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COGA SSAGA5: Medical History

0 Shared Subjects

The SSAGA-5, similar to prior versions of the SSAGA based on earlier DSM classification, covers a range of symptoms and behaviors that map onto DSM-5 criteria in order to yield DSM5 lifetime diagnoses of specific substance use disorders (tobacco, alcohol, cannabis, cocaine, other stimulants, opiates, and sedatives). DSM-4, 3R and ICD-10 substance dependence and abuse are also covered. Other lifetime disorders assessed are major depression, antisocial personality disorder, social phobia, panic with and without agoraphobia, obsessive-compulsive disorder, and PTSD. As well, nondiagnostic sections covering demographics, medical history, suicidality, current social relationships and religiosity are included. In the SUD sections, questions probing timing and specifics of treatment history and recovery are included. The SSAGA-5 has been programmed in Blaise and is designed for administration by a trained interviewer. Diagnostic scoring algorithms are available.
Clinical Assessments
Med History
08/10/2022
coga_ssaga5_mh01
08/16/2022
View Change History
01
Definition
Submission Template
Query Element Name Data Type Size Required Description Value Range Notes Aliases
subjectkey GUID Required The NDAR Global Unique Identifier (GUID) for research subject NDAR*
src_subject_id String 20 Required Subject ID how it's defined in lab/project
interview_date Date Required Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY
interview_age Integer Required Age in months at the time of the interview/test/sampling/imaging. 0::1440 Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month.
sex String 20 Required Sex of subject at birth M;F; O; NR M = Male; F = Female; O=Other; NR = Not reported
coga_ssaga5_skip_mh Integer Recommended SKIP_MH INTERVIEWER: Skip section MH? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL skip_mh
coga_ssaga5_mh1 Integer Recommended MH1 Now I have some questions about your physical health and medical history. First, at the present time, would you say your health is excellent, very good, good, fair, or poor? 1 :: 5;-8 1=Excellent;2=Very good;3=Good;4=Fair;5=Poor; -8= DK AND REFUSAL mh1
coga_ssaga5_mh2 Integer Recommended MH2 Has your health always been (ANSWER IN MH1), or has it been better or worse? 1;2;5;6;-8 1=No, Worse;2=No, better; 5=Yes, Same; 6=Both better and worse; -8= DK AND REFUSAL mh2
coga_ssaga5_mh3_1 Integer Recommended MH3_1.Has a doctor or other health professional ever told you that you had: 1. High blood pressure? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_1
coga_ssaga5_mh3yr1 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr1
coga_ssaga5_mh3_2 Integer Recommended MH3_2. Has a doctor or other health professional ever told you that you had: 2. Migraine headaches? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_2
coga_ssaga5_mh3yr2 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr2
coga_ssaga5_mh3_3 Integer Recommended MH3_3. Has a doctor or other health professional ever told you that you had: 3. A brain injury or concussion? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_3
coga_ssaga5_mh3yr3 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr3
coga_ssaga5_mh3_4 Integer Recommended MH3_4. Has a doctor or other health professional ever told you that you had: 4. Been unconscious for longer than 5 min? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_4
coga_ssaga5_mh3yr4 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr4
coga_ssaga5_mh3_5 Integer Recommended MH3_5. Has a doctor or other health professional ever told you that you had: 5. Epilepsy or have had a seizure? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_5
coga_ssaga5_mh3yr5 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr5
coga_ssaga5_mh3_6 Integer Recommended MH3_6. Has a doctor or other health professional ever told you that you had: 6. Meningitis or encephalitis? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_6
coga_ssaga5_mh3yr6 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr6
coga_ssaga5_mh3_7 Integer Recommended MH3_7. Has a doctor or other health professional ever told you that you had: 7. A stroke? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_7
coga_ssaga5_mh3yr7 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr7
coga_ssaga5_mh3_8 Integer Recommended MH3_8. Has a doctor or other health professional ever told you that you had: 8. Heart disease? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_8
coga_ssaga5_mh3yr8 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr8
coga_ssaga5_mh3_9 Integer Recommended MH3_9. Has a doctor or other health professional ever told you that you had: 9. Liver disease? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_9
coga_ssaga5_mh3yr9 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr9
coga_ssaga5_mh3_10 Integer Recommended MH3_10. Has a doctor or other health professional ever told you that you had: 10. Thyroid disease? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_10
coga_ssaga5_mh3yr10 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr10
coga_ssaga5_mh3_11 Integer Recommended MH3_11.Has a doctor or other health professional ever told you that you had: 11. Asthma? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_11
coga_ssaga5_mh3yr11 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr11
coga_ssaga5_mh3_12 Integer Recommended MH3_12. Has a doctor or other health professional ever told you that you had: 12. Diabetes? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_12
coga_ssaga5_mh3yr12 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr12
coga_ssaga5_mh3_13 Integer Recommended MH3_13. Has a doctor or other health professional ever told you that you had: 13. Cancer? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_13
coga_ssaga5_mh3yr13 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr13
coga_ssaga5_mh3_14 Integer Recommended MH3_14. Has a doctor or other health professional ever told you that you had: 14. HIV/AIDS? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_14
coga_ssaga5_mh3yr14 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr14
coga_ssaga5_mh3_15 Integer Recommended MH3_15. Has a doctor or other health professional ever told you that you had: 15. A sexually transmitted disease? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_15
coga_ssaga5_mh3yr15 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr15
coga_ssaga5_mh3_16 Integer Recommended MH3_16. Has a doctor or other health professional ever told you that you had: 16. Any other illness(es)? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_16
coga_ssaga5_mh3yr16 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr16
coga_ssaga5_mh3_17 Integer Recommended MH3_17. Has a doctor or other health professional ever told you that you had: 17. Another medical condition? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh3_17
coga_ssaga5_mh3yr17 Integer Recommended MH3 Year first diagnosed? YYYY; -8= DK AND REFUSAL mh3yr17
coga_ssaga5_mh4a Integer Recommended MH4a How many times have you been in a hospital overnight (including surgery and pregnancy), excluding psychiatric or substance abuse treatment? ___ ___ TIMES Number of Times; -8= DK AND REFUSAL mh4a
coga_ssaga5_mh4b Integer Recommended MH4b How many times have you had surgery when you did not have to stay in a hospital overnight (that is, outpatient surgery)? ___ ___ TIMES Number of Times; -8= DK AND REFUSAL mh4b
coga_ssaga5_mh4c Integer Recommended MH4c How many times have you been examined or treated in the emergency room or an urgent care center because of an accident or injury? ___ ___ TIMES Number of Times; -8= DK AND REFUSAL mh4c
coga_ssaga5_mh5 Integer Recommended MH5 In the last 6 months, how many visits have you made to a doctor, clinic, or emergency room for your physical health? DO NOT COUNT CHIROPRACTORS OR ROUTINE PHYSICALS. ___ ___ VISITS Number of Visits; -8= DK AND REFUSAL mh5
coga_ssaga5_mh6a_1 Integer Recommended MH6a_1 Have you ever taken any medications prescribed to you by a doctor for two weeks or longer for the following reasons 1. To make you feel less nervous? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6a_1
coga_ssaga5_mh6acd1_1 Integer Recommended MH6a Code1 ENTER THE MEDICATION CODE 1. MEDICATION CODE; -8= DK AND REFUSAL mh6acd1_1
coga_ssaga5_mh6acd2_1 Integer Recommended MH6a Code2 ENTER THE MEDICATION CODE 2. MEDICATION CODE; -8= DK AND REFUSAL mh6acd2_1
coga_ssaga5_mh6acd3_1 Integer Recommended MH6a Code3 ENTER THE MEDICATION CODE 3. MEDICATION CODE; -8= DK AND REFUSAL mh6acd3_1
coga_ssaga5_mh6acd4_1 Integer Recommended MH6a Code4 ENTER THE MEDICATION CODE 4. MEDICATION CODE; -8= DK AND REFUSAL mh6acd4_1
coga_ssaga5_mh6acd5_1 Integer Recommended MH6a Code5 ENTER THE MEDICATION CODE 5. MEDICATION CODE; -8= DK AND REFUSAL mh6acd5_1
coga_ssaga5_mh6a_2 Integer Recommended MH6a_2 Have you ever taken any medications prescribed to you by a doctor for two weeks or longer for the following reasons...2. To help you sleep? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6a_2
coga_ssaga5_mh6acd1_2 Integer Recommended MH6a Code1 ENTER THE MEDICATION CODE 1. MEDICATION CODE; -8= DK AND REFUSAL mh6acd1_2
coga_ssaga5_mh6acd2_2 Integer Recommended MH6a Code2 ENTER THE MEDICATION CODE 2. MEDICATION CODE; -8= DK AND REFUSAL mh6acd2_2
coga_ssaga5_mh6acd3_2 Integer Recommended MH6a Code3 ENTER THE MEDICATION CODE 3. MEDICATION CODE; -8= DK AND REFUSAL mh6acd3_2
coga_ssaga5_mh6acd4_2 Integer Recommended MH6a Code4 ENTER THE MEDICATION CODE 4. MEDICATION CODE; -8= DK AND REFUSAL mh6acd4_2
coga_ssaga5_mh6acd5_2 Integer Recommended MH6a Code5 ENTER THE MEDICATION CODE FOR 5. MEDICATION CODE; -8= DK AND REFUSAL mh6acd5_2
coga_ssaga5_mh6a_3 Integer Recommended MH6a_3 Have you ever taken any medications prescribed to you by a doctor for two weeks or longer for the following reasons... 3. To feel less depressed? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6a_3
coga_ssaga5_mh6acd1_3 Integer Recommended MH6a Code1 ENTER THE MEDICATION CODE FOR 1. MEDICATION CODE; -8= DK AND REFUSAL mh6acd1_3
coga_ssaga5_mh6acd2_3 Integer Recommended MH6a Code2 ENTER THE MEDICATION CODE FOR 2. MEDICATION CODE; -8= DK AND REFUSAL mh6acd2_3
coga_ssaga5_mh6acd3_3 Integer Recommended MH6a Code3 ENTER THE MEDICATION CODE FOR 3. MEDICATION CODE; -8= DK AND REFUSAL mh6acd3_3
coga_ssaga5_mh6acd4_3 Integer Recommended MH6a Code4 ENTER THE MEDICATION CODE FOR 4. MEDICATION CODE; -8= DK AND REFUSAL mh6acd4_3
coga_ssaga5_mh6acd5_3 Integer Recommended MH6a Code5 ENTER THE MEDICATION CODE FOR 5. MEDICATION CODE; -8= DK AND REFUSAL mh6acd5_3
coga_ssaga5_mh6a_4 Integer Recommended MH6a_4 Have you ever taken any medications prescribed to you by a doctor for two weeks or longer for the following reasons...4. For headaches? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6a_4
coga_ssaga5_mh6acd1_4 Integer Recommended MH6a Code1 ENTER THE MEDICATION CODE FOR 1. MEDICATION CODE; -8= DK AND REFUSAL mh6acd1_4
coga_ssaga5_mh6acd2_4 Integer Recommended MH6a Code2 ENTER THE MEDICATION CODE FOR 2. MEDICATION CODE; -8= DK AND REFUSAL mh6acd2_4
coga_ssaga5_mh6acd3_4 Integer Recommended MH6a Code3 ENTER THE MEDICATION CODE FOR 3. MEDICATION CODE; -8= DK AND REFUSAL mh6acd3_4
coga_ssaga5_mh6acd4_4 Integer Recommended MH6a Code4 ENTER THE MEDICATION CODE FOR 4. MEDICATION CODE; -8= DK AND REFUSAL mh6acd4_4
coga_ssaga5_mh6acd5_4 Integer Recommended MH6a Code5 ENTER THE MEDICATION CODE FOR 5. MEDICATION CODE; -8= DK AND REFUSAL mh6acd5_4
coga_ssaga5_mh6a_5 Integer Recommended MH6a_5 Have you ever taken any medications prescribed to you by a doctor for two weeks or longer for the following reasons...5. To have more energy? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6a_5
coga_ssaga5_mh6acd1_5 Integer Recommended MH6a Code1 ENTER THE MEDICATION CODE FOR 1. MEDICATION CODE; -8= DK AND REFUSAL mh6acd1_5
coga_ssaga5_mh6acd2_5 Integer Recommended MH6a Code2 ENTER THE MEDICATION CODE FOR 2. MEDICATION CODE; -8= DK AND REFUSAL mh6acd2_5
coga_ssaga5_mh6acd3_5 Integer Recommended MH6a Code3 ENTER THE MEDICATION CODE FOR 3. MEDICATION CODE; -8= DK AND REFUSAL mh6acd3_5
coga_ssaga5_mh6acd4_5 Integer Recommended MH6a Code4 ENTER THE MEDICATION CODE FOR 4. MEDICATION CODE; -8= DK AND REFUSAL mh6acd4_5
coga_ssaga5_mh6acd5_5 Integer Recommended MH6a Code5 ENTER THE MEDICATION CODE FOR 5. MEDICATION CODE; -8= DK AND REFUSAL mh6acd5_5
coga_ssaga5_mh6a_6 Integer Recommended MH6a_6 Have you ever taken any medications prescribed to you by a doctor for two weeks or longer for the following reasons...6. Women Only: For birth control? IF YES, ASK: What did you take?DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6a_6
coga_ssaga5_mh6acd1_6 Integer Recommended MH6a Code1 ENTER THE MEDICATION CODE FOR 1. MEDICATION CODE; -8= DK AND REFUSAL mh6acd1_6
coga_ssaga5_mh6acd2_6 Integer Recommended MH6a Code2 ENTER THE MEDICATION CODE FOR 2. MEDICATION CODE; -8= DK AND REFUSAL mh6acd2_6
coga_ssaga5_mh6acd3_6 Integer Recommended MH6a Code3 ENTER THE MEDICATION CODE FOR 3. MEDICATION CODE; -8= DK AND REFUSAL mh6acd3_6
coga_ssaga5_mh6acd4_6 Integer Recommended MH6a Code4 ENTER THE MEDICATION CODE FOR 4. MEDICATION CODE; -8= DK AND REFUSAL mh6acd4_6
coga_ssaga5_mh6acd5_6 Integer Recommended MH6a Code5 ENTER THE MEDICATION CODE FOR 5. MEDICATION CODE; -8= DK AND REFUSAL mh6acd5_6
coga_ssaga5_mh6a_7 Integer Recommended MH6a_7 Have you ever taken any medications prescribed to you by a doctor for two weeks or longer for the following reasons...7. Containing steroids? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6a_7
coga_ssaga5_mh6acd1_7 Integer Recommended MH6a Code1 ENTER THE MEDICATION CODE FOR 1. MEDICATION CODE; -8= DK AND REFUSAL mh6acd1_7
coga_ssaga5_mh6acd2_7 Integer Recommended MH6a Code2 ENTER THE MEDICATION CODE FOR 2. MEDICATION CODE; -8= DK AND REFUSAL mh6acd2_7
coga_ssaga5_mh6acd3_7 Integer Recommended MH6a Code3 ENTER THE MEDICATION CODE FOR 3. MEDICATION CODE; -8= DK AND REFUSAL mh6acd3_7
coga_ssaga5_mh6acd4_7 Integer Recommended MH6a Code4 ENTER THE MEDICATION CODE FOR 4. MEDICATION CODE; -8= DK AND REFUSAL mh6acd4_7
coga_ssaga5_mh6acd5_7 Integer Recommended MH6a Code5 ENTER THE MEDICATION CODE FOR 5. MEDICATION CODE; -8= DK AND REFUSAL mh6acd5_7
coga_ssaga5_mh6b_1 Integer Recommended MH6b_1 In the last 30 dayshave you taken prescription medications for two weeks or longer...1. To make you feel less nervous? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6b_1
coga_ssaga5_mh6bcd1_1 Integer Recommended MH6b Code1 ENTER THE MEDICATION CODE 1. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd1_1
coga_ssaga5_mh6bcd2_1 Integer Recommended MH6b Code2 ENTER THE MEDICATION CODE 2. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd2_1
coga_ssaga5_mh6bcd3_1 Integer Recommended MH6b Code3 ENTER THE MEDICATION CODE 3. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd3_1
coga_ssaga5_mh6bcd4_1 Integer Recommended MH6b Code4 ENTER THE MEDICATION CODE 4. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd4_1
coga_ssaga5_mh6bcd5_1 Integer Recommended MH6b Code5 ENTER THE MEDICATION CODE 5. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd5_1
coga_ssaga5_mh6b_2 Integer Recommended MH6b_2 In the last 30 dayshave you taken prescription medications for two weeks or longer...2. To help you sleep? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6b_2
coga_ssaga5_mh6bcd1_2 Integer Recommended MH6b Code1 ENTER THE MEDICATION CODE 1. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd1_2
coga_ssaga5_mh6bcd2_2 Integer Recommended MH6b Code2 ENTER THE MEDICATION CODE 2. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd2_2
coga_ssaga5_mh6bcd3_2 Integer Recommended MH6b Code3 ENTER THE MEDICATION CODE 3. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd3_2
coga_ssaga5_mh6bcd4_2 Integer Recommended MH6b Code4 ENTER THE MEDICATION CODE 4. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd4_2
coga_ssaga5_mh6bcd5_2 Integer Recommended MH6b Code5 ENTER THE MEDICATION CODE 5. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd5_2
coga_ssaga5_mh6b_3 Integer Recommended MH6b_3 In the last 30 dayshave you taken prescription medications for two weeks or longer...3. To feel less depressed? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6b_3
coga_ssaga5_mh6bcd1_3 Integer Recommended MH6b Code1 ENTER THE MEDICATION CODE 1. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd1_3
coga_ssaga5_mh6bcd2_3 Integer Recommended MH6b Code2 ENTER THE MEDICATION CODE 2. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd2_3
coga_ssaga5_mh6bcd3_3 Integer Recommended MH6b Code3 ENTER THE MEDICATION CODE 3. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd3_3
coga_ssaga5_mh6bcd4_3 Integer Recommended MH6b Code4 ENTER THE MEDICATION CODE 4. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd4_3
coga_ssaga5_mh6bcd5_3 Integer Recommended MH6b Code5 ENTER THE MEDICATION CODE 5. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd5_3
coga_ssaga5_mh6b_4 Integer Recommended MH6b_4 In the last 30 dayshave you taken prescription medications for two weeks or longer...4. For headaches? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6b_4
coga_ssaga5_mh6bcd1_4 Integer Recommended MH6b Code1 ENTER THE MEDICATION CODE 1. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd1_4
coga_ssaga5_mh6bcd2_4 Integer Recommended MH6b Code2 ENTER THE MEDICATION CODE 2. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd2_4
coga_ssaga5_mh6bcd3_4 Integer Recommended MH6b Code3 ENTER THE MEDICATION CODE 3. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd3_4
coga_ssaga5_mh6bcd4_4 Integer Recommended MH6b Code4 ENTER THE MEDICATION CODE 4. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd4_4
coga_ssaga5_mh6bcd5_4 Integer Recommended MH6b Code5 ENTER THE MEDICATION CODE 5. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd5_4
coga_ssaga5_mh6b_5 Integer Recommended MH6b_5 In the last 30 dayshave you taken prescription medications for two weeks or longer...5. To have more energy? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6b_5
coga_ssaga5_mh6bcd1_5 Integer Recommended MH6b Code1 ENTER THE MEDICATION CODE 1. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd1_5
coga_ssaga5_mh6bcd2_5 Integer Recommended MH6b Code2 ENTER THE MEDICATION CODE 2. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd2_5
coga_ssaga5_mh6bcd3_5 Integer Recommended MH6b Code3 ENTER THE MEDICATION CODE 3. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd3_5
coga_ssaga5_mh6bcd4_5 Integer Recommended MH6b Code4 ENTER THE MEDICATION CODE 4. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd4_5
coga_ssaga5_mh6bcd5_5 Integer Recommended MH6b Code5 ENTER THE MEDICATION CODE 5. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd5_5
coga_ssaga5_mh6b_6 Integer Recommended MH6b_6 In the last 30 dayshave you taken prescription medications for two weeks or longer...6. Women Only: For birth control? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6b_6
coga_ssaga5_mh6bcd1_6 Integer Recommended MH6b Code1 ENTER THE MEDICATION CODE 1. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd1_6
coga_ssaga5_mh6bcd2_6 Integer Recommended MH6b Code2 ENTER THE MEDICATION CODE 2. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd2_6
coga_ssaga5_mh6bcd3_6 Integer Recommended MH6b Code3 ENTER THE MEDICATION CODE 3. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd3_6
coga_ssaga5_mh6bcd4_6 Integer Recommended MH6b Code4 ENTER THE MEDICATION CODE 4. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd4_6
coga_ssaga5_mh6bcd5_6 Integer Recommended MH6b Code5 ENTER THE MEDICATION CODE 5. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd5_6
coga_ssaga5_mh6b_7 Integer Recommended MH6b_7 In the last 30 dayshave you taken prescription medications for two weeks or longer...7. Containing steroids? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6b_7
coga_ssaga5_mh6bcd1_7 Integer Recommended MH6b Code1 ENTER THE MEDICATION CODE 1. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd1_7
coga_ssaga5_mh6bcd2_7 Integer Recommended MH6b Code2 ENTER THE MEDICATION CODE 2. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd2_7
coga_ssaga5_mh6bcd3_7 Integer Recommended MH6b Code3 ENTER THE MEDICATION CODE 3. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd3_7
coga_ssaga5_mh6bcd4_7 Integer Recommended MH6b Code4 ENTER THE MEDICATION CODE 4. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd4_7
coga_ssaga5_mh6bcd5_7 Integer Recommended MH6b Code5 ENTER THE MEDICATION CODE 5. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd5_7
coga_ssaga5_mh6b_8 Integer Recommended MH6b_8 In the last 30 dayshave you taken prescription medications for two weeks or longer...8. For anything else? IF YES, ASK: What did you take? DO NOT COUNT OTC 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh6b_8
coga_ssaga5_mh6bcd1_8 Integer Recommended MH6b Code1 ENTER THE MEDICATION CODE 1. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd1_8
coga_ssaga5_mh6bcd2_8 Integer Recommended MH6b Code2 ENTER THE MEDICATION CODE 2. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd2_8
coga_ssaga5_mh6bcd3_8 Integer Recommended MH6b Code3 ENTER THE MEDICATION CODE 3. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd3_8
coga_ssaga5_mh6bcd4_8 Integer Recommended MH6b Code4 ENTER THE MEDICATION CODE 4. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd4_8
coga_ssaga5_mh6bcd5_8 Integer Recommended MH6b Code5 ENTER THE MEDICATION CODE 5. MEDICATION CODE; -8= DK AND REFUSAL mh6bcd5_8
coga_ssaga5_mh8 Integer Recommended MH8 Have you ever spoken to a professional about any emotional problems you might have had? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh8
coga_ssaga5_mh8a1 Integer Recommended MH8a1 Did you speak to ...a psychiatrist? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh8a1
coga_ssaga5_mh8a2 Integer Recommended MH8a2 Did you speak to ... a psychologist? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh8a2
coga_ssaga5_mh8a3 Integer Recommended MH8a3 Did you speak to ...a social worker? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh8a3
coga_ssaga5_mh8a4 Integer Recommended MH8a4 Did you speak to ...a counselor? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh8a4
coga_ssaga5_mh8a5 Integer Recommended MH8a5 Did you speak to ...another medical doctor? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh8a5
coga_ssaga5_mh8a6 Integer Recommended MH8a6 Did you speak to ...a nurse practitioner? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh8a6
coga_ssaga5_mh8a7 Integer Recommended MH8a7 Did you speak to ...a member of the clergy? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh8a7
coga_ssaga5_mh8a8 Integer Recommended MH8a8 Did you speak to ...another professional? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh8a8
coga_ssaga5_mh9 Integer Recommended MH9 How many times have you been an inpatient in a psychiatric hospital or ward or in a chemical dependency program where you stayed overnight? ___ ___ TIMES Number of Times; -8= DK AND REFUSAL mh9
coga_ssaga5_mh9a Integer Recommended MH9a How old were you the first time you were treated as an inpatient? __ __ AGE Age in Years; -8= DK AND REFUSAL mh9a
coga_ssaga5_mh9b Integer Recommended MH9b How old were you the last time you were treated as an inpatient? __ __ AGE Age in Years; -8= DK AND REFUSAL mh9b
coga_ssaga5_mh10 Integer Recommended MH10 Have you ever received outpatient treatment for psychiatric, emotional, or chemical dependency problems? This includes any visits to a psychiatrist, psychologist, therapist, or counselor. 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh10
coga_ssaga5_mh_ao10 Integer Recommended MH_ao10 How old were you the first time you were in outpatient treatment? Age in Years; -8= DK AND REFUSAL mh_ao10
coga_ssaga5_mh_o10 Integer Recommended MH_o10 (the first time you were in outpatient treatment) Was it within the last 30 days? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh_o10
coga_ssaga5_mh_ar10 Integer Recommended MH_ar10 How old were you the last time you were in outpatient treatment? Age in Years; -8= DK AND REFUSAL mh_ar10
coga_ssaga5_mh_r10 Integer Recommended MH_r10 (the last time you were in outpatient treatment) Was it within the last 30 days? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh_r10
coga_ssaga5_mh10a Integer Recommended MH10a Are you currently in treatment? 1;5;-8 1=NO; 5=YES; -8= DK AND REFUSAL mh10a
Data Structure

This page displays the data structure defined for the measure identified in the title and structure short name. The table below displays a list of data elements in this structure (also called variables) and the following information:

  • Element Name: This is the standard element name
  • Data Type: Which type of data this element is, e.g. String, Float, File location.
  • Size: If applicable, the character limit of this element
  • Required: This column displays whether the element is Required for valid submissions, Recommended for valid submissions, Conditional on other elements, or Optional
  • Description: A basic description
  • Value Range: Which values can appear validly in this element (case sensitive for strings)
  • Notes: Expanded description or notes on coding of values
  • Aliases: A list of currently supported Aliases (alternate element names)
  • For valid elements with shared data, on the far left is a Filter button you can use to view a summary of shared data for that element and apply a query filter to your Cart based on selected value ranges

At the top of this page you can also:

  • Use the search bar to filter the elements displayed. This will not filter on the Size of Required columns
  • Download a copy of this definition in CSV format
  • Download a blank CSV submission template prepopulated with the correct structure header rows ready to fill with subject records and upload

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