MONICA Manual, Part IV, Section 3

Event Registration Data
TEST CASE HISTORY FORM
CORONARY EVENTS
Form:K
Version: 5          30.11.89		 FOR MDC USE ONLY
Seq.no:

Received:
A Form identification and version number |_9|_1|_5|
B MONICA Collaborating Centre name |__|__|
C Form coded by: name |__|__|
D Test case serial number |__|__|__|__|__|
E Date of starting to code record (day,month,year) |__|__||__|__||__|__|
7 SEX |__|        22 PREMI prev myocardl infarct |__|
8 DBIRTH |__|__||__|__||__|__| 23 DDEATH |__|__||__|__||__|__|
9 DONSET |__|__||__|__||__|__| 24 ESTST survival time code |__|
10 MANAGEment |__| 25 ACCST |__|__||__|__||__|__|
11 SURVIVal at 28 days |__| 26 NECP necropsy performed |__|
12 SYMPToms |__| 27 NECD1 |__|__|__|__|
13 ECG findings |__| 28 NECD2 |__|__|__|__|
14 ENZ serum enzymes |__| 29 NECD3 |__|__|__|__|
15 NECSUM necropsy findings |__| 30 HISIHD history of IHD |__|
16 DIACAT diagnostic category |__| 31 ICDVER ICD version |__|
17 IATRO possible iatrogenic |__| 32 THROMBD thrombolytic therapy |__|
18 NUMECG number of ECGs |__| 33 FUTURE1 |__|
19 CLIND1 |__|__|__|__| 34 FUTURE2 |__|
20 CLIND2 |__|__|__|__| 35 FUTURE3 |__|
21 CLIND3 |__|__|__|__| 36 FUTURE4 |__|

 

General instructions

This test case history form has exactly the same format as the Core Data Transfer Format - Coronary Events with the exception of items A,B,C,D,E which replace items 1,2,3,4,5 in the latter. However, it is designed for coding test case histories directly on to paper forms without the use of magnetic tape. By these means small quantities of coded data can be sent at one time, particularly for quality control tests. These should be sent directly to the MONICA Quality Control Centre in Dundee according to the instructions sent out with the material.

When using this form the coding instructions for items 7-31 should be taken from the Specific Instructions for the Core Data Transfer Format - Coronary Events. In addition item B should be coded as for item 3, CENTRE. Local codes should be used for item C, coder, and Item D, Test Case Serial Number, should be that on the test material. Item E, Date of Starting to Code Record is as stated.

Blanks are not allowed in any field on this form, and all boxes should be filled only with permissible characters which are 0,1,2,3,4,5,6,7,8,9.

Before sending off coded forms:

  1. make sure that all codes are legible
  2. make sure that all fields have been filled
  3. ensure that any corrections are clear. These should be done with a horizontal line through the incorrect item - and the correct answer written alongside and not on top
  4. ensure that you have kept photostats of what is sent but send the originals for coding (unfortunately photostats are often of poor quality and may be badly aligned)
  5. complete the packing list supplied with the test cases and make sure that both what is sent and what is retained is a complete set of coded forms.