Answers: 1 = helped a lot 2 = helped 3 = helped only little 4 = didn’t help 5 = made things worse Depends on question(s): IV_PROCEDURE_QUESTION ------------------------------------------------------------------------------------